Last month, the world watched as a spectacle rarely seen in modern warfare unfolded in Gaza. The Israeli military tore through al-Shifa Hospital, the Gaza Strip’s main hospital, forcing the evacuation of patients and refugees as part of a siege on the medical complex that resulted in dozens of patient deaths and an untold number of additional casualties.

Israel’s months-long assault on Gaza has already resulted in more than 20,000 Palestinian deaths since Oct. 7, many of them civilians and children. Even in a conflict as brutal as the one currently unfolding in Gaza, an organized military operation against a hospital is virtually unheard of. Israel for weeks had made public its preemptive justification for an incursion into a medical establishment that is typically protected under humanitarian law — asserting that al-Shifa contained a Hamas command center within a network of tunnels and secret rooms that used patients and doctors as human shields against Israeli military action.

The Biden administration continues to back Israel’s position on the matter, and earlier this week reasserted their own claims of possessing “evidence that Hamas was operating underneath al-Shifa Hospital before Israel attacked.” On Monday, State Department spokesperson Matthew Miller told reporters in a press briefing that the U.S. remains “confident” that “Hamas was using al-Shifa as a command and control post, as it uses other civilian sites to hide terrorist infrastructure, to hide weapons, to hide fighters and ultimately to use civilians as human shields.”

Following the siege on al-Shifa, the Israeli government attempted to convince the world that the hospital held both the literal and figurative smoking guns which would prove its alleged connections to Hamas military operations. To justify such a brutal attack, one would expect there to have been clear, irrefutable evidence of Hamas’ presence and use of the complex, but aside from a handful of weapons and some paraphernalia, the findings have been lackluster. An analysis by The Washington Post of open-source materials and evidence provided by Israel in the aftermath of the attack found very little proof that the tunnels under al-Shifa led to a major Hamas command center.

It bears noting that Israel itself built some of the tunnels and rooms under al-Shifa in the 1980s, and their existence has been an open secret for decades. Following their incursion into the hospital, the Israeli Defense Forces (IDF) released footage of Israeli forces exploring the alleged network of Hamas tunnels within the medical complex. Analysis by the Post of tunnel footage, as well as maps and other materials released by the IDF, contradicted claims by Israel that several hospital buildings were connected to and could be accessed from within the tunnel network. The analysis also found that several small rooms attached to the tunnel, one of which the IDF had described as an evacuated Hamas “operational room,” contained no signs of recent use or occupancy.

A separate November analysis of IDF footage by CNN found that Israeli forces may have moved or rearranged weapons within al-Shifa Hospital before providing international news organizations access to the scene, prompting questions regarding the authenticity of the already limited findings provided by IDF forces.

Hospitals have become a primary target in Israel’s ongoing siege against the Gaza Strip. According to the World Health Organization, as of Thursday, there are no longer any functioning hospitals left in northern Gaza and only nine of the region’s major health facilities remain at least partially operational.

“WHO will keep striving to supply health facilities in northern Gaza. But without medicines and other essential needs, all patients will die slowly and painfully,” Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, said in a statement released on X. “More than ever, a humanitarian ceasefire is needed now to reinforce and restock remaining health facilities, [to] deliver medical services needed by thousands of injured people and those needing other essential care, and, above all, to stop the bloodshed and death.”