Dr. Hussam Abu Safiya. Image courtesy of Al Jazeera Fault Lines.

In the early hours of December 27, 2024, the walls of Kamal Adwan Hospital in northern Gaza shook as Israeli forces dropped bombs nearby. By sunrise, bulldozers had flattened the earth leading to the entrance and Israeli tanks were closing in. Snipers surrounded the complex. Inside, 350 patients, doctors, nurses and their families huddled in the hallways.

“I thought it was the last day of my life,” Abdel Moneim Al-Shrafi, a nurse in his early twenties, told Al Jazeera’s documentary program Fault Lines.

At around 6 a.m., a voice from a quadcopter hovering over the hospital summoned Dr. Hussam Abu Safiya, the acting director of the Kamal Adwan Medical Complex. His wife of more than 30 years, Albina, watched as he climbed through rubble to reach an Israeli tank a block away. “He went to them in his white coat,” she said. “He was going to them confident that he had not done anything wrong.”

A photo of Dr. Abu Safiya approaching the tank has become an iconic symbol of Israel’s merciless assault on Gaza—and of Palestinian resilience. He returned to the hospital shortly afterwards. By nightfall, Kamal Adwan had been emptied and shut down by the Israeli military. Dr. Abu Safiya and all the men inside were detained.

Dr. Abu Safiya has been in Israeli custody ever since without formal charge or trial in inhumane conditions.

That raid marked the final act in an 80-day siege on Kamal Adwan Hospital, the last standing hospital in northern Gaza. Dr. Abu Safiya became its acting director early in 2024 after its previous director was detained in another raid and the hospital was temporarily closed. “Dr. Hussam felt it was impossible not to have a hospital in the north,” said Rawiya Tanboura, 32, a nurse who had worked with him since 2019. “I think he was afraid that every person that would die in the north would die because he left.” Much of the hospital had been destroyed, but Dr. Abu Safiya reconvened what remained of its staff and reopened it.

Since October 7, 2023—the beginning of Israel’s current war on Gaza—Dr. Abu Safiya has refused to leave the north, despite having more than one chance to evacuate. With his wife originally from Kazakhstan, the family could have left, but he felt obligated to continue helping his patients—and he anticipated Israel’s plan was to completely clear the area of civilians. His eldest son, Elias, 27, recalled trying to convince him to evacuate, “He said to me, ‘The plan is much bigger than this. The plan is displacement and if we leave Kamal Adwan Hospital, the north will empty out.’”

So the Abu Safiyas, like many of the staff, moved into the hospital and lived among patients and displaced families. “To him, Gaza is his home. And there’s no way to change that,” Albina said, “The hospital was his first home and his house was his second home.”

Many of Dr. Abu Safiya’s staff felt called to the same mission as he was. “He told us, ‘Let’s keep serving to our last breath,’” Elias, his son, said. “People were saying that as long as Kamal Adwan is still standing, we’ll stay,” added Al-Shrafi, who began working as a nurse at Kamal Adwan after October 7.

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A Hospital Under Siege

By early October 2024, Israeli intelligence was contacting Dr. Abu Safiya directly. Albina recalls overhearing these calls from a Shin Bet officer who identified himself as “Captain Wael.” The message was blunt: Leave the hospital. The doctor refused. Instead, he started to film video diaries almost daily, his voice often competing with beeping machines in the ICU. In one video, he stands over a child whose body is burned. “We are appealing to the world and all international institutions," he said speaking to the camera in full scrubs, “to fulfill their humanitarian role given what is happening in northern Gaza.”

Before the war, Kamal Adwan Hospital, a hospital in Beit Lahia, was known mostly for its pediatrics and neonatal intensive care unit. When other hospitals in the area were bombed, it was deluged with patients coming in with injuries after airstrikes or artillery attacks or suffering from malnutrition due to Israel’s brutal siege. Its urban location, in between residential buildings, made it a natural shelter for hundreds of families fleeing nearby bombing.

At the same time, the north had been completely cut off. Essential supplies were blocked from entering, entire neighborhoods were razed, and famine loomed as families were told to evacuate. Of the three major hospitals in the north, Kamal Adwan, Awda, and Indonesian, only Kamal Adwan was functional enough to receive the hundreds of injured people streaming in weekly. Israeli strikes and raids had rendered the others nearly non-functional.

“They had unilaterally declared the entirety of the northern governorate a combat zone. It effectively made anyone in the area a target. This was evident by the casualties from indiscriminate bombardment and targeting by quadcopters,” said Dr. Azra Zyada, a London-based physician who was helping doctors in the north, including Dr. Abu Safiya, advocate for the protection of civilians. “By having the hospitals there, automatically you imply there are civilians there and you need to abide by international humanitarian law to ensure their protection.”

The First Interrogation

Living and working day and night at the hospital was hellish. Shrapnel flew into patient rooms. Nearby bombs interrupted surgeries. “There was no way to sleep at night. We were stressed 24-7,” Al-Shrafi recalled. Streams of patients came in, but there was never enough staff or supplies. “Some patients actually died in front of us,” Tanboura said, “they would have survived if they’d had surgery.”

On October 25, 2024 after a relentless campaign of bombardment, Israeli forces raided the hospital again. Female staff and family members were marched out and searched. Dr. Abu Safiya, along with about 44 other staff members were taken to an outpatient clinic, beaten, and interrogated. They also warned the doctor. “They told him, ‘Dr. Hussam, don’t connect with journalists,’” Albina recalled. “They didn’t want to tell the whole world what was going to happen in Gaza.”

