When Hospitals Become Battlegrounds: The Moral Maze of Urban Warfare in Gaza

The discovery of tunnel networks beneath Gaza’s medical facilities forces an uncomfortable reckoning with the impossible choices that define modern asymmetric warfare.

The Pattern Emerges

Recent reports from the Israel Defense Forces claim the discovery of extensive tunnel systems beneath multiple hospitals in Gaza City, including a 1.5-kilometer passage near the Jordanian Hospital and another beneath Hamad Hospital. These findings, if verified, add to a growing body of evidence suggesting the systematic use of civilian infrastructure for military purposes in the Gaza Strip. The allegations echo similar claims from previous conflicts, where hospitals, schools, and residential buildings have been identified as dual-use facilities.

The use of civilian structures for military operations is not unique to this conflict. From Mosul to Aleppo, urban warfare has increasingly blurred the lines between combatant and non-combatant spaces. What makes the Gaza situation particularly complex is the density of the population—over 2 million people in just 365 square kilometers—leaving few areas that could be considered purely military or purely civilian.

The International Law Dilemma

Under international humanitarian law, hospitals enjoy special protection and can only lose their protected status if used for acts harmful to the enemy. However, the law also requires that warnings be given before any attack on such facilities, and that any military response be proportionate. This creates a legal and moral quandary: How do military forces respond to threats emanating from protected sites without causing disproportionate harm to civilians who depend on these facilities for survival?

The presence of military infrastructure beneath hospitals also raises questions about medical neutrality. Healthcare workers in conflict zones operate under the principle of providing care regardless of political affiliation. When hospitals become militarized—whether willingly or under coercion—medical professionals find themselves caught between their duty to heal and the reality of operating in a weaponized space.

Beyond the Battlefield

The broader implications extend far beyond the immediate conflict. The militarization of civilian infrastructure sets precedents that could reshape how future urban conflicts unfold globally. As warfare increasingly moves from open battlefields to dense urban environments, the traditional distinctions that have governed the laws of war for centuries are under unprecedented strain.

For policymakers, these developments demand a reassessment of existing frameworks for protecting civilians in conflict. The Geneva Conventions, drafted in an era of more conventional warfare, may require updates to address the realities of 21st-century urban combat. Meanwhile, the international community faces the challenge of maintaining humanitarian access and protecting medical facilities while acknowledging the complex security dynamics at play.

The Human Cost

Lost in the strategic and legal debates are the civilians who depend on these hospitals for basic medical care. Whether treating chronic conditions, delivering babies, or providing emergency surgery, these facilities serve populations that have few alternatives. The militarization of medical infrastructure doesn’t just create targets—it undermines the entire healthcare system that civilians rely upon for survival.

As this pattern continues to emerge across various conflicts, we must ask ourselves: In an age where wars are fought not on distant battlefields but in the heart of cities, how do we preserve the humanitarian spaces that make survival possible for those caught in the crossfire?