Weapons caches, heavy artillery and hundreds of armed terrorists, including some of Israel’s most wanted – these were just some of what the IDF uncovered during an intense two-week operation inside Gaza’s largest medical complex, Al-Shifa Hospital, Rear Adm. Danial Hagari, the IDF spokesman, said this week as the army prepared to withdraw from the area.

Calling it “a significant blow for Hamas and Palestinian Islamic Jihad,” Hagari told journalists in a special briefing that more than 200 terrorists had been killed during the fighting and a further 900 arrested. Among those killed or captured by Israel were Marwan Issa, the deputy commander of Hamas’ military wing, and Ra’ad Thabet, head of Hamas’ recruitment and acquisition efforts.

Civilians, patients and medical staff in the hospital were evacuated to a nearby facility, he said, highlighting that no civilians were killed in the battle, which he said was carried out with precision by the army’s special forces.

Hagari also pointed out that the fighting had destroyed much of the expansive medical compound, which Israel has long claimed served as one of Hamas’ key command and control centers with an intricate network of underground tunnels leading to and from the grounds.

Images shared from inside the Strip showed massive destruction at the Gaza City facility and Hamas, in a statement on Monday, said that bodies were hidden under the rubble. The U.S.-designated terror group, which has governed Gaza since 2017, claims that more than 32,000 people have been killed in the war, now nearing its sixth month, but that count makes no distinction between civilians and combatants.

While the battles in and around Al-Shifa Hospital have drawn the most attention – and heavy international condemnation of Israel – it is not the only controversial site where battles between the IDF and terror groups have taken place.

Since the Israeli army launched its ground offensive into the Palestinian enclave at the end of October – following the mass Hamas-led terror attack on southern Israel – dozens of hospitals across the territory became the front lines of the war as thousands of terrorists hid among patients and staff, both inside hospital buildings and in bunkers beneath them.

Throughout the past six months, the IDF has shared information on military operations in hospitals such as Al-Amal in Khan Younis, Al-Nasser in Gaza City, Al-Aqsa Martyrs in Deir al-Balah and the Al-Ahli Hospital in central Gaza. Al-Ahli became a focus early on in the war when an errant Palestinian Islamic Jihad rocket hit the hospital’s parking lot, killing civilians. At the time, Hamas – and the international media – were quick to accuse Israel of attacking the facility.

The working assumption of the terror groups in Gaza is that the Israeli military will not enter a medical facility because it would contravene international humanitarian law, which dictates that hospitals, medical units and ambulances not be considered legitimate military targets.

However, legal and medical experts point out that the law does not categorically prohibit such attacks and that under some circumstances hospitals can lose their special protection, especially if they are being used for acts considered “harmful to the enemy.”

“Since it took over Gaza, Hamas has been using the population as human shields and civilian facilities as military centers to hide their missiles, launchers and rockets,” Nitsana Darshan-Leitner, president of Shurat HaDin, the Israel Law Center, told Jewish Insider. 

She explained that while there was clear evidence of this from previous rounds of fighting in Gaza, now it was on full display because Israel is battling much deeper inside the territory.

“This time, Israel has discovered the unbelievable scope that Hamas has been using civilian facilities, not only kindergartens and schools, which we already knew about from previous rounds of fighting, but also mosques and specifically hospitals,” Darshan-Leitner said.

“Why are they using hospitals?” she asked. “Because mosques, schools and kindergartens can be easily evacuated but in hospitals there are patients in life-threatening situations or hooked up to machines and you can’t simply clear them out.”

Also, Darshan-Leitner emphasized, “Hamas feels more protected in hospitals and that is why they are using them for everything relating to their military operation.”

The lawyer, whose 2017 book Harpoon explores the finances fueling terror organizations, pointed out that while international humanitarian law dictates that any place used for military purposes is a legitimate target, when it comes to hospitals, the attacking force must make greater efforts to refrain from harming civilians.

In his briefing on Monday, Hagari said that during Israel’s last controversial operation in Al-Shifa last November, the army gave those inside more than a week to leave the complex. This, he said, enabled many militants to escape the area. Since then, Hagari added, Hamas, Palestinian Islamic Jihad and other militant Palestinian groups had returned to the hospital grounds.

“Those that we captured told us very clearly that the hospital was considered safe and that there was water, food, and electricity inside,” Hagari recounted. “These were the orders given by the Hamas leadership… hospitals are part of Hamas’ military playbook.”

Last week, the IDF intelligence directorate released footage from the interrogations of two Palestinian terrorists who stated clearly that their orders had been to return to Al-Shifa Hospital because it was safe, even though it might put ordinary Gazans at risk.

Bakr Ahmed Bakr Qanita, a commander with Hamas, told interrogators that his unit had been holed up in the hospital for 25 days and that there were between 600-1,000 militants operating there.

Islamic Jihad was using the maternity ward and Hamas the management building, he said.

Asked why Hamas uses hospitals all over the Gaza Strip, Qanita replied that it was “because of the large population there and also because there is water, electricity and a lot of action…. and because a hospital cannot be touched in war.”

Itamar Yaar, a former deputy head of Israel’s National Security Council, said that Hamas itself has admitted to using hospitals and that the “information has been on the table for a long time.”

“They do it because they assume that Israel will not dare send its troops into these sites,” Yaar, who currently heads Commanders for Israeli Security, an organization of some 550 ex-senior security people, told JI.

He theorized that the IDF had most likely installed surveillance equipment inside Al-Shifa Hospital during the last round of fighting there and monitored Hamas’ return to the complex.

“The IDF had a lot of information this time and they had the element of surprise; Hamas did not think the IDF would come back,” Yaar said.

Yaar said that it was clear the staff at Al-Shifa – as well as other hospitals – are aware that Hamas is operating from within their facilities but said they have no choice about cooperating with them.

“Hamas controls Gaza by using terror against its people; if a hospital manager refuses to allow Hamas activity in his hospital then he could be fired or worse,” Yaar continued, adding that international agencies, including the World Health Organizations, remain silent for the same reasons.

“I can understand why the World Health Organization is embarrassed because there is no doubt that their people on the ground in Gaza knew what was happening there,” Yaar said. “Maybe not all the details but they definitely know Hamas is using hospitals.”

In a briefing on Monday, White House Press Secretary Karine Jean-Pierre emphasized that Hamas should not be operating out of hospitals.  

“We’ve said that over and over again,” she said, adding they are “putting civilians at risk” and that there are also concerns over how “Hamas appears to have been able to reconstitute a hospital so quickly.”

“We have made clear that we continue to support Israel’s right to defend itself,” Jean-Pierre said. “But we’ve also said, we do not want firefights in a hospital where innocent people, helpless people, people seeking medical care are caught in the crossfire.”

She added that the terrorists’ use of hospitals “just points to how challenging Israel’s military operation is because Hamas has intentionally embedded themselves into civilian infrastructure and into these hospitals.”