On 17 October 2023, an explosion took place in a courtyard of al-Ahli Arab Hospital in Gaza City during the Gaza war, resulting in a large number of displaced Palestinians seeking shelter there being killed or injured.
International media initially reported that over 500 Palestinians were killed according to the Gaza Health Ministry (GHM), but this was a mistranslation of a report that had mentioned over 500 total victims, including injured. The Gaza Health Ministry (GHM) later reported a more precise figure of 471 killed and 342 wounded. A report by Human Rights Watch (HRW) questioned the Health Ministry's casualty figures. The Anglican Diocese of Jerusalem, which manages the hospital, reported 200 people killed, while the U.S. assessed a figure between 100 and 300.
The cause of the explosion is contested. Israel, the United States, France, the United Kingdom, and Canada said that their intelligence sources indicated that the cause of the explosion was a failed rocket launch from within the Gaza Strip by the Palestinian Islamic Jihad (PIJ). Hamas and PIJ stated the explosion was caused by an Israeli airstrike.
In the days after the incident, several organizations concluded that an errant rocket from Gaza was the likeliest explanation, including the Associated Press (AP), CNN, The Economist, The Guardian, and The Wall Street Journal (WSJ). Le Monde and the New York Times (NYT) rejected the Israeli interpretation of Al Jazeera and Hevrat HaHadashot footage cited as evidence of a stray rocket from Gaza hitting the hospital, while noting that other evidence was consistent with that hypothesis and concluding that the cause of the blast remained uncertain. In November 2023, Human Rights Watch (HRW) said that the available evidence made an Israeli airstrike "highly unlikely".
Investigations by Channel 4 News, Al Jazeera, and research groups Earshot and Forensic Architecture (FA) contested Israeli claims of a misfired Palestinian rocket being responsible for the blast. In its investigation on 20 October 2023, Forensic Architecture concluded that the blast was the result of a munition fired from the direction of Israel. Subsequent investigations by Forensic Architecture published in February and October 2024—the first one tracking, in 3D, each rocket in a volley of Palestinian rockets that Israel accused of striking the hospital, and the latter including situated testimony from Dr. Ghassan Abu-Sitta—were said by the organisation to cast further doubt on the errant rocket launch theory.
Background
Al-Ahli Arab Hospital
The al-Ahli Arab Hospital is an 80-bed hospital in Gaza City. It was run by the Foreign Mission Board of the Southern Baptist Convention (SBC) between 1954 and 1982, and is still known as the Baptist Hospital (Arabic: المستشفى المعمداني) despite currently being under Anglican management.
The Anglican Archbishop of Jerusalem described the cancer treatment centre as the "Crown Jewel of Ahli Hospital" that had provided cancer diagnoses as a prelude to treatment options at Ahli and other hospitals.
Gaza war
Prior incidents
The World Health Organization (WHO) indicated that there were 51 attacks on health facilities in Gaza between 7 and 17 October 2023, killing 15 hospital workers and injuring 27 others.
Before the explosion, there was also 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. According to Human Rights Watch (HRW), armed Palestinian groups had unlawfully launched thousands of rockets towards Israel since 7 October. The Israel Defense Forces (IDF) said that in the 11 days preceding the explosion at the al-Ahli Hospital, 450 rockets fired by Palestinian militant organizations landed inside Gaza. The rockets which are fired on Israel by Palestinian groups usually "have only basic guidance capabilities"; Palestinian groups often use Qassam rockets and military-style Grad-type rockets, and both are, in most variants, unguided rocket artillery.
In addition to this, HRW claims that these rockets are prone to misfire, a term which means a rocket does not fire properly or its propellant fails to function properly, or alternatively that its payload does not explode on impact.
Human Rights Watch (HRW) said that Israeli and Palestinian armed groups have both demonstrated a longstanding failure to impartially and credibly investigate violations of international humanitarian law (IHL).
Israel made allegations of the Palestinian Islamic Jihad (PIJ) rocket launches killing Gaza civilians during the August 2022 conflict between Israel and the PIJ. Three munition strikes in Gaza that resulted in a notably high number of child deaths (together these three hits accounted for 12 out 15 child deaths in that conflict so far) were all attributed by Israel to PIJ munitions falling inside Gaza. The Associated Press (AP) examined two sites, of the first strike and of the second strike, both of which took place around the times when the PIJ announced they had just launched a rocket attack; in both places they: "saw none of the telltale signs of an Israeli [F-16 or drone] strike" which "lent support to suspicions they were caused by rockets that went off course". However the Israeli military later took responsibility for the second strike.
Concerning the first strike, the Israeli military published a video "purportedly showing a barrage of militant rockets, with one falling short", similar to initial claims after the al-Ahli explosion.
Incident on 14 October 2023
On Saturday 14 October, according to a statement by the Archbishop of Canterbury, Justin Welby, an Israeli rocket had damaged the upper two floors of the hospital's cancer treatment center, which contained the ultrasound and mammography wards, and injured four staff members. The Washington Post, Le Monde, and Human Rights Watch (HRW) reported that the munition on 14 October was likely an illumination shell.
The Washington Post reported that an Anglican pastor working for the diocese had filmed a video of a shell in the hospital's ultrasound room and that the video showed a 155mm artillery illumination shell. The report said:
"[I]llumination rounds are not fired directly at targets and descend on a parachute to signal, illuminate areas or mark targets, while the body of the shell falls from the sky."
An Israeli military spokesman said:
If an artillery round landed there, then it was probably a result of it falling or landing after having been fired, but definitely not targeting the hospital."
