What is the true reason for the shortcomings of the medical system in the Gaza Strip?

Overview

• The Hamas movement is accompanying its fight against COVID-19 with a campaign of blaming and threatening Israel. At the core of the campaign is blame for Israel for [allegedly] destroying the medical system in the Gaza Strip, preventing it from effectively coping with the virus and endangering the lives of the two million people living in Gaza. Senior Hamas figures, among them Yahya al-Sinwar, head of the Hamas political bureau in the Gaza Strip, threatened that if a shortage of ventilators and other medical equipment develops, Hamas will use force against Israel and “make six million Israeli settlers [sic] stop breathing.”

An analysis of how Hamas has conducted itself since it took control of the Gaza Strip shows that the difficulties of Gaza’s medical system and the Gazans’ economic hardships are not the result of Israeli policies. They are the direct consequence of Hamas’ order of strategic priorities, which gives preference to military buildup at the expense of civilian considerations and needs. Hamas’ order of strategic priorities is the outcome of Hamas’ ideology, which is founded on an uncompromising struggle using violence and terrorism to achieve the destruction of the State of Israel.

• A (rare) public statement was made by Khaled Mashaal, at the time chairman of Hamas’ political bureau, about a year after Operation Cast Lead. He gave a speech at an inter-Arab conference in Damascus convened to raise money, where he said that talk about construction and reconciliation [with Fatah] were merely lip service. He said, “…outwardly, [statements in the Gaza Strip] refer to reconciliation [between Hamas and Fatah] and rebuilding, however, what is not revealed is that most of Hamas’ funds and efforts are invested in the resistance and military preparations… We are intent on the resistance…” (June 12, 2009). A study of how Hamas has conducted itself in the years since indicates that in practice, Hamas has adhered to its order of priorities to this day.

Hamas blames and threatens Israel in the shadow of the COVID-19 crisis

• Since the outbreak of the COVID-19 crisis in the Gaza Strip, senior Hamas figures and spokesmen for the Hamas administration have repeatedly pointed a finger at Israel, accusing it of responsibility for the shortage of medicine and medical equipment, and for Gaza’s insufficient medical infrastructure. They claim that the medical system is in “critical” condition because of the “[Israeli] “occupation” and “siege,” which, they claim, destroyed it. As a result, they claim, they are fighting the spread of the virus under difficult medical and humanitarian conditions, and the lives of the two million residents of Gaza are in danger.
• The blame campaign is accompanied by public threats to Israel which are liable to be put into practice if there is an outbreak of COVID-19 inside Gaza and Hamas and its medical system lose control of the situation. The main threat is that if Hamas loses control of the fight against the disease (which so far has not happened), it will make Israel supply the Gaza Strip with everything necessary to deal with the virus by using force, including rocket fire.
• Following are examples of the threats made by senior Hamas and Palestinian Islamic Jihad (PIJ) figures accompanying the COVID-19 crisis:
  • Yahya al-Sinwar, head of the Hamas political bureau in the Gaza Strip, said that “When we need ventilators, I am telling Bennet [the Israeli defense minister] that we will make six million settlers [sic] stop breathing. When our people need ventilators and medical equipment we will take what we need from you, the way protection money is taken, and you know we can do it” (Shehab agency Twitter account, April 2, 2020).

     
Yahya al-Sinwar: “…We will make six million settlers [sic] stop breathing, when our people need ventilators and medical equipment…” (Hamas website, April 2, 2020).

• Senior Hamas figure Khalil al-Haya threatened that “All options are open to Hamas to force the [Israeli] occupation to supply everything necessary to deal with the virus” (Hamas website, April 19, 2020).
• Ziyad al-Nakhalah, PIJ leader, said that Israel had to choose between going into bomb shelters on one hand and “lifting the siege” and releasing prisoners on the other (al-Aqsa, April 5, 2020).

Priority given to Hamas’ military buildup over the needs of the civilian infrastructure:

• Since Hamas came to power in the Gaza Strip there have been severe economic hardships: the civilian infrastructure has suffered (the medical system, the supply of electricity, water, sewage) and living conditions have worsened. The medical system, which now has to deal with the spread of COVID-19, has routinely functioned poorly and its resources are limited (shortages of manpower, medical equipment, medicines).

However, the source of Gaza’s economic hardships, and the fact that its medical system’s resources are limited, is not Israel. Rather, they are the function of Hamas’ order of strategic priorities, which gives preference to military buildup at the expense of civilian considerations and needs. Preferring military buildup over civilian needs did not appear out of thin air but is a function of Hamas’ fundamental ideology and strategy, which are founded on an uncompromising fight using violence and terrorism to achieve the destruction of the State of Israel.