The following day, when Dr. Abu Safiya returned from being interrogated, he found his son had been killed. Ibrahim Abu Safiya, 20, died in an airstrike while sheltering at a friend’s house nearby. “[Dr. Abu Safiya] collapsed. He was crying for six or seven hours. He didn’t stop. Because he was very very very close to his son, Ibrahim,” Al-Shrafi said. Ibrahim had plans to follow in his father’s footsteps and study medicine after the war.

The family buried him in the soil just outside the hospital. “The war is one thing, but the day he was killed…,” Albina said, “that was the hardest day of my life.” But, his family said, the loss only strengthened Dr. Abu Safiya’s resolve. He was called to surgery during his son’s funeral. “He couldn’t even take the time to grieve my brother. He took his tears with him to the operating room,” Elias said.

Later that month, as Dr. Abu Safiya was preparing for surgery, an Israeli drone known as a quadcopter attacked him in the hospital. Six shards of shrapnel tore into his leg. From a video that very same day, beads of sweat across his face, he said, “I swear this will not stop us from completing our humanitarian mission and we will continue to provide this service no matter how much it costs us.”

The Final Raid

By December 2024, the hospital was barely holding together. Staff was exhausted, medical supplies depleted, and fuel almost nonexistent. On December 27, the siege reached a brutal conclusion. Just before dawn, Israeli tanks and bulldozers encircled the hospital. Snipers took their positions. Quadcopters hovered above.

“A big tank entered and stood by reception. And it started firing. It was firing forward, firing and turning. And then they pointed the muzzle through the reception door and it was [pointing at] patients,” Tanboura recalled.

Israeli officers ordered Dr. Abu Safiya to start evacuating critical patients.“If I see anyone moving who’s not a patient, you can only blame yourself,” a soldier warned him, according to Al-Shrafi. The women were then ordered onto buses and taken to Indonesian Hospital.

Israeli military press video of the raid shows Dr. Abu Safiya responding to a soldier’s questions about whether there was anyone left inside the hospital. It would be the last known image of him as a free man.

That night, the remaining men, including both Al-Shrafi and Dr. Abu Safiya, were stripped to their underwear, shackled, blindfolded and marched into the bitter cold. “They humiliated us, they hit us…They were treating us like we were terrorists,” Al-Shrafi recalled. “We walked in a straight line, behind each other. Dr. Hussam at the front, the medical staff behind him.”

Dr. Abu Safiya at the door of an Israeli tank. Image courtesy of Al Jazeera Fault Lines.

Endless Incarceration

It wasn’t until the next day, when some of the staff and their relatives who had been detained were released and found their way to Indonesian Hospital, that Albina realized her husband had been detained and was still in Israeli custody. "What did he do to end up in prison?” Albina said. “I am very surprised and I am still in shock.”

Dr. Abu Safiya wasn’t allowed a lawyer for 47 days. When one of his lawyers, Gheed Kassem, a Palestinian human rights attorney, finally managed to see him, he was shackled, forced to kneel, and flanked by prison guards. All of their visits, which take place behind glass, are recorded on video. Kassem told us that Dr. Abu Safiya has several broken ribs, indicating he has endured repeated beatings.

Dr. Abu Safiya is being held under Israel’s Incarceration of Unlawful Combatants Law, which allows Israel to hold Palestinians from Gaza indefinitely without formal charge or due process. The law was passed during Israel’s conflict in Lebanon in 2002 to give the state a tool to detain fighters from “hostile organizations” without having to charge them formally in court or recognize them as prisoners of war*,* which is a protected status under the Geneva Conventions. Since the war started, the Knesset has introduced multiple amendments to the law including extending how long a detainee can be denied access to a lawyer, most recently up to 75 days.

The law has been applied very broadly since October 2023, essentially to any Palestinians from Gaza. According to Hamoked, an Israeli human rights organization, at least 2,600 Palestinians from Gaza are currently held under this law. One joint investigation by +972 and the Guardian revealed that the state itself only considers about a quarter of detainees from Gaza to be militants.

At least 150 healthcare workers from Gaza are still in detention in addition to Dr. Abu Safiya, according to Healthcare Workers Watch, an organization that monitors attacks on the Palestinian healthcare system. Four healthcare workers have died while in Israeli custody including Dr. Iyad al-Rantisi, the former head of Obstetrics and Gynecology at Kamal Adwan, according to Healthcare Workers Watch.

Dr. Abu Safiya spent 25 days straight in solitary detention while held at Sde Teiman Facility, according to his son Elias. Detainees released from Sde Teiman, a large military detention camp in the Negev desert, describe harsh conditions including being handcuffed and blindfolded for most of the day. “I’m seeing prisoners that are being released from there,” Albina said, “I see it all over their bodies and faces, it shows in their faces and their bodies, how they tortured them.” At Ofer Prison, where Dr. Abu Safiya is now held, former detainees report being deprived of medical care and enough food.

Hearings to decide to extend detainees’ terms are perfunctory. It happens over the phone and lasts about a minute; a judge simply announces that a detainee’s detention is extended. “The trial is a sham trial,” Gheed said.

Despite his detention, Dr. Abu Safiya continues to ask his lawyer about the health care system in the north of Gaza. The targeting of Kamal Adwan Hospital is part of a broader pattern of shutting down hospitals, often the last remaining lifeline for civilians still living in the area. Only around half of Gaza’s 36 hospitals remain partially functioning, all of them understaffed and with severe shortages of medical supplies.

“We are telling [the lawyer] to tell him that we are ok,” Albina said, “We just want him to be reassured and we just want him to know we’re ok, but we are not ok and he’s not ok either.”

This article is adapted from the documentary, “The Disappearance of Dr. Abu Safiya,” produced by Al Jazeera Fault Lines. Watch the full documentary here.

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