Timeline of Hospital Strikes and Hamas Leadership Eliminations

The pattern of targeting Hamas leaders in medical facilities extends beyond the European Hospital strike. On March 23, 2025, Israeli forces struck Nasser Hospital in Khan Younis, killing Ismail Barhoum, a member of Hamas’s political bureau who was receiving medical treatment at the facility. The attack also claimed the life of a 16-year-old boy who had undergone surgery just days earlier. This strike came shortly after the resumption of major military operations following the collapse of a temporary ceasefire that had begun in January 2025.

Just hours before Barhoum’s assassination, Israeli forces killed another Hamas political bureau member, Salah al-Bardawil, along with his wife, in a strike on a tent shelter elsewhere in Khan Younis. Between March 23 and 28, Israeli operations killed four members of Hamas’s political bureau, representing a systematic effort to eliminate the organization’s senior leadership during a critical period of renewed conflict.

Earlier in the war, on March 28, 2024, Israeli special forces killed Ra’ad Thabet during a raid on Al-Shifa Hospital in Gaza City. Thabet, described as one of Hamas’s top 10 senior commanders, was responsible for research and development and headed the organization’s production unit. Israeli military officials reported that soldiers from Shayetet 13, an elite naval commando unit, engaged Thabet and two other militants in the hospital’s maternity ward during a firefight that erupted when the Hamas fighters attempted to flee.

The European Hospital Strike: Planning and Execution

The May 13 attack on the European Hospital represented months of intelligence gathering and operational planning. According to Israeli news outlet Walla, the IDF obtained what officials called a “golden piece of information” shortly before the strikes, allowing intelligence analysts to determine when Hamas’s military leadership would gather in the underground tunnel complex for a meeting. The strikes were approved in real-time by Prime Minister Benjamin Netanyahu, Defense Minister Israel Katz, and Chief of the General Staff Eyal Zamir after confirming that no Israeli hostages were present in the target area.

The Wall Street Journal reported that Hamas leaders had convened the underground meeting to discuss ongoing ceasefire negotiations with Israel. The gathering violated the organization’s own security protocols by bringing multiple high-value targets to a single location, creating a vulnerability that Israeli intelligence exploited. According to Israeli sources, Mohammed Sinwar typically traveled with Israeli hostages as a “human shield” to deter assassination attempts, but for reasons that remain unclear, he entered the tunnel without any hostage escort on this occasion.

The attack commenced at 6:19 PM local time when Israeli Air Force warplanes simultaneously released at least nine bunker-busting bombs along with dozens of other munitions targeting the hospital courtyard and surrounding areas. CNN described the bombardment as among the largest concentrated strikes in Gaza in recent weeks. The explosions struck one of Gaza’s largest medical facilities, which was actively treating patients and sheltering thousands of displaced Palestinians at the time of the attack.

Casualties and Aftermath

The Gaza Health Ministry reported that 28 people were killed in the European Hospital strikes with dozens more wounded. Among the injured was a freelance journalist working for the BBC. According to the Palestinian Civil Defence, bodies were scattered throughout the hospital complex, significantly hampering recovery operations. The casualties were transported to Nasser Hospital in Khan Younis, where medical staff struggled to cope with the sudden influx of dead and wounded.

Israeli officials confirmed Sinwar’s death through DNA analysis conducted on June 8, 2025, by testing remains recovered from the tunnel against samples from his brother Yahya Sinwar’s body. The exact cause of death remained unclear but likely resulted from shockwaves from the massive explosions, suffocation, or starvation in the collapsed tunnel system. In addition to Sinwar, Shabana, and Quara, reports indicated that all of Sinwar’s companions present in the tunnel were killed, including several field commanders.

Following the initial bombardment, Israeli forces conducted subsequent strikes on the bunker area to prevent the recovery of casualties. Two Palestinian Civil Defence members were injured by quadcopter drone strikes as they approached the hospital to assist with rescue efforts. Al Jazeera reported that six additional strikes hit the hospital area the following day, with one strike targeting a bulldozer in the courtyard attempting to clear debris.

