Introduction
Since October 7, 2023, Lebanon has witnessed a sharp escalation in political and military developments. Political tensions intensified in parallel with heightened military confrontations, beginning with attacks launched by the Lebanese group Hezbollah against Israel, and followed by Israeli airstrikes and ground incursions into areas in southern Lebanon. This wave of escalation culminated in a ceasefire agreement, which was last negotiated for extension on January 27, 2025. However, both parties have consistently violated the truce, with ongoing breaches and reciprocal attacks between Hezbollah forces and the Israeli army continuing up to the time of writing this report.
The latest Israeli offensives have caused extensive destruction to Lebanon's infrastructure, significantly impacting the healthcare sector. Between October 7, 2023, and February 7, 2025, the United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA) documented 161 attacks on health facilities in Lebanon, resulting in the deaths of 241 healthcare workers and injuries to 296 others. According to the World Health Organization (WHO), nearly half of these attacks claimed the life of at least one healthcare worker—marking the highest fatality rate among health workers in any armed conflict worldwide during that period.
Of the 68 Israeli strikes that directly targeted hospitals in Lebanon—primarily concentrated in the south, the west, and the capital, Beirut—eight resulted in the forced closure of medical centers, according to figures from the Lebanese Ministry of Public Health (MOPH). The southern city of Bint Jbeil emerged as the most heavily affected area. According to the United Nations Development Programme (UNDP), half of its healthcare facilities sustained damage, with three completely destroyed. An additional three medical centers were demolished in the Nabatieh Governorate. Among the destroyed institutions is Salah Ghandour Hospital, located at the entrance to Bint Jbeil, which has been bombed twice since October 2023.
This investigation delves into the twin attacks on Salah Ghandour Hospital, aiming to support ongoing justice efforts and underscore the urgent need to safeguard medical infrastructure in accordance with international law.
About the Hospital
It is the only private hospital providing health services in this border region.
Salah Ghandour Hospital is located at the entrance to Bint Jbeil, specifically at the "Saf al-Hawa" roundabout. Its geographical position is considered strategically sensitive due to its proximity to Lebanon's southern international border with Israel. According to OpenStreetMap data, the hospital is administratively affiliated with the village of Ainata, in the Bint Jbeil District of the Nabatieh Governorate. It is the only private hospital providing healthcare services in this border region.
The hospital serves residents of the Bint Jbeil District, which, according to the local municipality's figures, has a population of over 58,000—roughly 1.3% of Lebanon's total population. Bint Jbeil is one of four districts in the Nabatieh Governorate and spans an area of approximately 260 square kilometers.
Administratively, Salah Ghandour Hospital is operated by the Islamic Health Association, an entity considered part of the civil and social infrastructure linked to Hezbollah in Lebanon. The Association has been responsible for managing and operating the hospital since the Israeli withdrawal from the South in 2000, following a period during which it had been under what was known as the "Civil Administration."
The hospital includes essential medical departments such as the laboratory, emergency room, intensive care unit, radiology department, and others. Expansion plans announced in 2022 revealed the construction of a new four-story building, with each floor spanning 1,000 square meters. As part of this expansion, additional departments were opened to increase the hospital's operational capacity.
What Happened? — The First Strike
On May 27, 2024, reports began circulating on social media and in news outlets about an airstrike that targeted a motorcycle near Salah Ghandour Hospital in the city of Bint Jbeil. The strike caused damage to the hospital's façade and several rooms facing the blast site. One security guard stationed at the hospital entrance was killed.
Reviewing published content to determine the exact timing of the strike, it was found that the Israeli military had posted a video on its official website claiming to document the targeting of a "terrorist" by drone in the Ainata area of southern Lebanon. The statement was published at 11:30 a.m., indicating the attack occurred in the morning hours. The footage shows a location that matches Salah Ghandour Hospital, based on satellite imagery that will be analyzed later in this investigation.
A search on X led to the earliest report, posted at 9:58 a.m. Lebanon time by a user named @BassemDhyani, claiming that the strike had hit the entrance of Salah Ghandour Hospital.
Several other accounts, including @Lebanonsnews, shared a video from inside the hospital shortly after the strike. The footage shows smoke rising, with clear views of the hospital gate, guard booth, and surrounding trees—filmed in broad daylight. Tasnim News Agency also published two photos showing smoke plumes, while Al-Manar TV released a widely circulated image. All visuals show prominent shadows, clearly indicating both their length and direction.
An analysis by Nawa Media compared the shadow length in one of the videos with the height of the object casting it, estimating the filming time based on shadow angles and orientation. The results suggest the video was likely recorded at approximately 10:02 a.m.
Based on this time frame, it can reasonably be assumed that the airstrike occurred in the early morning hours, between the initial report at 9:58 a.m. and the shadow analysis estimate of 10:02 a.m. local time.
