The Israeli military’s seizure of Al-Shifa Hospital, Gaza’s largest medical complex, is central to the military strategy at the heart of the ground invasion: Eradicate Hamas and free roughly 240 hostages taken during the Oct. 7 surprise attack.
That strategy has unfolded over the past three weeks as more than 40,000 Israeli soldiers encircled Gaza City, where Israeli officials say Hamas commanders were concentrated. The soldiers then attacked fighters and bunkers, all while targeting a vast tunnel network that Israeli officials say enables Hamas forces to hide and carry out operations. Israeli officials also assessed that striking so deeply in the heart of Gaza City would pressure Hamas to reach a deal on hostage releases.
Israel has long accused Hamas of using civilians as human shields in the densely populated Gaza Strip, and says the terrorist group positioned underground military facilities near homes, schools, mosques and hospitals throughout Gaza. Al-Shifa became Exhibit A in this narrative, as the Israeli military claimed Hamas used a vast maze of tunnels underneath the hospital as a base.
So far it is not clear that the Israeli strategy is working.
U.S. military officials said their Israeli counterparts tell them to expect more weeks of clearing operations in the north before Israel prepares a separate initiative in southern Gaza, widening the offensive.
And although the Israeli defense minister, Yoav Gallant, said in a video statement on Monday that Israel had “accelerated our activities against the tunnels” and that Hamas militants had lost control in the north and were fleeing south, military analysts said Mr. Gallant’s statements raised many questions.
How will Hamas be eliminated if its fighters blend into the rest of the population as they head south? How long can Israel, which lost about 1,200 people in the Oct. 7 atrocities, sustain growing international pressure for a cease-fire as civilian casualties in Gaza mount? Most immediately, was Al-Shifa an important enough military target to raid?
Israel blames the civilian deaths — 11,000, according to the Gaza health ministry — in part on Hamas’s decision to hide its military fortifications and command centers in residential neighborhoods and hospitals like Al-Shifa.
But U.S. officials said Israel’s rapid decision to launch ground operations in the enclave left Israeli commanders little time for extensive planning to mitigate risks to civilians and all but guaranteed a high civilian death toll.
The hospital has become a particular flashpoint. The military has yet to present public evidence of an extensive tunnel network and command center under Al-Shifa, and Israel is coming under growing international pressure to show that the hospital was a critical military objective.
On Friday, Israeli military officials said the search of the hospital would take time because of the risk of encountering Hamas members and booby traps, and that they would have to use dogs and combat engineers. The Israeli forces are advancing slowly and currently control only part of the hospital site, according to three Israeli officers. They also have avoided entering a shaft that was discovered there.
But the military claims it already has proof of at least part of an underground tunnel complex under the hospital. A video, which an Israeli official said was filmed by a camera that was lowered into the shaft by troops on Friday, and which was reviewed by The New York Times, indicates that it is a man-made tunnel, with at least one lane wide enough for the passage of people. The tunnel appears to be 50 feet or more in length, and at the end of it is a door that the official said is fortified to withstand explosives. The video shows that the door has a small porthole that, according to the Israeli official, allows one-way shooting from the other side of the door into the tunnel.
Targeting Al-Shifa Hospital was “not the result of a strategy,” said Giora Eiland, a retired major general in the Israel Defense Forces and former head of the Israeli National Security Council. “It is more an important tactical maneuver” in Israel’s attempt to control the narrative about Hamas, he said.
While Hamas commanders might have been under Al-Shifa at the start of the war, Mr. Eiland said, most of them have evacuated to the south. As a result, he said, Israel will have to evacuate civilians and target Hamas brigades there in the coming weeks and months. Mr. Eiland predicted that this might be complicated by an international community losing patience with Israel.
Yagil Levy, an expert on the Israeli military, said that attacking Al-Shifa was “a show of power and might rather than part of a clear strategy.” In doing so, Dr. Levy said, Israel might have jeopardized the hostages’ lives.
“The army didn’t take into real consideration the future or the safety of the hostages by going into Al-Shifa,” Dr. Levy said. The recovery of two corpses near Al-Shifa Hospital was a clear sign, he said, that “we are losing hostages by delaying the exchange of prisoners.”
Gen. Kenneth F. McKenzie Jr., a retired head of the U.S. military’s Central Command, said the Israeli military had achieved some of its objectives, such as suppressing Hamas rocket fire into Israel and reducing risks to its own troops. More than 55 Israeli soldiers have died in the ground operation, an indication that the Israeli army is moving cautiously on the ground while warplanes and artillery pound targets.
But General McKenzie said it was still unclear how many top Hamas leaders the Israeli military had killed. And so far, Israel’s decision to reduce parts of Gaza to rubble and kill more than 1,000 Hamas fighters has not secured a major deal to release the roughly 240 hostages, many in the vast tunnel network.
Israel began its ground invasion after Hamas and Palestinian Islamic Jihad gunmen rampaged through southern Israel on Oct. 7, killing women, children, babies and the elderly. Israeli authorities are investigating claims of rape and other brutality.
Hamas fighters used video cameras to gleefully publicize the atrocities, taking a page out of the playbook of the Islamic State, which used beheading videos to shock the world and distributed violent propaganda as a recruiting tool.
The Pentagon has rushed a steady stream of arms and ammunition to Israel in recent weeks. U.S. Special Operations forces are flying unarmed MQ-9 surveillance drones over the Gaza Strip to aid in hostage recovery efforts, but are not supporting Israeli military operations on the ground, Defense Department officials say.
Gen. Michael E. Kurilla, the head of the Pentagon’s Central Command, arrived in Israel on Friday for briefings on the ground operation in Gaza and the military plans going forward, a U.S. military official said. It is General Kurilla’s second trip to Israel since the Oct. 7 attacks. The general and his senior staff are in daily contact with members of the planning department at the Israel General Staff and other senior Israeli military officials.
In the meantime, the longer the war drags on, the more the strain on Israel’s economy grows, with 360,000 military reservists pulled away from their civilian jobs to fight.
“Time is not on Israel’s side internationally or domestically,” General McKenzie said.
That is putting pressure on the Israeli military to inflict as much damage on Hamas as quickly as possible, officials and analyst said.
“They may not need an endgame because it’ll be imposed on them,” said Jeremy Binnie, a Middle East defense specialist for Janes, a defense and open-source intelligence firm in London. “They’ll make it look like they’ve done the best military operation in the time available.”
Adam Sella contributed reporting from Tel Aviv.