International Legal Concerns and Humanitarian Law Violations

The strikes on Gaza hospitals have raised profound concerns about violations of international humanitarian law, which provides special protections for medical facilities during armed conflict. British barrister Geoffrey Nice stated that Israel’s failure to issue warnings or evacuation orders before the European Hospital strike possibly violated international humanitarian law requirements. Legal expert Lawrence Hill-Cawthorne of the University of Bristol argued that even if a Hamas complex existed beneath the hospital, the attacks would only be lawful if adequate warnings were provided to civilians and the anticipated civilian harm was proportional to the expected military advantage.

International humanitarian law, codified in the Geneva Conventions, grants hospitals special protected status during wartime. However, these protections can be forfeited if medical facilities are used for military purposes or as bases for armed operations. Israel has consistently claimed that Hamas uses hospitals and other civilian infrastructure for military operations, embedding fighters and command centers within protected facilities. Hamas has denied these allegations, maintaining that it does not conduct military operations from hospitals.

In December 2024, Andrew Cayley of the International Criminal Court stated that Israeli claims about Hamas’s use of hospitals were “grossly exaggerated.” A United Nations investigation concluded in March 2025 that Israel had committed genocidal acts in Gaza by systematically destroying reproductive healthcare facilities while maintaining a siege that prevented necessary medications and medical supplies from entering the territory.

The World Health Organization’s Documentation

The World Health Organization has verified extensive attacks on healthcare infrastructure throughout the conflict. By April 2024, WHO had documented 906 attacks on healthcare facilities in Gaza, the West Bank, Israel, and Lebanon. As of June 2024, according to WHO statistics, Israeli operations resulted in the deaths of 727 healthcare workers, injuries to 933 healthcare workers, and damage or destruction of 113 ambulances in Gaza alone.

By October 2024, WHO reported verifying 516 separate attacks on healthcare facilities specifically in the Gaza Strip since the conflict began in October 2023. Healthcare workers and medical organizations have described unprecedented pressure on Gaza’s medical system, with systematic targeting of hospitals creating catastrophic conditions for treating the wounded and managing public health crises.

In September 2025, the UN Human Rights office documented at least 17 Israeli attacks on or near health facilities in Gaza City within a two-week period. Facilities directly struck included Al Quds Hospital, Al Rantisi Children’s Hospital, and the Medical Relief Health Centre. The Jordanian Field Hospital in Tal Al Hawa announced its evacuation to Khan Younis after Israeli strikes damaged the facility, while Israeli ground forces besieged Al Quds Hospital.

The August 2025 Nasser Hospital Massacre

The deadliest single attack on a medical facility occurred on August 25, 2025, when Israeli forces conducted a “double-tap” strike on Nasser Hospital in Khan Younis. The attack killed 22 people, including five journalists, medical staff, a paramedic, and other civilians. Approximately 50 additional people were wounded, including Reuters photographer Hatem Khaled, who later died from his injuries.

The journalists killed in the attack were Reuters cameraman Hussam al-Masri, Mariam Abu Dagga who freelanced for the Associated Press, Mohammed Salama an Al Jazeera cameraman, Moaz Abu Taha who worked with Reuters, and Ahmed Abu Aziz who reported for Middle East Eye and Quds News Network. All five journalists were working from a fourth-floor staircase that had become a de facto newsroom, providing media outlets with views overlooking the city for their broadcasts.

An investigation by BBC Verify revealed that the hospital was actually struck four times rather than twice as initially reported. Experts analyzing video footage identified that the first wave involved two simultaneous strikes on separate staircases, while the second wave consisted of two near-simultaneous blasts hitting the same location within fractions of a second. Evidence suggested that LAHAT missiles, precision-guided munitions capable of being fired from tanks, drones, or helicopters, were used in the attack.

Israel’s Disputed Justification

Israeli military officials initially claimed the strike targeted a Hamas camera that was supposedly being used to monitor Israeli forces. However, a comprehensive Reuters investigation involving review of more than 100 videos and photos from the scene and interviews with more than two dozen witnesses established that the camera in question actually belonged to Reuters and had been regularly used by the news agency’s own journalists for broadcasts.

Following international outcry, the IDF alleged that six people killed in the Nasser Hospital attack were Hamas militants, though this claim was disputed by medical staff and raised significant discrepancies. The IDF provided no supporting evidence, and one person on the list, Omar Kamal Shahada Abu Teim, did not appear on the hospital’s casualty records. Doctors and morgue workers confirmed no one by that name was killed. Another person identified as a militant, Jum’a al-Najjar, was actually a healthcare worker employed by Nasser Hospital, while Imad al-Shaer worked as a driver for the civil defense agency.

