Friday briefing: Why attacks on hospitals from Ukraine to Lebanon now happen with impunity

July 31, 2026 · War chronicles

Good morning. While you were asleep, Donald Trump claimed a deal had been reached for the “complete disarmament of Hamas” in Gaza. His announcement, characteristically, does not yet seem watertight, with briefings from both sides revealing points of contention, and as such is being treated with caution by some world leaders.

As anyone paying attention knows, the conflict has seen Israel and Hamas accused of war crimes, and two years ago, the international criminal court issued an arrest warrant for Benjamin Netanyahu. Elsewhere in the region, the Israel-US military operation in Iran has been repeatedly declared as “illegal”. That label now feels almost obsolete on the global stage, as laws are ignored, norms tossed aside, and multinational institutions degraded.

Cynics might suggest nothing new here; that the international rules-based order has always been illusory, wielded by the powerful to be followed (and disregarded) at will, to suit self-serving whims and ambitions. But even the mirage appears to have faded. And nowhere is this more acutely felt than in conflict zones, by those who are unwell or injured – and the healthcare workers treating them, in particular.

For today’s First Edition, we ask how this deathly reality came to be. Beirut-based Guardian reporter William Christou reflects on Israel’s ongoing campaign of attacks on Lebanese healthcare workers, and we ask Natasha Sax – a legal expert with Médecins Sans Frontières (MSF), who has worked in Gaza, Iraq and Lebanon – why international law is failing. Before that, today’s top stories.

Five big stories

England news | Hundreds of people have been evacuated and a major incident declared after a wildfire spread over more than 80 hectares (200 acres) on the coast of Suffolk, just a few miles from the Sizewell B nuclear power station.
UK politics | Labour has accused Reform UK of being “up to its neck in sleaze” as it called on the Electoral Commission to urgently investigate substantial donations made to the party by the mother of a convicted fraudster.
Middle East | Donald Trump has said a deal has been reached for Hamas to disarm and for Israel to withdraw its forces from Gaza, however briefings from both sides exposed disputes over its implementation that could prove difficult to overcome.
Europe | The Spanish government is deploying extra troops and police officers to its north African enclave of Ceuta after thousands of people swam and waded into the tiny territory from neighbouring Morocco in a matter of hours.
UK news | The co-founder of Palestine Action has won permission to challenge the ban against the group at the UK’s highest court.

In depth: ‘When international agencies withdraw, local medics remain’

Palestine tops the list of countries with the most healthcare workers killed in the past five years. There, Israel’s relentless attacks on Gaza’s medical infrastructure are well documented. Lebanon ranks second, with 569. It’s a subject William has covered extensively, his latest report turning to the psychological impact on medics and their families.

Countries with the most healthcare workers killed since 2021

During the last two wars in Lebanon, William tells me, Israel’s targeting of healthcare workers has been “consistent”. Since fighting escalated again this March, at least 135 Lebanese medics have been killed, with nearly 400 others injured. Including the last war in 2024, the death toll is close to 400.

Particularly common are “double-taps”: Israel striking a target, waiting for paramedics to arrive, then striking again. “In April there was a quadruple tap,” William says. In Mayfadoun, southern Lebanon, paramedics responded to the injured after an Israeli airstrike. “That team was hit,” says William. “Another team went out. They were also hit. Another crew went: hit, again.” Four medics were killed, and six wounded.

Southern Lebanon has borne the brunt, where Israel has been conducting what UN-appointed human rights experts describe as forced displacement. “The way healthcare officials put it to me,” William says, “is that it’s an attempt to degrade the ability to sustain life in these areas, similar to what’s been seen in Gaza, so the population leaves for ever.”

When international agencies withdraw, local medics remain long after.

“They stay, knowing the risk of death,” says William. “Some die, others watch their colleagues be killed.” A group of medics he met attempted to figure out the criteria Israel uses to target them. “It was impossible, so they gave up eventually.”

Many of them are unpaid. “One man I spoke to recently said that after the 2024 war, he promised he’d never do it again. But this time, he couldn’t stop himself from volunteering. There’s a sense of duty to their communities.”

William remembers many of their stories. There’s Hafez Yahya, a civil defence medic killed by an Israeli drone strike in May. He’d been a volunteer for 25 years. “I also met Mohammed Suleiman,” says William, “whose 16-year-old son Joud was one of three paramedics killed by an Israeli drone strike in March while bringing food to people in Nabatieh.”

They were wearing paramedic uniforms. It’s inconceivable.

Countries with most attacks on healthcare

Just 10 years ago, the United Nations security council condemned the “prevailing impunity” for attacks on medics, hospitals and other healthcare facilities in conflicts, urging they not “remain unpunished”. A decade on, the situation has deteriorated. Hospitals and medics are under attack; in Ukraine, in Sudan, in Gaza, in Lebanon, in Myanmar and far beyond in unprecedented numbers.