Le Monde published an article containing an analysis of a photo shared on social media depicting the damage from 14 October and the remnant of a shell. According to several experts consulted by Le Monde, the photo shows a 155 mm caliber shell. Richard Stevens, of the CAT-UXO collective, a specialist in collating information about explosive devices, told Le Monde that the color of the shell was consistent with an illumination projectile.
The Human Rights Watch (HRW) report published on 26 November 2023 said that the damage resulting from the 14 October incident appeared kinetic and not explosive, and that an illumination flare was visible in social media posts depicting the event.
Evacuation orders
On Friday 13 October, Israel ordered hospitals and the population of northern Gaza to evacuate to southern Gaza. 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.
The Anglican Diocese of Jerusalem said the hospital had received at least three evacuation warnings from the Israeli military on Saturday, Sunday, and Monday. Human Rights Watch (HRW) reported that all hospitals in northern Gaza—not just al-Ahli—received general evacuation orders on 13 October and the days after. On Saturday 14 October, the World Health Organization (WHO) issued a statement: "Evacuation orders by Israel to hospitals in northern Gaza are a death sentence for the sick and injured". In his statement on Sunday 15 October 2023 Archbishop of Canterbury, Justin Welby said: "The seriously ill and injured patients at the Anglican-run Ahli Hospital – and other healthcare facilities in northern Gaza – cannot be safely evacuated".
Day of the explosion
About 1,000 displaced Gazans remained sheltering on hospital grounds from the ongoing Gaza war, in addition to about 600 patients and staff inside hospital buildings, according to Reverend Sewell from the Diocese of Jerusalem. Throughout the day, Hamas published numerous posts on its Telegram channels, providing updates on rocket attacks aimed at Israeli territory. The New York Times later concluded that there appears to have been Israeli bombardment in the area, with two explosions visible near the hospital within two minutes of it being struck.
Explosion
Explosion
The explosion occurred in a parking lot in the courtyard at 6:59 p.m. local time on Tuesday 17 October, creating orange plumes in the sky.
Multiple videos captured the moment of the blast:
- Al Jazeera did broadcast the explosion live. During the few minutes preceding the al-Ahli explosion, the livestream captured several explosions in the Gaza Strip (at 6:54:28, 6:55:03, 6:57:42, and 6:58:04). A fifth explosion is visible at 6:59:55. Two seconds later, with the hospital complex in full view of the camera, the hospital courtyard is hit by a bright explosion and engulfed by fire.
- A video recorded by a person located close to the hospital shows building walls being suddenly illuminated by the flash of the explosion, then immediately pans to the explosion itself. Immediately before the flash of the explosion, a whooshing sound is heard. According to one description, the first sounds of the explosion are a "whirring noise". Local reports of the explosion were made between 7 p.m. and 7:20 p.m.
A video from Netivot broadcast by the Israeli Channel 12 news station, and initially claimed by some news outlets to depict a Palestinian rocket launch causing the explosion, was later confirmed by The New York Times to depict something else: Palestinian rocket launches, the launch of an Israeli rocket from a position near Nahal Oz (which later blew up mid-air, possibly intercepting a target), and an unrelated explosion on the ground in a different area than the al-Ahli hospital (southeast of it). Le Monde confirmed that this explosion occurred more than 20 seconds before the al-Ahli explosion. This video, and others such as a CCTV video from a suburb of Tel Aviv (showing a wide view of the Gaza Strip) and a CCTV video from Netiv HaAsara by the border wall (showing the same explosion as the Netivot video, not the al-Ahli explosion), were later used by The New York Times and Al Jazeera (separately) to create synchronized video compilations of the events.
Le Monde pointed out the presence of two warplanes over Gaza (which could be tracked because of decoy flares they were leaving behind), in both the Tel Aviv video and the Netivot video, at the time of the explosion; Le Monde did not make the claim that these warplanes were responsible for the blast. The videos also show Palestinian rocket salvos, including one salvo from a location a few kilometers southwest of the hospital, which Le Monde claimed is "compatible" with the hospital explosion (the paths of some rockets in that salvo passed over areas close to the al-Ahli hospital); however, Forensic Architecture disputed the possibility of accidental malfunction, pointing out how every rocket in that salvo can be tracked from the launch until the moment each rocket flamed out; and that all of them exhausted their fuel in flight, and none of them flamed out significantly earlier than the other ones.
Another fragment of the aforementioned Al Jazeera broadcast depicted a rocket exploding (or breaking up) in the air. It occurred when an Israeli rocket, launched from a site near Nahal Oz known to have an Iron Dome installation, exploded mid-air (possibly destroying a target), but the video was sometimes incorrectly claimed to show an accidental malfunction of a Palestinian rocket. This mid-air explosion was initially claimed by news outlets, and by an IDF spokesperson, to be the cause of the al-Ahli explosion; however, this was ruled out by The New York Times based on the location of the mid-air explosion and the time needed for the debris to fall to the ground.
The fire inside the hospital courtyard was filmed from a nearby rooftop.
Post-explosion
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. Photographs show a crater in a driveway, close to the point where the driveway reaches the parking lot, and the base of the fence on both sides of the driveway had been ripped out; the grassy areas on both sides of the driveway were covered with victims' belongings. A crater at the impact site was described as "fairly shallow". French intelligence assessed the crater to be about 1 m (3.3 ft) long, 75 cm (2.46 ft) across, and 30 cm (0.98 ft) to 40 cm (1.3 ft) deep. 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 Doctors without Borders, said that the ceiling of the operating room collapsed.
The cause of the explosion has not been confirmed. Early efforts to analyse the al-Ahli Arab Hospital explosion were quickly complicated by a variety of claims and counterclaims over who was responsible, as well as the rapid spread of unverified, misleading and false information on social media.