Double-tap strikes, which deliberately target rescuers and first responders arriving at the scene of initial attacks, are considered war crimes under international law. Such tactics have been notoriously employed by extremist groups including al-Qaeda, as well as Russian military forces and Syrian government troops loyal to former President Bashar Assad. Experts in international humanitarian law identified multiple aspects of the Nasser Hospital attack that could constitute war crimes, including targeting a hospital without warning and employing the double-tap strategy that deliberately endangers civilians.

Global Response and Condemnation

The attacks on Gaza hospitals have provoked widespread international condemnation from governments, humanitarian organizations, and international bodies. UN Secretary-General António Guterres condemned the Nasser Hospital strikes, calling for a prompt and impartial investigation while reiterating that medical personnel and journalists must be protected under international humanitarian law. The UN Office for the Coordination of Humanitarian Affairs mourned the loss of photojournalist Mariam Abu Dagga, who had worked with the agency.

WHO Director-General Tedros Adhanom Ghebreyesus condemned the attacks, stating on social media that while people in Gaza were being starved, their already limited access to healthcare was being further crippled by repeated attacks on medical facilities. The Committee to Protect Journalists issued a statement declaring that Israel’s broadcasted killing of journalists in Gaza continues while the world watches and fails to act firmly.

Multiple governments issued official condemnations of the hospital attacks. French President Emmanuel Macron called the Nasser Hospital strikes “intolerable,” while British Foreign Minister David Lammy stated he was “horrified” and demanded an immediate ceasefire. Turkey’s presidential communications office labeled the attacks a “war crime” and an assault on press freedom. Canada, Germany, Switzerland, Qatar, Saudi Arabia, and Kuwait also condemned the Israeli strikes.

Press Freedom Organizations Speak Out

Reporters Without Borders head Thibaut Bruttin emphasized that there are guarantees that should be granted to journalists covering conflicts, noting that none of these protections appeared to be applying in Gaza. The Foreign Press Association stated that the killings of journalists must serve as a watershed moment and urged international leaders to take action, calling on Israel to halt its practice of targeting journalists.

The UN human rights office reported that at least 247 Palestinian journalists have been killed in Gaza since October 7, 2023. According to the Committee to Protect Journalists, IDF fire has killed 189 Palestinian reporters in Gaza by September 2025. These journalists served as the eyes and ears of the world, with many international media organizations barred from entering Gaza and relying on Palestinian journalists for coverage of the conflict.

Context of the Broader Conflict

The hospital strikes occurred within the context of a devastating conflict that began with Hamas’s attack on southern Israel on October 7, 2023, which killed approximately 1,200 people, mostly civilians, and resulted in the capture of 251 hostages. Israel’s subsequent military campaign in Gaza has resulted in massive destruction and a humanitarian catastrophe affecting the territory’s 2.2 million residents.

A temporary ceasefire took effect on January 19, 2025, following extensive negotiations mediated by Qatar, Egypt, and the United States. The agreement’s first phase included the exchange of Israeli hostages for Palestinian prisoners, Israeli military withdrawal from populated areas, and increased humanitarian aid deliveries. However, both sides accused each other of violations during the ceasefire period, with the Gaza Government Media Office documenting 1,000 Israeli ceasefire violations by March 2025.

On March 18, 2025, Israel conducted a surprise military offensive that shattered the nearly two-month truce. Israeli forces acknowledged conducting extensive strikes during Ramadan, with the attack plan kept secret to create tactical surprise. The initial bombardment killed more than 400 Palestinians according to Gaza’s health ministry. Israel justified resuming operations by claiming Hamas refused to release additional hostages and violated ceasefire terms, while Hamas accused Israel of destroying the agreement through its own violations and siege tactics.

Humanitarian Crisis and Aid Restrictions

Following the ceasefire collapse, Israel imposed what UN officials described as a total blockade on Gaza, obstructing humanitarian assistance from entering the territory. The UN Human Rights office expressed alarm at Israel’s decision to suspend all goods and supplies, including life-saving humanitarian aid. UN experts called the blockade a flagrant breach of international law that weaponized starvation against Gaza’s civilian population.

