The report by the UN human rights office said such strikes raised grave concerns about Israel's compliance with international law, citing potential war crimes and crimes against humanity.
"Israel's pattern of deadly attacks on and near hospitals in Gaza, and associated combat, pushed the healthcare system to the brink of total collapse, with catastrophic effect on Palestinians' access to health and medical care," the UN rights office said in a statement.
Its 23-page report, entitled "Attacks on hospitals during the escalation of hostilities in Gaza", looked at the period from October 7, 2023 to June 30, 2024.
It said that during this time, there were at least 136 strikes on 27 hospitals and 12 other medical facilities.
Those claimed significant casualties among doctors, nurses, medics and other civilians, and caused significant damage to, if not the complete destruction of, civilian infrastructure.
'Death trap'
The report noted that medical personnel and hospitals are specifically protected under international humanitarian law, provided they do not commit, or are not used to commit, acts harmful to the enemy outside their humanitarian function.
It found Israel's repeated claims that Gaza hospitals were being improperly used for military purposes by Palestinian groups were "vague".
"Insufficient information has so far been made publicly available to substantiate these allegations, which have remained vague and broad, and in some cases appear contradicted by publicly available information," the report said.
UN human rights chief Volker Turk said the protection of hospitals during warfare was paramount.
He said the report "graphically details the destruction of the healthcare system in Gaza, and the extent of killing of patients, staff, and other civilians in these attacks in blatant disregard for international humanitarian and human rights law".
Mass graves
The UN rights office said Israel's raid on the Kamal Adwan hospital in north Gaza on Friday and Saturday wrought "appalling destruction" and reflected the pattern of attacks documented in the report.
The report said attacks on hospitals typically involved missile strikes on hospital buildings, the destruction of facilities, shooting of civilians, sieges, as well as the temporary takeover of hospital buildings.
Israeli military raids on the Al-Shifa medical complex had left it in "complete ruin", it added.
Three mass graves were later found at the hospital.
Some of the corpses retrieved still had catheters and cannulas attached, suggesting they were patients, the report said.
It said that at Al Awda Hospital in December 2023, "a volunteer nurse in the hospital was fatally shot in the chest while looking out of a window".
The Gaza war was triggered by the unprecedented Hamas-led October 7, 2023, attack on Israel.
That resulted in 1,208 deaths, mostly civilians, according to an AFP tally of Israeli official figures.
Israel's retaliatory military campaign has killed more than 45,500 people in Gaza, a majority of them civilians, according to figures from the Hamas-run territory's health ministry.
The UN considers those figures reliable.
Call for investigations
The report said intentionally directing attacks against hospitals, provided they were not military objectives, intentionally directing attacks against civilians and intentionally launching disproportionate attacks were war crimes.
"Several of these acts, if committed as part of a widespread or systematic attack directed against a civilian population... may also amount to crimes against humanity," it said.
The report concluded with a call for credible investigations into the incidents detailed, and said they had to be independent of Israel's justice system.
Israel rejected the "flawed" report and said the UN rights office had an "inherent obsession... with vilifying Israel".
It said Hamas was the "foremost cause of civilian suffering in Gaza".
"Israel operates in accordance with international law, and will never target innocent civilians," Israel's mission in Geneva said.
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