Hamas has not merely blurred the lines between its guerrilla operations and Gaza’s healthcare system—it has systematically erased them. Internal memos from Hamas’s own Ministry of Interior and National Security (MoINS) — declassified by the IDF and analyzed by NGO Monitor — expose a deliberate strategy: transforming hospitals into nodes in a vast terror infrastructure. The February and March 2020 documents, originating from the Gaza Interior Security Mechanism (ISM), reveal a chilling blueprint for militarizing healthcare settings under the guise of humanitarian care, and cast NGO actors in Gaza in a far more troubling light.

“Safe” houses are not what they seem

The documents, dated early 2020 and uncovered over the course of the current Gaza war, specify that hospitals in the coastal enclave are anything but neutral. They are strategic command centers serving multiple terror-related functions:

• Gathering points during escalations for wounded fighters who “hold sensitive positions.”
• Meeting venues for senior Hamas commanders and ministers.
• Safe zones for secure communications and coordination.

The ISM even remarks with pride that the International Committee of the Red Cross operates within Al-Shifa Hospital in a wing adjacent to Hamas offices, and that Doctors Without Borders (MSF) chose a room linked to Hamas’s encrypted communications network. These hospitals were not accidental shelters—they were prearranged operational hubs.

NGOs: Coerced or complicit?

The revelations don’t spare humanitarian actors. Hamas enforced tight controls:

• Movement restrictions, requiring NGOs to work in pre-approved areas distant from militarized zones.
• Staff vetting, with NGO teams submitting CVs and operational proposals in advance.
• Physical surveillance, with Hamas security personnel accompanying NGO workers.

Despite this oversight, NGOs continued to present Gaza hospitals as neutral zones and publicly condemned Israeli strikes—even as they, by presence or omission, concealed Hamas’s internal militarization.

A humanitarian front, militarized

Hamas’s internal strategy reveals a grotesque perversion of medical neutrality—hospitals are weaponized to shield militants, as well as strategic assets for command, intelligence, and logistics. NGOs, under enforced terms or ideological pressure, risk becoming enablers of that system. Their public denunciations of Israeli strikes—absent disclosure of Hamas’s own violations—contribute to a misleading narrative that hampers meaningful accountability and undermines both humanitarian and legal norms.

If hospitals cannot remain sanctuaries of compassion, they become contested symbols in a brutal war of narratives. Honest reporting, candid NGO disclosure, and transparent investigation are not optional—they are imperative.

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