Mohammed Suleiman makes the same pilgrimage every day. He kneels in the quiet of the cemetery, whispering a message to the grave of his son, an assistant rescuer killed in late March by an Israeli drone. “You went as a hero, my child – you chose that way,” Suleiman says. “Now, you are sitting beside God.”
As the director of the Nabatiyeh Ambulance Service, Suleiman is witnessing a crisis that has fundamentally altered the landscape of emergency medicine in his region. Since fighting renewed on March 2 between Israel and the Iran-backed Hezbollah militia, Lebanon’s first responders have faced a record death toll of 110 personnel, all killed by Israeli airstrikes and drone attacks.
While the scale of the casualties is unprecedented, the intended effect of the violence appears to have backfired. Rather than dissuading medical teams from entering danger zones, the loss of colleagues has deepened the resolve of those remaining to continue their lifesaving work.
The conflict, which intensified after Hezbollah launched rockets into Israel following the assassination of Iran’s supreme leader, Ayatollah Ali Khamenei, has evolved into a sweeping Israeli air and ground campaign. While tensions between the two sides have persisted for decades, the current campaign has seen a marked increase in the targeting of medical infrastructure.
The erosion of medical neutrality
Lebanon’s Ministry of Public Health alleges that the high casualty rate among paramedics is not accidental, but part of a deliberate strategy by Israel to undermine health infrastructure within Shiite communities in south Lebanon and the southern suburbs of Beirut—areas that serve as Hezbollah strongholds.
According to ministry tallies, Israeli strikes have damaged 131 emergency vehicles and resulted in the closure of three hospitals, with another 16 facilities sustaining damage. For the Nabatiyeh Ambulance Service, co-founded by Suleiman in 2002, the current conflict has brought the first deaths in the organization’s history.
The Israel Defense Forces (IDF) has denied specifically targeting medical teams. In official statements, the IDF maintains it strikes only military objectives, asserting that medical teams are afforded special protection under international law provided they do not engage in activities outside their humanitarian role.
The disparity between official denials and the reality on the ground is stark for the medics. Suleiman’s 16-year-old son, Joud, was killed on March 24 alongside volunteer paramedic Ali Jaber. The pair were riding a motorcycle just minutes after leaving their base near Nabatiyeh Hospital when they were struck.
The ‘triple tap’ and tactical survival
One of the most harrowing patterns reported by first responders is the “triple tap” strike—a tactic where successive waves of rescuers are targeted as they arrive to help previous victims. On April 15, in the town of Mayfadoun, four paramedics were killed in such an incident.
Body camera footage from the Nabatiyeh Ambulance Service documented the sequence: an ambulance from the Hezbollah-affiliated Islamic Health Committee was struck first. A second team from the Amal-affiliated Risala Scout Association arrived to rescue the first team and was also hit. Finally, a third team from the Nabatiyeh Ambulance Service was targeted—all within 30 minutes.
In response to these threats, Lebanon’s first responders have adopted rigorous new precautions to prove their neutral status and avoid becoming targets:
- Body-worn cameras: Medics now wear GoPro cameras to record every moment at strike sites and inside vehicles to provide evidence of their purely humanitarian activity.
- Strategic delays: Teams often wait 15 minutes before entering an attack location to ensure any ongoing military operations are complete.
- Uniform visibility: Responders maintain strict adherence to their distinctive blue uniforms with reflective gray and orange trim.
Mahdi Sadek, a co-founder and coordinator of the service, compares their neutral status to that of the International Committee of the Red Cross. Sadek insists that despite working occasionally alongside politically affiliated teams, his organization remains independent and observes no military activity during its missions.
A resolve rooted in faith and duty
The psychological toll of the conflict is immense. Sadek describes the bond between the 85 volunteers as more than a professional relationship, calling it a family forged through shared trauma. “Within seconds, they are gone. That puts a deep scar on us,” he says.
For many, the determination to persevere is tied to a broader cultural and spiritual legacy. Suleiman notes that his team looks to the example of Imam Hussein, the seventh-century Shiite leader venerated as a martyr who refused to abandon his faith. This legacy of generosity and sacrifice drives the volunteers to continue despite the risks.
“This institution is built on giving, and Joud, Ali, and Mohammed gave their lives,” Suleiman says. “We give our lives to help others – this drives us.”
The human cost of the wider conflict is staggering. Lebanese authorities report that 2,896 people, including both civilians and combatants, have been killed in the fighting. While the United States has brokered several short-term truces, including a recent 45-day ceasefire, violence persists as Israeli forces maintain a buffer zone along the southern border and Hezbollah continues its missile campaign.
The legal implications of these deaths are now under international scrutiny. Thameen Al-Kheetan, spokesperson for the Office of the United Nations High Commissioner for Human Rights, stated on April 24 that deliberately targeting medical personnel would amount to a war crime under international humanitarian law.
As the conflict continues, the next critical checkpoint will be the monitoring of the current ceasefire’s stability and whether international bodies will launch a formal investigation into the targeting of medical personnel in the Nabatiyeh and Sidon districts.
This is a developing story. We invite readers to share their perspectives or additional information in the comments below.
Disclaimer: This report contains information regarding mass casualty events and conflict-related violence. For those affected by such events, support is available through the World Health Organization’s mental health resources.
