Al-Shifa Hospital

Al-Shifa’s role extends beyond its immediate Gaza City surroundings: it is a central medical institution serving hundreds of thousands of people across the Gaza Strip.[1][2] The complex occupies several buildings in western Gaza City, near the Rimal neighborhood and the coast.[2][3] It is south of Shati refugee camp and near Gaza City’s marina and Rashid Road.[2] The Arabic name “Shifa” means “recovery.”[3]

Historically, its services included internal medicine, surgery, pediatrics, and ophthalmology.[6] The redeveloped central building included emergency and respiratory intensive-care facilities, while later restored services included pediatric intensive care and dialysis.[3][7] Its development from a former British military site into Gaza’s largest hospital involved successive British, Egyptian, and Israeli administrative settings and substantial alterations to both the campus and its services.[2][3] Israeli architects designed the central building and a larger campus plan intended to serve the whole Gaza Strip rather than Gaza City alone.[3]

Al-Shifa has also treated wounded people and accommodated displaced civilians during fighting, placing additional demands on its medical facilities.[8][9] During the 2023 war, patients substantially exceeded the bed count given in contemporary reporting, while maternity facilities were repurposed for treatment of the wounded.[8][10] Military operations, damage to buildings, shortages, and evacuations subsequently interrupted its work; later reopening restored particular departments rather than establishing that the entire hospital had returned to its previous operating capacity.[5][1]

The hospital was established in 1946, during the British Mandate, on a site previously used as British military barracks.[2] Its original medical purposes included treating diseases associated with high fever and quarantining patients.[6] When Israeli architects began work on its later redevelopment, the hospital had 320 beds and served approximately 210,000 Gaza City residents.[3]

After Egypt took control of Gaza in 1948, Al-Shifa developed into a central hospital, adding internal medicine, surgery, pediatrics, and ophthalmology.[6] Egypt expanded the hospital after the 1956 Suez Crisis.[2] These changes preceded the Israeli period of administration and the subsequent redevelopment of the campus.[2]

Following Israel’s takeover of Gaza in 1967, an Israeli doctor was appointed to oversee Gaza’s health system and the hospital’s return to regular operation.[3] In the 1980s, Israel renovated and expanded the hospital with American assistance.[3] The modernization included a subterranean concrete floor, as well as the broader enlargement of the medical complex.[11] Israeli architectural work during this period produced the hospital’s central building and plans for a considerably larger institution serving the wider Gaza Strip.[3]

Architects Gershon Tzapor and Benjamin Idelson worked on the hospital project; in the late 1980s, Tzapor, together with Teddy and Ben Kaplan, prepared a master plan looking ahead to the year 2000.[3] The plan was prepared for the Public Works Department, Civil Administration, and Housing Ministry and envisaged approximately 900 beds on a campus of roughly 50 dunams, or about 12.5 acres.[3][12] The proposed capacity was a planning target, not a definitive measurement of the hospital’s later operational bed count.[3][13]

The redevelopment altered the existing campus rather than simply adding an independent new structure: some older buildings were demolished or modified, and the central building was raised and given a new exterior.[3] The resulting six-story building contained an emergency department, respiratory intensive care, seven X-ray rooms, five operating rooms, and 150 beds.[3] These facilities formed part of the wider hospital complex rather than representing its entire capacity.[3]

Published descriptions of Al-Shifa give substantially different bed and staffing totals, ranging from relatively specific department-based figures to larger estimates for the sprawling complex.[2][10] A November 2023 account described six departments and 564 beds.[10] The Jerusalem Post summarized reports ranging from 700 to 1,400 beds and cited an Israeli military briefing that gave a figure of 1,500.[2] The American Jewish Committee put the total above 1,500 beds.[11]

Staffing estimates likewise range from more than 1,400 staff to approximately 4,000 employees.[2] These figures do not establish a single contemporaneous operational capacity, and the approximately 900 beds envisioned by the Israeli architectural master plan represent a separate design objective.[3][13] During the month preceding a November 2023 account, the number of patients was substantially above the reported 564-bed capacity.[10]

By early November 2023, the demands on individual departments were severe: the maternity ward was treating wounded people, and expectant mothers had been transferred to Al-Hilo Hospital.[8] Dr. Ghassan Abu-Sittah, a British-Palestinian plastic surgeon volunteering in the burn treatment unit, said the hospital had received approximately 70 patients from strikes on Jabaliya since the preceding Tuesday in an account published on November 7.[8] He described surgery under these conditions as “a grueling exercise of trying to use the fewest resources possible.”[8]

The hospital’s later service restoration also proceeded department by department.[5][7] Its September 2024 emergency reopening provided 70 beds, two emergency operating rooms, and 10 intensive-care beds in a repaired outpatient-clinic building.[5] In November 2025, a renovated pediatric intensive-care unit reopened with seven beds, and a dialysis department began operating with a reported capacity for 48 beds and machines.[7] These figures describe specific restored services rather than the capacity of the entire hospital.[5][7]

