Epidemiology of Microbial Diseases Department, Yale University School of Public Health, New Haven, Connecticut, USA
University of Heidelberg, Heidelberg, Germany.
BMJ Glob Health. 2024 Feb 11;9(2):e014768. doi: 10.1136/bmjgh-2023-014768.
Medical facilities are civilian objects specially protected during armed conflict by international humanitarian law (IHL). These protections are customarily applied regardless of the conflict, parties or contexts involved. Attacks on medical care have characterised the bombardment campaign of the Gaza Strip beginning 7 October 2023. This study presents evidence regarding patterns of damage to medical complexes relative to all other buildings in the first month of this conflict.
This is an observational pre/post-study of damage to buildings during the first month of the Israel Defence Force bombardment of Gaza from 7 October to 7 November 2023. Open-source polygons for the Gaza Strip were spatially joined with building damage assessments from satellite imagery analysis. Medical facilities were included in the analysis if they were cross-referenced by a minimum of two datasets. Welch's t-test was used to test for statistically significant differences in the proportions of damaged medical complexes and other buildings.
A total of 167 292 unique buildings were identified, including 106 cross-referenced medical complexes. Approximately 9% of non-medical buildings and medical complexes alike sustained damage during the first month of the bombardment (p>0.7292).
During the first month of the bombing campaign, evidence suggests medical complexes have not received special protection as required by IHL. This finding raises concerns about combatants' application of the principles of distinction, proportionality and precaution, suggesting the importance of further investigation.
医疗设施是国际人道法（IHL）在武装冲突期间特别保护的民用物体。这些保护通常适用于任何冲突、任何参与方或任何情况下。自 2023 年 10 月 7 日开始，对加沙地带的轰炸行动中就出现了针对医疗护理的攻击。本研究提供了有关在该冲突的第一个月内，相对于所有其他建筑物，医疗综合体受损模式的证据。
这是对 2023 年 10 月 7 日至 11 月 7 日期间以色列国防军轰炸加沙期间建筑物在第一个月内的损害情况进行的观察性前后研究。加沙地带的开放源多边形与卫星图像分析的建筑物损坏评估进行了空间连接。如果至少有两个数据集交叉引用了医疗设施，则将其包括在分析中。使用 Welch t 检验测试受损医疗综合体和其他建筑物的比例是否存在统计学差异。
总共确定了 167 292 个独特的建筑物，包括 106 个交叉引用的医疗综合体。大约 9%的非医疗建筑和医疗综合体在轰炸的第一个月都受到了损坏（p>0.7292）。
在轰炸行动的第一个月，有证据表明，医疗综合体没有像国际人道法所要求的那样受到特殊保护。这一发现令人关切的是，战斗人员对区分、相称性和谨慎原则的适用，这表明需要进一步调查。
