Protection of Healthcare Systems under International Humanitarian Law

Abstract

The protection of healthcare facilities, personnel, and transport in armed conflicts is a fundamental requirement of International Humanitarian Law and International Human Rights Law. Despite these afforded protections, contemporary armed conflicts demonstrate an alarming rise in targeting healthcare systems. The Gaza Strip represents a significant case of repeated attacks on healthcare facilities, personnel, and transport. This study examines the legality of the Israeli Occupation attacks on the Palestinian healthcare system in the Gaza Strip between 7^th October 2023 and 30^th December 2025, relying on the principles of distinction, proportionality, and military necessity, as well as the duties of the occupying power under the Fourth Geneva Convention and the 1907 Hague Regulations.

The research employs a qualitative case study approach combining legal analysis and interpretative evaluation. It uses primary legal sources, such as the Geneva Conventions, the Hague Regulations, the Rome Statute, alongside jurisprudence from the International Court of Justice (ICJ) and the International Criminal Court (ICC), as well as reports from the United Nations. The methodology is grounded in doctrinal interpretation supported by qualitative triangulation of institutional and humanitarian sources.

The findings demonstrate substantial concerns regarding compliance with treaty-based and customary norms, including the unlawful targeting of hospitals, the killing and detention of medical personnel, the destruction of ambulances, and the obstruction of humanitarian relief. For instance, more than 90% of healthcare facilities in the Gaza Strip have been damaged or destroyed, and medical staff have been killed or arrested. These acts undermine the right to health and may amount to war crimes and crimes against humanity under the Rome Statute. The findings also demonstrate that meaningful accountability remains constrained by geopolitical barriers, selective enforcement, and structural weaknesses within international mechanisms. The study underscores the urgent need to reinforce medical neutrality, strengthen investigative and judicial processes, and ensure equal application of international law to protect health systems in armed conflict. It advances legal studies by presenting a typology of healthcare targeting and an accountability mechanism arising from armed conflict.