Leaked documents expose Hamas's exploitation of Gaza hospitals
Hamas also tracked UNRWA, WHO, Doctors Without Borders, and Red Cross staff inside Gaza hospitals, framing aid groups as potential intelligence threats.
Hamas has exploited hospitals and medical facilities in the Gaza Strip for military purposes for years, according to a new report published by NGO Monitor on Wednesday.
The findings are based on internal Hamas ministry documents from early 2020 that describe health institutions not as neutral civilian spaces but as assets to be used for security and military activity.
The report, In Their Own Words: Hamas Turns Hospitals into Military Assets with NGO Compliance, cites internal correspondence showing that hospitals were systematically used to shield operatives, protect sensitive information, and monitor foreign presence.
One document, titled Report on the foreign activity inside health facilities, was sent by a Hamas officer to a senior commander. A second document, Security observation over the security threats of foreign presence inside health institutions, was sent to a deputy director-general of Hamas intelligence in March 2020.
Both documents note that the Health Ministry in Gaza, which oversees hospitals, health associations, and charitable medical centers, was one of the largest government bodies. The documents described the health system as holding “plenty of important information that can be utilized in security matters” and called the Health Ministry a “treasure chest for intelligence, especially at times of war.”
They warned that extensive involvement by foreign charities and aid groups created vulnerabilities, and concluded that Hamas must maintain surveillance of international actors inside health facilities to prevent leaks and protect operatives.
NGO Monitor assessment
NGO Monitor said the documents prove Hamas leadership viewed hospitals not as protected civilian infrastructure but as part of its military network. “Hamas explicitly states that health facilities in Gaza are not neutral spaces, but instead play a critical role in Hamas’s terror network,” the report said.
The group added that the documents show Hamas’s awareness that hospitals treated wounded fighters and contained sensitive information, requiring protection from foreign intelligence services. These findings intersect with ongoing debates over humanitarian oversight in Gaza, including an Israeli defense review challenging starvation statistics issued by Gaza authorities.
“The evidence of complicity is blatant,” said Gerald Steinberg, President of NGO Monitor. “This document exposes the hypocrisy of supposedly humanitarian international organizations like the Red Cross, Doctors without Borders and the Norwegian Aid Committee (NORWAC). While repeatedly echoing Hamas allegations and condemning Israel’s operations to end the exploitation of hospitals for terror, these groups clearly knew that Hamas exploited these facilities, and chose to remain silent. To make hospitals in Gaza safe for everyone, the NGO and UN code of silence must be broken.”
“Going forward, any humanitarian NGO or UN agency given permission to operate in a medical facility must suspend all activities and report whenever terrorists are present or suspected of involvement,” added Steinberg. “The era of silent cooperation is over. Only then can these organizations be trusted to return and truly help Gaza’s patients.”
Pattern confirmed in past incidents
The findings are consistent with previous revelations about the use of medical sites during the conflict. In December 2023, The Jerusalem Post reported that the director of Kamal Adwan Hospital, Ahmad Kahlot, admitted during questioning that he had joined Hamas in 2010 and held a senior position within the group. Several months later, in October 2024, an ambulance driver from the same hospital confirmed that operatives had used the facility for military purposes.
In January 2024, the IDF uncovered a 250-meter-long tunnel system beneath Shifa Hospital, which military officials described as a Hamas command site, drawing international attention to the strategic use of Gaza’s largest medical center. Most recently, in June 2025, the IDF said a command center had been built beneath the European Hospital in Khan Yunis and released drone footage showing tunnels below the facility.
Taken together, these incidents and the 2020 documents point to a consistent strategy of using hospitals to protect operatives and infrastructure. Related reporting has examined the humanitarian landscape, including an explainer on who is sending aid to Gaza and coverage of allegations of an aid freeze in northern Gaza.
Together, these incidents and the 2020 documents show a consistent strategy of using hospitals to protect operatives and infrastructure. NGO Monitor said the records provide rare confirmation of the practice in Hamas’s own words.