I ask Natasha Sax if these attacks are the result of gaps in international law. “Not at all,” she tells me. Healthcare in conflict zones is governed by international humanitarian law (IHL), “one of the most comprehensive and densely codified bodies of law anywhere”.

The legal framework for protecting hospitals, medical workers and ambulances is set out in the Geneva conventions, signed in 1949 by every internationally recognised state in the wake of the second world war. “Such universal agreement is basically unheard of in international law,” says Natasha. “The issue is a lack of will to implement it.”

Enshrined in law

IHL is clear: medical units such as hospitals and pharmacies – their patients, too – have special legal status. Parties have a duty to respect (not attack or actively harm) and protect: a positive obligation to ensure they can function. On the ground, Natasha says, this simply isn’t happening. “Mass displacement orders stopping access, local water and sewage systems destroyed, besieging, raiding and turning hospitals to rubble? We see all of this today – clear violations.”

There are narrow exceptions to these rules. Even then, harm to civilians and infrastructure must be proportional to military advantage gained; the impact on patients (present and future) must be considered. Evacuation warnings are a must, weapons and methods that minimise harm … the list continues.

All of this, Natasha says, is ignored today with alarming regularity. She points to Gaza. Here, half of hospitals are totally non-functional, the remaining 18 only operating partially. The consequences for the civilian population are both present and future.

Medical personnel are covered by IHL too: entitled to work, protected from acting against medical ethics, or punishment for providing assistance. The law dictates everyone is entitled to healthcare in conflict zones, whether civilian or previously fighting: in a medic’s care, all are patients. “IHL guarantees the workers who treat them are protected. Except, in many conflicts, we are seeing them killed, arrested, detained and persecuted.”

This is no accident

In the last 10 years, MSF recorded 255 security incidents, of which 107 took place in medical facilities. These increases are reflected in wider WHO data. Globally, incidents have more than doubled since 2021.

In 2015, a deadly US attack on an MSF trauma centre in Kunduz, Afghanistan killed 42 people. Simultaneously, medics were systematically targeted in Yemen and Syria. States strongly denounced the situation, with UN Resolution 2286 (pdf) unanimously passing one year later. “But we have not seen change materialise,” says Natasha. “More than that, we once had condemnation, now we have normalisation. It’s almost on a daily basis that healthcare is attacked. There is no outcry. The silence is shocking.”

Infrastructure for accountability already exists. At the domestic level, states are obliged to ensure their military complies with IHL. There’s the international humanitarian fact-finding commission – a Geneva-based investigative body, founded in 1991 – that can perform investigations of possible breaches. “We call it the sleeping beauty, as it’s so under utilised,” says Natasha. To date, it has launched investigations into just two localised incidents. And there’s always the international criminal court for prosecutions, if states were willing.

“People want to think a new treaty or law will fix things,” says Natasha. Except, there is no need: protections for patients and medics are clear, enforceable and bind us all … at least on paper. “But they’re being manipulated, misused, cynically interrupted or wilfully ignored with near total impunity,” she says. “The law seems to have turned into a suggestion, rather than a binding framework.”

Modern warfare technology allows militaries to operate with precision – assaults are rarely indiscriminate. These attacks, therefore, appear more than incidental. “When we see these patterns,” says Natasha, “it raises the question: is it reckless negligence, or an intentional strategy to deny certain populations of healthcare?”

What else we’ve been enjoying

Accustomed as we’ve become to the slurry of awful post-Brexit immigration horror stories, reading about the couple stuck in Kraków after living in UK for 80 years still got me. Michael
Aditya Chakrabortty is asking the real questions in his video on whether British graduates are being conned. As someone whose profession bears no relation to my degree, I’ve often wondered this. Micha Frazer-Carroll, newsletters team
As a fan of top food-guy Jimi Famurewa (and having edited his restaurant reviews in a previous life), I’ve been looking forward to his new video series, Feed. The first, on third culture bakeries, doesn’t disappoint. Michael
I loved this piece by Eromo Egbejule exploring why artists are flocking to the tranquil city of Grand Bassam, Côte d’Ivoire. Creatives are trading spiralling rents for fresher food, cheaper markets and scenic beachfronts. Micha
The wildfires spreading through Europe are terrifying. This visual guide offers a clear, engaging need-to-know outline of the scale of the emergency. Be warned: it’s confronting. Michael

Sport

Commonwealth Games | Emily Campbell set a new Commonwealth record in +86kg final, before revealing she will be appearing on Celebrity MasterChef next month.

Football | Fifa has responded to the threat of boycott from European nations with a statement saying that “nobody is selling football”, while blaming the media for disrupting its consultation process over controversial plans to sell chunks of the World Cup to US-based private investment.

Football | London City Lionesses will kick off the new Women’s Super League season against Manchester United on Friday 4 September.

