When The Healthcare System Becomes a Target: The Urgent Need for Protection and Accountability  

Background: Attacks against Medical teams and healthcare 

Since 8 October 2023, Lebanon’s healthcare system has been bearing the brunt of repeated Israeli attacks against hospitals, ambulances, medical centers, and healthcare workers, with nearly 226 medical workers killed by Israel during the 2024 war in Lebanon. According to the Lebanese Ministry of Public Health, between 8 October 2023 and 27 January 2026, there were 237 attacks against emergency medical teams (EMTs) and 177 attacks against ambulances. 

More recently, on 6 September 2026, Israel also targeted Ghandour Hospital in the Nabatiyeh District, destroying it completely. 

CLDH has also been documenting a repeated pattern of attacks against medical teams, raising serious concerns regarding violations of International Humanitarian Law (IHL), including the principles of distinction and proportionality, as well as the protections afforded to medical personnel and medical units under international humanitarian law, including the Geneva Conventions and applicable Additional Protocols. 

The protection afforded to healthcare under international humanitarian law, especially rule 25 of customary IHL, extends beyond protection against direct attacks. Medical personnel must be respected and protected and must be able to carry out their medical duties without unlawful interference. The wounded and sick are also entitled to receive the medical care required by their condition without adverse distinction other than on medical grounds. Attacks, threats, obstruction or other interference affecting the ability of medical personnel and facilities to provide healthcare may therefore have serious consequences for the protection of wounded and sick persons and the civilian population more broadly. 

Serious violations of the rules protecting medical personnel, medical units and medical transports may, depending on the circumstances and applicable legal framework, give rise to individual criminal responsibility. In particular, the intentional directing of attacks against protected medical personnel or medical objects may constitute a war crime where the required legal elements are established. 

CLDH's Documentation and engagement with UN investigators 

Beyond the reports and analyses published based on the data collected and documented by CLDH, the organization has also coordinated with other NGOs and civil society organizations documenting violations to facilitate the collection, verification, preservation, and sharing of relevant information with the OHCHR team of investigators deployed to Lebanon following the escalation of 2 March 2026. This work aims to support their investigation into violations of International Humanitarian Law (IHL) and International Human Rights Law (IHRL), and to contribute to the detailed report and analysis expected around the end of November 2026. Through this documentation and engagement, CLDH seeks to strengthen evidence-based advocacy and push for concrete and actionable measures through dialogue with relevant national, international, and UN actors. 

Key Concerns 

Despite the scale and repeated nature of these attacks, there remains a significant gap between the documentation of alleged violations and effective accountability for them. 

Significant gaps remain in the prevention, documentation, investigation, and accountability of such incidents, despite the efforts of the National IHL committee who is working with little to no financial support to fund its activities. Access to survivors, witnesses, and other relevant sources of information can also be challenging, particularly in areas affected by hostilities. This, combined with gaps in systematic evidence preservation and documentation, may hinder efforts to establish the circumstances of attacks and identify those responsible. More broadly, there remains a lack of effective accountability for alleged perpetrators of violations against medical personnel and healthcare facilities. Existing mechanisms have not sufficiently demonstrated their ability to ensure that allegations are independently investigated, perpetrators are held accountable, and victims and survivors have access to effective remedies. 

At the same time, insufficient measures appear to be in place to ensure the effective protection of medical personnel and healthcare facilities during hostilities. There is also a need for greater transparency regarding the mechanisms used by relevant authorities to document, investigate, and publicly report attacks affecting the healthcare sector. 

These gaps highlight the need to move beyond documenting violations towards ensuring effective investigations, preserving evidence, protecting survivors and witnesses, strengthening safeguards for medical personnel and facilities, and establishing clear pathways towards accountability and remedy. 

Recommendations: 

To the Lebanese Government 

Documentation and investigation 

• Ensure prompt, independent, impartial, and effective investigations into attacks against medical personnel and healthcare facilities. 

• Preserve physical, documentary, and digital evidence. 

• Ensure that investigations examine the circumstances of alleged violations and the chain of responsibility behind them. 

Protection 

• Strengthen measures to protect medical personnel, ambulances, and healthcare facilities during hostilities. 

• Ensure that medical personnel can carry out their duties without intimidation, interference, or attack. 

Accountability 

• Ratify the Rome Statute or lodge a declaration under Article 12(3) accepting the ICC’s jurisdiction over relevant crimes, and examine, where an appropriate basis for jurisdiction exists, the possibility of pursuing proceedings before the International Court of Justice (ICJ). 

• Ensure that perpetrators of serious violations are prosecuted through fair and effective judicial proceedings. 

• Ensure that victims and families have access to information, justice, and effective remedies. 

Cooperation 

• Fully cooperate with relevant UN investigative mechanisms. 

• Facilitate access to affected areas, witnesses, and relevant documentation. 

To the UN and relevant UN Mechanisms 

• Establish an independent international fact-finding mission or commission of inquiry with a mandate to investigate alleged violations of international humanitarian law and international human rights law affecting medical personnel, medical units, medical transport and the healthcare system in Lebanon since 8 October 2023. 

• Assess whether documented incidents may constitute violations of IHL or international human rights law and, where applicable, international crimes. 

• Request, collect, and preserve relevant evidence from Lebanese authorities and other available sources. 

• Engage with survivors, families, and witnesses while ensuring appropriate protection and confidentiality. 

• Call on the Lebanese authorities to conduct independent, impartial, and effective investigations into alleged violations. 

• Ensure that attacks against medical personnel and healthcare facilities are reflected in relevant UN reporting and accountability processes. 

• Support measures aimed at preventing further attacks against medical personnel, medical units, and ambulances and ensuring respect for their protection under IHL. 

Conclusion 

Medical personnel must be able to carry out their life-saving work without fear of being targeted. Attacks against medical teams do not only affect individual healthcare workers; they undermine the provision of healthcare and place civilians at greater risk. Lebanon must ensure that allegations of violations are promptly and independently investigated, while relevant UN mechanisms should continue documenting cases, preserving evidence, and supporting efforts to establish accountability.