Geographic Location of the Strike
A review of visual content published in the aftermath of the incident reveals that the attack consisted of two separate strikes. A video shared by Al-Akhbar newspaper and another broadcast by Al-Manar TV show that the first strike targeted a motorcycle at the entrance of Salah Ghandour Hospital, while the second aimed at a car on the opposite side of the road but missed its target. We were able to verify the details presented in these videos by cross-referencing visible elements in the footage with satellite images of the site, confirming the location and sequence of the strikes.
Following a thorough visual cross-reference of the published material, we were able to determine the precise geographic location of the attack, which consisted of two separate airstrikes. The first strike targeted a motorcycle at the entrance of Salah Ghandour Hospital, located on the Tebnine–Bint Jbeil road in the Bint Jbeil district of southern Lebanon, at coordinates 33.130648, 35.430183. The second strike occurred by the hospital's roadside sign, near the Saf al-Hawa roundabout, at coordinates 33.130828, 35.429988—approximately 40 meters from the first impact site.
We further confirmed the geographic site by aligning landmarks from the Israeli army's released strike footage with available satellite imagery.
Footage broadcast by Al-Manar also documented the aftermath of the attack. According to hospital director Mohammad Suleiman, the strike injured three hospital staff members—specifically gate security personnel—as well as several civilians and patients. The hospital's outer rooms sustained structural damage. The targeted motorcycle was seen completely burned out, and the windshield of a nearby parked vehicle was shattered.
Based on circulated reports and visible damage, the strike was likely carried out by an Israeli drone targeting a motorcycle near the entrance of Salah Ghandour Hospital, close to the Saf al-Hawa roundabout in Bint Jbeil District, southern Lebanon, on the morning of May 27, 2024. The attack left the hospital's outer facilities damaged and resulted in injuries to three staff members, one of whom later succumbed to his wounds.
What Happened? — The Second Strike
Amid rising tensions in the Israeli-Lebanese conflict—and following Israel's announcement of the launch of ground operations in southern Lebanon on September 30, 2024—Israeli attacks on critical infrastructure intensified—part of a strategy aimed at weakening Hezbollah forces.
On Friday, October 4, 2024, Salah Ghandour Hospital came under a second attack, this time by artillery shelling, rendering the facility non-operational. The hospital's official Facebook page later issued a statement confirming it had been shelled in the evening, following an evacuation order. The statement also reported that nine members of the medical staff sustained serious injuries in the assault.
By analyzing the available content and timestamps related to the incident, Nawa Media identified several reports concerning the hospital on October 4. The first came from the account @akhbaralhodod [Southern Border News], which posted at 11:32 a.m. local time, claiming that an Israeli drone strike had targeted a vehicle near the hospital.
Screenshot of a post by Southern Border News on X mentioning an Israeli drone attack targeting a car near Salah Ghandour Hospital. Below: Timestamp analysis via TweetedAt tool indicating October 4, 2024, at 11:32 AM local Lebanon time.
Although various accounts later claimed that four hospitals—including Salah Ghandour—had gone out of service, these posts, published around 4:11 p.m., were not confirmed by any official hospital source at the time. Al-Manar subsequently denied the claims, stating that the hospital remained operational.
The first alert about an Israeli airstrike on the Bint Jbeil area came at 8:13 p.m. from the @kon_mowaten [Be a Citizen] account on X. Roughly half an hour later, at 8:42 p.m., the same account reported direct artillery shelling of Salah Ghandour Hospital.
Both Legal Agenda and Human Rights Watch (HRW) documented testimonies related to the incident. According to hospital director Mohammad Suleiman, the shelling occurred around 8:30 p.m. "The hospital was hit three times. One shell struck the duty room, another hit the paramedics' waiting area—both located inside the hospital," he stated.
Testimonies also revealed that at 6:00 p.m., a local official in the Bint Jbeil area received a phone call from an Israeli military officer instructing the evacuation of patients and paramedics from Salah Ghandour Hospital within a four-hour deadline. The strike reportedly took place two and a half hours after this warning was issued.
The following day, the Israeli Ministry of Defense released a statement claiming the attack targeted a "command center" located inside a mosque adjacent to the hospital. It added that prior "notices were sent to residents and conversations were held with significant parties" before the strike.
Based on the available content, the timing of the attack on Salah Ghandour Hospital can be estimated to have occurred between 6:00 p.m., when the evacuation warning was received, and 8:42 p.m., when the first report of a strike on the hospital was posted following an air raid on Bint Jbeil.
Geographic Location of the Strike
By comparing key landmarks visible in social media footage, we were able to pinpoint the exact geographic location of the attack. One recurring visual reference was the minaret of the mosque adjacent to Salah Ghandour Hospital, which appeared prominently in most of the visual materials and served as a central visual anchor for visual verification.
In a video published by Voice of Lebanon, a new visual marker reappeared—previously seen in Al-Manar's footage of the first attack: a "Bank of Beirut and the Arab Countries (BBAC)" sign located directly across from the rubble of the mosque next to Salah Ghandour Hospital. The footage also revealed the roundabout where Saf al-Hawa Road intersects with the Tebnine–Bint Jbeil road.
