Medical staff and ambulance drivers who attempted to assist casualties of the Israeli invasion of Gaza have told the Guardian that they were attacked by Israeli forces while trying to carry out their job.
The offensive left 16 medics dead. Nearly all of them were killed by Israeli fire while trying to save lives, and many more were wounded. According to the World Health Organisation, more than half of Gaza's 27 hospitals were damaged by Israeli bombs. Two clinics were completely destroyed and 44 others received damage.
Dr Moawa Hassenein, the head of Gaza's Red Crescent ambulance teams, said it was the worst assault he had seen on ambulance workers: "I have never seen anything like what happened … Never in all my years have I seen this many health workers and facilities targeted in this way."
In a report released yesterday, Physicians for Human Rights Israel said there was "certainty" that Israel had violated international humanitarian law, with attacks on medics, damage to medical buildings, indiscriminate attacks on civilians and delays in medical treatment for the injured.
"We have noticed a stark decline in IDF [Israeli Defence Forces] morals concerning the Palestinian population of Gaza, which in reality amounts to a contempt for Palestinian lives," said Dani Filc, the chairman of the pressure group. On one day – 4 January – four medics were killed in two separate incidents.
The first saw paramedics Khaled Abu Saada and Arafa Abdel Daym hit by an Israeli tank shell packed with 8,000 flechettes ‑ dart-like nails ‑ as they moved one of three wounded civilians into their ambulance.
The patient died instantly; the paramedic died on the way to hospital.
Saada was thrown to the ground with three flechettes in the back of his head. "I picked myself up and found Arafa kneeling down with his hands up in the air and praying to God, his body was riddled with darts," he said. "The patient was in pieces, his head was missing. I was hysterical."
In the second incident, two ambulances called out to rescue injured men from a field in the Tel al Hawa district of Gaza City were hit by Israeli helicopter fire.
Three medics and a 12-year-old boy, Omar, who was guiding them, were killed.
The Geneva convention explicitly forbids the targeting of medics or medical facilities. "Medical personnel exclusively engaged in the search for, or the collection, transport or treatment of, the wounded or sick shall be respected and protected in all circumstances," it says.
In a statement, the IDF said: "The IDF does not target medics or other medical staff. As a part of their training, IDF soldiers receive instructions on identifying and avoiding injury to medical staff in the battlefield.
"However, in light of the difficult reality of warfare in the Gaza Strip carried out in urban and densely populated areas, medics who operate in the area take the risk upon themselves."
The International Committee of the Red Cross went further than ever before in criticising Israel's attacks on medical staff and facilities during the 23-day Israeli operation.
In one incident, a Red Cross-led convoy of 13 ambulances carrying wounded to Egypt was fired on, despite Israeli clearance for the journey.
The convoy was forced to turn back and two of the wounded died after being unable to receive treatment.
Ambulance workers have described more than 30 incidents in which they were prevented from reaching the injured.
Medics have also said their ambulances were used as human shields by the Israeli army. Ambulance driver Hassan Kalhout described one such ordeal: "They were firing mortars and phosphorus bombs at the houses. They placed our vehicles in front of them while they continued to fire. They made us stay in the ambulances and used us as cover as they fired on civilians."
The Israeli military declined to comment directly on why more than half of Gaza's hospitals were damaged by Israeli bombing but told the Guardian "an extensive post-invasion investigation" was under way and that it was looking into allegations that hospitals were targeted during the offensive.
Some Israeli officials have said that Palestinian fighters were either treated in these hospitals or took shelter in them.
What the Geneva convention says
Preventing care constitutes a serious violation of the laws of war. Article 17 of the fourth Geneva convention clearly states that "the parties to the conflict shall endeavour to conclude local agreements for the removal from besieged or encircled areas, of wounded, sick, infirm, and aged persons, and for the passage of ministers of all religions, medical personnel and medical equipment on their way to such areas". The fourth convention also says hospitals should "at all time be respected and protected" by parties at war.