Protests erupted across the Middle East following the deadly explosion at a Gaza hospital as Israeli and Palestinian officials traded accusations over who was to blame just hours before US President Joe Biden is set to arrive in Tel Aviv.
Hundreds of people were likely killed in the blast on Tuesday at the Al-Ahli Baptist Hospital in the center of Gaza City, where thousands were sheltering from Israeli strikes, the Palestinian Health Ministry said in a statement.
CNN cannot independently confirm what caused the explosion at the Al-Ahli hospital.
But the blast marks a dangerous new phase in Israel's war with Hamas, which threatens to spill over regionally as crowds gathered in major Middle Eastern and North African cities to voice their anger.
In a televised news conference Wednesday, Israeli military spokesan Rear Adm. Daniel Hagari claimed a lack of structural damage at the hospital proved the Israel Defense Forces (IDF) were not involved in the explosion. He also claimed IDF intelligence showed that Palestinian Islamic Jihad -- a rival Islamist militant group to Hamas in Gaza -- caused the explosion when one of its rockets launched at Israel misfired.
Palestinian officials, however, blamed ongoing Israeli airstrikes for the lethal incident.
Dr. Ashraf Al-Qudra, a spokesperson for the Palestinian Ministry of Health in Gaza, described "unparalleled and indescribable" scenes after the blast.
"Ambulance crews are still removing body parts as most of the victims are children and women," Al-Qudra said. "Doctors were performing surgeries on the ground and in the corridors, some of them without anesthesia."
Video geolocated by CNN from inside the al-Shifa Hospital, where some victims of the blast were taken, shows chaotic scenes with injured people packed into the crowded facility, doctors treating the wounded on the hospital floor and an emergency worker calling out as he carries an injured child.
Images show women crying out and terrified children covered in black dust huddled together on the hospital floor.
Calling the deadly hospital blast "unacceptable," UN Human Rights chief Volker Turk said hospitals are sacrosanct and the killings and violence must stop.
"Words fail me. Tonight, hundreds of people were killed -- horrifically -- in a massive strike... including patients, healthcare workers and families that had been seeking refuge in and around the hospital. Once again the most vulnerable," Turk said in a statement.
President Biden, who is en route to Tel Aviv for a high-security wartime visit to meet Israeli Prime Minister Benjamin Netanyahu, said he was "outraged and deeply saddened by the explosion."
But the fallout from the blast threatens to derail US diplomatic efforts to ease the humanitarian suffering in Gaza, where concerns are mounting over Israel's deprivation of food, fuel and electricity to the enclave's population.
While Israelis grieve those killed in Hamas' terror attacks on Israeli soil and families plea for the return of loved ones taken hostage, millions of civilians in Gaza are at risk of injury, death or starvation as vital supplies have been cut to an area that is impossible to leave amid heavy Israeli bombardment.
Jordan canceled a planned Wednesday summit between Biden and the leaders of Jordan, Egypt and the Palestinian Authority. Authority President Mahmoud Abbas pulled out of the meeting earlier Tuesday in the immediate aftermath of the explosion.
Biden was scheduled to visit Amman after his trip to Tel Aviv, though a White House official said the trip was "postponed."
"There is no point in doing anything at this time other than stopping this war," Jordan's Foreign Minister Ayman Safadi told Al Jazeera Arabic early Wednesday. "There is no benefit to anyone in holding a summit at this time."
Anger spreads
The blast has added fuel to rising anger in the region over Israel's actions in Gaza.
Israeli forces have laid siege to the coastal enclave controlled by Hamas following the October 7 attacks on Israel in which the Islamist militant group killed at least 1,400 people and took more than 150 hostages, including children and the elderly.
Protests condemning the hospital explosion have erupted in multiple cities across the Middle East and North Africa, including in Jordan, Lebanon, Iraq, Iran and Tunisia. Protests also rocked the occupied West Bank city of Ramallah as demonstrators clashed with Palestinian security forces.
In the Jordanian capital Amman, angry protesters attempted to gather near the Israeli Embassy in the Rabieh area but security forces pushed them away. Two activists told CNN on Tuesday that Jordanian security forces used tear gas to disperse crowds.
