Beirut's Hospitals under the 1982 Siege: Shelling, Medicine Blockade and "Begin Amputations"

In the summer of 1982 the hospitals of West Beirut became another front of the siege. On one side, the Israeli occupation army cut off their water, electricity, fuel and medicine and held Red Cross shipments in the ports, until the city’s largest hospital had oxygen left for only two days. On the other, its artillery, aircraft and gunboats shelled the hospitals themselves: the Palestine Red Crescent’s Gaza and Akka hospitals, Berbir Hospital on the Green Line, the American University Hospital, and the homes for the elderly, the mentally ill and orphans. ^{[1][2][3][4][5]}

In these hospitals Palestinian and Lebanese doctors and nurses, and volunteers from around the world, worked under bombardment, operating by generator light and sometimes without anaesthetic, receiving the victims of phosphorus and cluster bombs, until amputation in Beirut’s hospitals acquired a name of its own: “Begin amputations.” This article is part of a series on the Israeli invasion of Lebanon and the 1982 siege of Beirut. ^[6][7][8]

Contents

1. The hospitals under siege at a glance
2. The first days: hospitals in the line of fire
3. “Begin amputations”: wounds of a particular kind
4. The siege of medicine
5. The hospitals under bombardment
6. The elderly, the sick and the orphans
7. After the departure: Akka Hospital
8. Differences between the accounts
9. Timeline
10. Frequently asked questions about Beirut’s hospitals under the 1982 siege

The hospitals under siege at a glance

Sources: ^{[1][9][5][4][10][7]}

The first days: hospitals in the line of fire

From 4 June, two days before the ground invasion, the hospitals were within reach of the raids: aircraft struck around Gaza Hospital, the main Palestinian emergency hospital in Sabra camp, and the Nazareth Children’s Hospital near the camp took a direct hit. A foreign witness who sheltered for three hours in Gaza Hospital’s emergency room on 5 June wrote that she saw not one soldier among the dead and wounded, only old men, women and children. ^[11][2]

That same day aircraft hit two buses carrying pupils of a UN school, killing at least 14 children and wounding many more. The hospitals of the south, limited to begin with, had been badly damaged, so the wounded poured into Beirut, where medical facilities were strained “beyond imagination,” and the Red Cross estimated at least fifteen thousand casualties awaiting treatment. In a 70-bed Palestine Red Crescent children’s hospital the incubators were full of premature babies, because constant stress had made early births common. ^[2]

In Sidon, after the city fell, the occupation arrested the doctors of the Palestine Red Crescent hospital, leaving a single doctor for 58 patients. Within ten days the PLO opened 12 new medical facilities with two thousand beds, and 75 doctors and technicians arrived to support the Lebanese Red Cross and the Palestine Red Crescent Society. ^{[12][13][14][15]}

“Begin amputations”: wounds of a particular kind

On 26 June Beirut’s hospitals were receiving huge numbers of wounded and issued urgent appeals for doctors and supplies. Berbir Hospital reported whole families killed, most of them civilians; many patients were victims of cluster bombs or burned by phosphorus, and a great number needed amputation. What came to be called “Begin amputations” spread through the hospitals, caused by high-velocity projectiles that crushed muscle and bone without breaking the skin. ^[7]

In many of the cases that reached Palestine Red Crescent hospitals, burns covered at least 80% of the body, a level at which survival is very difficult, while a single cluster bomb scattered thousands of fragments. Doctors noted that the ratio of dead to wounded had reached about one to one, instead of the usual one to five, so intense was the bombardment. Fathi Arafat, head of the Palestine Red Crescent Society, estimated the killed and wounded since 4 June at about 35,000 by 26 June. ^[8][14][7]

The siege of medicine

The occupation did not merely shell the hospitals; it besieged them. From the first week Red Cross ships loaded with supplies waited off Cyprus, barred from entering Jounieh and the other ports. On 5 July the American University Hospital had oxygen for only two days, and anaesthetics ran out, so that doctors sometimes had no time to anaesthetise the wounded. ^[2][1][6]

