After Gaza devastation, Israeli attacks on Lebanon's health care system feel familiar for many

SIDON, Lebanon (AP) — Two years ago, Dr. Mohammed Ziara watched Israel ravage Gaza's health care system, shelling hospitals, striking ambulances and forcing patients to evacuate.

Now Ziara — along with other medical workers, human rights groups and many civilians — warns that the same scenario is unfolding in Lebanon.

Israel is pushing deep into the southern part of the country in its campaign against the Iran-backed group Hezbollah, a powerful militant force and political party that long has exercised de facto control over much of Lebanon’s Shiite community.

To describe its strategy in this war, the Israeli military invokes the devastation it wrought in Gaza after the Hamas-led Oct. 7, 2023, attacks. Israeli warplanes dropped leaflets over Beirut last month warning that after “great success in Gaza, a new reality is coming to Lebanon, too.”

“I've lived this before,” Ziara, a burn surgeon from Gaza City, told The Associated Press on Thursday at the government hospital in the Lebanese port city of Sidon. “I cannot go back to Gaza now,” Ziara said. “But I can be here, in Lebanon.”

As it did with Hamas in Gaza, Israel accuses Hezbollah of hiding in and operating from civilian areas, and using hospitals and ambulances for military purposes. Israel has increasingly targeted first responders and medical centers, forcing several hospitals to evacuate.

“I was besieged in a hospital,” Ziara said of his work in Gaza. “I lost my brother in an airstrike. I feel what these people feel.”

An Israeli offensive threatens a health system, again

Since the war between Israel and Hezbollah reignited on March 2, Israeli airstrikes have killed at least 54 health professionals as of Sunday, according to the Lebanese health ministry.

Israel has carried out 152 attacks against emergency medical workers and ambulances, and forced the closure of six hospitals and 49 health clinics through attacks or threats, the ministry says.

In Sidon, Ziara and his team from U.K.-based nonprofit Interburns have set up the Lebanese public health system's first specialized burn unit — a critical resource in this crisis-stricken country where the war between Israel and Hezbollah has already killed 1,461 people and wounded 4,430, according to the ministry. Israel claims to have killed hundreds of Hezbollah operatives in the latest bombardment and ground invasion.

The Israeli military argues that Hezbollah’s use of medical facilities makes them legitimate military targets under international law. It does not offer evidence to support its claims.

Hezbollah denies conducting militant activities within civilian sites. Although the group's presence in residential areas is well-documented, there has been no independent verification of its use of hospitals for military purposes.

Interburns, which trains local medics in burn care around the world, began building up the unit at Sidon Government Hospital during the 2024 Israel-Hezbollah war. Lebanese authorities asked the team to return when the war reignited last month.

As the first city just north of Israel’s evacuation zone that covers nearly all southern Lebanon, Sidon takes more wounded people every day.

The rising toll of rescue work

Kamal Fakih, 27, hates when people ask him what happened on March 17.

It’s not that it pains him to recall the Israeli airstrike. It’s that he doesn’t remember anything at all. He regained consciousness a day later at the hospital in Sidon, his body burned and lacerated by shrapnel.

Once stabilized, Fakih tried to connect with the paramedic who pulled him and his friend Hassan from the burning rubble, hoping to hear his account and thank him for saving their lives. But by the time Fakih got his contact, Muhammad Tafili was already dead, killed with a fellow paramedic in an Israeli airstrike on ambulances in the southeastern village of Kfar Tebnit on March 28, according to Lebanon’s health ministry.

That same day, Israeli attacks killed seven other medics across four additional villages, the World Health Organization said. Among the dead was a medic targeted while responding to an Israeli airstrike that killed three journalists working for pro-Hezbollah TV channels. Footage of the incident shows two strikes in quick succession — the first hitting journalists in their car, the second crashing into paramedics as they rushed to the rescue.

Israel's military accused the two medics, and two of the three journalists killed, of being Hezbollah operatives. Its claim alarmed watchdogs that witnessed its similar justifications for killing more than 260 journalists and 1,700 health workers in Gaza, according to the United Nations humanitarian agency.

Although Lebanese medical workers and journalists were killed during the 2024 war with Hezbollah, “this time is different,” said Ramzi Kaiss, the Lebanon researcher at Human Rights Watch.

He pointed to a startling promise by Israeli Defense Minister Israel Katz last week that, to protect its border towns from Hezbollah rockets, Israel would flatten all the houses in southern Lebanon “in accordance with the model used in Rafah and Beit Hanoun in Gaza” — two cities that Israel almost entirely razed in its offensive against Hamas in the enclave.

“There’s a new kind of brazenness in declaring an intent to commit unlawful attacks,” Kaiss said. “It appears impunity has emboldened the Israeli military.”

Hospitals in the line of fire

Sweeping Israeli evacuation orders in recent weeks have sent over 1 million Lebanese flocking north. As the south came under heavy bombardment, clinics shuttered or suspended operations. Nabih Berri Hospital was swamped by an influx of casualties. To make room, it evacuated dozens of patients.

Such transfers involve coordination with the Lebanese army, health ministry and U.N. peacekeeping force — a game of telephone, doctors say, that creates potentially life-threatening delays. Admitting patients isn’t easy either; the Sidon burn unit must discharge a patient to free up a bed.

But the referrals keep coming, straining a health system already crippled by economic collapse.

“The health system is on its knees,” Ziara said, as the hospital was plunged into darkness until backup generators kicked in 10 minutes later, a result of Lebanon’s long-running electricity crisis. “Now front-line hospitals are lacking staff and supplies. They're overwhelmed.”

Civilians search for answers

Lebanese civilians say that Israeli bombs can come without warning and hit indiscriminately, leading to a growing feeling that Palestinians in Gaza know well — that nowhere is safe.

Mohammad Qubaisi, 53, said his neighborhood of Zuqaq al-Blat in central Beirut had not received Israeli evacuation guidance before March 18, when Israeli munitions slammed into his seventh-floor apartment.

Carrying his wife from the smoldering ruins, he shouted for his sons. His eldest, Adam, called to him. But he couldn’t hear Jad.

Qubaisi ran back into the skin-searing steam to search for his 15-year-old. When he woke up at the hospital hours later, his face raw with second-degree burns, he knew his son was gone.

The Israeli military said it was targeting Hezbollah. Qubaisi pushed back.

“These are civilian buildings, not military targets. They hit us and we still don’t know why,” he said from the Sidon hospital. “We were sleeping safely in our home, and look what happened to us.”