In a video released by Lebanon News, the camera traced a path along the Tebnine–Bint Jbeil road descending toward the roundabout in front of the hospital, then turned toward the Rmeish–Bint Jbeil road.
By comparing the camera's route in the Lebanon News video with satellite imagery on Google Maps, the exact site of the strike was identified at coordinates 33.130706, 35.429690, in the vicinity of the mosque adjacent to Salah Ghandour Hospital, along the Rmeish–Bint Jbeil road in the town of Ainata, Bint Jbeil District, Nabatieh Governorate, southern Lebanon. To verify whether the shells hit the hospital directly, as eyewitnesses claimed, we reviewed recent satellite imagery. The data confirmed extensive destruction in the area, including visible damage to the hospital building itself.
To further refine the analysis, we relied on high-resolution satellite imagery from Planet, dated October 24, 2024. These images revealed damage to the hospital's northwestern wing, strongly suggesting that a room near the mosque was hit directly. This finding aligns with the testimony of hospital director Mohammad Suleiman, who told HRW that the hospital was struck first, followed by the mosque.
A video report by Al Araby TV on YouTube captured the hospital's internal damage, including shattered windows in two medical clinics and a collapsed ceiling in one of the corridors. According to the reporter, the attack occurred in two phases: the first at around 8:00 p.m., followed by another strike at dawn, which ultimately rendered the hospital entirely out of service.
The Attacks from a Legal Perspective
International humanitarian law (IHL) establishes the legal framework governing the conduct of hostilities during armed conflicts, and grants special protection to medical facilities due to their essential role in saving lives. Within this framework, and based on the available evidence concerning the two attacks on Salah Ghandour Hospital, located at the entrance to Bint Jbeil in Lebanon's Nabatieh Governorate, it is evident that the hospital was directly targeted twice by the Israeli military.
The first attack occurred on May 27, 2024, striking the hospital's front gate and resulting in the death of one staff member and injuries to ten others, alongside structural damage to several rooms within the facility. The second strike, on October 4, 2024, injured nine medical personnel and forced the temporary closure of the hospital. The building's roof, staff rest area, and central courtyard were damaged, as confirmed by recent satellite imagery that clearly illustrates the extent of destruction.
Reports indicate that a warning to evacuate the hospital was issued roughly two and a half hours before the October 4 strike, though other accounts suggest the timeframe may have been four hours. The warning allegedly cited the presence of 'non-medical activities' within the hospital. The hospital director confirmed that the evacuation order was received around 6:00 p.m., while the strike took place at approximately 8:30 p.m.
Legal Assessment
Based on the available information, Salah Ghandour Hospital appears to have been dedicated to providing medical care, qualifying it as a civilian medical facility under Article 18 of the Fourth Geneva Convention and a civilian medical unit under Article 12 of Additional Protocol I. The presence of wounded and ill patients further reinforces its legal status as a protected facility.
Regarding Israeli claims about 'non-medical activities' inside the hospital or an alleged Hezbollah command center located in the adjacent mosque, HRW has noted that "The Israeli military did not provide public evidence that either the hospital or the mosque were being used to commit hostile acts."
Even if the claim is limited to the mosque housing a command center, the IHL imposes strict obligations to uphold the principles of distinction (targeting only military objectives while sparing civilian objects), proportionality (ensuring that any incidental harm to the hospital, its patients, and medical staff is not excessive in relation to the concrete and direct military advantage anticipated), and precaution (taking all feasible measures to minimize incidental damage, including considerations of timing, choice of weapons, and issuing effective warnings).
When assessing whether the issued warning before the attack was sufficient and reasonable—as required by Article 19 of the Fourth Geneva Convention and Article 13 of Additional Protocol I—the roughly two-and-a-half-hour timeframe cannot be considered sufficient for a full evacuation, particularly for critically ill patients. Article 19 specifies that the protection afforded to civilian hospitals ceases only if they are used to commit "acts harmful to the enemy," and only after a clear warning has been issued with a reasonable time limit that goes unheeded. The allegation of "non-medical activities" may be invoked to justify targeting the hospital under this clause, though the burden of proof lies with the attacking party.
The IHL guarantees protection for medical personnel and health facilities. The International Committee of the Red Cross (ICRC) clarifies that members of armed groups whose roles are limited to non-combatant functions—or who belong to political entities with military wings such as Hezbollah—retain protection unless they directly participate in hostilities. This includes medical personnel affiliated with Hezbollah, such as civil defense members performing strictly medical and humanitarian duties.
The analysis of the strikes on Salah Ghandour Hospital raises serious concerns about the compatibility of the attacks with the IHL rules, pointing to the possibility of violations that may amount to war crimes. The recurring pattern of Israeli allegations regarding the use of civilian infrastructure—without providing sufficient and credible evidence—is a matter of grave concern, as it may serve as a pretext for striking objects protected under the IHL.