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al-Ahli Arab Hospital explosion

Part of the 2023 Israel–Hamas war
al-Ahli Arab Hospitalclass=notpageimage| Location of the hospital in the Gaza Strip
Date	17 October 2023 c. 6:59–7:00 pm.
Location	Zeitoun, Gaza, Gaza Strip
Coordinates	31°30′17.6″N 34°27′41.9″E / 31.504889°N 34.461639°E / 31.504889; 34.461639
Type	Disputed (misfired rocket or airstrike)
Deaths	200–471 (Gaza Health Ministry) ~250 (al-Shifa hospital director) 100–300 (United States Director of National Intelligence) ~50 (Center for Naval Analyses)
Non-fatal injuries	314 (Gaza Health Ministry)

On 17 October 2023, an explosion took place in the parking lot of the courtyard of al-Ahli Arab Hospital in Gaza City during the 2023 Israel–Hamas war, resulting in a large number of fatalities and injuries. The true death toll of the explosion is yet to be determined.

The hospital, along with the entire northern part of the Gaza Strip, had received evacuation orders from Israel four days earlier. At the time of the explosion, around 1,000 displaced Palestinians were taking refuge at the hospital. Reports of the number of fatalities varied widely. The Hamas-run Gaza Health Ministry initially reported a figure of over 500 deaths, before revising the count to 471. Some analysts estimated that the death toll was as low as 50, and U.S. intelligence agencies assessed a range of between 100 and 300.

The cause of the explosion is contested. Israel, United States, France, and Canada said that their intelligence sources indicate the cause of the explosion was a failed rocket launch by the Palestinian Islamic Jihad (PIJ) from within Gaza, while the PIJ has denied any involvement. Hamas said that Israel carried out an airstrike on the hospital. Subject-matter experts largely agreed that a misfired rocket launched from within Gaza was the likely cause of the explosion based on video analysis and the extent of the damage caused by the impact, though several analysts raised questions regarding the IDF's explanation.

Background

Ahli Arab Hospital, in operation since 1882, was founded by the Church of England's Church Mission Society. It was managed by the Anglican Diocese of Jerusalem and had about 80 beds. It was the only Christian hospital in the Gaza Strip.

On 14 October, according to a statement by the Archbishop of Canterbury, Justin Welby, Israeli rocket fire damaged two upper floors of the hospital, leaving four staff members injured. According to the Undersecretary of the Gaza Ministry of Health, Yousef Abu al-Rish, the 14 October airstrike was followed by a call from the Israeli army saying the shells were a roof knocking, and that they had to evacuate the hospital. The Anglican Diocese of Jerusalem stated the hospital had received at least three evacuation warnings from the Israeli military on Saturday, Sunday and Monday.

On 16 October, Israel ordered the al-Ahli Arab Hospital, and the rest of northern Gaza, to evacuate. Because of insufficient beds in the southern Gaza Strip and no means of transporting patients, such as newborns in incubators or patients on ventilators, the evacuation orders were widely regarded as impossible to comply with. Thousands of people displaced by the evacuation of northern Gaza sought shelter at al-Ahli Arab Hospital to avoid Israeli airstrikes. The hospital sheltered around 6,000 displaced persons, with around 1,000 in the hospital courtyard.

Throughout 17 October, Hamas published numerous posts on its Telegram channels providing updates on rocket attacks aimed at Israeli territory. According to the IDF, in the 11 days preceding the explosion at the Al-Ahli Hospital, 450 rockets fired by Palestinian militant organizations landed inside Gaza. Before the explosion, there was a history of Palestinian militant groups firing rockets from within the Gaza Strip that fell short of their target, resulting in property damage and casualties.

Explosion

The explosion occurred in a parking lot in the courtyard at 6:59 pm local time, creating orange plumes in the sky. A video captured the explosion's first sounds, described as a "whirring noise." Local reports of the explosion were made between 7 pm and 7:20 pm.

The explosion did not cause significant damage to surrounding buildings. Scorch marks and fire-damaged vehicles, including one vehicle that was flipped over, were observed in the parking lot at the explosion site the following day. A crater at the impact site was described as "fairly shallow". According to CNN, the impact crater was approximately 3 ft (91 cm) by 3 ft wide, and 1 ft (30 cm) deep.

Ghassan Abu Sittah, of Médecins Sans Frontières, said that the ceiling of the operating room collapsed.

