456.           “I hope you can help achieve justice for my colleague; I hope that you can persuade the Israelis to let us do our job without getting fired at.” Ambulance driver

“The International Committee of the Red Cross (ICRC) firmly condemns this extremely alarming series of attacks against humanitarian workers, ambulances, and hospitals. These are serious violations of the law of war. An immediate stop must be put to them.”

457.           Three incidents that occurred during the ground operations in Shuja’iya, in Rafah and in Shuja’iya market are detailed above (see chapter V.A.3. on ground operations). According to witnesses, a military medical aid ambulance was directly hit twice while attempting to provide first aid to victims in Shuja’iya, resulting in two people  being killed, one of them a rescue worker, and two injured. Ten days later, in Shuja’iya market, in a context of intense fire, a shell struck the ground close to three ambulances in the proximity of a house that had been attacked. As a result of the shelling, a paramedic and 22 other people were killed. In Rafah, on 1 August, eight people burned to death in an ambulance that was hit.

458.           In addition, the commission examined an incident that took place on 25 July, after 11 p.m., in Al Qarara village, Khan Younis. Two eyewitnesses and one witness told the commission that Mohammed Hassan Al Abadla an ambulance driver aged 26, came under fire while evacuating an injured person. According to the witnesses, when the ambulance arrived at the location, the IDF instructed the crew to exit the vehicle and continue on foot. Mohammed Hassan Al Abadla and one of two volunteers got out of the ambulance and approached the patient with a flashlight on, as directed. They had walked about twelve metres when they came under fire and Mohammed Hassan Al Abadla was hit in the chest and thigh. Two ambulance teams that arrived a little later to rescue their wounded colleague also came under fire, despite earlier ICRC information that the IDF had approved their entry to the area.  A third team was finally allowed to take Al Abadla to Nasser hospital in Khan Younis, where he died shortly upon arrival. The ambulances’ movements were at all times coordinated with the IDF through the ICRC. According to the witnesses, all ambulances were marked with the Palestinian Red Crescent Society (PRCS)’s emblem, and Mohammed Hassan Al Abadla and his colleagues were wearing uniforms The MAG has ordered a criminal investigation into this case the outcome of which is pending.

459.           The commission further interviewed several witnesses to an incident that occurred on 25 July, at around 4.15 p.m., when a missile appears to have hit the back of a PRCS ambulance during a rescue operation in Beit Hanoun. As a result, Aaed Al Borei, an ambulance volunteer aged 29, was killed and two other rescuers inside the ambulance were injured. When another ambulance team was dispatched to respond, a missile hit the rear part of this vehicle, which caught fire.  The ambulance had its siren and flashing red light on and, at the time of the strike, the street was deserted. The two survivors told the commission that the missile hit the vehicle with such force that it felt as if the “explosion was inside the ambulance”.  They saw Aaed’s body torn apart on the ground.The back of the ambulance was completely destroyed.  During an additional rescue operation, another ambulance apparently came under fire, wounding the driver. Aaed’s burned body could only be retrieved the following day.On 7 December, the MAG announced that it had ordered a criminal investigation into the incident.

460.           In addition, in a number of instances, ambulances are reported to have been prevented from evacuating the wounded from areas where the IDF was operating (in Beit Hanoun, Khuza’a, Qarara, Shujai’ya and Beit Lahiya). According to the Palestinian Human Rights Coalition, 407 Palestinians died as a result of delays in the delivery of medical aid. Some of these incidents, which occurred in Khuza’a, are discussed above. On several occasions, the authorization for ambulances to access sites of military operations where civilians were injured was delayed for days. The commission received heart-breaking testimony and reports of people who saw their injured children and family members die because ambulances arrived too late, sometimes hours or days after the attacks.

461.           The commission notes the IDF’s general allegation that Palestinian armed groups used ambulances to transport fighters, i.e. for military purposes. As no specific information was received in this regard, the commission is unable to verify this claim. In relation to the incidents highlighted above, the commission did not find any information, or receive any allegations indicating that the ambulances involved were used for a purpose other than their humanitarian function. Given the pivotal importance of ambulances and medical personnel in areas with a civilian presence where intense shelling takes place, reports of repeated strikes on ambulances that came to the rescue of injured staff are of particular concern, as they suggest that the ambulances and personnel may have been specifically targeted.

462.           The commission observed that the 2014 hostilities resulted in damage to 16 ambulances,the death of 23 health personnel (16 of whom were on duty), and injury to least 83.  At least 24 strikes involving ambulances and medical personnel were reported. The “Medical Aid for Palestinians” organization reported the loss of 30 ambulances following attacks. Many, if not most, of the reported strikes on ambulances that resulted in casualties, and in some cases, deaths appear to have occurred without there having been any obvious threat or military activity in the area. Furthermore, ambulances were marked with emblems, health workers wore uniforms, and the IDF had been notified repeatedly of their movements. In some incidents (Beit Hanoun and Khan Younis on 25 July and Rafah on 1 August), medical personnel and ambulances appear to have been hit by direct and targeted fire, while in other cases they were likely victims of indiscriminate shelling occurring in the area at the time.

463.           The commission notes that the MAG has ordered criminal investigations into two of the cases discussed above and recommends that the MAG investigations pay particular attention to allegations relating to health personnel and ambulances.

464.           Ambulances and medical personnel enjoy special protection under international humanitarian law. They are to be protected from attack under all circumstances. They only lose this protection if they are used outside of their humanitarian function to commit acts harmful to the enemy. Some of the incidents above constitute a violation by the IDF of the prohibition of attacks on medical transports and medical personnel, and may amount to war crimes, in particular, if the vehicles or personnel attacked used the distinctive emblems of the Geneva Conventions.

465.           In addition, the many reported incidents involving the blocking or delaying of ambulances raise serious concern as to the compliance by the IDF with their obligation to respect medical transport. This obligation is not limited to the prohibition against attacking such vehicles themselves, but also includes the obligation to refrain from interfering with their rescue work. As stated in the ICRC Commentary on article 21 of Geneva Convention IV, “The enemy should avoid interfering with them, but that is not enough; he must also allow them to carry out their work.” Preventing or delaying ambulances may also constitute a violation of the obligation to collect and care for the wounded and sick as provided by Common article 3 of the Geneva Conventions and the prescription that the wounded shall receive to the fullest extent practicable and with the least possible delay, the medical care and attention required by their condition. Delaying medical care may also amount to a violation of the right to health and if it is confirmed that denial of access or delays to ambulances contributed to the death of sick and wounded persons, of the right to life.