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The attack came without warning. At night, the Israeli strike targeted residential buildings in the Jnah area of Beirut, right next to the . By Tuesday afternoon, rescue efforts were still ongoing, with at least 18 people, including four children, confirmed dead.ĢżĢż

The Lebanese Civil Defense workers were still pulling out bodies from the rubble of which were three multi-storey buildings; the effort was ongoing all night, Saad al-Ahmar, southern district of Beirut fire and rescue commander told °®Āžµŗ. ā€œIt was a very densely populated area, with many families staying in one apartment,ā€ he added.ĢżĢż

Thirty-five-year-old Basil, who requested to go by his first name only, came to Lebanon from Syria with his family in 2011. He spoke to °®Āžµŗ at the site of the strike on Tuesday, after spending the entire night searching for any information about his uncle and his family of six, who were staying on the ground floor of one of the levelled buildings. "We left Syria to escape the war, and now this has happened to my relatives," he lamented.Ģż

ā€œWe were afraid another strike might followā€Ģż

The Rafik Hariri Hospital, which is now hosting patients evacuated from medical facilities in Dahiyeh, the heavily bombed southern suburbs of Beirut, was damaged in the attack.

The hospital's director, Dr Jihad Saadeh, announced that the hospital would not be evacuated but warned that "the damage inflicted on the hospital is severe and must be repaired as soon as possible."Ģż

Another medical facility, Sahel Hospital in Dahiyeh, was evacuated after the Israeli army claimed that Hezbollah was storing hundreds of millions in cash and gold in tunnels beneath the hospital.Ģż

For renowned British-Palestinian surgeon Dr Ghassam Abu-Sittah, now working in Beirut, the situation feels strangely familiar.

ā€œThe incident, not just targeting the area surrounding Hariri hospital, but also the whole narrative about underground tunnels under the Sahel hospital, is almost a repeat of Gaza's Al Shifa Hospital story and highlights the centrality of the destruction of the health system as the central element of Israeli military doctrine,ā€ he toldĢż°®Āžµŗ.Ģż Ģż

TheĢżĢżsaid that out of 207 primary healthcare centres and dispensaries in areas affected by the conflict, at least 100 are now closed. Fifteen hospitals were damaged due to bombardment; six are now out of service, and a further five are partially operating, according to theĢż

One such facility was the government hospital in Marjayoun, south Lebanon, which was evacuated after an airstrike targeted ambulances at its entrance on October 4.

Shoshanna Mazraani, the head of the hospitalā€™s emergency department, was standing outside having coffee at the time. ā€œI wanted to run there, but others held me back, saying it was too dangerous,ā€ she recalls. ā€œWe were afraid another strike might follow.ā€Ģż

The strike shattered the hospitalā€™s windows and doors. It wasnā€™t the first time an area nearby had been hit, but never this close, says Dr Mounes Kalakesh, the hospitalā€™s director.Ģż

ā€œWe took it as a warning that the next strike would be on the hospital, so we decided to evacuate to protect the staff until we could get reassurances that health workers would be protected,ā€ Dr Kalakesh told °®Āžµŗ. ā€œItā€™s peopleā€™s right to have a hospital in an accessible area, but the current situation doesnā€™t allow for that.ā€Ģż

Mazraani is particularly concerned about patients with chronic conditions who can no longer access their treatments. ā€œThis is a major problem because there are no medical facilities left in the area. Before the clashes, we had 67 dialysis patients, and it will now be incredibly difficult for them to reach another facility.ā€Ģż

ā€œItā€™s very clear that the total destruction of a healthcare system is now a key part of Israeli military doctrine. Israel believes that one way to make an area uninhabitable is by dismantling its health infrastructure. Thatā€™s the pattern weā€™re seeing in Lebanon, which we previously saw in Gaza,ā€ Dr Abu-Sittah added.Ģż

ā€œItā€™s an attempt to empty south Lebanon.ā€Ģż

With Lebanon suffering from a major economic crisis and shrinking public services since 2019, the healthcare system was already fragile, adds the surgeon. ā€œThere are structural problems. This is a system that is very reliant on the private sector, small and medium-sized private hospitals, and these have difficulties coping with whatā€™s about to happen.ā€Ģż

'We are civilians'ĢżĢż

The attacks donā€™t spare any emergency and rescue workers. As they intensified in the last couple of weeks, members of the Lebanese Civil Defense have adopted a new, grim routine. Between missions, smoking cigarettes, and chatting, they now instruct each other on what message to pass on to their families in case they donā€™t make it back.

