Hamas has transformed Gaza’s healthcare system into a military apparatus, John Spencer, a leading international expert on urban warfare, revealed in an exclusive interview with Maariv on Monday.
Spencer also explained why IDF operations in hospitals are legal and praised the unique tactics employed by the IDF to identify terrorists posing as patients.
“My research showed that from the first day of the Israel-Hamas War, Hamas left no hospital untouched for terrorist purposes, and this has only proliferated since,” said Spencer, head of the Urban Warfare Department at the Modern War Institute (MWI) at West Point. Spencer served for 25 years as an infantry soldier, including two deployments in Iraq.
Spencer outlined the legal framework for IDF operational activities in humanitarian sites such as hospitals: “Hospitals receive special protection under international law as places of refuge. However, the law explicitly prohibits the use of hospitals to shield military objectives from attack.”
In the interview, Spencer addressed the central dilemma: “Under the laws of war in international law, if a hospital is found to be used for warfare by the enemy, one of the primary requirements is to notify the enemy in advance that if they do not vacate the hospital, the military will attack.”
However, he added, “The main problem is that after notifying the enemy of an impending attack, the enemy naturally exploits this to escape or prepare for the attack.”
Systematic use of hospitals and unique IDF tactics
Spencer detailed the extent of the phenomenon: “In almost every hospital the IDF entered, there was evidence of Hamas’s military use of the facility, which the army revealed and publicized. At Shifa Hospital, evidence was found of hostages being held, weapons and ammunition stored, and an extensive tunnel with command and control infrastructure. In other cases, Hamas operatives were documented firing from within Sheikh Hamad Hospital, while others fired rockets near Al-Quds Hospital before running inside.”
“The problem,” Spencer continued, “is that after the IDF completes its operations—making significant efforts to avoid damaging hospital structures and infrastructure—it doesn’t take long for Hamas to resume using the hospital for warfare.”
Advanced IDF tactics
Spencer noted two main tactics developed by the IDF to address this challenge: “The IDF often surrounds the hospital and calls on the terrorists to come out while simultaneously using advanced facial recognition techniques to identify Hamas operatives attempting to ‘blend in’ with civilians.”
He recounted an example: “An officer told me that Hamas operatives often try to appear as the most vulnerable patients—using wheelchairs, crutches, or carrying a sick baby.”
“I think the tactics here are unique,” Spencer stressed, adding: “The way the IDF protects innocent civilians while minimizing the number of escaping terrorists demonstrates a significant improvement in reducing harm to civilians while simultaneously targeting and apprehending Hamas members. The rapid intelligence gathering and operational execution are quite remarkable.”
Recommendations for the IDF and criticism of international media
Spencer emphasized the importance of transparency: “It is crucial for the IDF to continue showing the media the weapons found in hospitals, the names of Hamas operatives, and videos demonstrating that damage to hospitals occurred during exchanges of fire with terrorists who were previously ordered to leave.”
He also criticized international media: “Although the international media often ignores or dismisses the evidence shared by the IDF, as highlighted in the Henry Jackson Society report, it is vital that at least the Israeli public and media understand and disseminate this information.”
Spencer also criticized one-sided condemnations of international organizations and the message that they send. “The fact that the Red Cross, the World Health Organization, and the UN condemn Israel for searches in hospitals while never condemning Hamas for using hospitals in the first place is alarming. This creates a global perception that hospitals are entirely immune to military action, sending a message to terrorist organizations that using hospitals is an effective, albeit illegal, military strategy.”
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