Updated October 18, 2023 at 9:51 AM ET

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JERUSALEM – After a catastrophic explosion at a hospital in the Gaza Strip, President Biden told Israeli Prime Minister Benjamin Netanyahu on Wednesday that "it appears as though it was done by the other team, not by you."

"But there's a lot of people out there who aren't sure," Biden added, even as he reaffirmed U.S. solidarity with Israel in the face of unprecedented attacks by Palestinian militants.

A woman reacts as people gather at the site of Al Ahli Arab hospital in central Gaza on Wednesday in the aftermath of an overnight explosion there.
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A woman reacts as people gather at the site of Al Ahli Arab hospital in central Gaza on Wednesday in the aftermath of an overnight explosion there. / AFP via Getty Images

Later, reporters asked the president what made him confident in accepting Israel's explanation that it was not behind the hospital explosion.

"The data I was shown by my defense department," Biden said.

Biden also said he was "saddened and outraged" by the explosion at Al Ahli Arab Hospital in Gaza that killed hundreds of people, including children.

After the tragedy, both Israel and Palestinian militants accused the other side of being responsible for the explosion.

A man pushes a cart carrying salvaged mattresses, pillows and sheets at the site of Al Ahli Arab hospital in central Gaza on Wednesday.
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A man pushes a cart carrying salvaged mattresses, pillows and sheets at the site of Al Ahli Arab hospital in central Gaza on Wednesday. / AFP via Getty Images

Biden calls for Israel to allow aid trucks into Gaza

The president arrived in Israel Wednesday, urging Netanyahu to open humanitarian relief corridors to allow badly needed water, fuel and other supplies to enter Gaza.

Biden also told Netanyahu that the world is watching Israel as it wages war against militants in the Palestinian territory.

"We have to bear in mind that Hamas does not represent all the Palestinian people and has brought them only suffering," Biden said.

He came to Tel Aviv, the president said, to demonstrate that the U.S. stands and grieves with Israel after the shocking attack on Oct. 7 by Hamas — the Islamist group that controls the Gaza Strip — and other violence that has killed some 1,400 Israelis and 31 Americans.

Disaster strikes a hospital where families sought shelter

The deadly blast at Al Ahli hospital quickly sparked protests across the Middle East and strong condemnation of Israel by Arab governments. It also marked a dramatic escalation in the violence gripping the region since the deadly Hamas attack against Israeli towns nearly two weeks ago.

Israel continues to launch airstrikes on Gaza as Biden is in Israel in the wake of the hospital blast.

Israel has blamed the militant Palestinian Islamic Jihad group for the explosion, saying a misfired rocket launched nearby hit the hospital. Hamas and the PIJ said it was an Israeli airstrike that struck families as they were sleeping in the confines of the hospital's grounds. Bodies continue to be recovered from the scene.

Meeting with Israel's war cabinet in Tel Aviv earlier Wednesday, Biden vowed that the United States "will continue to have Israel's back" in its fight against Hamas. "We will continue to work with you and partners across the region to prevent more tragedy," Biden said.

Netanyahu seemed to warn that the violence will continue: "As we proceed in this war, Israel will do everything it can to keep civilians out of harm's way," but he also said that "the road to victory will be long and hard."

A woman reacts while holding a pillow as she stands amid debris outside the site of Al Ahli hospital in central Gaza on Wednesday. The blast killed hundreds.
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A woman reacts while holding a pillow as she stands amid debris outside the site of Al Ahli hospital in central Gaza on Wednesday. The blast killed hundreds. / AFP via Getty Images

U.N. Secretary-General Antonio Guterres has called for an immediate humanitarian cease-fire. He said too many lives and the fate of the entire region hang in the balance.

Biden's trip comes as Israel prepares for a ground offensive in Gaza. Biden wants to learn more about the objectives and plans for coming days and weeks, said National Security Council spokesperson John Kirby.

"He'll be asking some tough questions – he'll be asking them as a friend, as a true friend of Israel but he'll be asking some questions of them," Kirby told reporters on the eve of Biden's visit.

U.S. President Joe Biden is shown arriving at Tel Aviv's Ben Gurion airport on Wednesday, Oct. 18, amid the ongoing battles between Israel and the Palestinian group Hamas.
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U.S. President Joe Biden is shown arriving at Tel Aviv's Ben Gurion airport on Wednesday, Oct. 18, amid the ongoing battles between Israel and the Palestinian group Hamas. / AFP via Getty Images

The Biden administration has been attempting to prevent the violence from spreading to the other parts of the region, but a meeting that was scheduled in Jordan with Biden and the leaders of Jordan, Egypt and the Palestinian Authority was cancelled by the Arab leaders after the hospital disaster.

The White House said the president looks "forward to consulting in person with these leaders soon, and agreed to remain regularly and directly engaged with each of them over the coming days."

The hospital explosion marks a turning point in the war

Israeli Prime Minister Benjamin Netanyahu, who is under intense domestic pressure to respond forcefully to the Oct. 7 Hamas attacks, said in a statement that it was the "barbaric terrorists in Gaza" that attacked Al Ahli hospital.

Israeli army spokesman Daniel Hagari told reporters late Tuesday evening that an initial internal review showed it was a misfired rocket from Gaza, based on footage from Israeli drones and chatter among militants calling it a PIJ misfire.

"We don't see a direct hit at the hospital, we see kind of a hit in the parking lot but we're still finishing the investigation of that," he said, before adding that Israel continues to gather intel, including off Al-Jazeera live footage and other sources.

