Ashka Jhaveri, Peter Mills, Johanna Moore, Alexandra Braverman, Kathryn Tyson, Elizabeth Volynsky-Lauzon, Rachel Friedman, and Brian Carter

Information Cutoff: 2:00 pm ET

The Israel Defense Forces (IDF) continued to conduct an operation in and around al Shifa Hospital in Gaza City on March 22. The IDF 401st and Nahal Brigades (162nd Division) and Israeli special operations forces have killed approximately 150 Palestinian fighters in the hospital area since the operation began on March 18. Palestinian militias focused their attacks in the Gaza Strip on March 22 on Israeli forces al Shifa Hospital. A Palestinian journalist reported that Israeli forces ”intensified” operations in Gaza City east of al Shifa Hospital. Hamas' infiltration into the al Shifa Hospital area after Israel’s initial clearing operation highlights Hamas’ efforts and determination to reestablish itself in the northern Gaza Strip.

Palestinian fighters may be retreating from certain areas of the Gaza Strip during Israeli clearing operations there before reentering those areas after the Israelis depart. Israeli forces are not permanently securing the areas that they clear, which allows Palestinian fighters to return after the IDF leaves. The current clearing operation in and around al Shifa Hospital is the third clearing operation in southern or western Gaza City. Israeli forces have launched new clearing operations in several neighborhoods surrounding al Shifa Hospital three times—including the ongoing operation—since January. Israeli forces re-cleared al Shati Camp—to the immediate north of al Shifa Hospital—and Rimal neighborhood—where al Shifa Hospital is located—in early February and Zaytoun neighborhood, southeast of Rimal, in late February. Palestinian militias may have temporarily retreated from these areas during the Israeli operations there, as demonstrated by the large number of fighters that Israeli forces have detained during the newest Israeli clearing operation in Rimal focused on al Shifa Hospital, which began on March 18.

Palestinian militias may be maintaining at least one VBIED cell near Tubas. Hamas fighters detonated a vehicle-borne improvised explosive device (VBIED) targeting an IDF bulldozer in Tubas during an Israeli raid on March 21. Palestinian fighters have deployed at least three VBIEDs targeting Israeli forces in the northern West Bank in 2024, including two VBIEDs in Tubas since March 7. CTP-ISW previously noted on March 7 that the two VBIED attacks on and prior to March 7 suggested the existence of a VBIED cell in the northern West Bank. It is unclear how sophisticated or well-manufactured these VBIEDs are. VBIEDs require significant logistical infrastructure, including dedicated workshops to reassemble cars after technicians take apart the vehicles and pack them with explosives. VBIEDs also require bombmaking facilities, an area to stash the VBIED prior to its deployment, and a security detachment for the workshop and bombmaking facilities. The Palestinian militias in Tubas may be collaborating to assemble and deploy these VBIEDs, given the level of resources and expertise required.

Key Takeaways:

• Gaza Strip: The IDF continued to conduct an operation in and around al Shifa Hospital in Gaza City. Palestinian fighters may be retreating from certain areas of the Gaza Strip during Israeli clearing operations there before reentering those areas after the Israelis depart.

• West Bank: Palestinian militias may be maintaining at least one VBIED cell near Tubas.

• Iraq: The pause in Iranian-backed Iraqi militia attacks does not indicate a change in the long-term Iranian and Iranian-backed proxy objective to expel the United States from the Middle East.

• Yemen: US CENTCOM and the French Navy intercepted multiple Houthi ballistic missiles and a Houthi naval attack drone in the Red Sea in several separate incidents.

• Iran: Iranian Foreign Affairs Minister Hossein Amir Abdollahian discussed the Israel-Hamas war in separate phone calls with Hamas Political Bureau Chairman Ismail Haniyeh and PIJ Secretary General Ziyad al Nakhalah.

Click here to read the full update.

ISW and CTP has launched an interactive map of Israeli ground operations to accompany our daily campaign assessments of the Israel–Hamas war. This product complements the daily static maps that ISW-CTP produces with high-fidelity and, where possible, street-level assessments of the war in Israel.

Follow ISW on Social Media:

Facebook | X | YouTube | Instagram | LinkedIn | Threads | Bluesky

Visit our website: UnderstandingWar.org

Donate online or by sending a check to the Institute for the Study of War at 1400 16th Street NW, Suite #515, Washington, DC, 20036. Please consider including the Institute for the Study of War in your estate plans.

ISW is a tax-exempt organization under section 501(c)(3) of the Internal Revenue Code. Donations are tax-deductible to the extent permitted by law.

The Institute for the Study of War (ISW) is a non-partisan, non-profit, public policy research organization. ISW advances an informed understanding of military affairs through reliable research, trusted analysis, and innovative education. We are committed to improving the nation's ability to execute military operations and respond to emerging threats in order to achieve US strategic objectives.