Something for the weekend

Our critics’ roundup of the best things to watch, read, play and listen to right now

Music
Shaboozey: The Outlaw Cherie Lee & Other Western Tales | ★★★★☆
It’s fair to say that if Shaboozey never released another note of music, his place in history would still be assured. He wasn’t the only Black country-leaning artist brought to a wider audience by a guest appearance on Beyoncé’s 2024 album Cowboy Carter, but no one else capitalised on the exposure quite so remarkably. As a demonstration of his eclecticism, The Outlaw Cherie Lee works well. The pop-facing tracks hit, the strike rate when he diversifies is higher than his naysayers would suggest, and there’s an impressive boldness about his evident desire to draw R&B, soul and hip-hop artists into his world. The overarching storyline is tight and well handled. Perhaps most importantly, the album never feels like the work of an artist whose career has been destabilised by a huge, unexpected and unrepeatable hit, but rather the work of an artist digging in for the long haul. Alexis Petridis

TV
Jared Leto: Hollywood’s Dark Secret | ★★★★★
Jared Leto has long been a person with something of a reputational issue. The public-facing side of this was bad enough, but for years there have been upsetting rumours about what he does in private. After a lengthy investigation, this BBC documentary has finally brought at least some of them to light. This is, as you might imagine, not a fun thing to watch. The film documents allegations of what are said to be decades of systematic criminal misconduct against teenage girls. What is particularly galling about Hollywood’s Dark Secret is that this is not the first time someone has tried to investigate these claims. Maybe the floodgates will finally open. Stuart Heritage

Film
Spider-Man: Brand New Day | ★★★☆☆
Just a few weeks ago, Tom Holland was telling us that his role as Telemachus in Christopher Nolan’s Odyssey was his “last chance to play a boy”. Well, Holland is back as the supposedly scrappy, gawky, arachnid young superhero Spider-Man. Zendaya saves this film, rescuing it from silliness and the generic deja vu overfamiliarity that is always threatening to sink it. Something in MJ’s civilian status, her non-superhero identity, brings Zendaya’s grownup acting presence to the fore in ways denied to everyone else on screen, including Holland. It’s an entertaining spectacle, but really without the novelty of movie-iterations like the more experimental Spider-Verse animations. A more radical reboot is needed. Peter Bradshaw

Game
Halo: Campaign Evolved (PC, Xbox, PS5) | ★★★★☆
I had my misgivings after the opening level of this 25th-anniversary remake of Xbox’s most iconic shooter, in which the freshly defrosted supersoldier Master Chief fends off an alien attack on a disintegrating spaceship. After that, however, I spent much less time thinking about what has been changed, and much more thinking about what hasn’t. Nobody really makes single-player shooters like Halo any more: tense, adaptable, challenging. Halo: Campaign Evolved reminded me what we’ve been missing. It is a good remake of a brilliant game. For millions of younger players, it is a perfect, modernised introduction to everything that was great about the 00s-style first-person shooter. For those of us who were there at the time, it’s a welcome return trip. Keza Macdonald

The front pages

“Reform is ‘up to its neck in sleaze’, says Labour as it calls for inquiry”, is the Guardian’s front page today.

“Uefa backs World Cup boycott”, is the Times’ front page, the Sun says “Football’s staying home”, and the i Paper writes “Game changer: Europe tackles Infantino by boycotting the World Cup”. The Express also goes with “England join boycott of World Cup” while the Mirror’s take is “Red card for Infantino”.

Elsewhere, the Mail says “Burnham admits oil drilling can ease cost of living”, the Telegraph writes “Labour’s £18bn council raid”, and the FT has “BoE holds rates steady but sees risks ahead if war drags on”. Lastly, Metro, on the heatwave, splashes “Cruel summer”.

The Latest

US-Iran strikes risk regional war in Middle East

The US military has carried out a wave of airstrikes against Iran in response to Tehran targeting American bases in Jordan. The strikes were launched after Donald Trump vowed to hit Iran “very hard” following a days-long pause in fighting. Iran has expanded its military strikes in the region, raising fears of an all-out war. Lucy Hough speaks to Guardian senior international reporter, Peter Beaumount.

Cartoon of the day | Ben Jennings

The Upside

A bit of good news to remind you that the world’s not all bad

In what they hope will prove a spectacular feat of memory, this weekend the Aurora Orchestra will attempt to perform Mahler’s (almost hour long) First symphony entirely by heart. For the musicians, it’s exhilarating – and for those listening, they hope, it’ll be transformative.

Twelve years ago, the orchestra attempted a similar feat with Mozart’s 40th. This weekend’s piece is almost twice as long, and requires double the number of musicians.

“I want to find ways to give audiences the same breathtaking experience I have,” says artistic director Jane Mitchell.

Sign up here for a weekly roundup of The Upside, sent to you every Sunday

Bored at work?

And finally, the Guardian’s puzzles are here to keep you entertained throughout the day. Until tomorrow.