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This article documents a recent mass-casualty explosion. Information may change rapidly as the event progresses, and initial news reports may be unreliable. The latest updates to this article may not reflect the most current information. Feel free to improve this article or discuss changes on the talk page, but please note that updates without valid and reliable references will be removed. (October 2023) (Learn how and when to remove this message)

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 p.m.
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)
Accused	File:Flag of the Islamic Jihad Movement in Palestine.svg Palestinian Islamic Jihad (alleged by Israel and the United States, denied by PIJ) Israel (alleged by Hamas, Palestinian Islamic Jihad, and Palestinian National Authority denied by IDF)

On 17 October 2023, an explosion took place in the parking lot of the courtyard of al-Ahli Arab Hospital, located in Gaza City, amid the 2023 Israel–Hamas war, resulting in an unverified number of fatalities and injured.

Around a thousand displaced Palestinians were taking refuge at the hospital, which had been hit by Israeli rocket fire three days earlier as a warning. Reports of the number of fatalities varied widely, with analysts estimating as low as 50, U.S. intelligence agencies assessing a range of 100 to 300 deaths, and the Hamas-run Gaza Health Ministry reporting a figure of 471 deaths.

Hamas accused Israel of deliberately shelling the hospital. Israel and the United States said that intelligence sources indicated that the cause of the explosion was a failed rocket launch by Palestinian Islamic Jihad from within the Gaza Strip, which Palestinian Islamic Jihad denied.

Background

Ahli Arab Hospital, in operation since 1882, was founded by the Church of England's Church Mission Society, and as of the explosion operated as a nonsectarian hospital managed by the Anglican Diocese of Jerusalem, which reported that it had about 80 beds, and was the only Christian hospital in the Gaza Strip.

Thousands of people displaced by the evacuation of the northern Gaza Strip had sought shelter at al-Ahli Arab Hospital to avoid Israeli airstrikes. Before the rocket fire on 14 October, the hospital sheltered around 6,000 displaced persons; subsequently many of them fled, with around 1,000 remaining in the courtyard.

On 16 October, Israel ordered at least 20 hospitals in Gaza, including al-Ahli Arab Hospital, to evacuate. Because of insufficient beds at hospitals already over capacity in the southern Gaza Strip and no means of transporting certain patients, such as newborns in incubators or patients on ventilators, the evacuation orders were widely regarded as impossible to comply with.

Prior to the explosion at the hospital, the World Health Organization said Israel had attacked health facilities in the Gaza Strip 51 times, killing 15 hospital workers and injuring 27 others, since 7 October. Throughout the day on 17 October, Hamas published numerous posts on its Telegram channels providing updates on rocket attacks aimed at Israeli territory. According to the IDF, in 11 days preceding the explosion at the Al-Ahli Hospital 450 rockets fired by Palestinian militant organization from Gaza Strip landed inside its territory.

Earlier attack

Two upper floors of the hospital were damaged by Israeli rocket fire late on 14 October, leaving four staff members injured, according to a statement by the Archbishop of Canterbury, Justin Welby. Hospital officials said the hospital was struck by a roof knocking missile on Saturday evening, followed by a call from the Israeli army requesting the hospital's evacuation. The army clarified that the initial shells were a warning.

Explosion

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

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".

A doctor from Médecins Sans Frontières said that the ceiling of the operating room caved in.

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. 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. 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. 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. Agence France-Presse interviewed an unnamed senior European intelligence official who said he believed the death toll as no more than 50. A video geolocated by Bellingcat showed "t least two dozen bodies" in a grassy area near the explosion.

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

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.

A quadrilateral summit between King Abdullah II, Mahmoud Abbas, the Egyptian President Abdel Fattah el-Sisi, and Joe Biden was canceled after Jordan annulled it and Abbas withdrew from it.

News coverage of the event changed quickly, with conflicting reports from Gazan, Israeli and American sources.

Analysis

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.

The Guardian initially reported that "the scale of the blast appeared to be outside either of the militant groups' capabilities."

The death toll asserted by the Gazan Health Ministry was not independently verified as of October 18. The New York Times, after reviewing video footage and witness accounts, said 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.

Bronk said that while not conclusive, "an airstrike looks less likely than a rocket failure causing an explosion and fuel fire." 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 The Independent, agreed.

India Today's OSINT Team analyzed the footage and images of the explosion as well as 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.

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.

Channel 4 News stated 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. It also stated that 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. Channel 4 reported that these facts make it "unlikely" that the cause of the explosion was a ground-detonating Israeli missile strike, although it does not rule out an air-burst explosion. Channel 4 also reported that although Palestinian Islamic Jihad had indicated they had recovered a warhead, they have not produced it.

On 19 October, Al Jazeera published its analysis of the hospital explosion. Al Jazeera stated that 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 5 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 claim 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.

Israeli position

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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. 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" with it being a conversation between Islamic militants.

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, presumed 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.

Palestinian position

Palestinian Islamic Jihad has denied responsibility, blaming Israel for the explosion and drawing attention to the fact that Israel had also hit this hospital on 14 October and previously ordered its evacuation.

American position

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 stated 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, stated that "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."

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 stated that he was "outraged and deeply saddened by the explosion", but did not immediately attribute blame for the incident, stating instead that the US would investigate the event. 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". 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 "Israeli 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 vowed a "harsh response" to what happened. Turkey also declared three days of mourning for the victims of the explosion.

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
• Jabalia camp market airstrike
• Disinformation in the 2023 Israel–Hamas war

Notes

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

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