On 8 July the International Committee of the Red Cross was allowed into West Beirut for the first time with ambulances, medicines, blood and equipment, but its supplies in Jounieh were still held up. About 95% of the wounded treated at the American University Hospital were civilians, and its nursing staff had fallen to about half the normal level, so the university launched a $5 million appeal to save the hospital from financial collapse. ^[9]

In late July, with water and electricity cut for five days running, West Beirut’s hospitals faced acute shortages of food and water. On 30 July the occupation refused entry to some $1 million worth of US-supplied medical supplies, letting through only a shipment for the American University Hospital after Red Cross intervention. Generator fuel became a matter of life and death for operating theatres and life-support equipment. ^[10]

The hospitals under bombardment

Gaza and Akka hospitals

Gaza Hospital, overlooking the camps of Sabra and Shatila, and nearby Akka Hospital were the Palestine Red Crescent Society’s two largest hospitals in Beirut, receiving the wounded of the camps and surrounding districts of every nationality. Both were shelled again and again: occupation shells hit them in June, including on 24 June, and a neurosurgeon at Gaza Hospital said the occupation’s artillery had shelled it “deliberately.” ^[16][5]

On 30 July Gaza Hospital was shelled twice in a single day, and the International Committee of the Red Cross protested to the occupation over its artillery’s continuing attacks on hospitals, after a phosphorus shell had landed on the roof of the ICRC’s own offices, even though it had given the occupation army maps of every medical facility in the city. ^[3][17]

The Palestinian doctor Fayez Rashid worked at Gaza Hospital and at the Haik Zian school, turned into a field hospital, treating children, women, elderly people and fighters, and recorded their testimonies in his book The Wounds Bear Witness: Memoirs of a Doctor under Siege. Volunteer doctors and nurses from around the world also worked at the hospital, among them the Palestinian doctor Aziza Khalidi and the surgeon Swee Chai Ang. ^[18][16]

Berbir Hospital on the Green Line

Berbir Hospital stood on the Green Line near the Museum crossing, which made it the most heavily shelled of all. By mid-July it had been badly damaged, its corridors running with blood and its mortuary full of bodies. It was hit repeatedly until it had lost 75% of its staff by 2 August; the Lebanese doctor Amal Shamma said it was shelled from 1 to 12 August “until everything in it was destroyed,” and on 12 August it took a direct hit. ^[5][4][19]

The American University Hospital

Not even the American University Hospital, Beirut’s largest, was spared. On 4 August, the day of the Museum battle, it was hit by shrapnel and mortar fire; its staff said there was “nothing military anywhere near” the hospital and that 99% of its cases were war trauma. Its crematorium could no longer cope with the number of dead. ^[5][20]

The elderly, the sick and the orphans

On 26 June the bombardment hit the Islamic hospital that sheltered 850 elderly and mentally disabled people. Testimonies gathered by the American scholar Noam Chomsky in The Fateful Triangle say the Islamic home for the disabled was shelled again and again up to mid-August, that only 15 of its 200 staff remained, and that several disabled children there died of starvation. ^[7][5]

According to the same source, a psychiatric hospital in Beirut was hit by artillery and naval fire, including four phosphorus shells, despite the Red Cross flags flying over it, and some 800 of its patients spilled into the streets; medical staff said there was no military target within half a mile. By 4 August eight of Beirut’s nine orphanages had been destroyed by cluster and phosphorus bombs, and the ninth was hit despite the red cross painted on its roof. ^[5]

By 6 August, according to Red Cross figures, only about 130 of roughly 1,400 beds in West Beirut were still usable, and Amal Shamma spoke of 17 hospitals shelled in a single day. ^[5]

After the departure: Akka Hospital

The Palestinian hospitals kept working even after the fighters left at the end of August, and so they witnessed the massacre that followed. In September 1982, during the Sabra and Shatila massacre, carried out after the occupation army had sealed off the two camps and lit them with flares, nurses and doctors were taken from Akka Hospital and executed, while the doctors and nurses of Gaza Hospital went on treating the wounded and the survivors. ^[21][16]

Differences between the accounts

The figures in this article rest mainly on the Institute for Palestine Studies’ Palestine Chronology and on the testimony of doctors and correspondents and Red Cross figures. Some details, such as the shelling of the psychiatric hospital and the orphanages and the share of beds still available, come from the testimonies compiled by Chomsky, for which we found no independent Arab source. The occupation denied shelling the hospitals and denied the scale of casualties, as it denied holding up the Red Cross ships, while its soldiers at the checkpoints claimed the hospitals were shelled because they treated “terrorists.” ^[2][5]

Timeline

Frequently asked questions about Beirut’s hospitals under the 1982 siege

Did the occupation shell Beirut’s hospitals in 1982?

Yes: the Gaza, Akka, Berbir, American University and Nazareth children’s hospitals were shelled, along with homes for the elderly, the disabled and orphans. ^{[11][3][4][5]}

What were “Begin amputations”?

The name Beirut’s doctors gave to the amputations made common by high-velocity projectiles and cluster bombs that crushed muscle and bone. ^[7][8]

Did the occupation block medicine to Beirut?

Yes: it held up Red Cross ships, and on 30 July it blocked about $1 million of US medical supplies. ^[2][10]

What were the main Palestine Red Crescent hospitals in Beirut?

Gaza Hospital overlooking Sabra and Shatila, and nearby Akka Hospital. ^[16][21]

How much of its staff did Berbir Hospital lose?

75% by 2 August 1982, before taking a direct hit on 12 August. ^[4][19]

What happened at Akka Hospital?

During the Sabra and Shatila massacre in September 1982 nurses and doctors were taken from it and executed. ^[21]

Read also on Palestinuna

• The 1982 Israeli invasion of Lebanon
• Shatila camp
• Battles archive

Sources and references

1. Institute for Palestine Studies, Palestine Chronology, “Monday, July 5, 1982”.
2. “Beirut Under Fire,” Institute for Palestine Studies.
3. Institute for Palestine Studies, Palestine Chronology, “Saturday, July 31, 1982”.
4. Institute for Palestine Studies, Palestine Chronology, “Monday, August 2, 1982”.
5. Norman Finkelstein, “Israel Would NEVER Bomb Hospitals (Part 2),” quoting Noam Chomsky, The Fateful Triangle.
6. Justin Salhani, “Survivors of Israel’s siege of Beirut see history repeating itself in Gaza,” Al Jazeera English, 2 January 2024.
7. Institute for Palestine Studies, Palestine Chronology, “Saturday, June 26, 1982”.
8. Naim Nasser, “The 34th Anniversary of the Invasion of Lebanon and the Siege of Beirut in 1982,” Palestine Research Center, 6 May 2018 (in Arabic).
9. Institute for Palestine Studies, Palestine Chronology, “Thursday, July 8, 1982”.
10. Institute for Palestine Studies, Palestine Chronology, “Friday, July 30, 1982”.
11. Institute for Palestine Studies, Palestine Chronology, “Friday, June 4, 1982”.
12. Institute for Palestine Studies, Palestine Chronology, “Monday, June 14, 1982”.
13. Institute for Palestine Studies, Palestine Chronology, “Thursday, June 10, 1982”.
14. Institute for Palestine Studies, Palestine Chronology, “Wednesday, July 7, 1982”.
15. Institute for Palestine Studies, Palestine Chronology, “Wednesday, June 16, 1982”.
16. “Gaza Hospital: Beirut,” Witness, Al Jazeera English, 4 September 2014.
17. Institute for Palestine Studies, Palestine Chronology, “Wednesday, July 28, 1982”.
18. Fayez Rashid, The Wounds Bear Witness: Memoirs of a Doctor under Siege (Beirut 1982), Arab Scientific Publishers, 2015 (in Arabic).
19. Institute for Palestine Studies, Palestine Chronology, “Thursday, August 12, 1982”.
20. Belén Fernández, “A ‘cosmic stink’: Israel’s invasion of Lebanon, 40 years on,” Al Jazeera English, 4 June 2022 (opinion).
21. “Sabra and Shatila: A Bleeding Wound in Palestinian Memory,” Al Jazeera Encyclopedia (in Arabic).