A United Nations inquiry has concluded that Israel implemented a deliberate strategy to dismantle Gaza’s health care system during the ongoing conflict, actions that the report describes as war crimes and the crime of extermination.
In a statement accompanying the report, former U.N. High Commissioner for Human Rights Navi Pillay accused Israel of "relentless and intentional attacks on medical personnel and facilities."
These assaults followed Hamas' Oct. 7, 2023 incursion on southern Israel.
Pillay emphasized the devastating impact on children, who have suffered both directly from the violence and indirectly from the breakdown of healthcare services.
Her 24-page report, covering the first 10 months of the conflict, will be presented to the U.N. General Assembly on Oct. 30.
Israel's diplomatic mission in Geneva dismissed the report as "outrageous" and rejected its conclusions.
"(The report) is another blatant attempt by the Commission of Inquiry to delegitimize the very existence of the State of Israel and obstruct its right to protect its population," it said.
Israel claims Hamas operates under the cover of populated areas, including schools and hospitals, and it will strike them wherever they emerge while trying to avoid harming civilians.
Hamas denies hiding weapons and command posts among civilians.
The U.N. inquiry's statement also accused Israeli forces of deliberately killing and torturing medical personnel, targeting medical vehicles and restricting permits for patients to leave the besieged Gaza Strip.
It cited the death of a Palestinian girl, Hind Rajab, in February, along with family members and two medics who came to rescue her from under Israeli fire as they evacuated.
The report said the ambulance was hit by a tank shell while within 50 meters (55 yards) of the family, despite its route having been coordinated in advance with Israeli security forces.
Irreplaceable loss
The World Health Organization (WHO) says more than 10,000 patients requiring urgent medical evacuation have been prevented from leaving Gaza since the Rafah border crossing with Egypt was shut in May.
The Palestinian Health Ministry says nearly 1,000 medics have been killed in Gaza in the past year in what the WHO called "an irreplaceable loss and a massive blow to the health system."
In cases where four hospitals were asked to evacuate by Israeli forces, the inquiry found that the orders were "not feasible" since they did not give medics time to evacuate hundreds of patients, and Israeli forces did not assist them.
The inquiry also revealed that the treatment of Palestinian detainees in Israel was under investigation, with serious allegations of torture and sexual violence emerging.
It has a broad mandate to collect evidence and identify suspected perpetrators of international crimes committed in Israel and the occupied Palestinian territories. It bases its findings on a range of sources, including interviews with victims and witnesses, submissions and satellite imagery.
The commission has previously alleged that both Israel and Hamas committed war crimes in the early stages of the Gaza war and that Israel's actions constituted crimes against humanity because of the immense civilian losses.
The term is reserved for the most serious international crimes knowingly committed as part of a widespread or systematic attack against civilians.
Israel has not cooperated with the inquiry, which it says has an anti-Israel bias.
The commission has accused Israel of obstructing its work and preventing investigators from accessing both Israel and the Palestinian territories.
The evidence gathered by such U.N.-mandated bodies has sometimes formed the basis for war crimes prosecutions and could be drawn on by the International Criminal Court.