Israeli army spokesman Rear Admiral Daniel Hagari speaks to the press from The Kirya, which houses the Israeli Ministry of Defence, in Tel Aviv on Wednesday, Oct. 18.
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Israeli army spokesman Rear Admiral Daniel Hagari speaks to the press from The Kirya, which houses the Israeli Ministry of Defence, in Tel Aviv on Wednesday, Oct. 18. / AFP via Getty Images

Hamas described the explosion at the hospital as a massacre that "also exposes the American and Western support for this criminal occupation." Hamas called on Muslims and Arabs across the world to protest and rally against Israel.

Protests erupted after the hospital disaster in Egypt, Jordan, Iraq and Lebanon, to name a few. Protests also broke out in Palestinian cities in the West Bank with protesters in Ramallah chanting slogans against Israel and the Palestinian Authority leadership as police tried to disperse them.

Egyptian President Abdel-Fattah el-Sissi said he condemns Israel's "deliberate bombing" calling it a clear violation of international law.

Saudi Arabia, which had been in serious talks to normalize relations with Israel just weeks ago, also slammed Israel, saying it "condemns in the strongest terms the heinous crime committed by the Israeli occupation forces."

The United Arab Emirates, which has close security and trade ties with Israel, said that it, too, condemns Israel over the hospital tragedy.

Hamas, meanwhile, continues to launch missiles at Israeli cities. Israel's Iron Dome defense system intercepts most. Air raid sirens are frequently heard in cities like Tel Aviv and Jerusalem.

Scenes of carnage at the Gaza Hospital

The Al Ahli Arab hospital was crowded when calamity struck. In addition to treating people wounded in Israel's continuous bombardment of the Gaza Strip, the compound was also sheltering families with nowhere else to go.

Israel has told half of Gaza's population to leave their homes, with hundreds of thousands heading south. But areas in the south, and across Gaza, continue to be hit by Israeli airstrikes.

In a news conference after the hospital disaster, a senior Health Ministry official in Gaza, Dr. Yousef Abu Al-Reesh, stood at a podium surrounded by the dead bodies of children, including babies.

He said that before Al Ahli hospital was hit, Israel had shelled the hospital twice, causing some damage. He said this was followed by a warning from Israel asking why the hospital had not yet been evacuated.

Dr. Fadel Naim, a doctor at Al Ahli hospital, told NPR that doctors were operating on patients when they heard a loud explosion. He ran outside and saw dead and wounded everywhere.

"We tried to help who we can help. Some of them died in our hands," he said. Many were missing limbs and bleeding out," Dr. Naim said.

"We found one baby on the roof of the hospital," he said, describing the horrific scene and impact of the explosion. "Many babies died yesterday. Many babies."

Footage online and carried on channels like Al-Jazeera show the carnage of dead bodies strewn on the grass outside the hospital. Bloodied and traumatized women and children were show being treated in other nearby hospitals, screaming, shaking or still in shock. Medications have run low in Gaza at the two dozen or so still functioning hospitals, where medical supplies like painkillers have run out.

Palestinians inspect their destroyed homes following Israeli bombardment in Rafah in the southern Gaza Strip, on Wednesday, amid ongoing battles between Israel and the Palestinian group Hamas.
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Palestinians inspect their destroyed homes following Israeli bombardment in Rafah in the southern Gaza Strip, on Wednesday, amid ongoing battles between Israel and the Palestinian group Hamas. / AFP via Getty Images

People in Gaza say they have nowhere to go

Gaza is under a complete siege, with no food or fuel entering for more than a week after militants from the Gaza Strip infiltrated Israel, killing more than 1,300 people. Entire towns were destroyed in southern Israel, and at least 200 hostages were taken to the Gaza Strip.

Israeli air and naval strikes on Gaza have killed at least 3,300 people, a third of them children, according to the Palestinian Health Ministry. That death toll does not include casualties from Al Ahli Hospital. Another 1,200 people are missing, presumed dead or still alive under the rubble of thousands of homes that have been destroyed.

In Gaza City, which falls under Israel's evacuation notice, many people simply cannot leave or refuse to, citing the lack of safety anywhere in Gaza.

Medical student Tasneen Ahl's home in Gaza City has already been destroyed in this war. She and dozens of family members, including 10 children, remain the city, though. She says her family isn't leaving because hundreds of people have been killed in the south after evacuating there.

"There's no place here in Gaza we can go. We can't. We can't leave our home," she told NPR.

She says the last time she drank a sip of water was over 24 hours ago. Ahl says her father walked over a mile to source flour for bread. The family is cooking on woodfire because of power outages.

"I can't see my family like this. We are dying slowly," she said, before adding the are "no human rights" for people in Gaza.

Thousands of aid trucks are positioned in Egypt near its border crossing with Israel.

Egypt's Foreign Minister Sameh Shoukry told CNN in an interview Israel has bombed the crossing several times in recent days, including as Egyptian workers were repairing damage from one of the airstrikes, wounding several of them.

A U.N. shelter where thousands of Palestinians were seeking refuge was also struck by Israel on Tuesday, killing six people, according to the U.N. agency for Palestinian refugees.

The U.N. relief agency, OCHA, says Gaza has been under full electricity blackout and that its largest hospital only has a few more days of fuel for its generators after the World Health Organization delivered locally stored fuel to it.

The U.N. agency also said that every person in Gaza is estimated to have less than a gallon of water for all their needs per day, including for drinking, hygiene and cooking. That's in part because water and sanitation facilities have been severely damaged.

Israel partially resumed water supply to the eastern Khan Younis area of Gaza this week, but the U.N's OCHA says that only reaches 14% of Gaza's population.

"People have resorted to consuming brackish water extracted from agricultural wells, increasing exposure to pesticides and other chemicals, placing the population at risk of death or infectious disease outbreak," the U.N. relief agency said.

NPR staffers Aya Batrawy reported from Jerusalem, Bill Chappell reported from Washington, D.C., and Ruth Sherlock contributed reporting from Tel Aviv, Israel.

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