UNRWA, the UN agency for Palestinian refugees, reported running out of food supplies at the end of April 2025 after being blocked by Israeli authorities from directly bringing humanitarian assistance into Gaza for nearly 10 months since March 2. The agency had pre-positioned outside Gaza enough food parcels for 1.1 million people, flour for 2.1 million individuals, and shelter supplies for hundreds of thousands, but Israeli authorities prevented these supplies from entering the territory.

Hospital conditions deteriorated dramatically due to the aid restrictions. Medical facilities ran out of blood supplies, pain medications, anesthetics, and antibiotics. In April 2025, the UN Secretary-General stated that the blockage of aid had “opened the floodgates of horror” and that Gaza had become “a killing field” with civilians trapped in “an endless death loop.” Nasser Hospital was operating at full capacity with over 1,000 patients at the time of the August strikes, despite critical shortages of supplies and staff.

Death Toll and Destruction

According to Gaza’s Ministry of Health, the conflict has resulted in catastrophic loss of life and widespread destruction. By December 2025, at least 70,668 Palestinians had been killed in the Gaza Strip with another 171,152 injured since October 7, 2023. The ministry, which does not differentiate between military and civilian casualties in its counts, reported that approximately 70 percent of those killed were women and children.

Beyond direct combat casualties, the conflict has created secondary humanitarian crises. The Gaza Health Ministry reported that 303 people died from starvation by August 2025, including 117 children. Tens of thousands of children went unvaccinated due to medical system collapse and aid restrictions. Widespread destruction of residential buildings and displacement camps has left hundreds of thousands living in precarious conditions in makeshift shelters and tents.

UNRWA documented the deaths of 382 colleagues killed in Gaza since the war began, including 309 UNRWA personnel and 73 persons supporting agency activities. The toll on humanitarian workers reflects the dangerous conditions faced by those attempting to provide aid and services to Gaza’s civilian population during the conflict.

Strategic and Political Dimensions

The targeting of Hamas leadership in hospitals served multiple Israeli strategic objectives beyond eliminating specific individuals. Mohammed Sinwar’s death removed a key figure whom Israeli and American officials viewed as an obstacle to ceasefire negotiations and hostage releases. Former U.S. Ambassador to Israel Dan Shapiro stated there was little chance the war could end before Sinwar’s death and that his removal could open the door for releasing all hostages and moving toward a post-war future for Gaza without Hamas control.

However, the pattern of hospital strikes has complicated Israel’s diplomatic position and contributed to international isolation. The International Criminal Court has launched investigations into potential war crimes, with ICC officials questioning Israeli claims about Hamas use of medical facilities. Multiple countries have reassessed their military and diplomatic relationships with Israel based on concerns about international humanitarian law violations.

Israeli Prime Minister Benjamin Netanyahu has defended the military’s operations, describing the IDF as “the most moral army in the world” and maintaining that Israel adheres to Geneva Conventions requirements including proportionality in attacks and protection of civilians. Israeli officials have consistently claimed that Hamas deliberately uses civilian infrastructure including hospitals for military purposes, thereby forfeiting protected status under international law.

Hamas Leadership Succession

Despite Israeli successes in eliminating senior Hamas figures, the organization has demonstrated resilience through its succession mechanisms. When Mohammed Sinwar was killed, other commanders assumed leadership roles. The systematic targeting of Hamas’s political bureau members has forced the organization to operate with greater secrecy and decentralization, but has not resulted in organizational collapse or surrender.

Israeli security analysts have questioned whether eliminating individual leaders significantly advances strategic objectives when the underlying conditions that enable Hamas recruitment and operations persist. The deaths of thousands of Palestinian children and destruction of Gaza’s infrastructure have created conditions that some experts warn could produce a new generation of recruits for militant organizations.

Medical Ethics and Healthcare Under Fire

Healthcare workers in Gaza have faced unprecedented challenges maintaining medical ethics and professional duties while operating under combat conditions. Dr. Feroze Sidhwa, a trauma surgeon volunteering at Nasser Hospital, described operating on the 16-year-old boy killed in the March strike just days before the attack. He stated the patient would likely have been discharged the next day but was instead killed when Israeli munitions struck the facility.

Sidhwa reported that the surgical ward for male patients was completely destroyed, requiring total reconstruction. The entire electrical system was destroyed, every door was blown off its hinges, most windows were shattered, and the ceiling collapsed. The hospital smelled of smoke throughout, and the damaged ward became completely unusable. Medical staff struggled to continue providing care despite infrastructure damage, supply shortages, and the constant threat of additional strikes.

