President Joe Biden arrived in Israel on Wednesday pledging solidarity in its war against Hamas and saying that a blast that killed huge numbers of Palestinians at a Gaza hospital appeared to have been caused not by Israel but by its foes.
The fireball that engulfed the Al-Ahli al-Arabi hospital on Tuesday evening wrecked White House plans for Biden's emergency diplomatic mission to the Middle East, with Arab leaders calling off their planned summit with him.
Palestinian officials blamed an Israeli air strike for the blast, which they said had killed as many as 500 people. Israel said the blast was caused by a failed rocket launch by the Palestinian Islamic Jihad militant group, which denied blame.
Speaking alongside Israeli prime minister Benjamin Netanyahu, Biden said: "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."
"But there's a lot of people out there not sure, so we’ve got a lot, we’ve got to overcome a lot of things," Biden added.
"The world is looking. Israel has a value set like the United States does, and other democracies, and they are looking to see what we are going to do."
Biden's trip to the Middle East was designed to calm the region, even as he demonstrated U.S. support for its ally Israel, which has vowed to annihilate the Hamas movement whose fighters killed 1,400 Israelis in a rampage on Oct. 7.
But after the hospital blast, Jordan canceled the second half of Biden's itinerary: a planned summit in Amman with the leaders of Jordan, Egypt, and the Palestinian Authority.
Netanyahu thanked Biden for his "unequivocal support." President Isaac Herzog's office said the head of state had told Biden: "God bless you for protecting the nation of Israel."
At a later meeting, Netanyahu promised "Israel will do everything it can to keep civilians out of harm's way." Biden said the United States would "continue to have Israel's back as you work to defend your people."
'Help us, help us'
The accounts of destruction at the hospital were horrific even by the standards of the past 12 days, which have confronted the world with relentless images, first of Israelis slaughtered in their homes and then of Palestinian families buried under rubble from Israel's retaliatory strikes.
Rescue workers scoured blood-stained debris for survivors. A Gaza civil defense chief gave a death toll of 300, while the health ministry put it at 471, though Israel disputed those figures. Palestinian ministry spokesperson Ashraf Al-Qudra said rescuers were still recovering bodies.
"People came running into the surgery department screaming, 'Help us, help us, there are people killed and wounded inside the hospital!'" said Dr Fadel Naim, Head of the hospital's Orthopedic Surgery Department.
"The hospital was full of dead and wounded, dismembered bodies, and dead," he told Reuters. "We tried to save whoever could be saved but the number was too big for the hospital team to be able to save. ... We saw them alive but we couldn't help them and they were martyred."
Israel later released drone footage of the scene of the explosion, which it said showed it was not responsible because there was no impact crater from any missile or bomb.
The Israeli military published what it said was an audio recording of "communication between terrorists talking about rockets misfiring."
Palestinians were convinced the explosion was an Israeli attack, with no warning given for civilians to leave a hospital that was being used as a shelter by thousands of Gazans already made homeless by Israeli bombing.
"This place created a safe haven for women and children, those who escaped the Israeli bombing," another doctor at the hospital, Ibrahim Al-Naqa, told Reuters. "We don't know what the shell is called but we saw the results of it when it targeted children and ripped their bodies into pieces."
'Cool heads'
After Biden's remarks that Israel was not to blame, other Western leaders also called for caution.
"Last night, too many jumped to conclusions around the tragic loss of life at Al Ahli hospital," Britain's foreign secretary James Cleverly posted on X. "Getting this wrong would put even more lives at risk. Wait for the facts, report them clearly and accurately. Cool heads must prevail."
World leaders from U.N. Secretary General Guterres to Russian president Vladimir Putin denounced the blast in statements that nonetheless avoided addressing who was to blame.
The blast unleashed new fury across the Middle East.
Palestinian security forces fired tear gas and stun grenades to disperse anti-government protesters in the West Bank city of Ramallah, seat of Palestinian Authority president Mahmoud Abbas, one of the Arab leaders who cancelled meeting Biden.
The U.S. State Department issued a new warning to Americans not to travel to Lebanon, where border clashes between the Iran-backed Hezbollah movement and Israel over the past week have been the deadliest since the last all-out war in 2006.
Biden has strongly backed Israel following the Oct. 7 attacks. But he is under intense pressure to win a clear Israeli commitment to alleviate the plight of civilians in the Gaza Strip, where 2.3 million Palestinians are under total siege, with no access to food, fuel, water, or medical supplies.
The Israeli military announced on Wednesday that humanitarian aid would be made available in a "humanitarian zone" in Al-Mawasi on the south of the Gaza Strip coast near the Egyptian border. It did not spell out how aid would get there.
(Reporting By Nidal Mughrabi in Gaza, Steve Holland aboard Air Force One, and Jerusalem Bureau; writing by Peter Graff; editing by Gareth Jones)