The cause of the explosion has not been confirmed.

Casualties

The number of persons killed in the explosion has not been independently verified. As of 19 October 2023, the death toll reported by the Hamas-led Gaza Health Ministry was 471, revised from their initial report of 500. The Board Chair of the American Friends of the Episcopal Diocese of Jerusalem told a local ABC News station that the organization believes approximately 200 people died in the explosion. As of 19 October 2023, U.S. intelligence agencies had assessed that the blast killed 100 to 300 people, and that the actual number was likely on the low end of that range.

Mohammed Abu Selmia, director of the nearby al-Shifa Hospital, estimated a death toll of 250 and reported that around 350 injured people were brought to his hospital by both ambulances and personal cars. He said the terrible condition of many bodies made it difficult to arrive at a total number of dead.

IDF spokesman Rear Admiral Daniel Hagari criticized media outlets for quickly disseminating what he termed as "unverified claims" by Hamas regarding the death toll, saying it was implausible for Hamas to accurately determine the casualty figures so soon after the incident.

Hamas declined to disclose any information about the identity of the deceased to The New York Times.

Aftermath

The explosion sparked protests in a number of countries, including Canada, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Qatar, Syria, Tunisia, Turkey, United Kingdom, and Yemen. In Ramallah and other cities in the West Bank, protestors chanted against Mahmoud Abbas and threw stones, leading to police using tear gas and stun grenades in an attempt to disperse protestors. Thousands of protestors marched outside the Israeli Consulate in Istanbul to protest against the war, and in Jordan, protestors attempted to storm the Israeli embassy. The US and French embassies in Beirut also faced protests aimed at their support for Israel.

Jordan canceled a quadrilateral summit that had been scheduled to take place between Jordanian King Abdullah II, President of the Palestinian National Authority Mahmoud Abbas, Egyptian President Abdel Fattah el-Sisi, and U.S. President Joe Biden, after Abbas withdrew from it in protest of the explosion.

News coverage of the event changed quickly, with conflicting reports from Gazan, Israeli and American sources. The Guardian initially reported that "the scale of the blast appeared to be outside either of the militant groups' capabilities." BBC correspondent Jon Donnison told BBC News viewers on the evening of the explosion: "It's hard to see what else this could be, really, given the size of the explosion, other than an Israeli air strike, or several air strikes", adding, "When we've seen rockets being fired out of Gaza, we never see explosions of that scale." Two days after the event the BBC said that "he correspondent (Jon Donnison) was wrong to speculate about the cause of the explosion of the hospital."

Analysis

Open source analysts

Rocket vs. airstrike

BBC Verify spoke to a number of experts to establish whether publicly available evidence could establish the cause of the explosion. Some experts said they could not form a view on what occurred, while two experts said that the evidence was inconsistent with an Israeli airstrike or warhead damage, and that evidence was consistent with an explosion caused by rocket fuel. Security experts said that the preliminary evidence suggests that a Palestinian rocket fired inside Gaza caused the explosion.

Justin Bronk at Royal United Services Institute said that, while not conclusive, "an airstrike looks less likely than a rocket failure causing an explosion and fuel fire" was a more likely explanation than an Israeli airstrike. Independent open-source intelligence (OSINT) groups and analysts interviewed by The Telegraph, including Evan Hill, an OSINT investigator for The Washington Post, as well as The Independent, agreed. The Wall Street Journal reported that analysts who examined publicly available images said the explosion site did not "bear the hallmarks of a strike with a bomb or missile of the types used by Israel" and that the "damage appeared more consistent with a fireball from a rocket."

The Guardian quoted Marc Garlasco as saying that the crater at the blast site required kinetic energy inconsistent with a Joint Direct Attack Munition (JDAM) aerial bomb, and was also inconsistent with an airstrike, concluding that it was "more likely to be a weapon that failed and released its payload over a wide area." In an interview with PBS, Garlasco also referred to an unusual amount of fire damage, pointing to a long period of burn which, according to him, is also inconsistent with the way standard military munitions work. Bellingcat noted that one of the images the IDF spokesman used to demonstrate there was no crater did in fact show what appeared to be a crater, and also quoted Garlasco's analysis. They requested comments and the next day IDF spokesman Jonathan Conricus stated that the size of the crater and the damage caused were too small for the munitions used by the IDF, as previously stated: "Scroll through pictures of rockets that impacted in Sderot, Ashkelon, in Be'er-Sheva, you'll see very similar sites," he said. "A small crater, lots of soot and fire remarks and you can see that all of the buildings around are generally intact."

