Documents from the Hamas Ministry of Interior and National Security in Gaza, dating from 2020, have emerged that detail how the terror organization has long exploited medical facilities in the territory for military purposes.

Two documents declassified by the IDF and recently brought to public attention by the pro-Israel watchdog NGO Monitor organization detail how Hamas has used hospitals in Gaza for its own purposes, including to shelter and harbor its operatives and leaders.

Hamas’s use of hospitals has come under increasing scrutiny amid the Gaza war, with Israel facing international condemnation for operations in and around hospitals.

Hamas has fought from within hospitals and from tunnels under hospitals throughout the war, and periodically hid some of the hostages kidnapped from Israel on October 7, 2023, inside them. International law generally prohibits targeting hospitals during wartime, but hospitals can lose this protection if they are used for military purposes.

NGO Monitor argued that the ministerial documents demonstrate Hamas’s deliberate strategy of “embedding its military infrastructure, fighters, and leadership within hospitals and medical facilities in Gaza,” and“thereby violating international law and endangering civilian lives.”

In one document of Hamas’s Ministry of Interior and National Security dated February 25, 2020, the Gaza Interior Security Mechanism of the ministry stated that the Gaza Ministry of Health was one of the largest government agencies in the territory.

“These facilities are considered to be of interest to hostile security parties and an important source for intelligence gathering, especially in times of war, since these health facilities are a place of gathering for the wounded during times of escalation, and these wounded cases [i.e., people] hold sensitive positions in the resistance,” the document states.

“Furthermore, these health facilities are a place of gathering for numerous leaders of the [Hamas] movement and the government during times of escalation,” it adds.

The document also contained information testifying to the presence of Hamas’s terrorist and paramilitary forces.

It was stated in the document that the Doctors Without Borders (MSF) France organization “chose the only room in Abu Yousef El-Najar Hospital that has a (safe) communication landline which belongs to the positive’s activity, in order for MSF to work in it separately.”

According to NGO Monitor, “The positive” is a known term for Hamas’s Al-Qassam Brigades, the name of the terror group’s terrorist and paramilitary forces.

A second document, dated March 17, 2020, detailed Hamas directives for limiting access to the staff of foreign humanitarian organizations in Gaza hospitals and medical facilities to prevent them from encountering Hamas operatives.

“Do not let these associations have their own locations to work inside health facilities. When a location is allocated for these associations, it shall be outside the main building of the clinic or hospital, and far away from [Hamas] movement locations, and [only] following security authorization,” the second Ministry of Interior and National Security document states.

“Medical [Hamas] members from the Gaza Strip must join incoming delegations, whether the delegations work in hospitals or their own locations,” the document adds.

The Ministry of Interior and National Security documents also detailed how Hamas requires extensive pre-approval procedures for foreign medical organizations, and imposes ongoing surveillance of these personnel “to ensure compliance and prevent exposure of Hamas activities,” NGO Monitor said.

“The internal Hamas documents reviewed in this report expose a systematic Hamas strategy to militarize Gaza’s healthcare system, using hospitals and medical facilities as extensions of its military and security apparatus,” NGO Monitor stated.

“Medical centers in Gaza are not merely spaces of treatment, but rather they serve as hubs for Hamas leadership, gathering points for operatives, safe zones for wounded terrorists, and locations for secure communications infrastructure.

“This arrangement is fundamentally inconsistent with the principle of medical neutrality in Gaza, transforming humanitarian spaces into dual-use facilities that serve both medical and military purposes.”