The increase in hospital attacks across global conflicts should concern everyone

In the weeks of the United States and Israel’s war with Iran, Defense Secretary Pete Hegseth has made clear his disregard for international law and rules of engagement. He has referred to these standards as “stupid” and has vowed “no quarter, no mercy for our enemies.” And unsurprisingly, his rhetoric has been the backdrop to potential war crimes, including attacks on healthcare workers and facilities. 

The bombing campaigns that started in Iran and spread  into Lebanon have taken an appreciable toll on local healthcare systems. Per the World Health Organization, there have been 18 verified attacks on health care facilities in Iran that have resulted in the deaths of eight medics. Further, more than  100 Israeli strikes have resulted in the deaths of  40 medical workers in Lebanon, according to the country’s Health Ministry. And not far from the Middle East battlefield, Pakistani airstrikes in Afghanistan killed over 400 in a Kabul rehabilitation center, according to that country’s government, and 64 people died in a hospital attack in Sudan’s Darfur region, according to WHO. 

These attacks are part of a much larger war strategy that has recently taken hold in the world’s major conflict zones. In Russia’s attack on Ukraine and Israel’s attack on Gaza, a dangerous precedent was established as health care facilities and staff were targeted with impunity. And if these unlawful assaults are once again permitted to continue unchecked in Iran and Lebanon, then we risk losing not only the healers of these besieged countries, but also our common humanity.

The advent of warplanes has allowed for civilian hospitals to be targeted more frequently and ferociously. Notably, international protections would become necessary after Allied forces indiscriminately bombed German hospitals during World War II, and the U.S. utilized both napalm-filled and nuclear bombs and caused widespread civilian damage in its bombardment of Japan. 

In 1949, the Fourth Geneva Convention enshrined into international law that civilian hospitals “may in no circumstances be the object of attack, but shall at all times be respected and protected.” A 1977 amendment further bolstered protections for civilians and those requiring medical care. 

“In the case of hospitals, we have a very clear prohibition against the targeting of hospitals. Hospitals are absolutely protected unless they’ve been used to commit acts that are harmful to the enemy,” said Jessica Peake, director of the International and Comparative Law Program at UCLA. Yet, even if hospitals are used for military purposes, the law says, civilian medical staff and patients retain their legal protection. 

Despite this prohibition, attacks have continued. In 2015, America’s airstrikes against a Médecins Sans Frontières trauma hospital in Kunduz, Afghanistan, killed 42 people. The United Nations duly responded with Security Council resolution 2286 to strongly condemn the assault and to curb future wartime incidents involving medical infrastructure.

But most grisly has been the recent trend in warfare, which has left civilians cut off from access to health care. A 2025 study in the British Medical Journal found that from 2020 to 2024, the number of attacks on healthcare in many of the world’s major conflict zones — Sudan, Gaza, Lebanon, Myanmar and Ukraine — has almost tripled. Many of these attacks and the resulting injuries and deaths have occurred in Ukraine and Gaza, perpetrated by Russia and Israel, respectively. 

As Len Rubenstein, professor at Johns Hopkins Bloomberg School of Public Health, told the British Medical Journal, “This is a very disturbing trend … where highly explosive weapons are being used throughout the areas of conflict and beyond — missiles, rockets, air power, bombs — in which combatants do not distinguish between military or civilian targets, or they deliberately target hospitals and other civilian infrastructure.”