“The destruction of the healthcare system in Gaza, and the extent of killing of patients, staff and other civilians in these attacks, is a direct consequence of the disregard of international humanitarian and human rights law,” it read.

Daniel Meron, Israel’s permanent representative to the U.N. in Geneva, described the report’s data as fabricated. He said on X that Israel operates in accordance with international law, would never target innocent civilians and accused Hamas of using Gaza hospitals for what he called “terror activity.”

The Israeli military has accused Hamas of using hospitals as command centers for military operations and said that people Israel has detained at the facilities were suspected militants.

The U.N. report alluded to such arguments, but said not enough information had been made public to substantiate them.

Israel has in the past few days conducted operations against hospitals in Gaza that drew criticism from the head of the World Health Organization (WHO) among others.

The report said deliberately directing attacks against hospitals and places where the sick and wounded are, provided they are not military objectives, would be war crimes.

It also warned that a systemic pattern of rights abuses against civilians could constitute crimes against humanity.

Israel has consistently rejected such suggestions.

The U.N. said that responding to its report, the Israeli government said its military had taken extensive measures to mitigate civilian harm and minimize disruption, including providing aid and evacuation routes, and setting up field hospitals.

“As if the relentless bombing and the dire humanitarian situation in Gaza were not enough, the one sanctuary where Palestinians should have felt safe in fact became a death trap,” U.N. High Commissioner for Human Rights Volker Türk said in a statement.

Hamas killed 1,200 people and abducted 251 to Gaza in its attack on southern Israel on Oct. 7, 2023, according to Israeli tallies.

More than 45,500 Palestinians have been killed in Israel’s subsequent war on Gaza, Palestinian health officials say.

Once muscular and strong, Palestinian bodybuilder Moazaz Obaiyat’s nine-month spell in Israeli custody left him unable to walk unaided upon his release in July. Then, in an October pre-dawn raid on his home, soldiers detained him again.

Before being re-arrested, the 37-year-old father of five was diagnosed with severe PTSD by Bethlehem Psychiatric Hospital, related to his time at Israel’s remote Ktz’iot prison, according to medical notes seen by Reuters from the hospital, a public clinic in the occupied West Bank.

The notes said Obaiyat was subjected to “physical and psychological violence and torture” in prison and described symptoms including severe anxiety, withdrawal from his family and avoidance of discussion of traumatic events and current affairs.

Alleged abuses and psychological harm to Palestinian detainees in Israeli prisons and camps are in renewed focus amid stepped-up efforts in December by international mediators to secure a ceasefire that could see the release of thousands of inmates detained during the Gaza war and before, in return for Israeli hostages held by the Palestinian group Hamas in Gaza.

An investigation published by the United Nations human rights office in August described substantiated reports of widespread “torture, sexual assault and rape, amid atrocious inhumane conditions” in prisons since the war began. The U.N. office has also said Hamas’ Oct. 7 attacks could amount to war crimes and crimes against humanity.

The White House has called the reports of torture, rape and abuse in Israel’s prisons “deeply concerning.”

In response to Reuters questions, the Israeli military said it was investigating several cases of alleged abuse of Gazan detainees by military personnel but “categorically” rejected allegations of systematic abuse within its detention facilities.

The military declined to comment on individual cases. The Israel Prison Service (IPS), which falls under hard-right national security minister Itamar Ben-Gvir, and the country’s internal security service said they were not in a position to comment on individual cases.

“Terrorists in Israeli prisons are granted supervised living conditions and accommodations appropriate for criminals,” Ben Gvir’s office said in response to Reuters questions, adding that the facilities operate in accordance with the law. “The ‘summer camp’ is over,” Ben Gvir’s office said.

Speaking from his hospital bed in July, a severely emaciated Obaiyat called the treatment of himself and fellow prisoners “disgusting,” showing scars on his wasted legs and describing isolation, hunger, handcuffs and abuse with metal rods, without giving details.

Photos of Obaiyat taken before his incarceration show a powerfully-built man.