State Comptroller: Poor IDF-MDA Coordination Hurt Evacuation of the Wounded on October 7

State Comptroller Matanyahu Englman today (Tuesday) published an audit report dealing with the evacuation of the wounded from the various scenes on October 7, 2023.

In the report, the comptroller detailed a series of failures and deficiencies in the system for evacuating the wounded. In his words, "the evacuation was characterized by the absence of an orderly response by the IDF, the absence of orderly command and control between the IDF and MDA, and the late coordination of transfer points מול מד"א - close to eight hours after the start of the terror attack".

The report noted that evacuation of the wounded to the hospital was delayed during the critical hours of October 7, and that "the failures relating to medical evacuation are intensified in light of the number of wounded and murdered. While information about wounded soldiers, their condition, and the routes to reach them was passed directly through army officials to the medical officer of the Gaza Division, who was involved in the evacuation, regarding civilian wounded people - although MDA placed in the division a system that reflects in real time all the incidents received at dispatch centers - military medical officials did not use the system".

As a result, the comptroller determined, "the information in MDA's possession that could have helped army forces reach the civilian wounded and provide medical care did not reach the army forces in the combat zone. Use of MDA's information could also have helped build the situational picture, as can also be learned from remarks given by the Southern Command commander on October 7 to the Office of the State Comptroller, according to which information from MDA about the location of the wounded and their number would have advanced him and helped him build a situational picture".

The comptroller concluded that the IDF and the health system must "significantly improve their preparedness in aspects of command and control for managing emergency incidents, particularly mass-casualty incidents, in all matters concerning evacuation of the wounded." Alongside that, he added that the response provided by the Health Ministry together with the entire system was life-saving.

The audit stated that responsibility for evacuating the wounded from the combat areas on October 7 rested with Southern Command and the Gaza Division, since they are the military bodies responsible for the communities near Gaza. The comptroller determined that evacuation of the wounded by army forces was partial, among other reasons because of the lack of complete information about the location of civilian wounded people and their condition.

The report states that the former Operations Branch officer of Southern Command, who served in the role on October 7, told the audit team: "In several situation assessments in Southern Command, no problems were raised regarding evacuation of the wounded or the fact that MDA was not entering to evacuate wounded people from the communities near Gaza."

The report stated that there was difficulty in forming a situational picture in the aspect of evacuating the wounded; the medical forces and evacuation capabilities on the ground did not match the scale of casualties, and the ambulance transfer points, which had been set in advance, were not relevant. According to the comptroller, in the first hours the goal was first and foremost to kill terrorists and stop the massacre. As part of the efforts accompanying the fighting, IDF forces dealt with providing medical response (treating the wounded and evacuating them), and the forces on the ground evacuated whoever they could.

The comptroller noted that because of the many terrorists in the area and blocked traffic routes, MDA forces were instructed "to concentrate forces on the outskirts and in safe places" outside the Gaza border region areas where fighting was taking place, due to the threat to rescue forces. In his words, "ad hoc transfer points should have been determined according to the operational situation on the ground."

The audit found that half an hour after the attack began, the MDA dispatch center instructed the organization's forces not to enter Highway 232 - where many terrorists were present. According to MDA's event log, around 2:30 p.m. - about eight hours after the attack began - an orderly instruction was received from the division to evacuate wounded people to transfer points. Until that time, although there were attempts to coordinate transfer points, Southern Command's command and control for evacuating the wounded from the Gaza border region was not orderly. In practice, throughout all those hours, many wounded people arrived independently at hospitals.

Englman wrote in the report that "the Office of the State Comptroller views with great severity the fact that the IDF did not carry out a dedicated and comprehensive investigation into the evacuation of the wounded from the field on October 7."

According to MDA, "throughout the entire day of fighting, continuous and ongoing contact was maintained between the senior command levels in the IDF and the organization's managers, and conversations took place between the division's medical operations room and MDA's operations centers in order to transfer information regarding the locations of wounded people and to coordinate evacuation actions under the fog of war.

MDA also stated that on October 2, a few days before the outbreak of the fighting, an organization representative was present in the division and verified that the system was operating. Therefore, it was claimed, on October 7, 2023, the Gaza Division had at its disposal a system reflecting a full, detailed, and dynamic situational picture of all reports received at MDA's dispatch centers.

However, the medical officer of the Gaza Division told the State Comptroller in May 2026 that he entered the role at the end of August 2023, and during the handover process he was not exposed to the existence of a "digital medical operations room" system, and the MDA officials he met with also did not raise it with him.

In June 2026, the IDF responded to the comptroller that it does not accept MDA's determination that on October 7, 2023, the Gaza Division had at its disposal a full, detailed, and dynamic situational picture of all reports received at MDA's dispatch centers.