Background Briefing

Anatomy of an Attack

The following is Human Rights Watch’s reconstruction of the incident based on the forensic and testimonial evidence researchers have collected and verified:

During the day of July 23, multiple attacks by Israeli Apache Helicopters and drones hit civilian vehicles on the roads of southern Lebanon. Among the attacks that day was one that hit the German-Lebanese Srour family fleeing from Mansouri, killing two and wounding four; an attack that hit the car of the Abad family, also fleeing Mansouri, that wounded nine; an attack near a taxi on the outskirts of Qana that killed a young Lebanese photographer, Layal Najib; and an attack that hit a van carrying the Shaita family near Kafra that killed three and wounded 14.3 Lebanese Red Cross ambulances were busy trying to make their way through the heavily bombed roads of southern Lebanon to evacuate the wounded.

At about 9:30 pm, Israeli forces fired artillery shells near the Tibnine home of Ahmad Fawaz, 41, a car mechanic. The family hid inside their hallway, but a shell exploded just outside the house, spraying shrapnel inside. The attack injured five members of the Fawaz family: Ahmad Fawaz received shrapnel wounds to his hip and arm; his son Muhammad, 13, received shrapnel in the toe of his left foot and in his stomach area; Ali, Muhammad’s twin brother, had slight shrapnel wounds to his leg; Ahmad’s wife Fatima had shrapnel wounds to her leg and left shoulder; Ahmed’s mother Jamila, 80, had a nerve in her leg cut by shrapnel, and also had cuts on her body from glass shattered by the explosion.4

After the attack, Ahmad Fawaz put his family in his car – a clear indication both his legs were still functioning at the time – and drove them to the local gendarmerie (serail) building, where he arrived at about 10 pm. The civil defense officials based at the gendarmerie building first took the wounded to the Tibnine hospital, where they received first aid, but decided to move them to the better-equipped Tyre hospital for further treatment, since the Tibnine hospital had no pain killers available. The records of the Tibnine Red Cross office, located adjacent to the hospital, document the intake of the wounded members of the Fawaz family, as well as the nature of their injuries. Most important, the records confirm that Ahmad Fawaz had no major injuries to his legs.

Husain Ayyad, 27, an eight-year veteran of the Lebanese Red Cross, and Husain Farhat, 21, a five-year veteran, recalled in separate interviews with Human Rights Watch that the local gendarmerie had contacted their office to alert them to wounded civilians; they immediately put their Tibnine ambulance, number 782, on standby.5 Ambulance 782 was staffed by Ayyad, who drove the ambulance, Farhat, and Muhammad Burji. Shortly after 10:30 p.m., the Tibnine Hospital asked the Red Cross to prepare to transfer the three most seriously wounded – Ahmad Fawaz, his son Muhammad, and his mother Jamila – to Tyre. The Tibnine ambulance crew strapped Jamila into a wheelchair directly behind the driver’s cabin, and then put Ahmad and Muhammad on the two stretchers in the back of their ambulance.

 The Lebanese Red Cross officials in Tibnine made contact with their counterparts in Tyre; they decided to dispatch a second ambulance, number 777, from Tyre to meet ambulance 782 mid-way in Qana to take the wounded so that the Tibnine ambulance could return to its base. The Tyre ambulance was staffed by Qasim Cha`lan, as driver, Muhammad Hasan and Nadir Juda.

The ambulance crews interviewed by Human Rights Watch reported that both ambulances were clearly marked and identifiable as ambulances from a great distance. Painted white, they had large red crosses painted on their sides and roof. They each had a large Red Cross flag attached to the roof, illuminated by a spotlight mounted on the roof. The ambulances also had a piercing, flashing blue light designed to be visible at a great distance, even at night. The ambulance personnel confirmed that they had left their lights and sirens on during the entire operation, as standard procedure.

On the way to Qana, the Tibnine ambulance crew spotted Israeli warplanes flying overhead. They saw an Israeli warplane fire a missile just ahead of them, near the village of Haris, causing a huge explosion. Husain Ayyad, the driver, called the Tibnine Red Cross office to report what had happened and to ask for instructions, and was told to proceed cautiously.6 The Tibnine operations room decided to hold off on sending a second ambulance with the other wounded family members because of the precarious security situation.

