IDF strike on Nasser Hospital: Tragic mistake or justified target?

If you try to understand the battlefield through the eyes of a prime minister or president, you'll never see it the way the soldiers do. 

Leaders weigh diplomacy, politics, and global headlines, while fighters on the ground focus only on survival. The gap between these perspectives is the stark reality of war.

In the Hamas-Israel conflict, that reality has stretched on for nearly 23 months. Soldiers have lived under relentless stress and strain. And while investigations are still underway, the deadly incident at Nasser Hospital on Monday in Khan Younis – where reports say 20 Palestinians, including five journalists, were killed – underscores this point. It may have been a mistake. It may not have been. But it is what happens in the fog of combat.

"Our soldiers do not have TVs or radios. They are focused on fighting the enemy and trying to stay alive," stressed Brig. Gen. (Res.) Amir Avivi. "They are not looking from a diplomatic perspective. They are in a different reality."

And they are also young men and women.

Most of Israel's soldiers in the field are 20-year-old commanders and young officers who can easily make mistakes. To grasp the scale of this reality, one only has to look at the percentage of soldiers killed by friendly fire in this war, Avivi told ALL ISRAEL NEWS.

The IDF recently revealed that nearly 80 of the roughly 900 soldiers killed since the Hamas massacre on October 7, 2023, were killed by friendly fire – about 9%.

Avivi also pointed to proportionality in modern warfare. Typically, a "reasonable" ratio is considered one militant killed for every five to 10 civilians. In this war, Israel's proportionality has been closer to one-to-one.

"This is unheard of," Avivi stressed. "No army can get even closer to that."

Moreover, as former British army officer Andrew Fox told ALL ISRAEL NEWS, Israel is not only fighting in one of the most densely populated urban environments in the world but also against a terror organization that blurs the lines between civilians and militants. In a standard war zone, if soldiers passed a hospital, they would not think twice. "A hospital is off bounds," Fox said. "In Gaza, anything could be a firing point."

Over the course of the war, Hamas tunnel openings and weapons caches have even been found in schools and children's bedrooms.

"These soldiers are being asked to make life and death decisions in a blurred, contested, congested environment," Fox said. "It would be difficult for anyone, especially soldiers under huge strain."

Earlier this week, Fox published an article on the Spiked website in which he detailed how the Nasser Hospital had already been discovered as a terror stronghold earlier in the war.

"It has repeatedly been abused by Palestinian militant groups," Fox said of Nasser. "In February 2024, the IDF arrested more than 100 militants inside the hospital, some of whom were directly involved in the October 7, 2023, massacre. Weeks earlier, freed Israeli hostage Sharon Aloni Cunio told CNN that hostages had been held in the hospital. In April, the hospital's own director of nursing, Mohammed Saqer, revealed in a since-deleted social-media post that Palestinian Islamic Jihad had threatened him after he reopened wards to the sick and wounded."

Mohammed Sinwar, who replaced his brother Yahya – the mastermind of the October 7 massacre – after his assassination, was himself killed by the IDF at Gaza's European Hospital in May.

According to reports in Israeli media, the IDF was targeting a man who had been monitoring them with a camera from the hospital's fourth floor, Fox also highlighted. In addition, at least six terrorists were killed in the strike, according to the army. That means that despite Prime Minister Benjamin Netanyahu's apology and U.S. President Donald Trump's immediate reprimand, the strike – now under investigation – was likely justified despite the civilian deaths.

"I think they were aiming at something," Fox said. "It might have been a Reuters live stream, maybe someone trying to film audio from the ground. If it was the latter, this was an entirely legal target."

Fox explained that it is important to understand the IDF's rules of engagement. The standard is self-defense, but soldiers may also shoot if there is perceived hostile intent in some cases.

He said the next question would be why the IDF felt tank fire – a large and damaging weapon – was the best weapon to use for what was allegedly a small target. A sniper or another precision weapon might have been more accurate and caused less damage.

"Normally, precision strikes are carried out with drones or guided munitions, not by tank shells," Fox wrote. "Whether this was a legitimate strike, an operational error, a breakdown in communication or something more sinister will need to be determined through a full investigation. Significant questions remain about proportionality and anticipated collateral damage in this strike."

Avivi agreed. The question, he said, is not whether there was a mistake but how the IDF investigates itself and ensures these things do not happen again.

"The big issue is not about having mistakes in war … it is about how you investigate them and treat them," Avivi said. "No war can have zero mistakes. But if in the end you debrief, check it, and try to do better, then you are doing what you are supposed to do."

He concurred with Fox that the lines between civilians and terrorists are blurred in Gaza and that often even journalists are either terrorists themselves or at least affiliated with the same ideology.

"The problem is the time it takes to really know what happened, and the media works fast," he added. "By the time they investigate, it is old news and the damage is done."

Avivi said what Israel should do now is work faster to finish the job in Gaza, get out, and end the war.

"In two or three months, hopefully talking about warfare in Gaza will be behind us," Avivi told ALL ISRAEL NEWS.

There is a lot of noise, he said, but if you clear the noise, things become simpler: Israel must destroy Hamas and get back its hostages. That is what it is trying to do.

"I think by the end of the year, the war in Gaza will be over and there will be a decisive win for Israel," Avivi concluded.

Until then, the battlefield remains a place of impossible choices, where young soldiers must navigate blurred lines, targets, and truths, with the eyes of the world watching every move.