The Associated Press noted the absence of any large crater of the sort that would be expected if the explosion were caused by an Israeli airstrike. Although Israel does have smaller munitions in its arsenal, the AP noted that "there has been no public evidence of such missile strikes in the area around the al-Ahli Arab Hospital on Tuesday night." AP reported that David Shank, a retired U.S. Army colonel with expertise in military rockets and missiles, explained that the large explosion and subsequent fire was likely caused by the fact that the rocket was still full of propellant. A later analysis by the AP, including video evidence and satellite imagery, as well as expert opinion, assessed that a rocket was fired from Gaza, and that "the hospital explosion was most likely caused when part of that rocket crashed to the ground", though the lack of physical evidence makes definitive proof unlikely if not impossible.

Der Spiegel reported that the opinion of Fabian Hoffman, a weapons researcher at the University of Oslo, is that the most likely explanation regarding the cause of the explosion is that a rocket fell apart in several phases and hit the hospital. According to Der Spiegel, Hoffman could not say for sure what caused the rocket's failure, but he suspected that the engine overheated, causing the rocket to fall to the ground.

Agence France-Presse (AFP) published an article on 20 October 2023, reporting on interviews of several analysts, who "remained cautious, preferring not to rule out any scenario." Heloise Fayet, a researcher at the French Institute of International Relations, said that it was difficult to link the minor damage observed at the hospital with the large explosion seen on video. Based on the nature and extent of the damages, Fayet concluded that the most likely scenario was that a rocket hit the gas tanks of several cars. The same AFP article quoted Joseph Henrotin, editor-in-chief of the journal Defense and International Security (DSI), as saying that the visible damage was "consistent with the hypothesis of engine pieces, for example, of a rocket, which fall in a ballistic alignment, projecting debris, flaming materials, and creating a blast effect," at the same time noting that the absence of any structural damage to the building, the impact site being in the parking lot, and the size of the craters were all inconsistent with "the ammunition and targeting capabilities available to the Israelis". Similarly, Xavier Tytelman, an air defense consultant who also works for the magazine Air & Cosmos, said that the grade of munitions used by Israel, which frequently destroy entire buildings with a single strike, "would have done infinitely more damage" than that seen in the hospital parking lot, noting that the images of the scene were not comparable to the effects of laser-equipped JDAM bombs. The analysts interviewed by AFP stated that they could not completely rule out the scenario of a micro munition fired from an Israeli drone, at the same time observing that they were not aware of any evidence to support it.

CNN's investigative report from October 21, 2023, suggests that a rocket launched from Gaza malfunctioned mid-air, causing the explosion at a hospital complex. Experts consulted found the damage inconsistent with an Israeli airstrike. Missile expert Markus Schiller hypothesized that the rocket broke apart mid-air and ignited fuel at the hospital's car park, causing the explosion. Both Cedric Leighton, former National Security Agency of US deputy director, and Chad Ohlandt, a senior engineer at Rand Corporation, concurred. Analysis of mobile phone-captured audio also did not align with a high-grade military explosion. The experts noted a smaller impact crater and lack of wide destruction, undermining the possibility of an aircraft bomb. Patrick Senft from ARES and an unnamed explosives specialist emphasized that the damage was more likely caused by the rocket's fuel and shrapnel, rather than an artillery shell. All cautioned that definitive conclusions couldn't be made due to various limitations.

The Wall Street Journal published a report on 21 October 2023 containing an analysis of four geolocated and verified videos of the incident, concluding that the explosion was caused by a misfired rocket.

Channel 4 News noted that the explosion site contained only small craters, that buildings surrounding the explosion site were only superficially damaged (and did not structurally collapse), and some of the windows of a nearby church were undamaged–all facts that made it unlikely that the cause of the explosion was a ground-detonating Israeli missile strike, without ruling out the possibility of an air-burst explosion. Channel 4 also observed that although Palestinian Islamic Jihad had indicated they had recovered a warhead, they have not produced it.

India Today's OSINT Team analyzed the footage and images of the explosion and the aftermath as well as comparing the explosion site to previous aerial bombings by Israel. India Today reported that the visual evidence does not match previous aerial bombings by Israel but that a more detailed investigation would be needed for a conclusive verdict.

Numerous other news outlets reported on similar opinions from experts they spoke with–all agreeing that the cause of the explosion was more likely a misfired rocket than an Israeli airstrike.

Death toll

The death toll asserted by the Gazan Health Ministry was not independently verified as of 18 October. The Wall Street Journal reported that open-source intelligence analyst Blake Spendley estimated the death toll at 50, based on his review of videos and photos of the scene. On 19 October, Agence France-Presse cited an unnamed senior European intelligence official who said he believed the death toll was no more than 50. A video geolocated by Bellingcat showed "t least two dozen bodies" in a grassy area near the explosion.

The New York Times, after reviewing video footage and witness accounts, said on 18 October that there were "scores" of bodies in the hospital's courtyard and the number of casualties was "high". One analyst cast doubt on the death toll figure from the Gazan Health Ministry, citing the limited shock-wave damage and the small size of the open area. Blake Spendley opined that, based on a review of imagery at the scene, a death toll of 50 was more likely than the death toll of 500 that the Gaza Health Ministry states.

Authenticity of purported call recording

Shortly after the explosion, IDF released an audio recording purportedly containing an intercepted conversation between two Hamas operatives saying that a misfired rocket launched by PIJ caused the explosion. BBC Verify and CNN said they could not verify the recording. Channel 4 News reported on a forensic analysis of the alleged Hamas operative audio released by the IDF, concluding that it was digitally manipulated. Channel 4 News spoke to two Arab journalists who said that the recording did not appear authentic, because the "language, accent, dialect, syntax and tone" were not credible. Channel 4 News also reported on a preliminary audio assessment performed by a sonic analysis company called Earshot, which concluded that the audio recording had been edited to fuse two channels that were recorded separately, one for each speaker.

Origin and trajectory of munition

According to the video analysis of The Wall Street Journal, a long-range rocket was launched from Gaza in a northeastern direction toward Israel. Ten seconds after the rocket was launched, it malfunctioned and veered back toward the west, with the hospital in its path. The Wall Street Journal's analysis also concluded that the impact crater was consistent with a rocket fragment incoming from the east.

On 20 October 2023, the Associated Press (AP) reported that it concluded from analyzing "more than a dozen videos from the moments before, during and after the hospital explosion, as well as satellite imagery and photos" that "the rocket that broke up in the air was fired from within Palestinian territory, and that the hospital explosion was most likely caused when part of that rocket crashed to the ground," while acknowledging the unavailability of definitive proof. AP reported that its preliminary conclusion was supported by experts in open-source intelligence, geolocation, and rocketry, "who all agreed the most likely scenario was a rocket from within Gaza that veered off and came apart seconds before the explosion." Andrea Richardson, an experienced war crimes investigator, told AP: "From the video evidence that I have seen, it’s very clear that the rockets came from within Gaza." Justin Crump, an intelligence consultant, said: "You can see obviously it fails in flight, it spins out and disintegrates, and the impacts on the ground follow that." Henry Schlottman, another intelligence expert, indicated that the most likely scenario based on available video evidence is that a rocket was launched within Gaza, failed mid-air, and accidentally struck the hospital.

Channel 4 News said that the trajectory of the missile that appeared on Al Jazeera Live is inconsistent with the missile launching location stated by the IDF and noted a contradiction in IDF statements on the location of the launching site of the alleged Palestinian missile that hit the hospital in their presentation. Channel 4 News also used Doppler effect sound analysis of the strike and visual analysis of the crater created by the strike. Both analyses indicated that the object that cased the blast would have come from points "east of the hospital not west as the IDF claimed." Forensic Architecture (FA), a research agency based at Goldsmiths, University of London, investigating human rights violations including violence, and Earshot NGO, experts in audio analysis, analyzed the Al Ahli hospital explosion in Gaza. Earshot's Doppler Effect analysis on two videos indicates the missile approached from the northeast, east, or southeast, challenging the IDF's claim of a southwest trajectory. Their findings, combined with a 3D analysis by FA, suggest the projectile likely originated from the Israeli-controlled side. They also pointed out that crater size points to a munition larger than typical IDF drones. Markus Schiller, a missile expert who has provided analyses for NATO and the European Union, told CNN that it would be impossible predict the flight path of a malfunctioning rocket based on normal flight path and burn time.

CNN consulted a leading American acoustic expert who spoke anonymously due to a lack of permission to speak publicly from the expert's university. The acoustic expert analyzed the sound waveform and concluded that although the changes in frequency indicated the projectile was in motion, no information could be gleaned regarding the direction of the motion. CNN also reported that the dark scorch marks on the "dark patches on the ground fanning out in a southwesterly direction from the crater," and burnt trees and a knocked-over lamppost behind the crater were consistent with a rocket approaching from the southwest. CNN noted that, if the projectile were an artillery munition, this could indicate a trajectory from the northeast, but the direction on impact would be inconclusive if the projectile malfunctioned and broke apart in the air.

Iron Dome

After the explosion, there was speculation on social media that Israel's Iron Dome air defense system could have played a role in causing the event. Der Spiegel relayed the analysis of weapons expert Fabian Hoffman, of the University of Oslo, who noted that the Iron Dome is not designed to intercept rockets during their ascent. Similarly, the Associated Press cited to the opinion of John Erath, senior policy director at the Center for Arms Control and an expert on missile defense, who also relayed that the Iron Dome is designed to intercept rockets during their downward path into Israeli territory—not while they are in an upward trajectory—though Erath conceded that it is not technically impossible for Iron Dome to destroy a rocket during its ascent. Retired U.S. Army colonel David Shank, an expert in missiles, concurred with this view, telling the Associated Press that the air defense system is generally not engaged unless a rocket has a high probability of causing casualties or damage within Israel, and would not likely be used to destroy a rocket flying over Gaza. Experts consulted by CNN found no evidence that the Iron Dome intercepted the projectile that caused the explosion

Al Jazeera published its analysis of the hospital explosion. Al Jazeera said they had constructed a second-by-second timeline by analyzing video footage of the event. According to Al Jazeera, a rocket launched from Gaza was intercepted by an Iron Dome interceptor and "completely destroyed" in mid-air five seconds prior to the hospital explosion. As no more rocket launches could be seen in video footage from Gaza from this time until the hospital explosion, Al Jazeera said that they found "no grounds" for the IDF assertion that the hospital explosion was caused by a failed rocket launch from Gaza. The investigation also identified "four Israeli air strikes on Gaza, targeting the area near the hospital" in the minutes before the explosion.

Governmental entities

Israel

The Israeli Defense Forces said the cause of the blast was a misfired rocket targeting the Israeli city of Haifa and launched by Palestinian Islamic Jihad (PIJ), a Palestinian militant group allied with Hamas. Rear Admiral Daniel Hagari of the IDF Spokesperson's Unit said that intelligence indicated that PIJ had launched a barrage of rockets near the hospital, and shared drone-collected aerial photography that he said was inconsistent with Israeli munitions.

The IDF also published audio that it says contains intercepted discussions among militants saying that their misfired rocket caused the explosion. BBC Verify said that it could not verify the recording.

On 18 October, the IDF released drone footage, which it said showed the hospital before and after the explosion. The annotated video showed burned vehicles in the hospital parking lot, and noted the apparent lack of a crater or significant structural damage to surrounding buildings. The IDF said these attributes were inconsistent with the aftermath of Israeli munition strikes.

Following the explosion, the official Israel Twitter account published a statement saying that the attack was the result of an enemy rocket. Attached to the tweet was footage, purported to be proof of the rocket coming from Gaza. Aric Toler, a journalist on the visual investigations team of the The New York Times, noted that the timestamps on the video were at least 40 minutes after the explosion was known to have occurred. Shortly after, the Israeli government Twitter account edited the tweet, removing the video from it. The IDF said it was not involved with the video, and attributed it to the Israeli Ministry of Foreign Affairs.

According to the The New York Times, Israel has declined its requests to share logs of its military activity in the area at the time of the explosion or say what video it was basing its assessment that a failed Palestinian rocket launch was responsible for the blast on.

Palestine

The Gaza Health Ministry said the explosion was caused by an Israeli airstrike. Palestinian Islamic Jihad has denied responsibility, blaming Israel for the explosion and drawing attention to the fact that Israel had also hit the hospital on 14 October and previously ordered its evacuation. Hamas stated that Israel struck the hospital as punishment for the failure to evacuate.

David Leonhardt of The New York Times wrote on 20 October that "Gaza officials and their supporters have three main arguments, all circumstantial":

• First, Palestinians have noted that the al-Ahli Arab Hospital was hit by rocket fire three days earlier, although according to The New York Times, the source of the rocket fire remains unclear, and staff had received text messages and phone calls demanding that the hospital be evacuated. Anglican Archbishop Hosam Naoum said the Israeli military had telephoned and texted the hospital at least three times since 14 October, asking patients and staff to leave. He said these warnings were specific to the hospital, and not part of Israel's general push to have civilians leave northern Gaza: "There were specific warnings to get out of the building."
• Second, Israel dissembled about civilian casualties before, such as in the death of Palestinian-American journalist Shireen Abu Akleh.
• Third, Israeli government officials have put out inconsistent information regarding the hospital explosion, including a video of a rocket barrage showing a time stamp well after the time of the explosion. Hananya Naftali is frequently cited on this point. Naftali, an Israeli social media influencer and a social media advisor to Netanyahu, initially posted a statement on X, stating the Israeli Air Force had struck a Hamas terrorist base inside a hospital. Naftali promptly deleted this, later stating that his previous post was a false assumption he had made based on a Reuters report. PolitiFact found no evidence of Naftali being "an official spokesperson for Israel or its military". PolitiFact also noted, "He said in an Oct. 14 Facebook video that Netanyahu assigned him to a task force to defend Israel in the media."

Channel 4 concluded on 20 October that "Hamas and Islamic Jihad have so far offered little evidence to back their claims that Israel fired the missile at the hospital that night. Islamic Jihad claimed to have a missile fragment, but have not produced it."

Ghazi Hamad, a Hamas spokesperson, indicated that Hamas would welcome an independent investigation into the explosion by the United Nations.

On 22 October 2023, Hamad told The New York Times that the munition was not available for inspection, stating: "The missile has dissolved like salt in the water. It’s vaporized. Nothing is left." N.R. Jenzen-Jones, director of the Australia-based Armament Research Services, said that "ne would expect remnants to be recoverable in all but the most extreme circumstances, and the available imagery of the hospital site suggests something ought to be identifiable on the ground"

United States

U.S. President Joe Biden supported the Israeli account of events, and referred to Pentagon intelligence sources that indicate the explosion was caused by a Palestinian Islamic Jihad (PIJ) rocket misfire.

U.S. officials said that the U.S. had collected "high confidence" signals intelligence indicating that PIJ was responsible. Adrienne Watson, a spokesperson for the United States National Security Council, said, "While we continue to collect information, our current assessment, based on analysis of overhead imagery, intercepts and open-source information, is that Israel is not responsible for the explosion at the hospital in Gaza yesterday." Other U.S. intelligence officials concurred, adding the analysis was still preliminary and investigations would continue.

Blake Spendley of CNA said that "At the moment, the preponderance of evidence does point to it being a Hamas or PIJ rocket hitting the area."

France

France's Directorate of Military Intelligence stated that a misfired rocket from within Gaza was the "most probable cause". A French military official who spoke with Associated Press on condition of anonymity stated that French intelligence drew this conclusion from classified information, satellite imagery, intelligence shared by other countries, and open-source information. The official stated that the blast crater was indicative of an explosive charge of approximately 5 kilograms, which is consistent with several types of rockets used by Palestinian militant groups. With regard to the origin of the rocket, the French official said that the impact hole suggested the projectile was on a south-to-north trajectory. In addition, the French military intelligence official indicated that, while he could not say for certain, the reported death toll of 471 did not seem possible based on the apparent size of the rocket.

Canada

As of 19 October 2023, Canada had refrained from taking a position regarding the cause of the explosion. Prime Minister Justin Trudeau said that Canadian officials "saw some preliminary evidence," but would continue to work with allies "before reaching any firm and final conclusion." On 21 October, Canada's Department of National Defence announced that an independent analysis conducted by Canadian Forces Intelligence Command had determined "with a high degree of confidence that Israel did not strike the hospital on October 17, 2023," and that the more likely cause was an errant rocket fired from inside Gaza. The assessment was based on open source intelligence and classified reporting.

Calls for international investigation

On 19 October 2023, during a State Department daily briefing, U.S. Department of State spokesperson Matthew Miller, indicated that he did not believe an international investigation into the explosion was "appropriate at this time" given the fact that Israel had provided evidence to support its claims, whereas Hamas had provided none.

On 20 October 2023, the United Nations called for an independent investigation into the explosion. A spokesperson for the UN Human Rights Office stated that there was a need for accountability and observed that it would be difficult for the UN to monitor an investigation because of the ongoing conflict between Israel and Hamas.

Reactions

Palestinian Authority President Mahmoud Abbas declared three days of mourning following the deadly event and canceled a planned meeting with US President Joe Biden. Biden said that he was "outraged and deeply saddened by the explosion", but he did not immediately attribute blame for the incident, saying instead that the US would investigate the event. Canadian Prime Minister Justin Trudeau described the explosion as "horrible" and "unacceptable", but did not assign blame. The Director-General of the World Health Organization, Tedros Adhanom Ghebreyesus, condemned the alleged attack. The secretary-general of the United Nations, António Guterres, said that he was "horrified by the killing of hundreds of Palestinian civilians in a strike on a hospital". UN human rights chief, Volker Türk, condemned the "totally unacceptable" and "horrific" strike and demanded accountability. Médecins Sans Frontières said it was "horrified" by the "recent bombing", and called it a "massacre." The Red Cross was "shocked and horrified" by the reports.

Hezbollah said the blast was an Israeli "massacre" and called for a "day of rage" on 18 October against Israel and Biden's pending visit to the Middle East. Egypt, Iran, Iraq, Jordan, and Turkey also condemned the alleged attack, while Qatar condemned what they described as "a dangerous escalation". Saudi Arabia condemned "the forces of the occupation" for the alleged attack, which it described as a "heinous crime". Russia and the United Arab Emirates called for an urgent meeting of the UN Security Council. The King of Jordan, Abdullah II, said that the Middle East was "on the brink of falling into the abyss" amid fears that the conflict could escalate into a wider war involving other armed groups. Iranian President Ebrahim Raisi promised a "harsh response" to what happened. Turkey also declared three days of mourning for the victims of the explosion.

On culpability

Biden subsequently said at a meeting with Israeli Prime Minister Benjamin Netanyahu that, "Based on what I've seen, it appears as though it was done by the other team, not you", later adding "I'm not suggesting that Hamas deliberately did it, either – it's that old thing: You've got to learn how to shoot straight".

Israeli President Isaac Herzog condemned Palestinian Islamic Jihad, writing, "Shame on the vile terrorists in Gaza who wilfully spill the blood of the innocent." Herzog said that accusations that Israel caused the blast were "a 21st-century blood libel."

Saudi Arabia, Jordan, Qatar, UAE, Oman, Egypt, Algeria, Lebanon, Egypt, Algeria and Libya condemned the explosions as attacks, and accused Israeli forces of bombing the hospital. The UAE condemned the explosions as Israeli attacks, and demanded an "immediate cessation of hostilities". The Turkish President Recep Tayyip Erdogan denounced the bombing as "the latest example of Israeli attacks devoid of the most basic human values." The Chairperson of the African Union Commission denounced the IDF attack as a "war crime" and demanded that other countries stop what they said was Israeli aggression.

Caretaker Prime Minister Anwaar-ul-Haq Kakar and the Ministry of Foreign Affairs of Pakistan condemned the IDF as the perpetrators of the attack. They described the attack as "inhumane and indefensible" and asserted that IDF targeting of civilians and medical personnel were "war crimes". Kakar denounced IDF military operations as a "campaign of terror"; and the Foreign Ministry demanded global action to swiftly stop "Israeli bombardment and siege of Gaza".

See also

• October 2023 UNRWA school airstrike
• al-Shati refugee camp airstrike
• Church of Saint Porphyrius airstrike
• Jabalia camp market airstrike
• Palestinian rocket attacks on Israel
• Disinformation in the 2023 Israel–Hamas war

Notes

1. J. Andres Gannon at Vanderbilt University and Justin Bronk at Royal United Services Institute
2. Formerly Twitter
3. US federally funded nonprofit, primarily through the US Department of Defense

References

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• Current events from October 2023
• 2023 Israel–Hamas war
• Explosions in 2023
• History of Gaza City
• October 2023 events in Asia
• Zeitoun, Gaza
• Explosions in Asia
• Disasters in hospitals
• Palestinian war casualties