• A clear expression of Hamas’ ideology can be found in the political document issued for the end of Khaled Mashaal’s term as chairman of Hamas’ political bureau^[1] (May 2017). Its objective was to update the ideology and basic tenets of Hamas’ 1988 charter and to adapt them to contemporary times without changing the charter. An analysis of the document showed that no change has occurred in Hamas ideology and fundamental principles, which are based on an uncompromising fight using violence and terrorism to achieve the destruction of the State of Israel, even if it is done in stages.
• Hamas’ order of strategic priorities was what determined its position in contacts for a lull arrangement with Israel that took place in Cairo (December 2019). Senior Hamas figures publicly announced that Hamas opposed a “long term lull” (ten years) which would lead to the cessation of “resistance” attacks (i.e., terrorism and violence). The lull Hamas wants is based on minimalist understandings and easing the “siege” of the Gaza Strip.^[2]
• A long-term lull arrangement, if it had been achieved, could have led to the reconstruction of the civilian infrastructure in Gaza and an improvement in its economy. However, the policies Hamas adheres to, at whose center is the continuation of terrorism and violence against Israel, forces the residents of Gaza into poverty, hardship and the absence of any genuine possibility of reconstructing the civilian infrastructure, especially the medical system.

Khaled Mashaal reveals Hamas’ true priorities

• Hamas does not publicly acknowledge its true order of priorities. One reason is that it might harm its propaganda strategy of blaming Israel and could make Hamas’ relations with the local population difficult. However, there was one exceptional occasion, about a year after Operation Cast Lead, when the reconstruction of the Gaza Strip was on the agenda. Khaled Mashaal, at the time chairman of Hamas’ political bureau, in a rare expression of sincerity, publicly expressed Hamas’ true order of priorities.
• On November 12, 2009, Khaled Mashaal met with several senior figures who participated in a conference of the Arab political parties held in Damascus. He presented Hamas’ intentions regarding its policies in the Gaza Strip. His main message was that Hamas would continue the path of “resistance” [i.e., terrorism], therefore most of its money and efforts would be given over to military preparations. The main points of his speech were the following (Filastin al-A’an website, November 12, 2009):
  • Hamas’ main effort is given to military preparations: “Outwardly, [statements in the Gaza Strip] refer to reconciliation [between Hamas and Fatah] and rebuilding, however, what is not revealed is that most of Hamas’ funds and efforts are invested in the resistance and military preparations… We are intent on the resistance.”

وفيما يتعلق بغزة، قال مشعل “ظاهر الصورة في غزة أنهم يتحدثون عن المصالحة والبناء، لكن باطن الصورة يقول إن معظم المال والجهد يذهب للمقاومة والاستعدادات العسكرية”.. مؤكدا “نحن شغالين على المقاومة”.

Khaled Mashaal’s original statement in Arabic

• Hamas has financial difficulties and needs donations to escalate the “resistance:” Khaled Mashaal urged the Arab parties to raise donations in preparation for the next stage of “resistance” [i.e., the next round of confrontation in the Gaza Strip] since Hamas is under financial “siege.” He warned against conditioning financial support for Hamas on the “resistance’s” carrying out terrorist [attacks] because, he said, “the money is invested in preparing for escalating the ‘resistance.’ “

The implementation of Hamas’ true order of priorities: from theory into practice

• Hamas’ true order of priorities, as described by Khaled Mashaal, has been put into practice to this day by allotting most of Hamas resources (funds, essential raw materials such as cement^[3] and steel) to reconstructing its military infrastructure, both before and after Operation Protective Edge (2014). Between 2014 and 2020 Hamas has significantly increased the size of its rocket arsenal; constructed an ambitious array of tunnels, which includes attack tunnels crossing the Israeli border; recruited new operatives; rehabilitated damaged units; fostered an elite unit (the nukhba) and a naval force; trained militias and improved the fighting capabilities of its security forces. While Hamas invested most of its resources in its military buildup, the civilian infrastructure, including the medical system, suffered from ongoing neglect and a lack of resources.

    
Picture from a video produced by Hamas showing Izz al-Din Qassam Brigades operatives digging a tunnel (hinting at an attack tunnel). The video shows the installation of concrete slabs (Safa, June 8, 2015). Hamas used large amounts of cement in constructing its tunnels despite the shortage in Gaza.