The two ambulances arrived in Qana around the same time and parked close to each other in the central square, adjacent to the large open public memorial. They chose the site because it was an open area, where they would be clearly visible from the air. Both ambulances left all their lights on during the transfer operation. They parked facing the same direction, with ambulance 777 just in front of ambulance 782 (so the rear door of ambulance 777 was just next to the driver’s window of ambulance 782 on its right).

D notes the location of the driver seat in the ambulance.

The ambulance crews quickly transferred the three wounded from ambulance 782 to ambulance 777. All three of the Tibnine ambulance 782 crew and two of the Tyre ambulance 777 crew reentered their respective ambulances; Qasim Cha`lan of ambulance 777 remained outside, talking to Husain Ayyad of ambulance 782, to get information about the wounded. As Cha`lan was closing the back door of ambulance 777, a missile most likely fired from an Israeli drone (not from an Israeli airplane or helicopter, as earlier reported) struck the rear of the roof of ambulance 777, which was now holding the wounded, in the same positions as in the Tibnine ambulance (Jamila in the chair behind the driver, Ahmad and Muhammad on the stretchers in the back).

Human Rights Watch originally reported that the ambulances had been struck by missiles fired from an Israeli airplane, but that conclusion was incorrect. In its follow-up investigation, Human Rights Watch considered all of the possible sources for the missiles that hit the ambulances, including Israeli air plane fire, Israeli helicopter fire, Israeli drone fire, or Israeli artillery fire, as well as the possibility that the ambulances had been hit by a Hezbollah-fired Katyusha rocket or artillery.

A missile from an Israeli airplane can be ruled out, as such missiles would have caused much more massive destruction and have left a huge crater. The precision with which the vehicles were struck from the air, the limited damage caused, and the non-existence of heavy shrapnel, also rule out an artillery-fired round from Israel or Hezbollah, as well as an errant Katyusha rocket fired by Hezbollah. It is nearly impossible that two artillery rounds or two Katyusha rockets would have hit the ambulances with such accuracy, and they would have caused much more pronounced damage and left behind shrapnel as evidence.

The limited damage and the high precision of the strikes on the ambulances suggest that the weapon was a smaller type of missile fired from an Israeli drone or helicopter. Israel is in possession of an arsenal of highly precise missiles that can be fired from either helicopters or drones and are designed to limit the damage to their targets. The Israeli-designed and manufactured SPIKE anti-armor missile system7 and the still experimental DIME (dense inert metal explosive) missile8 are examples of smaller missiles designed to cause smaller explosions and limit collateral damage. Such missiles cause less powerful explosions than the previous generation of US-manufactured TOW and Hellfire missiles (often used by the IDF in assassination attempts against Palestinian militants in Gaza and the West Bank), which would have destroyed the ambulances completely. While the smaller missiles can be fired from either drones or helicopters, none of the witnesses reported hearing helicopters in the air before or during the attack, so it is most likely the missiles were fired from an Israeli drone.

Human Rights Watch cannot conclusively state which missiles were used in the attack on the ambulances, because our researchers did not find diagnostic shrapnel or missile parts at the scene, and because of the experimental nature of some missiles used by the IDF. The DIME is a weapon with a casing designed to disintegrate in an effort to minimize collateral damage from its fragmentation. Regardless of the weapon used, the IDF certainly has the capability to attack vehicles with limited impact missiles designed to cause low collateral damage.

The accuracy, limited lethality, and limited structural damage caused by drone-fired missiles are consistent with other similar incidents documented by Human Rights Watch involving Israeli drone-fired missiles. For example, an Israeli drone also attacked a white van carrying 17 members of the Shaita family traveling near Kafra on July 23, hitting the van in the middle of its roof and causing a limited explosion that killed three persons and wounded 14, but did not destroy the vehicle. Human Rights Watch also observed similar limited damage caused by the July 18 missile strikes on a convoy of the United Arab Emirates’ Red Crescent Society transporting medicines, vegetable oil, and food supplies, as well as a subsequent attack on a convoy of fuel smugglers hit in the Bekaa Valley on July 19.

