The deadly October 17 strike on the Ahli Arab hospital in Gaza sparked worldwide indignation, but no definitive conclusions could be drawn in the immediate aftermath about the source of the blast, with Israel and Palestinian militants each blaming the other side. Here is what we know, based on visual evidence and experts consulted by AFP.
At around 8:00 pm (1700 GMT) on Tuesday, the health ministry in Gaza reported an Israeli air strike had hit the Christian-run hospital in central Gaza City.
Israel denied it was responsible, pinning the blame on a misfired rocket aimed at Israeli territory by the Palestinian militant group Islamic Jihad from near the hospital.
Hamas has dismissed Israel’s position, saying its “outrageous lies do not deceive anyone.”
US President Joe Biden backed Israel’s account during a visit to the country, telling a news conference: “Based on the information we have seen today it (the blast) appears the result of an errant rocket fired by a terrorist group in Gaza.”
The Gaza health ministry said at least 471 people had been killed in the strike and more than 300 wounded, some in critical condition. But the US intelligence community has estimated there were likely 100 to 300 people killed in the strike, and a senior European intelligence source told AFP he believed the death toll was 50 at most.
AFP correspondents saw dozens of bodies at the scene, with medics and civilians recovering bodies wrapped in white cloth, blankets or black plastic bags.
Shortly after the strike, the World Health Organization said the hospital remained operational while condemning the loss of civilian life.
French President Emmanuel Macron, who on Tuesday said “nothing can justify targeting civilians,” told AFP two days later he was not prepared to say who was responsible.
“I am very prudent… I did not attribute this (to either side) because we don’t have our own information.”
The United Nations Office for the Coordination of Humanitarian Affairs told AFP it was “nearly impossible at the moment to provide verification on a daily basis because our teams have been forced to evacuate toward the south of Gaza” while adding that the Gaza health ministry in the past had provided “reliable” information.
Backdrop of violence
Violence has spiraled since Hamas militants stormed across the border into southern Israel on October 7 and shot, stabbed and burned to death more than 1,400 people, mostly civilians, according to Israeli officials.
More than 4,100 people have been killed in the Gaza Strip since Israel launched a ferocious air and artillery bombardment in response, according to the Hamas-controlled health ministry.
Tens of thousands of families have sought refuge from the bombardment in and around Gaza’s overwhelmed hospitals.
Social media, visual evidence
Some of the claims focus on a now-deleted post on X, formerly Twitter, from Hananya Naftali, a social media influencer who has advised Prime Minister Benjamin Netanyahu. Screenshots show Naftali posted that Israel “struck a Hamas terrorist base inside a hospital.” He later wrote he had shared erroneous information.
Israel meanwhile released what it said was audio from an intercepted phone conversation between two members of Hamas acknowledging the misfire from the Islamic Jihad and also shared a clip from Al Jazeera claiming it is evidence of a failed rocket launch from Gaza (archived here).
The explosion can be seen in the longer stream from Al Jazeera below, from about the one-hour mark.
The video shows a rocket being launched over Gaza, followed a few seconds later by a flash of light in the air. Moments later, a flash on the ground is seen followed by an explosion and fire.
The flames reveal visual clues including the solar panels visible on the roof of the hospital buildings (outlined below).
AFP was able to locate the site around the explosion and the likely trajectory of the rocket using landmarks such as the Al-Wafa Hospital (outlined in yellow), about a kilometer west of Ahli Arab.
It is recognizable by its general shape and those of its windows, the number of floors and a logo visible on the front.
By using geolocation points on Google Maps, it is possible to determine the cameraman’s point of view.
The rocket in question does appear to be moving in a northerly direction from Gaza toward Israel, but trajectories can be difficult to determine, especially at night.
The Qatar-based TV channel said its analysis found no grounds for the Israeli claim and that the explosion likely came from an interception of the rocket, but some analysts disputed this, saying Israel’s Iron Dome is a “terminal phase” interceptor and does not stop rockets in the launch phase.
Xavier Tytleman, an aeronautics consultant and editor of Air & Cosmos, said the rocket was likely an Iranian-designed BADR-3 which is used by Palestinian militants. “What is possible is that the first stage detached at the wrong moment, which would orient the missile on a different trajectory.”
He added: “The visible crater was not very big. Even if it was a mistake and they had targeted that place by mistake, there is no Israeli bomb that does that.”
Other analysts queried by AFP said the damage at the site does not appear consistent with an Israeli missile strike.
Héloïse Fayet, researcher at the French Institute of International Relations, said: “For the moment, it is difficult to make the link between the strong explosion on the ground (visible on the Al Jazeera video) and the slight damage observed at the hospital…The most likely hypothesis is the fall of a projectile on the cars and an explosion in the gas tanks of several of these cars.”
Some analysts using the same visual evidence offered a different hypothesis: that there were two simultaneous events — the mid-air rocket explosion and an Israeli missile strike on the ground, supporting the Hamas claim.
Damage on the ground
An AFP drone video, recorded the day after the explosion, showed a makeshift mortuary with a number of bodies, and damage in the parking lot of the hospital, with several cars burned. Some windows were shattered but the buildings appeared relatively undamaged.
Describing the scene, Mohammed Qriq, a resident of Gaza, told AFP: “People were scattered outside in the gardens and under the trees. Suddenly everything became black, with bodies and blood everywhere.”
Another video circulating on social media, which AFP geolocated to the hospital parking lot, shows what appears to be bodies piled on the nearby grass.
According to the Guardian, the hospital sustained damage the previous week, another complication in determining the cause of the October 17 explosion.
Analysts interviewed by AFP are cautious, due to the lack of an independent investigation into the scene of the tragedy. Without definitively excluding any scenario, many said it was unlikely that an Israeli strike — particularly a bomb dropped from an airplane — was involved in this tragedy. Such strikes usually gut or completely destroy buildings.
Joseph Henrotin, editor in chief of the French military journal Défense et sécurité internationale, also expressed reservations about the Israeli attack claim, saying: “If you target a building with the ammunition available to the Israelis, normally you hit that building.”
Albert Moukheiber, a French neuroscientist and clinical psychologist, said the lack of clarity about a highly emotional event often drives people to conclusions based on their own bias.
“When a situation is unclear, we tend to structure the ambiguity according to our preconceptions,” he said.
“We call this motivated reasoning, we will restructure and reorganize the evidence to move towards the conclusion we have chosen.”
Governments in Arab countries and the wider Muslim world have meanwhile overwhelmingly backed Hamas’s account of the hospital deaths, expressing outrage at Israeli strikes on civilian populations.
Even countries with diplomatic relations with Israel, such as Jordan and the United Arab Emirates, blamed Israel for the strike.
From Tehran to Tripoli, thousands have joined protests against Israel following calls for a “day of rage” across the region.
Russia described the strike as a “crime” and an “act of dehumanization,” calling on Israel to provide proof it was not involved.
But late Friday, France’s Directorate of Military Intelligence (DRM) said there was “nothing to indicate… an Israeli strike.”
The DRM said it identified a hole at the blast site, not a crater, about one meter (three feet) by 75 centimeters, and 30-40 centimeters deep.
“It takes about five kilograms of explosives to produce this effect, certainly less than 10 kilograms,” he said.
The statement said an Israeli bomb or missile was unlikely to be behind such an impact because the minimum charge of such weaponry is much higher.