The al-Shifa hospital raid shows the limits of US influence on Israel

Joe Biden’s administration has made clear it does not want to see ‘firefights’ inside hospitals in Gaza, writes Kim Sengupta in Tel Aviv. Given Israel has gone ahead regardless, what diplomatic price could they pay?

Medics inside al-Shifa hospital, which Israel claims is concealing a Hamas command and control facility (Gaza Ministry of Health via Reuters)

The attack on al-Shifa hospital has shown the apparent limits of the influence of the US, the main international ally of Israel, on military decisions taken by Benjamin Netanyahu’s government in the Gaza conflict.

The US administration of Joe Biden has stressed that it does not wish to see Israeli forces carrying out assaults on medical facilities, and has counselled extreme caution on the part of the Israeli military while conducting operations in surrounding areas.

President Biden said: “My hope and expectation is that there will be less intrusive action relative to hospitals. I remain somewhat hopeful, but the hospital must be protected.” His national security adviser, Jake Sullivan, wanted to reinforce the US president’s message: “The position of the United States on this matter is clear. Hospitals should be protected. The United States does not want to see firefights in hospitals where innocent people, patients receiving medical care, are caught in the crossfire.”

But firefights have now taken place inside al-Shifa, a place where, alongside doctors and patients, thousands of civilians have taken refuge while Israel has pounded Gaza from air, land and sea.

The Israeli military said it had fought off and killed a number of “terrorists”. It said in a statement: “Before entering the hospital, our forces were confronted by explosive devices and terrorist squads. Fighting ensued in which terrorists were killed.” Five Hamas fighters were killed, the IDF said later, without specifying exactly where this had happened.

Munir al-Bursh, the director general of Gaza’s health ministry, described “big explosions causing damage and creating dust which is entering where we are”. A doctor, Ahmed el Mokhallalati, told Palestinian journalists that staff were trying to take shelter. “Bombardment. Shooting around the hospital and within the hospital. It’s really horrible ... And then we realised that the tanks are moving around the hospital,” he said. “They just parked in front of the hospital emergency department. All kinds of weapons were used. They targeted the hospital directly. We try to avoid being near the windows.”

Israel claims that Hamas has a command and control centre inside the hospital. Washington appears to endorse this assertion, with Mr Sullivan saying: “Without getting into intelligence information, we can just look at open-source reporting that Hamas is using hospitals for command and control, for weapons storage, to house its fighters, in violation of the rules of war.”

On Tuesday, the US officially stated that it had intelligence of a Hamas presence in al-Shifa, but insisted that sharing this information did not constitute endorsement of a military operation involving the hospital. National Security Council spokesperson John Kirby said: “We do not support striking a hospital from the air.” He repeated Mr Sullivan’s stricture that Washington does not want “firefights” in locations where innocent people are seeking medical care.

Hamas said that the US administration had given a “green light” to the operation. “We hold the occupation [Israeli military] and President Biden wholly responsible for the assault on al-Shifa medical complex,” it said, labelling it a “barbaric crime against a medical facility” and warning that “all those responsible will be brought to account”.

There was condemnation of the attack in Arab countries. The Jordanian foreign ministry called it “a violation of international humanitarian law, especially the 1949 Geneva Conventions relative to the protection of civilian persons in time of war, holding Israel responsible for the safety of civilians and the medical staff working in the hospital”.

The extent of the fallout from the al-Shifa operation will depend upon the number of casualties incurred and also whether the Israelis manage to produce conclusive evidence that the complex is indeed the “beating heart” of Hamas, as an IDF spokesperson claimed while the operation was under way.

The Israeli military said it had found a substantial amount of weaponry in a bunker underneath the hospital. This will be displayed, it is believed, later. Palestinian officials claim that the underground facility was actually built by Israel in 1983 when it still controlled Gaza, and that it will be used to “stage” evidence of a Hamas arsenal.

Accusations and recriminations continue as this, the bloodiest of the many Gaza wars thus far, continues into a sixth week.