• On November 4, 2019, Yahya al-Sinwar, head of the Hamas political bureau in the Gaza Strip, boasted that Hamas now has a military force substantially larger than what it had during Operation Protective Edge. He said Hamas (and the other terrorist organizations) have thousands of rockets which could turn Israel’s cities into “piles of rubble and ghost towns.” He claimed there are thousands of anti-tank missiles, hundreds of tunnels, hundreds of command and control rooms and thousands of ambushes waiting for IDF forces, should Israel decide to enter the Gaza Strip. The struggle against Israel, he said, has to continue, although Hamas knows how to deal with Israel without entering into a broad military confrontation.^[4] Hamas’ significant military infrastructure, which Yahya al-Sinwar boasts about, was constructed at the expense of meeting the needs of the civilian population, including the medical system.
• To make a massive military buildup difficult for Hamas, which needs weapons and raw materials, Israel has been forced to impose strict supervision over the sea lanes and overland routes leading to the Gaza Strip. Egypt has also imposed strict supervision over the Rafah Crossing. In addition, Egypt neutralized Hamas’ extensive tunnel system leading from the Gaza Strip to the Sinai Peninsula (which in addition to smuggling were used by global jihad operatives). Hamas’ response to the control of the routes leading to Gaza was a smear campaign against Israel’s so-called “siege.” According to Yahya al-Sinwar, “breaking the siege” is its main challenge, and the demand to ease the “siege” is used as an excuse to exert controlled pressure on Israel through the return marches.

The priority of military considerations over civilian considerations: attacking the Kerem Shalom Crossing, the Gaza Strip’s lifeline

• An example of the Hamas’ priority of military considerations over civilian considerations is the endangering of the vital Kerem Shalom Crossing. The crossing is a lifeline for Gaza, and every day tens of thousands of tons of merchandise and supplies enter for the civilian population, including food, medical equipment and building materials. Pipelines also pass through it, providing gas and diesel fuel.
• Nevertheless, the Kerem Shalom Crossing was attacked twice on consecutive Fridays during return marches (May 4 and 11, 2018), when hundreds of rioters broke into the Gazan side of the crossing and vandalized vital facilities and destroyed humanitarian equipment which had been donated by foreign countries. According to the IDF spokesman, they caused millions of shekels worth of damage. One of the facilities vandalized was the fuel terminal (operations halted but later restored), gas pipes, and the main station for connecting to the gas line. Also damaged was a conveyor belt for merchandise (operations also halted but later restored) and the electric grid, fences, lighting poles and cameras (IDF spokesman, May 12, 2018). However Hamas made no significant effort to prevent the attacks on the crossing, which is vital for the civilian population.

    
Right: Rioters burn the gas pipes on the Palestinian side of the Kerem Shalom Crossing (IDF spokesman, May 12, 2018). Left: The damage done to the gas pipeline
(Facebook page of Hassan Aslih, May 12, 2018).

• Another example of the priority Hamas gives to its military considerations was the exposure of the 1.5 kilometer (0.9 miles) tunnel dug from the Rafah region to the Egyptian side of the border. The route of the tunnel crossed the border security fence into Israeli territory and passed under the Kerem Shalom Crossing near the gas and diesel fuel pipes. The IDF attacked the tunnel (January 14, 2018). An attack against Israel from the tunnel would have endangered the vital civilian activities of the Kerem Shalom Crossing and impeded the provision of energy to the Gaza Strip.

    
Right: The tunnel attacked by the IDF. Its route passed under the Kerem Shalom Crossing. Left: The route of the tunnel from the Gaza Strip through Israeli territory in the area of the Kerem Shalom Crossing (IDF spokesman’s Facebook page, January 14, 2018).

^[1] For further information, see the May 8, 2017 bulletin, "The goals and significance of Hamas’s new political document." ↑
^[2] For further information,, see the December 12, 2019 bulletin, "Hamas’s perception of the lull agreement with Israel, recently discussed in Cairo." ↑
^[3] Cement is vital for the Gaza Strip because civilians need it to rebuild their houses. For years Hamas has given priority to providing it to the Izz al-Din Qassam Brigades to construct its military infrastructure, including the tunnel project. ↑
^[4] For further information, see the November 10, 2019 bulletin, "Yahya al-Sinwar gave a belligerent speech warning Israel that Hamas and the Palestinian people would not accept the continuation of the "siege" of the Gaza Strip, saying, 'We can no longer bear it and our patience is at an end.' " ↑l

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