It took Israel’s military several weeks and three divisions, backed by heavy air and artillery strikes, to reach and attack Gaza’s al-Shifa hospital last year.
Last week a small force of commandos and tanks, numbering little more than a brigade, about 1,000 troops, encircled the strip’s largest medical facility in a matter of hours.
Yet this second Israeli raid on al-Shifa is stretching into its ninth day — and shaping into the biggest battle of Israel’s nearly six-month war against Hamas , and one of the most revealing.
For supporters of Israel’s campaign, the raid has demonstrated the Israel Defense Forces’ determination and tactical nous, catching the enemy off-guard and striking a heavy blow.
It also underlines how the dynamics have shifted in Gaza. In November Israel moved into the strip with a nearly 100,000-strong force. Today, most have been withdrawn, the north is a largely deserted wasteland and the military’s operational focus has shifted to the south.
But to critics, the need for this second operation tells a different story: Hamas’s resilience and its fighters’ ability to regroup even in areas that Israel had previously conquered.
Few episodes in the war have brought to light more about Israel’s strategy — or have as clearly signalled what is to come in Gaza, and how far the IDF remains from achieving its objectives, former Israeli military officers and analysts say.
“This won’t be the last operation and it won’t be the decisive operation,” said Tamir Hayman, formerly the head of Israeli military intelligence. “It’s part of a sequence that will take many months until the ultimate erosion of Hamas.”
Hayman, who helped formulate Israel’s Gaza war strategy, placed the al-Shifa operation as a key feature of the third “low-intensity” phase of the campaign, which began in January.
Daniel Hagari, the IDF’s chief spokesperson, this week said the IDF had killed more militants in the second assault on al-Shifa than in any other single operation since the war began.
Some 180 militants from Hamas and the smaller Palestinian Islamic Jihad faction have been killed, according to the IDF, and more than 500 taken captive, including senior field commanders. Weapons and millions of US dollars and Jordanian dinars were also allegedly seized. Three Israeli soldiers have been killed.
The Israeli raid also forced thousands of Palestinians who had sought refuge at al-Shifa to evacuate through a checkpoint to shelters south of the hospital. Patients and medical staff were moved to a dedicated wing of the sprawling facility as Israeli special forces conducted room-to-room searches. Videos captured firefights unfolding and the use of miniature drones and bulldozers by the IDF.
An unknown number of militants remained barricaded in the maternity ward and emergency room, with others outside the complex firing mortars at the hospital and Israeli troops, according to IDF officers.
The latest raid on a hospital comes as Israel’s closest allies, including the US, rapidly lose patience with Israel’s conduct during the war. At issue is not only the vast loss of life, widespread destruction, and the deepening humanitarian crisis inside Gaza, but also the abject lack of postwar planning.
In this regard, critics contend, al-Shifa is indicative: a tactical and operational success for the Israeli military that has highlighted Hamas’s continued survival, even in areas that the IDF had previously captured.
“The fact that Israel had to go back to this place is a reflection of the fact that we have no strategy,” said Michael Milshtein, a former Israeli intelligence officer and expert on Palestinian affairs.
“If you took control of this neighbourhood in the centre of Gaza City and destroyed all the Hamas infrastructure there, how come [when] you leave those places Hamas immediately gets in to the vacuum? It means you didn’t create any new order.”
Israeli Prime Minister Benjamin Netanyahu has vowed to maintain “overall security responsibility” for Gaza well into the future, meaning such raids may become as common in the strip as they have been for years in the Palestinian cities of the occupied West Bank. Yet Netanyahu has presented no clear plan about who will administer Gaza or maintain civil order.
Still, the IDF insists the battle at al-Shifa represents its war plan in action. With just four brigades left inside Gaza, the IDF focus is on smaller, more targeted raids against the scattered remnants of the militant group’s organised fighting units.
“We planned this,” Hayman said, adding that this ongoing third phase of the war was expected to last at least through the summer, if not longer.
One senior Israeli military official claimed the troop withdrawal from the north was intended to encourage Hamas fighters to surface in a way that would make it easier for the IDF to target them. This was the opening that Hamas provided Israel at al-Shifa, the official said.
Significant pitched battles between Israeli forces and Palestinian militants had been rare since Hamas’s October 7 cross-border attack, where the group killed 1,200 people and took another 250 hostage, according to Israeli figures. Unable to match IDF firepower, Hamas fighters chose to operate in smaller cells, deploying guerrilla tactics and hiding in the group’s vast tunnel network.
Several Israeli officials said Hamas and Islamic Jihad militants had converged on al-Shifa because of both the aid available at the hospital and because they believed the IDF would not return after the international outcry during the initial raid last year.
Israel has long claimed al-Shifa sat atop an extensive tunnel network that Hamas used as a command centre. Some critics argued the infrastructure uncovered in the first operation did not meet IDF claims.
The fact that those tunnels were destroyed or blocked during the first Israeli raid helped to isolate and capture militants this time, said a second senior Israeli military official.
However, Milshtein cautioned that Hamas was a savvy foe, and would probably “learn” from the al-Shifa reversal and not allow Israel “the opportunity to repeat it” in other hospitals and locales.
The human cost for Gaza’s civilians has also been heavy. Another hospital, even partially functional, may now be damaged beyond use and the strip’s entire health system is in a state of collapse.
Describing the conditions inside al-Shifa as “utterly inhumane”, Tedros Adhanom Ghebreyesus, head of the World Health Organization, last week said nearly 150 patients and 50 health workers were being held in one building with limited food and water.
Gazan health officials said more than a dozen patients were “killed” in the intensive care unit by Israeli forces preventing medical care and supply of oxygen — adding to the 32,000 the officials say have died in Gaza since the start of the war.
The Israeli military has rejected the claims regarding al-Shifa, saying no medical staff or patients had been harmed and it was providing the hospital with food, water, medicine and electricity.
Israel continues to maintain Hamas is using Gaza’s hospitals, including al-Shifa, as command centres, turning them into legitimate military targets.
Several Israeli officials and analysts said such operations are likely only to be repeated until a new governing regime for Gaza is in place, one that Netanyahu has done little to encourage. In recent days the IDF also launched another raid at the al-Amal hospital in the southern city of Khan Younis, the second in less than two months.
“Look at al-Shifa, [the IDF] are now back. It’s like they did nothing,” said Samer Sinijlawi, a prominent Palestinian activist in East Jerusalem with close ties to Gaza. “Whenever [Israel] leaves one square kilometre Hamas rebuilds . . . someone needs to take the keys from Hamas in Gaza.”
Additional reporting by Heba Saleh in Cairo and James Shotter in Jerusalem