It is clear that the limited damage to the ambulances was not caused by a malfunction of the missile but rather by a weapon designed to cause limited damage. The conclusion that the ambulances were hit by a smaller missile fired from an Israeli drone also addresses some of the “hoax” claims, such as the statement by Australia’s foreign minister that his skepticism came from the fact that “the ambulance would have been pulverized if it had been hit by a missile.”9 In fact, many of the Lebanese vehicles hit by drone-fired missiles during the 2006 conflict were not “pulverized,” sustaining only limited damage.

The interior of the van carrying the Shaita family, which was struck by an Israeli missile on July 23, killing three persons. Like the Qana ambulance, the van was struck in the middle of the roof (by two missiles), but the missiles caused only limited destruction inside the van.
© 2006 Peter Bouckaert/Human Rights Watch

The missile traveled from the roof of ambulance 777 through the gurney on which Ahmed Fawaz was strapped, severing his leg, and then through the floor of the ambulance deep into the pavement of the road. This first explosion also blew out the windscreen of Tibnine ambulance 782, and sprayed the three Tibnine ambulance crew and the Tyre ambulance crew with shrapnel. Because all of the ambulance crews were wearing flak jackets and helmets, they were spared serious injuries, but one of the Tyre ambulance crew, Muhammad Hasan, was hit with so much shrapnel to his helmet that he momentarily lost consciousness.10

The roof of ambulance 777, showing the entry and exit points of the missile. The location of the exit point of the missile corresponds with the missile impact location on the gurney mattress on which Ahmed Fawaz was located (see picture below).
© 2006 Peter Bouckaert/Human Rights Watch

All of the ambulance workers managed to run away from their vehicles and sought shelter in a nearby building. Minutes later, Ayyad, the driver of ambulance 782, returned to his ambulance to try to use its radio to contact his office when a second Israeli drone missile hit the ambulance right through the middle of the Red Cross emblem on the roof. As Ayyad again ran away from the ambulance, he saw the young patient, Muhammad, make his way out of ambulance 777 and lose consciousness. He carried Muhammad back to the building. Muhammad had received additional shrapnel wounds to his chest and head from the first attack on the ambulance. The crew members were unable to retrieve Ahmed Fawaz and his mother Jamila from the first ambulance hit, and believed them to have been killed.

The ambulance crews stayed in the basement of the building for one hour and 40 minutes. They used cell-phones to contact their offices, but had to leave their basement shelter to obtain a signal. In the basement, they administered first aid to each other, using the first aid supplies that they carried in their pockets, dressing shrapnel wounds and trying to stem their bleeding ears and noses. Representatives of the ICRC confirmed to Human Rights Watch that the Lebanese Red Cross had contacted them that night, and they in turn contacted Israeli officials to inform them of the incident and seek safe passage for a second ambulance convoy to retrieve the wounded patients and the ambulance crews. At 1:15 a.m., an ambulance crew from Tyre finally managed to reach Qana and evacuate the wounded patients and ambulance crews.

The Qana basement in which the wounded ambulance crews and Muhammad Fawaz took shelter. The floor of the basement was still littered with discarded first aid equipment when visited by Human Rights Watch on September 14.
© 2006 Peter Bouckaert/Human Rights Watch

As the ambulance workers would soon discover, both Ahmad Fawaz and his mother Jamila had actually survived the attack. Ahmad Fawaz recalled to Human Rights Watch that he was knocked unconscious by the first attack, but soon awoke to realize he had lost his leg:

“When I woke up, there were still explosions, but farther away from us…. I extended my hand to my leg, and realized I had lost my leg. It was my right leg. I did not feel anything. I also received shrapnel to my left leg, and it was broken. My left knee cap was also affected…. I stayed in the ambulance for one and a half hours…. During that time, I would wake up and black out. I got cold, so I covered myself and blacked out until I saw the light of the ambulance coming. Then, they did not come to me, as they must have thought I was dead. I raised my arms three times before they saw me. They then came and got me.”11

After the second attack, Jamila managed to crawl out of ambulance 777 to the entrance gate of a nearby building, where she sought shelter. She sustained serious shrapnel wounds, and was losing a lot of blood. When the second ambulance crew arrived, Ahmad told them that his mother was alive and had crawled out of the ambulance.12

The new ambulances from Tyre took all of the wounded to Jabal Amal hospital in Tyre, before sending them to other hospitals. Muhammad, the most seriously injured, remained in intensive care for five days. Although the ambulance crews’ flak jackets and helmets protected them from major injuries, all suffered significant damage to their ear drums, including bleeding from their ears, due to the impact of the explosion, and from minor shrapnel wounds.