ā€œAt first, we were shocked,ā€ Ghassam Zhein, the head of operations for the Lebanese Civil Defense in Ghoubeiry, tells °®Āžµŗ.

ā€œWe never expected civil defence workers and medics to become targets of strikes. In the beginning, we felt relatively safe commuting from one area to the next because, in the back of our minds, we relied on the Geneva Convention and other international agreements, which we believed would protect us.ā€Ģż

ā€œWe started getting phone calls from the Israeli enemy telling us not to intervene or we would be targeted. The calls were very specific ā€” they would tell us, ā€˜Thereā€™s your vehicle here, move it within five minutes, or youā€™ll become a targetā€™ā€

Now, as Israel's brutal war expands into Lebanon, Zhein has become disillusioned. Just a couple of days ago, he lost two colleagues during a mission in Haret Hreik, an area in Beirutā€™s southern suburbs. As firefighters were trying to put out a fire caused by a bombing, a nearby building was hit by a missile, collapsing onto the firefighting vehicle. Two of the rescuers inside were killed.Ģż

ā€œTo date, weā€™ve lost 18 civil defence workers. They were just civilians, not affiliated with any military group.ā€Ģż

According to the UN, more than Lebanese medical and emergency workers have been killed since October 8 last year; the Lebanese Public Health minister places the number over . Most of the casualties have occurred in the past several weeks, as Israelā€™s aerial campaign intensified.Ģż

First responders told °®Āžµŗ about receiving calls urging them not to carry out missions in bombed areas. ā€œWe started getting phone calls from the Israeli enemy telling us not to intervene or we would be targeted. The calls were very specific ā€” they would tell us, ā€˜Thereā€™s your vehicle here, move it within five minutes, or youā€™ll become a target,ā€™ā€ Zhein explained.Ģż

However, sometimes the warnings never come. A bombing happens, and once rescue teams arrive, the area is struck again in a sort of horrific pattern.

"When they target a place, they want to make sure that everyone there is dead, without interference from health workersā€Ģż

ā€œIt happens a lot,ā€ says Nabil Saleh, the head of the Civil Defense Training Department. ā€œI donā€™t know why they consider civil defence a target. Itā€™s well-known that our mandate is purely civilian; we donā€™t have military ranks. We are civilians, as you can see.ā€Ģż

Zhein adds, ā€œThere were times when we were heading to an area after coordinating with the Red Cross and UNIFIL, and still when we arrived, we were hit. When they target a place, they want to make sure that everyone there is dead, without interference from health workers.ā€Ģż

Relentless attacks have forced rescuers to adapt and develop new strategies for completing their missions safely. One such strategy is to wait for a period after a bombing before approaching the area, scouting it on a motorbike first to assess the risks.

ā€œWhat weā€™re doing now isnā€™t something that you would learn in first aid training. Weā€™ve had to adapt our techniques based on what we need in the field,ā€ Saleh explained to °®ĀžµŗĢżfrom his office.Ģż

of the rescuers who have been targeted belong to organisations like Al-Risala Scouts or the Islamic Health Committee (IHC), healthcare providers affiliated with the Amal Movement and Hezbollah. However, rights experts emphasise that mere affiliation with the group doesnā€™t change the protected status of paramedics under international law.Ģż

'There is fear'

Israeli army Arabic-language spokesperson Avichay Adraee posted on that Hezbollah is using ambulances to transport weapons and warned that necessary measures will be taken against any vehicle transporting gunmen, regardless of its type. However, the accusation was not supported with evidence.Ģż

ā€œThey can say whatever they want, but until now, in all the strikes on Civil Defense and other organisations working as first responders, we found no weapons, no militants, when we came to the rescue,ā€ Saleh comments.Ģż

These attacks not only put emergency workers at risk but also severely limit access to medical facilities for the local population, which is already suffering from a massive displacement crisis.Ģż

Lebanese caretaker Prime Minister Najib Mikati has called on the international community to pressure Israel to ā€œallow rescue and relief teams to reach bombed sites and allow them to moveā€ casualties.Ģż

Saleh, head of the Training Department, echoes this appeal. As he highlights, most of the Civil Defense members are volunteers, serving in more than 230 centres across the country.

ā€œWe still have all our teams on the ground, but I wonā€™t lie to you, there is fear. Itā€™s very difficult, more and more, for us to understand whatā€™s happening and how to deal with it,ā€ he admits.Ģż

ā€œWeā€™re doing very complicated work. We hope this aggression will spare first responders so they can provide aid to citizens uninvolved in military actions."

Jagoda Grondecka is an award-winning independent journalist focusing on Afghanistan and the Middle East. She is currently reporting from LebanonĢż

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