‘They are bombing them directly’: Medics in Lebanon increasingly worried about ‘double tap’ air strikes

MSF says at least 50 paramedics were killed by Israeli attacks in a single fortnight. Ambulance teams are delaying initial emergency responses to avoid getting hit in second act of ‘double-tap’ strikes

Civil defence responders on the site of an air strike in central Beirut last week. Israel’s assault on Lebanon has seen medics and first responders killed en masse. Photograph: Sally Hayden
Civil defence responders on the site of an air strike in central Beirut last week. Israel’s assault on Lebanon has seen medics and first responders killed en masse. Photograph: Sally Hayden

Mohamad Hassanen unlocks a compartment in the fire engine beside him. “No weapons,” he says, pointing to the boots, helmets and other protective clothing inside. Before this, Hassanen has opened an ambulance, which holds the flak jackets and hard helmets his medics wear for their own survival. “It would never happen that ambulances carry weapons, as a medic we know the rules,” he says.

Hassanen and his team from the Al Shifaa Association, a Lebanese healthcare-focused NGO, respond to air strikes in Beirut’s hard-hit southern suburbs. It is a dangerous job – Israel’s brutal assault on Lebanon has seen medics and first responders killed en masse. More than 100 medics and emergency workers have been killed since last October, the UN human rights office said last week – out of a total recorded death toll in Lebanon of more than 2,300 since the Israeli-Hizbullah conflict flared up in the wake of the Hamas-led attack on Israel.

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The frequency of such deaths has escalated in the past few weeks. At least 50 paramedics were killed by Israeli attacks in one recent fortnight alone, medical charity Médecins Sans Frontières (MSF) said.

The Israel Defense Forces (IDF) says it follows international law “and takes feasible precautions to mitigate civilian harm”, but it has issued multiple warnings to healthcare workers. One, posted on X on October 4th, said rescue vehicles were being exploited by Hizbullah to “transport saboteurs and combat equipment”.

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“The IDF warns of the repercussions of the continuation of this phenomenon, calling on medical teams to stay away from Hizbullah elements and not to co-operate with them,” its statement said. This could be interpreted as a threat not to respond to air strikes at all, given that Israeli forces say they are striking Hizbullah targets, though evidence shows air strikes have hit civilian homes and an Ottoman-era market, and killed civil defence emergency service volunteers inside a church, amid a growing civilian death toll.

Mohamad Hassanen, a team leader with the Al Shifaa Association, in Beirut's southern suburbs: 'We used to go directly to the bombing. Now we don’t, we wait a bit because they’ll do a second strike.' Photograph: Sally Hayden
Mohamad Hassanen, a team leader with the Al Shifaa Association, in Beirut's southern suburbs: 'We used to go directly to the bombing. Now we don’t, we wait a bit because they’ll do a second strike.' Photograph: Sally Hayden

On October 12th, IDF spokesman Avichay Adraee reiterated claims that ambulances were being used “to transport terrorists and weapons… The IDF stresses that action will be taken against any vehicle carrying armed men, regardless of its type”.

Many people in Lebanon are deeply worried that Israeli forces want to turn Lebanon into a new Gaza.

A UN commission of inquiry report, released this month, found Israel has “implemented a concerted policy to destroy the healthcare system of Gaza”, and its security forces “have deliberately killed, wounded, arrested, detained, mistreated and tortured medical personnel and targeted medical vehicles, constituting the war crimes of wilful killing and mistreatment, and the crime against humanity of extermination”. It said those actions were “collective punishment” and that Israel’s attacks occurred at a time when the hospitals and medical facilities should have been protected under international humanitarian law.

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In regard to Lebanon, World Health Organisation spokesman Christian Lindmeier said there had been 18 attacks on health facilities since September 17th alone.

The UN Office for the Co-ordination of Humanitarian Affairs said six hospitals and 40 general healthcare facilities in Lebanon had stopped operating by October 1st.

On October 10th, MSF said its staff had been forced to suspend some work in areas affected by air strikes – including Hermel, in Lebanon’s northeast; in southern Lebanon; and in Beirut’s southern suburbs. The charity said this had led to “to devastating consequences for civilians and their access to healthcare”. François Zamparini, MSF’s emergency co-ordinator in Lebanon, said a hospital in southern city Nabatieh, which MSF had planned to support, was hit by an air strike on October 5th.

Standing between the ambulance and fire engine in Beirut southern municipality, Ghobeiry, Mohamad Hassanen says there is a new Israeli threat he and his colleagues are increasingly worried about: so-called “double tap” air strikes.

“When the bombing was not so heavy we used to go directly to the bombing. Now we don’t, we wait a bit because they’ll do a second strike,” he says.

This is echoed by Riad al Aynin, director of Al Hamsharie hospital in Saida, a city 40km south of Beirut, who says he has been warning his staff about second blasts. Lawyers say “double tap” strikes are likely a war crime, given that they usually target civilian responders, rather than fighters. The IDF did not respond to a request for comment.

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Hassanen saysi the resulting delay in medical care means that some people who weren’t severely injured in an initial blast, and might have survived, die from inhaling chemical substances. Others die of shock, when they could easily have survived with proper treatment, he says.

Asked if he thinks Israel is deliberately targeting medics, Hassanen references the surveillance drones constantly humming above his city. “Israel knows everything. They are taking photos of everything. So I can’t imagine that they are not hitting first-aid teams on purpose. They are bombing them directly.”

Is Israel is also deliberately targeting civilians? “Any person not carrying weapons and in civilian clothes, it’s a civilian to me,” says Hassanen. “I can’t tell if a place was ever a military place, but they are bombing a city, a civilian city.”