Paramedic Abbas Hijazi stood over a puddle of blood, gesturing towards what used to be the entrance of a healthcare centre in the southern Lebanon. On Friday, he had greeted his friend, Hussein, who was washing blood off the stairs leading up to the clinic.
“The next time I saw him – two hours later – he was already dead,” he told The National.
Mr Hijazi was nearby when an Israeli strike on the Islamic Health Authority centre in the town of Burj Qalawiya killed everyone inside. He was among the first responders at the scene, hoping to find survivors. He found only body parts and corpses, their faces so charred he could not recognise his friends.
“It was 100 per cent a deliberate hit,” he said. “The building caught on fire. The Lebanese Civil Defence and the army came and helped us put the fire out. Some of them put out the fire and the rest filled the body bags.”
The attack killed all 12 of his colleagues. The four-storey health centre was reduced to rubble. It took rescuers until Sunday to find all the bodies.
It was the deadliest Israeli attack against medical staff since the war between Hezbollah and Israel restarted on March 2. Two other health workers died on the same day in another strike.
In less than two weeks, Israeli strikes have killed more than 850 people, including 32 medical staff.
In recent days, Israel has expanded its military campaign in Lebanon to strike infrastructure and civilian areas beyond those where Hezbollah traditionally has influence.
“There is a clear pattern, reflecting the general recklessness the Israeli military has shown towards the protections afforded under international humanitarian law,” Ramzi Kaiss, Lebanon researcher at Human Rights Watch, told The National.
“The fact that the number of health workers killed is rapidly increasing is deeply concerning. Nearly half of the health workers killed so far died in a single day."
The force of the strike in Burj Qalawiya flung two paramedics into the street, killing them instantly, according to Ali Shim, a rescue worker who was at the site within three minutes. “We found a third body at the entrance. And the rest were inside,” he said.
The attack drew widespread condemnation from the Lebanese government and the international community. Israel had already killed at least 163 medical staff in Lebanon during the 2023-2024 conflict with Hezbollah. In 2024, HRW said Israel's repeated attacks on medical workers and healthcare facilities in Lebanon might amount to war crimes.
The Islamic Health Authority is a civil defence and ambulance association affiliated with Hezbollah, which co-ordinates with Lebanese authorities and other ambulance teams to carry out rescue missions. In Lebanon, it is not uncommon for local civil defence groups to be affiliated with various political entities – particularly in areas where the Red Cross or Lebanese Civil Defence have difficulty operating due to the intense bombing.
The health centre in Burj Qalawiya served six villages and was one of the few operating in an area where state civil defence centres are rare. In wartime, its paramedics, many of them volunteers, rescue the injured and retrieve bodies from the rubble.
“We’re needed here,” said Wassim, another paramedic who was forced to look for the bodies of his colleagues amid the destruction. Since the attack, the centre's paramedics have been sleeping in parked ambulances, he said. “We will never leave.”
'Only medical supplies'
Rescue and healthcare workers are protected under international law, regardless of political affiliation.
“The patterns we are seeing now are eerily similar to those documented in 2024, when paramedics were targeted at civil defence centres, in ambulances and in hospitals. In those cases, we concluded that the attacks were apparent war crimes,” Mr Kaiss said.
The Israeli army claimed that Hezbollah's fighters were using ambulances and medical centres for military purposes. “In the attacks we investigated in 2024, however, we did not find any evidence indicating use of facilities for military purposes that would justify attacking them,” Mr Kaiss added.
After the 12 paramedics were killed in Burj Qalawiya, Israeli army spokesman Col Avichay Adraee said that the army would continue to attack “military activity carried out by the terrorist group Hezbollah using these facilities and ambulances".
Col Adraee spoke less than a week after the Israeli special forces, disguised in army fatigues, used ambulances resembling those of the Islamic Health Authority to raid a village in the Bekaa valley, according to the Lebanese army. In January 2024, security cameras captured how Israeli troops disguised as doctors and nurses killed three Palestinian suspects in a raid on a hospital in the city of Jenin, in the Israeli-occupied West Bank.
There have been no documented instances of Hezbollah using medical centres or ambulances for military purposes, nor has Israel provided evidence of such incidents.
But independent verification is difficult. Hezbollah, notoriously secretive and controlling, restricts media from entering southern Lebanon without permission. The group allowed foreign media to visit the destroyed medical centre.
All first responders interviewed by The National dismissed Israeli claims that their healthcare centres or ambulances were being used for military activity. “The Israeli army is known for something: when it does not have military targets, it starts with civilians,” Mr Hijazi said.
“We have only bandages, heaters and medical supplies”, the paramedic named Wassim said, standing amid the rubble where boxes of medicine and administration papers mixed with the debris.
As The National spoke to the first responders, the sound of not-so-distant combat could be heard – the echo of rockets fired from one side and artillery from the other. Soon, sirens of the UN peacekeeping force Unifil went off, warning of an impending attack.
A Hezbollah source told The National that the militant group has its own military health centre and that the Islamic Health Authority does not treat its fighters. The National could not verify the claim. According to international humanitarian law, treating military personnel does not make medics a military target.
Rescuers, who said they have seen harrowing scenes countless times, have long lost hope of one day seeing Israel held to account. “I’ve picked up my friends from the rubble, what do you want me to tell you? We’re used to it; it’s not the first or the last time”, Mr Hijazi said.