In Lebanon's Beirut, hundreds of protesters gathered in the square that leads to the US Embassy on Tuesday and tried to break through security barriers, according to a CNN team there.
Hamas said more than 500 people were killed in the Gaza hospital blast. The Palestinian Health Ministry earlier said preliminary estimates indicate that between 200 to 300 people died.
The hospital tragedy comes as health services in Gaza are on the brink, with no fuel to run electricity or pump water for life-saving critical functions. UN agencies have warned that stores are less than a week away from running out of food stocks and that Gaza's last seawater desalination plant had shut down, bringing the risk of further deaths, dehydration and waterborne diseases.
While the IDF has said it does not target hospitals, the UN and Doctors Without Borders say Israeli airstrikes have struck medical facilities, including hospitals and ambulances.
IDF claims no direct hit on the hospital
Israel has insisted it was not responsible for the hospital blast.
The IDF presented imagery Wednesday that it said shows the destruction at the hospital could not have been the result of an airstrike.
In the 30-second montage, the IDF claimed that a fire broke out at the hospital as a result of a failed rocket launch by Islamic Jihad. The imagery included fire damage to several vehicles in the hospital parking lot. The IDF said there were no visible signs of craters or significant damage to buildings that would result from an airstrike.
"There are no craters here. The walls stay intact. This shows is it not an aerial munition that hit the parking lot" of the hospital, said Hagari, the IDF spokesperson.
"Analysis of our aerial footage confirms that there was no direct hit of the hospital itself. The only location damaged is outside the hospital in the parking lot where we can see signs of burning."
Hagari said IDF analysis confirmed rockets were fired from close proximity to the hospital and most of the propellant (rocket fuel) was still visible because the trajectory of the rocket was short.
"At 6:59 p.m. a barrage of around 10 rockets was fired by Islamic Jihad from a nearby cemetery. It was at the time... when there were reports of an explosion at the hospital in Gaza City," he said.
Hagari also said the IDF had intelligence of "communications between terrorists" of rockets misfiring, which included mention of the hospital.
Islamic Jihad has denied Israel's assertions that a failed rocket launch was responsible for the hundreds of civilian casualties at the hospital.
The group described Israeli accusations as "false and baseless" and claimed it does not use public facilities such as hospitals for military purposes, according to a statement Wednesday.
The US is also analyzing intelligence provided by Israel on the explosion, which includes signals intelligence, intercepted communications and other forms of data, according to an Israeli official and another source familiar with the matter.
Several nations have condemned Israel following the explosion. Pakistan called it "inhumane and indefensible" and Palestinian observer to the UN Riyad Mansour said Israeli officials were being dishonest in blaming Islamic Jihad.
The UN Security Council will hold an open meeting Wednesday on developments in the Middle East, including the hospital bombing and both Israel and Palestinian representatives are expected to speak.
Nowhere is safe
More than a week of Israeli bombardment has killed at least 3,000 people, including 1,032 girls and 940 boys, and wounded 12,500 in Gaza, the Palestinian Ministry of Health said Tuesday. Casualties in Gaza over the past 10 days have now surpassed the number of those killed during the 51-day Gaza-Israel conflict in 2014.
Conditions are dire for the 2.2 million people caught in the escalating crisis and now trapped in Gaza and those on the ground warn that nowhere is safe from relentless Israeli airstrikes and the rapidly deteriorating humanitarian situation.
Urgent calls for help are mounting and diplomatic efforts to secure a humanitarian corridor out of Gaza have ramped up in recent days.
US Secretary of State Antony Blinken, who has led intense efforts across the Middle East, on Tuesday said the US and Israel "have agreed to develop a plan that will enable humanitarian aid from donor nations and multilateral organizations to reach civilians in Gaza."
But officials have said the Rafah border crossing -- the only entry point in and out of Gaza that Israel does not control -- remains extremely dangerous.
On the Egyptian side of the crossing, a miles-long convoy of humanitarian assistance is awaiting entry into Gaza, Egyptian Foreign Minister Sameh Shoukry told CNN.
"Until now, there is no safe passage that has been granted" as they do not "have any authorization or clear, secure routes for those convoys to be able to enter safely and without any possibility of their being targeted," he said.
He added that the crossing was bombed four times in the past few days.