Gaza City – Dr Hussam Abu Safia, 52, remains in an Israeli prison a year after Israel detained him without charges or trial.

His family and supporters are demanding his release as his health deteriorates amid reports of the inhumane conditions under which he is being held.

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Abu Safia, known for his steadfast presence as director of Kamal Adwan Hospital in Beit Lahiya, north of Gaza City, has become central in international discussions on the protection of medical personnel in armed conflicts.

He insisted on staying at the hospital, along with several medical staff, despite continuous Israeli attacks on the facility.

Israel eventually surrounded the hospital and forced everyone to evacuate. Since then, Abu Safia has been in detention, and the hospital has been out of service.

He was transferred between Israeli prisons, from the notorious Sde Teiman holding facility to Ofer Prison, being mistreated continuously.

No charges have been brought against Abu Safia, who is held under the “unlawful combatant” law, which allows detention without a standard criminal trial and denies detainees access to the evidence against them.

A family’s suffering

Abu Safia is being held in extreme conditions and, according to lawyers, has lost more than a third of his body weight.

His family is worried about him as he also suffers from heart problems, an irregular heartbeat, high blood pressure, skin infections and a lack of specialised medical care.

His eldest son, Ilyas, 27, told Al Jazeera via Zoom from Kazakhstan, where the family fled a month ago, about their grief over Abu Safia’s detention, adding that his father’s only “crime” was being a doctor.

Ilyas, his mother Albina and four siblings stayed with his father at Kamal Adwan through the Israeli attacks, despite opportunities to leave Gaza, especially as Albina is a Kazakh citizen.

On October 26, 2024, Israel killed Ilyas’s brother, Ibrahim, 20, while it shelled the hospital.

“The entire medical staff cried in grief for [my father] and for Ibrahim,” Ilyas said.

The taking of Dr Abu Safia

At dawn on December 27, 2024, the hospital woke up to a tightened Israeli siege with tanks and quadcopter drones.

Israeli tanks had been around Kamal Adwan since mid-October 2024, gradually moving closer – destroying parts of the infrastructure like water tanks – until that day when they were so close nobody could move outside.

Dr Walid al-Badi remained with Abu Safia in Kamal Adwan until they were forced to evacuate [Abdelhakim Abu Riash/ Al Jazeera]

Patients and staff gathered in the emergency reception corridor, according to Dr Walid al-Badi, 29, who stayed with Abu Safia until his arrest, and spoke to Al Jazeera on December 25 at the Baptist Hospital in Gaza City.

“The situation was extremely tense, loudspeakers were calling on everyone to evacuate, but Dr Abu Safia asked us to remain calm. Then the loudspeakers called Dr Abu Safia to come to the tank.”

Abu Safia was ordered to enter an armoured vehicle. According to al-Badi, the doctor returned carrying a sheet of instructions, dishevelled, his clothes dusty and a bruise under his chin.

Everyone rushed to check on him, and he told them that he had been assaulted.

“Israeli media showed a video claiming they … treated him with respect, but they didn’t show … how he was assaulted in the tank, threatened,” al-Badi said.

Abu Safia was ordered by the Israelis to prepare a list of everyone in the hospital, which he did and returned to the armoured vehicle, where he was told that only 20 staff could remain. The rest had to leave.

“Around 10am, the Israelis allowed some ambulances to take patients, wounded people, some displaced civilians, and the doctor’s family to the Indonesian Hospital [about 1km away] while the medical teams left on foot,” al-Badi recounts.

However, several patients remained, besieged along with the medics.

“The doctor told me to go, but I told him I would stay with him until the end.”

The only female medic who remained was intensive care unit head, Dr Mai Barhouma, who spoke to Al Jazeera from the Baptist Hospital.

Barhouma had been working with critical patients dependent on medical equipment and oxygen, and her conscience would not allow her to leave, despite Abu Safia asking her to.

The Israeli army repeatedly summoned Abu Safia for new instructions, once, according to Drs Barhouma and al-Badi, offering a safe exit for him alone.

He refused, insisting that he would stay with his staff. At about 10pm, the quadcopters ordered everyone to line up and evacuate.

During this time, Israel shelled and set fire to the upper floors and turned off the electricity.

“We were heartbroken as Dr Abu Safia led [us] out,” al-Badi recalled. “I hugged Dr Abu Safia, who was crying as he left the hospital he tried so hard to stay in.”

Testimonies from that day say medical staff were taken to al-Fakhoura School in Jabalia, where they were beaten and tortured by Israeli soldiers during interrogations.

Barhouma left in an ambulance with an ICU patient, but the ambulance was held for hours at the school.

Dr Mai Barhouma, who oversaw the ICU at Kamal Adwan Hospital, insisted on staying with Dr Abu Safia until the moment the hospital was evacuated [Abdelhakim Abu Riash/ Al Jazeera]

“The soldiers bound our hands and forced us to walk towards al-Fakhoura school, [2km away] from the hospital. Our colleagues who had left in the morning were still there, being tortured,” al-Badi recalled, adding that they arrived at about midnight.

“They ordered us to strip down to our underwear, tied our hands and began severely beating us with boots and rifle butts, insulting and verbally abusing us.”

The interrogation and beatings of the medics in the freezing cold continued for hours while Barhouma was in the ambulance with the critically ill patient.

“The oxygen ran out, so I started using a manual resuscitation pump. My hands swelled from pumping nonstop, terrified that the patient would die,” she said.

She described hearing the screams of the male medics being tortured, and then being ordered out of the ambulance by Israeli soldiers.

“The soldier asked for my ID and took an eye scan, then ordered me to get out, but I refused and told him I had a critical patient who would die if I left them.”

Eventually, the Israelis released the medics, including al-Badi and Abu Safia, ordering them to head for western Gaza, while sending the ambulance with Barhouma in it on an alternate route westwards.

But the relief didn’t last. They had only walked a few metres when an Israeli officer called out to Abu Safia.

“Our faces froze,” al-Badi said. “The doctor asked what was wrong. The officers said: ‘We want you with us in Israel.’”

Al-Badi and a nurse tried to pull the doctor away, but he rebuked them and told them to keep walking.

“I was crying like a child being separated from his father as I watched the doctor being arrested and dressed in the white nylon uniform for detainees.”

Calls for his release

Abu Safia’s family are appealing to human rights and legal bodies for his immediate release.

“My father’s lawyers visited him around seven times over the past year, [each visit allowed only] after exhausting attempts with the prison administration. Each time, my father’s condition has deteriorated significantly,” Ilyas told Al Jazeera.

Ilyas Abu Safia, Abu Safiya’s eldest son, speaking to Al Jazeera via Zoom from Kazakhstan about the latest updates on his father’s case and detention conditions [Abdelhakim Abu Riash/ Al Jazeera]

“[He] has fractures in his thigh and shrapnel in his foot from an injury while at the hospital before his arrest. He also suffers other health problems and is subjected to severe psychological and physical abuse that does not befit his age.

“Israel is trying to criminalise my father’s work, his continued service to people and his efforts to save the wounded and the sick in an area Israel itself considered a ‘red zone’ at the time.

“My father’s presence and steadfastness inside the hospital posed a major obstacle to the Israeli army and its plan to empty the north of its residents.”

Ilyas is proud of his father.

“My father is a doctor who will be held up worldwide as an example of adherence to medical ethics and courage.

“I am proud beyond words, and I hope to embrace him soon and see him emerge from the darkness of prison safe and well.”

Dr Hussam Abu Safia [Courtesy Ilyas Abu Safia]