A cohort of 168 Palestinian doctors have received their advanced medical certifications in Gaza amid the rubble of what was once the Palestinian territory’s largest hospital.

The graduation took place in front of the destroyed facade of the al-Shifa Medical Complex in Gaza City on Thursday. It was a symbolic act of resilience as the doctors, calling themselves the “Humanity Cohort”, completed their Palestinian Board certifications under extraordinary circumstances after two years of Israel’s war.

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The graduates had studied and sat for examinations while working nonstop inside Gaza’s hospitals during two years of starvation, displacement and genocide. Some were also injured, arrested or had family members killed.

Gaza Health Ministry official Youssef Abu al-Reish described the ceremony as graduation from “the womb of suffering, under bombardment, among rubble and rivers of blood”.

Dr Mohammed Abu Salmiya, al-Shifa’s medical director, said Israel sought to destroy Palestine’s human capital throughout its attacks on healthcare facilities, “but it failed in that”.

Dr Ahmed Basil, one of the graduates, said earning advanced degrees in the most difficult of times inside a destroyed building sent a message that Palestinians love life and remain committed to scientific advancement.

The ceremony included empty chairs displaying photographs of healthcare workers killed during the war.

‘An empty shell with human graves’

Al-Shifa Medical Complex has been repeatedly targeted since Israel’s genocidal war began in October 2023.

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The facility was invaded twice, first in November 2023, when Abu Salmiya himself was arrested and detained for seven months, and again in March 2024, when the complex suffered catastrophic destruction.

A World Health Organization assessment conducted in early April 2024 found the hospital had been reduced to what WHO Director-General Tedros Adhanom Ghebreyesus described as “an empty shell with human graves”.

The hospital has since been partially renovated but still largely lies in ruins.

The destruction of al-Shifa exemplifies a broader systematic campaign against Gaza’s healthcare system.

Of the territory’s 36 hospitals, only 18 remain even partially functional as of mid-December, with all but three field hospitals operating under severe limitations. More than 18,500 critically ill patients, including 4,000 children, require medical evacuation that remains largely inaccessible.

Hospitals attacked, medics killed

The WHO Health Cluster has documented 825 attacks on healthcare facilities since October 2023. These attacks have killed 985 people and injured approximately 2,000 others.

According to the Palestinian Ministry of Health, 1,722 healthcare workers have been killed in Israeli strikes over the past two years. An additional 306 individuals have been detained over the course of the war, many of whom have since been released, according to the WHO Health Cluster.

At least five healthcare workers have died while in detention, with other released detainees, and the corpses of people returned showing signs of torture and abuse.

The UN Human Rights Office has identified a consistent pattern in Israeli operations against hospitals. Initial air strikes and shelling, followed by ground troop sieges that prevent access, then raids employing heavy machinery, including tanks and bulldozers, mass detentions of medical staff and patients, forced evacuations, and finally withdrawal, leaving facilities non-functional.

Palestinian human rights organisation Al-Haq has documented what it characterises as the “systematic destruction” of Gaza’s healthcare system as a genocidal pattern.

According to the Gaza Ministry of Health, 70,942 Palestinians have been killed and 171,195 injured since 7 October 2023. Since a ceasefire was announced this October, 406 people have been killed and 1,118 injured, with the ministry noting that violations continue. An additional 653 bodies have been recovered from under rubble during this period.