Doctors Without Borders and other medical organizations have documented Israeli forces’ “complete disregard for the protection and safety of medical and humanitarian missions and their staff.” Healthcare workers have pleaded for basic protections under international law, with surgical department supervisor Salah Mansour stating that for two years medical staff had been subjected to killing, destruction, and starvation despite being entitled to the highest level of protection under international law.

Psychological Impact on Medical Personnel

The repeated targeting of hospitals has created severe psychological trauma among Gaza’s healthcare workers. Medical professionals have been forced to work under constant threat of bombardment while treating overwhelming numbers of casualties with inadequate resources. Many have witnessed colleagues killed while performing their duties and have seen patients they treated killed in subsequent strikes on medical facilities.

International medical volunteers who served in Gaza hospitals have described the experience as unlike any other conflict zone. The systematic nature of attacks on healthcare infrastructure, combined with restrictions on medical supplies and the targeting of ambulances and rescue workers, has created what healthcare professionals characterize as deliberate destruction of Gaza’s medical capacity rather than incidental damage from combat operations.

Ongoing Ceasefire Efforts and Future Prospects

Despite the resumption of hostilities in March 2025, diplomatic efforts to achieve a lasting ceasefire continued throughout the year. By December 2025, negotiations mediated by Qatar, Egypt, and the United States had made progress toward implementing a comprehensive peace agreement. Prime Minister Netanyahu announced that Israel and Hamas would enter the ceasefire’s second phase soon, while Hamas officials indicated readiness to discuss freezing or storing weapons as part of a broader settlement.

The Trump administration played an increasingly active role in ceasefire negotiations, with President Donald Trump stating at a September 2025 White House press conference that the United States would ensure Israel’s security following a new ceasefire agreement. Trump emphasized that if Hamas accepted the deal, all hostages would be released almost immediately, and expressed his intention to end the war.

However, significant obstacles remained to achieving a permanent peace settlement. Disagreements persisted over the sequencing of hostage releases, prisoner exchanges, Israeli military withdrawals, and long-term governance arrangements for Gaza. Hamas demanded credible guarantees for a permanent ceasefire and adequate humanitarian aid protocols, while Israel insisted on demilitarization of Gaza and verification mechanisms to prevent Hamas from reconstituting its military capabilities.

Reconstruction and Recovery Challenges

The scale of destruction in Gaza presents enormous challenges for any future reconstruction effort. Entire neighborhoods have been reduced to rubble, critical infrastructure including hospitals, schools, and utilities has been destroyed or severely damaged, and the territory’s economic base has been devastated. International organizations estimate that reconstruction could require years and tens of billions of dollars in investment.

The targeting of hospitals has created particularly severe long-term consequences for Gaza’s healthcare system. Rebuilding medical infrastructure requires not only physical reconstruction but also replacing specialized equipment, recruiting and training healthcare workers to replace those killed or displaced, and restoring supply chains for medications and medical supplies. The destruction of reproductive healthcare facilities has caused what UN investigators described as “irreversible harm” to the reproductive prospects of Palestinians in Gaza.

Conclusion

The Israeli strikes on Gaza hospitals that killed Hamas leaders represent a controversial aspect of modern urban warfare that has generated intense international scrutiny and legal questions. While Israel has achieved tactical successes in eliminating senior Hamas commanders including Mohammed Sinwar, these operations have come at significant civilian cost and raised serious concerns about violations of international humanitarian law protecting medical facilities and healthcare workers during armed conflict.

The pattern of hospital attacks has contributed to the systematic destruction of Gaza’s healthcare infrastructure, creating a humanitarian catastrophe that extends far beyond immediate combat casualties. International organizations including the United Nations, World Health Organization, and International Criminal Court have documented extensive violations and called for accountability.

As diplomatic efforts continue toward achieving a lasting ceasefire and eventual reconstruction, the legacy of hospital strikes will shape discussions about military conduct, humanitarian law enforcement, and the protection of civilians and medical facilities in future conflicts. The international community faces urgent questions about how to restore protections for healthcare in armed conflict and ensure accountability for violations that have resulted in unprecedented destruction of medical systems and loss of healthcare workers’ lives.