Israeli intelligence assessed that Hamas began using parts of Al-Shifa, including basement areas, for command-and-control purposes after Israel’s 2005 withdrawal from Gaza.[11] Reports of Hamas activity at the institution also concerned the 2007 Fatah–Hamas conflict, and a 2009 Palestinian Authority health-ministry statement alleged that Hamas controlled the hospital.[13] In 2008, the head of Israel’s Shin Bet said Hamas leaders were at Al-Shifa; Hamas denied that allegation.[13]

During the 2014 Gaza conflict, accounts described Hamas leaders and operatives using the hospital while it continued treating patients.[11][14] These included descriptions of designated command buildings, Hamas members moving through hallways and offices, and operatives gathering in an underground bunker.[11][14] A Finnish reporter’s account described witnessing a rocket launch from the hospital parking lot on August 1, 2014.[14]

A French journalist recounted being questioned and intimidated by Hamas officials in what appeared to be an office area inside Al-Shifa.[15] He described young men in civilian clothing, some carrying guns beneath their shirts and using walkie-talkies, and said he was ordered to empty his pockets and remove his shoes and belt before questioning.[15] He was then told to leave Gaza.[15]

Other reporting from July 2014 described journalists being questioned or threatened by Hamas after photographing armed men in civilian clothing or gunmen preparing to launch rockets from civilian structures.[15] An Israeli official alleged that part of Al-Shifa served as a command-and-control center and that reporters were not allowed downstairs.[15] These accounts formed part of the history of allegations about the hospital before the Israeli operations of 2023 and 2024.[11][15]

Before entering Al-Shifa in November 2023, the Israel Defense Forces alleged that Hamas maintained command facilities and weapons in or beneath the hospital.[11] Hamas rejected the allegations.[1][13] Israeli forces began operating inside a targeted part of the compound on the night of November 14 after notifying hospital management.[13][14]

The military said medical personnel and Arabic-speaking soldiers accompanied the operation and humanitarian supplies.[13] On November 15, Israeli forces delivered medical equipment, incubators, and baby food, with military medical teams present to help the supplies reach those who needed them.[16] The initial account of the entry said approximately five armed men were killed in fighting outside the hospital and that no hostages were found during that search.[13]

The IDF reported finding weapons and military technology in the MRI building, including guns, ammunition, protective vests, and Hamas uniforms behind MRI machines and in storage areas.[11][14] It also displayed laptops containing images and videos of captives and identified a tunnel entrance in the compound.[14] The military released footage of what it described as a tunnel 55 meters long and 10 meters deep beneath the hospital complex.[14]

Israeli forces recovered the bodies of hostages Noa Marciano and Yehudit Weiss from buildings at or adjacent to the hospital complex.[14] The IDF said Marciano was found in a building next to Al-Shifa and Weiss in a building where Hamas stored weapons.[14] It also released security-camera footage that it said showed two non-Israeli captives being taken into the hospital.[14]

On November 16, U.S. spokesperson Matthew Miller said the United States had made a specific assessment that Hamas operated a command node at Al-Shifa and used tunnels beneath hospitals.[4] He distinguished that assessment from a claim that every hospital contained a command post and said hospitals should be protected and civilian harm minimized during Israeli operations.[4] A later reported U.S. intelligence assessment described command-and-control activity, weapons storage, and the holding of some hostages at the complex and beneath it.[14]

The reported U.S. assessment also said Hamas and Palestinian Islamic Jihad had largely evacuated before Israeli troops entered and had destroyed documents and electronics.[14] The underlying intelligence was not publicly disclosed. U.S. National Security Council spokesperson John Kirby likewise said American information indicated that the organizations used Al-Shifa and tunnels beneath hospitals to conceal or support military operations and hold hostages.[14]

During the November fighting, patients, medical staff, and displaced people left Al-Shifa, while a skeleton medical crew remained with patients too ill to move.[9] The IDF said the hospital director had asked for help enabling people to leave and denied ordering an evacuation.[9] It also said soldiers transferred more than 6,000 liters of water and over 2,300 kilograms of food to the facility.[9]

Contemporary accounts described particularly serious risks for infants and patients dependent on intensive treatment.[13][17] Gaza’s health ministry said approximately 700 patients would not survive transfer and reported 36 infants in the neonatal unit after three had died when power interruptions prevented incubators from functioning.[13] Israel offered portable incubators to facilitate transfer, while Gaza’s authorities said transfer was not possible.[13] By late November, some patients, including infants, had been evacuated, while others remained at the hospital.[17]

Warnings about pediatric care and other hospital services accompanied these evacuations.[17] A subsequent U.S. human-rights assessment linked deaths at Al-Shifa to Israel’s interruption of electricity and fuel, reporting the deaths of five premature babies and 40 intensive-care and kidney patients.[18] That assessment also identified Hamas and Israeli military activity around hospitals, together with forced evacuations of patients and staff, as impediments to civilian access to medical care.[18]

