62 Casualties Before Noon: Inside Nabatiyeh's Hospitals Under Siege

Since the morning of June 19, doctors at Najdeh Al-Shaabiyeh hospital in Nabatiyeh, southern Lebanon, had taken in 25 dead and 37 wounded, many in critical condition, before the day was half over. "Our team is responding to an influx of patients of all ages, including paramedics wounded during rescue missions," said Pierre Boulet-Desbareau, an emergency coordinator with Médecins Sans Frontières (MSF), describing people arriving with severe head injuries, heavy bleeding, shrapnel wounds, and traumatic amputations, while others remained trapped under rubble as bombardment continued. Lebanon's Ministry of Public Health put the toll across Nabatiyeh governorate at more than 50 killed and at least 97 wounded that day alone, with the number rising by the hour.

The attacks landed despite a ceasefire that has technically been in place since the war's last major escalation. Lebanese media and first responders counted at least 27 people killed and 26 wounded in strikes on the Nabatiyeh region the same weekend, with Israeli aircraft, drones, and artillery hitting residential buildings before dawn. Across the wider 48-hour window, Lebanon's health ministry reported 83 people killed and 141 wounded nationwide, most of them in the south — a level of violence aid workers say has made the word "ceasefire" a formality rather than a fact on the ground.

The toll did not begin this month. Since the conflict between Israel and Hezbollah escalated in late 2023, Lebanon's health system has absorbed wave after wave of mass-casualty events, each followed by a brief lull and then a fresh round of strikes. The pattern repeating now in Nabatiyeh — bombardment, casualties, a fragile truce, renewed bombardment — has become familiar enough to Lebanese health workers that some hospitals maintain standing shelter-in-place protocols, treating a return to violence less as an exception than as a recurring operating condition.

147 Attacks Since March

The June 19 mass-casualty event was not an isolated spike. From March 2 up to the most recent fragile truce, the World Health Organization documented 147 attacks on healthcare in Lebanon — near-daily strikes that damaged hospitals and left more than 100 health workers dead and 233 injured. At least six hospitals were forced to close entirely, and of 207 primary health centres and dispensaries operating in conflict-affected areas, 100 are no longer functioning, according to WHO. Some facilities were struck more than once while teams were actively treating patients inside.

Sleeping Where They Work

To keep care running, hospital staff in Nabatiyeh largely stopped going home. "Healthcare staff in Nabatiyeh's hospitals slept inside the hospitals for a total of 46 days," said Tania Hachem, an MSF medical programme manager. At Nabatiyeh governmental hospital, around 42 people — medical staff and their children among them — sheltered inside the building itself rather than risk the commute through the city. "Part of our emergency-preparedness plan was for everyone to remain inside the hospital, so no one had to go back and forth," said Mona Abu Zeid, a physician and director of Najdeh Al-Shaabiyeh hospital, who stayed at the facility throughout the worst of the bombardment. "Doctors slept here and their children stayed with them."

The losses were not abstract for the staff treating them. Ahmad Zreik, a general practitioner at Nabatiyeh governmental hospital, described the morning he learned a paramedic colleague had been killed responding to a strike. "We had just seen him that very morning — everything was perfectly normal, until suddenly it isn't," Zreik said. "He left to respond to an emergency, suffered severe trauma, and was killed as a result. He returned in body, but without his soul."

When Rescue Itself Becomes Dangerous

MSF says some of the search-and-rescue and ambulance teams it supports have been unable to reach wounded civilians or evacuate them at all, because moving through Nabatiyeh during active bombardment is, in the organisation's words, simply too dangerous — and because responders have repeatedly come under fire while doing their jobs. In Sour, medical staff at Hiram hospital were wounded by shattering glass from a nearby blast; at Lebanese Italian hospital, strikes in the vicinity damaged kidney dialysis machines; staff at Jabal Amel hospital reinforced their own windows after they were blown out by the force of nearby explosions.

A Protection Question, Not Just a Medical One

Under international humanitarian law, hospitals, ambulances, and medical and rescue personnel carry explicit protected status — they are not legitimate military targets, and attacking them is a serious violation regardless of the surrounding conflict's politics. Amnesty International, investigating four earlier strikes on health facilities and vehicles in Beirut and southern Lebanon, found they killed 19 health workers and wounded 11 more, and called for the attacks to be investigated as war crimes. MSF's appeal after June 19 was correspondingly narrow and specific: not a call to end the war, but a demand for "the immediate protection of civilians and medical and rescue workers" and unhindered access for the teams trying to reach the wounded.

A new round of US-mediated regional talks was, as of June 20, scheduled to convene in Switzerland — talks that the strikes on Nabatiyeh threatened to derail before they even began. Whatever their outcome, the gap they are unlikely to close quickly is the one inside Lebanon's hospitals: 147 documented attacks, more than 100 health workers dead, and a healthcare workforce that has spent over six weeks sleeping next to the wards it treats, because going home was judged more dangerous than staying.