Human Rights Watch found significant physical evidence to support the version of events provided by the ambulance drivers, their patients, and their supervisors, and found no inconsistencies in their accounts. The intake logs of the Tibnine hospital and the dispatch logs of the Tyre and Tibnine Red Cross offices accurately reflect the injuries sustained by the victims and the timeline of events.

In Qana, Human Rights Watch researchers visited the scene of the incident. There, they located two small impact craters from drone-fired missiles on the pavement, located exactly where the eyewitnesses reported the ambulances to have been parked and hit. Nearby, in a basement shelter, Human Rights Watch researchers found discarded latex gloves, bandages, and other first aid equipment, consistent with the account provided by the witnesses.

The location of the two missile impact craters outside the Qana memorial (visible in the background). The location of the missile impact craters corresponds with testimony from witnesses on the location of the two ambulances, with ambulance 777 parked in front and to the left of ambulance 782.
© 2006 Peter Bouckaert/Human Rights Watch

A close-up picture of the missile impact crater below where ambulance 777 was reportedly parked. The missile round penetrated deeply into the pavement.
© 2006 Peter Bouckaert/Human Rights Watch

Human Rights Watch examined the struck ambulances, which were stored at the Red Cross parking lot in Tyre, and found that the damage to the vehicles also supports the accounts of the eyewitnesses. Both ambulances clearly show missile entry points on the roof, with ambulance 782 struck directly through the Red Cross emblem and ambulance 777 towards the rear of its roof, and smaller missile exit points on the floor of the ambulances. Human Rights Watch found the rooftop air vent of ambulance 782, which showed that it had itself been penetrated by a missile; the circular vent was about 30 cm in diameter, and was located at the center of a much larger red cross that covered the entire roof of the ambulance. Human Rights Watch located the gurney on which Ahmad was lying when the missile struck and severed his leg, which clearly shows the impact of a missile.

A Lebanese Red Cross worker holds the destroyed air vent, penetrated by an Israeli drone missile, next to the hole in the roof of ambulance 782.
© 2006 Peter Bouckaert/Human Rights Watch

A close-up of the destroyed air vent of ambulance 782.
© 2006 Peter Bouckaert/Human Rights Watch


3 See Human Rights Watch, Fatal Strikes, pp. 39-41; Anthony Shadid, “Terror Rains Down From Sky on Fleeing Lebanese: Several Refugees Killed by Missile-Firing Israeli Helicopters,” Washington Post, July 24, 2006; Megan K. Stack, “‘Unbelievable’ Losses, Terror as Civilians Flee Missiles,” Los Angeles Times, July 24, 2006; Tim Butcher, “Any Moving Car Becomes A Target, as Israelis Turn the Screw, Tactics Get Tougher,” Daily Telegraph, July 24, 2006; Thanassis Cambanis, “For Fleeing Lebanese Families, Road to Safety Exacts Heavy Toll,” Boston Globe, July 24, 2006; Raed El Rafei, “‘Good Samaritan’ Survives Attack After Rescuing Wounded: 8 Passengers Barely Escape Burning Vehicle,” Daily Star (Lebanon), July 25, 2006.

4 Human Rights Watch interview with Ahmad Fawaz, Beirut, September 16, 2006.

5 Human Rights Watch interview with Husain Farhat, Tibnine, September 13, 2006; Human Rights Watch interview with Husain Ayyad, Tibnine, September 13, 2006.

6 Human Rights Watch interview with Husain Ayyad, Tibnine, September 13, 2006.

7 For a discussion of SPIKE missiles, see

8 For a discussion of DIME missiles, see

9 Misha Schubert, “Downer Attacks Lebanon Coverage,” The Age (Australia), September 1, 2006.

10 Human Rights Watch interview with Muhammad Hasan, Tyre, September 15, 2006; Human Rights Watch interview with Husain Farhat, Tibnine, September 13. 2006.

11 Human Rights Watch interview with Ahmad Fawaz, Beirut, September 16, 2006.

12 Human Rights Watch interview with Jamila Fawaz, Beirut, September 16, 2006; Human Rights Watch interview with Ahmad Fawaz, Beirut, September 16, 2006.