Israeli forces returned to Al-Shifa on March 18, 2024, saying Hamas officials had reestablished a presence at the hospital and were using the area for military activity.[19][20] The operation continued through March 31, with troops withdrawing overnight into April 1.[19] On its first evening, the military reported approximately 20 gunmen killed within the hospital premises, another 20 nearby, and approximately 200 suspects detained.[21]

U.S. National Security Advisor Jake Sullivan said on March 18 that Hamas had returned to Al-Shifa after Israel previously cleared it and had fired at Israeli forces from the hospital.[20] He described Israel’s stated targets as senior Hamas commanders and other armed members of the organization.[20] Israeli accounts of the operation subsequently described fighting in and around the complex and the seizure of weapons, documents, money, and intelligence material.[19][22]

At the operation’s end, Israeli accounts reported that approximately 900 suspects had been detained, including more than 500 identified as Hamas or Palestinian Islamic Jihad terror operatives, and that more than 200 gunmen had been killed.[19][22] A more specific account gave 513 detainees identified by the military as members of the two organizations.[19] Senior Hamas and Palestinian Islamic Jihad commanders were among those killed or detained, according to the military.[22]

Israeli forces said weapons were found in the maternity complex, including among patient beds and pillows, inside ceilings, and within walls.[22] The military also reported that armed men barricaded themselves in the emergency room, maternity ward, and a management building, attributing significant damage there to the ensuing fighting.[19] Another account described damage to hospital buildings and the shutdown of a generator.[14]

The IDF said it moved approximately 350 patients and medical staff to another part of the complex, providing aid and supplies, and evacuated approximately 6,200 civilians sheltering there.[23] Israel’s chief of staff said no medical staff or patients were injured during the operation.[22] These military descriptions accompanied accounts of extensive destruction across the hospital grounds.[23][22]

After the withdrawal, an AFP journalist saw damaged buildings and evidence of fire, while a doctor said more than 20 bodies had been recovered.[23] The Hamas-run health ministry reported dozens of bodies and accused Israel of burning buildings and putting the complex out of service.[23][22] A humanitarian team visited on April 5, and subsequent accounts described widespread destruction around Al-Shifa.[24]

Al-Shifa reopened an emergency department in September 2024 after months of interrupted activity following the March operation.[5] Staff placed the department in the outpatient-clinic building because it had sustained the least damage and could be repaired comparatively quickly.[5] The restored department had 70 beds, two emergency operating rooms, and 10 intensive-care beds, while hospital sources described heavy damage to the former emergency, surgical, and maternity departments.[5]

A South African dossier circulated as a UN Security Council document in December 2025 said only a third of Gaza’s hospitals were partly or barely functioning and cited announcements that Al-Shifa and Nasser hospitals would soon have to close.[25] The document did not establish a specific closure date for Al-Shifa.[25] Some services nevertheless expanded that year: the hospital reopened a renovated seven-bed pediatric intensive-care unit in November and began operating a dialysis department with reported capacity for 48 beds and machines.[7]

By December 2025, reconstruction was under way on the women’s and maternity wing, which had been almost completely destroyed during the war.[1] Some hospital activity had resumed despite severe shortages of construction materials, basic medical equipment, and advanced devices.[1] Al-Shifa continued to be described as a major medical center serving hundreds of thousands of people.[1]

In early 2026, director Muhammad Abu Salmiya described the hospital as being “in a state of collapse,” reporting shortages of more than 70 percent of medicines and minimal operating capacity despite increased patient numbers.[26] He said the hospital had 34 dialysis machines and was treating approximately 750 patients, exceeding its capacity.[26] These were the director’s reported assessments rather than a separately verified inventory of equipment or service availability.[26]

An October 2026 account described Al-Shifa as having been largely destroyed in two rounds of intense fighting and rebuilt over the preceding year.[27] The same account said no hospital in Gaza was fully operational, but did not establish Al-Shifa’s individual operating capacity after reconstruction.[27] The recorded reopening of particular departments therefore does not supply a comprehensive measure of the complex’s later medical capabilities.[5][27]

The extent and character of Hamas’s military use of Al-Shifa remain central to disputes over the hospital’s wartime history: Israeli and U.S. assessments described command facilities, weapons, and hostages, while Hamas and Gaza health officials repeatedly denied that hospitals served as military command centers.[1][14] Western doctors who had worked at Al-Shifa said they had not seen Hamas members and questioned the plausibility of the alleged underground headquarters.[13] An earlier UN fact-finding mission did not investigate Al-Shifa itself and could not determine whether it had served as a military base during the 2008–09 conflict; its wider investigations found no evidence supporting broader Israeli allegations about military use of medical facilities.[28]

A later analysis criticized the evidence publicly presented before the November 2023 entry, questioning a recorded conversation’s credibility and finding that the subsequently displayed discoveries did not match the earlier description of a strategic tunnel and command network.[29] Hamas and Palestinian Authority responses included allegations that weapons had been planted.[6] In April 2024, U.S. officials said they lacked independent assessments of Israeli casualty and detention figures, civilian deaths, and conflicting damage accounts.[30] Published military death totals also varied, including an earlier figure of 170 and a later figure above 200.[14][22]