President Biden said on Tuesday that he was “outraged and deeply saddened” by a devastating blast that struck a hospital in Gaza City just hours before he left Washington for a wartime trip to Israel.
The explosion, which killed hundreds of people, reflects the volatility of the conflict and put into relief the enormous political and security risks Mr. Biden is taking by flying to Israel in the midst of an ever-worsening war.
After the blast, Israel and the Palestinians issued contradictory statements about who was responsible. Mr. Biden’s statement did not address the question.
“The United States stands unequivocally for the protection of civilian life during conflict,” he said, “and we mourn the patients, medical staff and other innocents killed or wounded in this tragedy.”
The rapidly changing events of the day and the anger that followed demonstrate the perils of a trip by the president less than two weeks after sweeping massacres by Hamas in Israel prompted a new war. With his visit, Mr. Biden was intending to show solidarity with America’s closest ally in the Middle East and urge Israel to avoid civilian casualties. He had also planned to travel onward to Jordan to stress to leaders of Jordan, Egypt and the Palestinian Authority the risks of the crisis expanding beyond Gaza.
But after Tuesday’s strike, key parts of the plan began unraveling.
As Air Force One sat on the tarmac at Joint Base Andrews in Maryland, White House officials told reporters that the summit in Jordan planned for Wednesday had been abruptly canceled. For a moment, it was unclear to reporters and some administration officials aboard the plane whether it would take off to the Middle East at all. Mr. Biden had boarded without answering questions.
Eventually, Air Force One departed, carrying an American president bound for Tel Aviv at a moment when Gaza was facing a humanitarian catastrophe and anger was reverberating across the Middle East.
“The timing and optics of such a significant visit couldn’t be any worse,” said Charles Lister, the director of counterterrorism at the Middle East Institute. “Whatever the circumstances behind this strike at the hospital in Gaza, it doesn’t really matter at this point. The tensions have been inflamed beyond anything we’ve seen over the last week.”
Even before the explosion, Mr. Biden’s trip was a diplomatic high-wire act.
On Monday, the president’s top advisers debated among themselves for the better part of a day about the concerns surrounding a trip to Israel, which has launched daily airstrikes in retaliation for the Oct. 7 cross-border attacks. Mr. Biden ultimately decided to go, advisers said, because he wanted to support Israel and call for humanitarian aid to people trapped in Gaza. They also said he believed an in-person visit could help him better understand Israel’s strategy as a ground invasion of Gaza loomed.
“The failure to have an actual major strategy, I think, is the long-term biggest risk here,” Jonathan Panikoff, the director of the Scowcroft Middle East Security Initiative at the Atlantic Council’s Middle East Program, said in an interview. “Because the Israelis don’t have it, and the U.S. is so closely supporting Israel.”
John F. Kirby, a White House spokesman, said in an interview on NBC’s “Today” show on Tuesday morning that the president was traveling to Israel to speak directly to Israeli officials “about their plans, about their strategy, about how things are going on the ground.”
“So he’s looking forward very much to getting more of a fingertip feel of how things are,” Mr. Kirby said.
Hamas, the group that controls Gaza, said an Israeli airstrike caused the explosion at the Ahli Arab Hospital, better known as Al-Ma’amadani. The Israeli military said its intelligence indicated that a failed rocket launch against Israel by the group Islamic Jihad had caused what could be the deadliest single episode of the 10-day-old war.
Mr. Biden hoped to use the visit to deter Iran and its proxy forces in the region and prevent the conflict from expanding beyond Israel, and he will have significant firepower backing him up. The Pentagon has sent two aircraft carriers to the eastern Mediterranean that help give the United States more than 100 attack planes. And a team of Special Operations forces has been sent to help the Israelis collect information and plan to rescue hostages taken by Hamas.
But anger over the hospital strike grew as the day went on. Hezbollah, the Iranian-backed Lebanese group that has fought wars with Israel in the past, called for protests on Wednesday.
Inside the administration on Tuesday, more than one official, speaking anonymously to preserve relationships, said the hospital blast could complicate efforts by Mr. Biden to learn more about the whereabouts of 13 Americans who have been missing since the Oct. 7 attack. Some of them are presumed to be hostages. Tensions were also flaring on Israel’s northern border with Lebanon, creating worries that the war could spread.
Iran’s foreign minister warned on Monday that a regional network of militias known in parts of the Middle East as the “axis of resistance” would open “multiple fronts” against Israel if its attacks continued to kill civilians in Gaza.
Daniel C. Kurtzer, a former ambassador to Israel now teaching at Princeton, said that the explosion in Gaza put the president “in a situation I’m sure he was hoping not to face, which is walking into an even more catastrophic situation than he already was.”
“Palestinians and Arabs,” he added, “are not going to believe this is not Israel, and perception becomes reality.”
Mr. Kurtzer said the conversation between Mr. Biden and Prime Minister Benjamin Netanyahu of Israel would now become more challenging. “The private agenda gets much tougher,” he said. “The message now has to be much more straightforward — ‘last week you guys you were the story, now you’re the negative story.’”
But others said that Mr. Biden, who has long described Mr. Netanyahu as an old friend with whom he shares deep differences, would need to strategically use the good will he has built among Israelis to emphasize, as he said in a “60 Minutes” interview on Sunday, that Hamas does not “represent all the Palestinian people.”
Richard Haass, the president emeritus of the Council on Foreign Relations, said the risks of the trip were stark. But he said Mr. Biden has an opportunity to make clear to Israeli officials that a prolonged occupation or invasion of Gaza would not be realistic or sustainable in the long run.
“Biden is the most popular person in Israel right now. More popular than Bibi Netanyahu,” Mr. Haass said, using a nickname for the prime minister. “So I actually think it allows him to make this argument that the only sustainable policy is one that distinguishes between Hamas and Gaza.”
Ron Klain, Mr. Biden’s former chief of staff, said that if he had been in the room advising Mr. Biden about visiting the Middle East, the security concerns surrounding the president’s travel would have been on his list. But Mr. Klain said he was not surprised that the president proceeded with the trip to show solidarity with an ally — particularly after Mr. Biden made a secret trip to war-torn Ukraine in February.
“I think he’s going to go there and make clear to the Israelis that we have their back,” Mr. Klain said, “and he wants to make sure that they know that we’re going to come up with the aid and the assistance they need. And reinforce the points he has made publicly, that they should conduct their military missions in accordance with the rule of law and international law.”
Aaron Boxerman contributed reporting from Jerusalem.