Dr. Hussam Abu Safiya has spent 19 months in Israeli detention without charge, his health failing, for the offense of directing Gaza’s last functioning hospital when Israeli forces came for it. The same week his son pleaded publicly for his release, the International Criminal Court’s member states voted out the one prosecutor who tried hardest to hold Israel accountable for what happened there.

Kamal Adwan Hospital was northern Gaza’s last functioning hospital when Israeli forces evacuated it in December 2024. Abu Safiya, a pediatrician, had directed it since February that year — through months when it operated as the only option for a besieged population with nowhere else to take the wounded or the sick. He was abducted from the hospital site during the evacuation and has been held without charge ever since. His son Elyas, who hasn’t seen him in person in all that time, told Zeteo’s Diana Buttu in a recent interview that his father’s health is deteriorating rapidly behind bars. “Being a doctor is not a crime,” Elyas said — a sentence that shouldn’t need saying, and that has needed saying for 19 months regardless.

Abu Safiya’s case isn’t isolated. It’s the clearest instance of a pattern human rights monitors have documented since the start of the Gaza offensive: Israeli forces detaining Palestinian medical staff seized or evacuated from hospitals, holding many without charge or trial, and in several cases holding them long enough that their own health becomes a second, quieter casualty of the same war their patients were caught in. Medical neutrality is one of the oldest principles in the laws of war — doctors, hospitals and patients are protected precisely because health care has to keep functioning even when everything else has stopped. Abu Safiya’s detention is what it looks like when that principle simply isn’t applied. It also isn’t the first time it has ended badly: Dr. Adnan al-Bursh, head of orthopedics at al-Shifa Hospital, died in Israeli detention in April 2024 without ever being charged. That precedent is exactly why Elyas’s account of his father’s failing health reads as an emergency rather than a complaint.

The same week, a different accountability mechanism took its own hit. ICC member states voted 82–13, with 15 abstentions, to remove chief prosecutor Karim Khan — the first time in the court’s history a sitting chief prosecutor has been ousted. The vote followed findings on sexual misconduct allegations brought by a junior lawyer who had worked in his office; Khan denies the allegations and says they are retaliation for the arrest warrants he sought in 2024 against Benjamin Netanyahu, former Israeli defense minister Yoav Gallant, and Hamas leaders over the war in Gaza. Israel, which is not an ICC member and has never recognized the court’s jurisdiction over its own conduct, welcomed Khan’s removal and called the warrants a witch hunt.

Khan’s removal doesn’t erase the arrest warrants themselves — an ICC warrant survives its author, and nothing so far suggests the registrar intends to withdraw them. But a warrant with no one actively championing it inside the institution is a different instrument than one being pursued, and it will fall to whoever member states install next to decide how much practical weight the Gaza warrants still carry.

Whether the misconduct findings against Khan are sound is a separate question from what his removal does to the court’s Gaza case, and it’s worth being honest that both things can be true at once — the allegations can be real and worth taking seriously, and his removal can still function as the most consequential setback the ICC’s Gaza accountability effort has had since the warrants were first issued. Khan was the official most identified with that effort. He is now gone from the institution at exactly the moment it needed him to still be there.

Put next to each other, these are two different institutions failing in the same direction in the same seven days. One is supposed to protect doctors and hospitals as a matter of basic wartime law — untouchable, not a target, not a bargaining chip — and it did not protect Abu Safiya. The other is supposed to hold the people responsible for what happens to doctors like him accountable after the fact, and it just lost the prosecutor who was actually trying to do that. Neither failure required a policy change or a new law. Both just required someone with power to decide not to act, or to act against the person doing the enforcing rather than the people being enforced against. That is a cheaper, quieter kind of impunity than a war crime — no missile, no headline strike — and this week it was exactly as effective as one.

For anyone who has spent a career arguing that health systems are political infrastructure, not neutral ground above the fray, this is the argument made concrete: the neutrality of medicine survives only as long as someone with power chooses to honor it, on both ends — in the hospital and in the courtroom that’s supposed to answer for what happens there.

Also from this week’s feed: