On Tuesday, the Al-Ahli Arab Hospital exploded—killing 471 Palestinian civilians. Immediately, social media was awash with theories and conspiracies—was it an Israeli strike or a misfired Hamas rocket? As angry protests spread across the Middle East, does the answer matter—or is it too late to stop the rising tide of rage.
Editor’s note: For more context, check out our two-part series on the Hamas attack on Israel: part one lays out the Hamas offensive and failures of Israeli intelligence; part two explains the big picture—and Hamas’ motive driving what seems like a suicidal attack.
The catastrophe at Al-Ahli Arab
About the hospital: Founded in 1882, the 80-bed hospital is run by the Anglican church—the Episcopal Diocese of Jerusalem. It typically serves 3,500 patients. This is what it looked like before the explosion:
Why Al-Ahli Arab matters: Hospitals have been shutting down in Gaza due to relentless Israeli airstrikes. Al-Ahli Arab was one of the few still able to treat patients—despite severe shortages in medical supplies, electricity blackouts and water shortages. It was also jammed with Gaza residents seeking a safe haven from the bombing:
Dr Fadel Naim, head of orthopaedic surgery, said about 1,000 people were in Al Ahli Arab Hospital on Tuesday morning and more rushed there later in the day after he said the Israeli army had warned residents in the Zeitoun neighbourhood to evacuate their homes. Dr Ibrahim Al-Naqa said more than 3,000 people had sought refuge at the hospital at the time of the strike.
An Israeli warning shot: Although international law forbids targeting hospitals, the rule has been broken in almost every conflict in the Middle East. And Israel has been no different. According to the WHO, there have been over 51 attacks on healthcare facilities in Gaza since the conflict began on October 7. In fact, on October 12—days before the explosion—Israel told 22 Gaza hospitals to evacuate within 24 hours—or bear responsibility for the consequences. On October 14, the hospital was hit by Israeli rocket fire—that health officials described as a “warning.”
The catastrophic explosion: Around 7:30 pm on Tuesday, the hospital exploded—instantly killing hundreds of people. This is a clip of the moment of the blast verified by the Washington Post:
And this AP vid shows the size of the explosion:
The fallout: According to one doctor: “We were operating in the hospital, there was a strong explosion, and the ceiling fell on the operating room.” The blast also took out a courtyard where many displaced Palestinians were taking refuge. This is how the doctors describe it:
"People came running into the surgery department screaming help us, help us, there are people killed and wounded inside the hospital… The hospital was full of dead and wounded, dismembered bodies… We tried to save whoever could be saved but the number was too great for the hospital team." [The head of orthopaedic surgery said]...
British-Palestinian doctor Ghassan Abusittah said the hospital had been shaking all day because of bombing. He said he heard the sound of a missile just before a huge explosion and then the operating room ceiling collapsed on top of him and other physicians. In the courtyard he could see bodies and limbs everywhere. He treated a man whose legs were blown off.
Yesterday, the hospital officials—and the Hamas-run Health Ministry—held a press conference in the midst of the carnage:
This video of the hospital has far more graphic imagery.
The death toll: As of now, the blast killed 471 Palestinians—and injured around 314. It is the largest death toll from a single incident since 2007.
The big Q: who is to blame?
The Hamas, Palestinian Authority in the West Bank and the various Arab states immediately blamed the tragedy on an Israeli airstrike—while Tel Aviv denied responsibility:
The Israel Defence Forces produced evidence on Wednesday morning that it said showed there was no crater at the hospital that would have pointed to an airstrike. Instead, a spokesperson said the blast had been caused by the warhead and propellant of a misfired Islamic Jihad rocket, which failed soon after launch from a nearby cemetery and had landed in the hospital car park. He claimed the high number of casualties was because the area was crowded with civilians.
The evidence against Israel: seemed strong at first. Initial tweets by Hananya Naftali—aide to Prime Minister Benjamin Netanyahu—claimed: “Israeli Air Force struck a Hamas terrorist base inside a hospital in Gaza.” He later deleted the tweet and apologised.
The official handle of the Israeli PM didn’t help matters by declaring: “This is a struggle between the children of light and the children of darkness, between humanity and the law of the jungle.” Another tweet that has since been deleted. But more importantly, a number of foreign correspondents argued that Hamas or any of the local extremist groups don’t have the firepower to cause that kind of damage. Watch BBC journalist John Donnison below:
Also this: Other analysts pointed out to the clip capturing the moment of the blast—arguing the “whistle before the blast does not seem consistent with the remnants of a falling rocket, or a misfire.” Of course, there’s also Israel's long track record in denying responsibility for civilian deaths—and then reluctantly admitting to them weeks or even months later (see: our Big Story on the killing of Al Jazeera reporter Shireen Abu Akleh).
But, but, but: Over the course of yesterday, US- and UK-based experts took a closer look at the imagery of the aftermath—and arrived at the opposite conclusion:
The small size of the open area where the explosion occurred, coupled with limited shock-wave damage, was inconsistent with the death toll claimed by the Palestinian Health Ministry, several open-source intelligence analysts said. Photos and videos taken at the site of the blast show a very shallow crater in the parking lot outside, and that the hospital compound’s buildings hadn’t sustained major damage.
In one example, the handle @Osinttechnical pointed to the cars that seemed to have survived the damage in the parking lot:
Also this: Israel shared alleged audio recordings of telephone conversations between Hamas members that indicates they knew this was a rocket launch of one of the local militants:
Biden’s big shout out: At a press conference with Netanyahu, the US president made clear that he didn’t think this was an Israeli strike:
I was deeply saddened and outraged by the explosion of the hospital in Gaza yesterday, and based on what I've seen, it appears as though it was done by the other team, not you.
Though he was careful to make clear that he did not think that Hamas had engineered the tragedy. The conclusion has since been underlined by the US National Security Council:
The U.S. government assesses that Israel was not responsible for an explosion that killed hundreds of civilians yesterday at the Al Ahli Hospital in the Gaza Strip. Our assessment is based on available reporting, including intelligence, missile activity, overhead imagery and open source video and images of the incident. Intelligence indicates that some Palestinian militants in the Gaza Strip believed that the explosion was likely caused by an errant rocket or missile launch carried out by Palestinian Islamic Jihad (PIJ).
Doubting the body count: But the naysaying has not ended with just the blast. The same intelligence experts claim the death toll has been vastly exaggerated—with some saying it could be as low as 50. This is astonishing since video footage verified by Western publications shows “scores of bodies in the hospital’s courtyard, suggesting the number of victims was high.”
What happens next: A tipping point?
The first diplomatic casualty of the hospital blast was a planned Arab summit—to be attended by Biden. The Palestinian Authority pulled out—and Jordan cancelled the meet.
Foreign Minister Ayman Safadi… said the meeting would be held at a time when the parties could agree to end the “war and the massacres against Palestinians”, blaming Israel with its military campaign for pushing the region to “the brink of the abyss”.
This means Biden only met Netanyahu on his lightning trip to the region—which severely dents his attempt to position himself as the “honest broker.”
Angry protests: There have been enraged protests across the region—even in nations where any kind of dissent is instantly squelched (see images here). The list includes US allies, as well: Lebanon, Iraq, Jordan, Kuwait, Egypt, and Tunisia. In Jordan, the crowd tried to storm the Israeli embassy. Of course, in places like Lebanon—controlled by the Hezbollah—the crowds on the streets were far greater:
A Kuwaiti academic says: “The Arab street has a voice. That voice may have been ignored in the past by governments in the region and the west … but they cannot do this any more. People are on fire.” Yup, that’s in Kuwait—one of the US’ closest allies in the Middle East.
The key quote to note: When asked about the evidence presented by Israel and others, the Jordanian foreign minister said: “Nobody is buying that narrative in this part of the world. Try and find anybody who is going to believe it in this part of the world.”
The US strategy: Biden has pushed hard on supplying humanitarian aid–as a way to defuse the fury. He announced $100 million in aid—and has brokered a deal with Cairo and Tel Aviv to allow 20 trucks of aid into Gaza. He also counselled Netanyahu and his cabinet not to be blinded by rage—as the US was after 9/11. Tel Aviv continues to block any aid into Gaza from within its own borders until all the hostages taken by Hamas are returned.
But, but, but: None of this may be good enough to assuage his Arab allies:
“His visit today was seen as full-throated support of the Israeli government without caveats,” said Sarah Parkinson, political science and international studies professor… “That is rapidly eroding relationships in the region.”... By saying the “other team” was responsible for the incident, the US president aligned himself even more squarely with Israel. “To a lot of people in the region that doesn’t seem like it’s fact-based, it seems like it’s a political decision,” Parkinson said. “It’s putting a lot of US allies into an incredibly difficult position.”
The bottomline: This ongoing tragedy—shrouded by the fog of war, geopolitical jockeying and Twitter punditry—is only going to get worse when Israel sends in the ground forces.
Reading list
The Wall Street Journal (splainer gift link) has the best and most detailed overview of the explosion at the hospital—and its fallout. Reuters has the best doctors’ account of the blast. We highly recommend reading Bloomberg News on Biden’s visit—and the US’ uncomfortable position. The Guardian sums up the rage across the region. New York Times has a fascinating piece on how Biden’s full-throated defence of Israel may hurt his popularity with certain Democratic voters. Want something to cheer you up: Watch Scotland’s First Minister Humza Yousaf make an impassioned speech on why Scotland should welcome refugees from Gaza—something no Arab state is willing to do.
