Hospital blast looms over Biden’s complicated diplomatic mission to Israel

(CNN) — President Joe Biden arrived in Israel Wednesday for one of the most complicated diplomatic trips of his presidency, an extraordinary high-stakes trip to a region gripped by violence, including an explosion at a Gaza City hospital that he said appeared to be done by “the other team.”

In his first public remarks on the hospital bombing, Biden explicitly offered Israel – and Prime Minister Benjamin Netanyahu – his support, with wording that labeled Palestinians as others. The moment, and Biden’s off-the-cuff wording, revealed the complex diplomatic balancing act he must navigate.

“I was deeply saddened and outraged by the explosion at the hospital in Gaza yesterday. And based on what I’ve seen, it appears as though it was done by the other team, not you. But there’s a lot of people out there who’re not sure. So we have to overcome a lot of things,” he said.

The president did not elaborate on what evidence led him to that conclusion. Before he left for Israel, according to one US official, the government had not yet drawn a conclusion about the source of the rocket strike on the hospital. Biden had instructed his national security team to continue evaluating incoming information. Officials have not said if the government has collected any intelligence beyond the information provided by the Israelis.

Biden’s historic arrival in wartime Tel Aviv Wednesday – the first trip to Israel by an American president during a time of war – marked his most forceful public show of support for Israel since the October 7 attacks by Hamas that left 1,400 of Israelis and dozens Americans dead. Other Americans, along with many Israelis, are also being held hostage by Hamas. And at least 3,000 people have been killed in the Gaza Strip since the fighting began, the Palestinian health ministry in Gaza said Tuesday.

“Americans are grieving with you, they really are. And Americans are worried,” Biden told Netanyahu as they began a bilateral meeting, acknowledging the complex dynamic. “Because we know this is not an easy field to navigate, what you have to do.”

Biden said it was important he “personally come,” suggesting the trip was a critical signal to other democratic nations as the world watches the events unfolding in the Middle East.

“I wanted the people of Israel – the people of the world – to know where the United States stands. … The world is looking. Israel has a value set like the United States does, and other democracies. And they’re looking to see what we’re going to do,” he told Netanyahu, who called Biden’s presence as the first American president in Israel at a time of war “deeply, deeply moving.”

Netanyahu thanked Biden for the “unequivocal support” and “unprecedented” cooperation between the two nations.

“From the moment Israel was attacked, you’ve rightly drawn a clear line between the forces of civilization and the forces of barbarism,” Netanyahu told the president.

The president has been attempting to walk a fine line between supporting Israel and keeping the violence from spiraling into a wider military conflict, a mission made more complicated by the hospital blast. He and other US administration officials have been warning other regional players, namely Iran and its proxy Hezbollah, from expanding the fighting further.

Biden’s focus will be on managing a complicated situation and less on securing clear deliverables, according to two sources close to the matter – a clear sign that the White House is seeking to manage expectations after the Jordan portion of the trip was scrapped.

Hospital blast looms over trip

The trip comes less than a day after a horrifying blast at Al-Ahli Baptist Hospital in Gaza City. Palestinian officials have said hundreds are dead following the explosion at the center of the city and blamed Israel. The Israelis denied responsibility and pinned blame on a failed rocket launch by Palestinian Islamic Jihad.

CNN has asked the White House if the US government has assessed further the cause of the blast since the president’s departure.

The US via surveillance satellites, ground-based radar and other technology has broad capability to detect launches and determine their origin. For instance in 2014, analysts at the Defense Intelligence Agency were able to determine within days that it was a Russian anti-aircraft missile that shot down Malaysia Airlines Flight 17 over Ukraine.

Later Wednesday, Netanyahu signaled that the hospital bombing belied a “different kind of enemy” in Hamas as he detailed the terrorist group’s willingness to “(hide) behind their civilians.”

“This will be a different kind of war because Hamas is a different kind of enemy,” he told Biden, adding that Hamas “wants to kill as many Israelis as possible, and has no regard whatsoever to Palestinian lives.”

The hospital explosion caused a scramble of Biden’s plans for the trip as the president walked onto Air Force One. The president was expected to meet King Abdullah II of Jordan, President Abdel Fattah el-Sisi of Egypt and Palestinian Authority President Mahmoud Abbas to discuss a humanitarian response during the Jordan leg of the visit, but the summit – and the Jordan leg of the trip – was scrapped. The White House cited a period of mourning announced by Abbas as the reason for the postponement.

The world, Netanyahu added, was “rightfully outraged” by Tuesday’s events.

“But this outrage should be directed not as Israel, but at the terrorists,” he said, seeking to assure Biden that Israel “will do everything it can to keep civilians out of harm’s way.”

The explosion and subsequent blame game will hang over Biden’s meetings in Israel. He was greeted at the airport by Netanyahu and President Isaac Herzog, hugging them on the tarmac before embarking for the meeting site in Tel Aviv.

The presence of Biden, who places a premium on personal diplomacy, is meant to show solidarity with the United States’ closest allies and to deter rogue actors in the region from opening up a second front in the war.

While violence such as the hospital blast was always seen as a possible risk of the visit, the president’s team concluded that the merits of the trip outweighed those risks. Multiple sources told CNN that the president’s top advisers did not come close on Tuesday to canceling the Israel portion of the trip.

Israel readies its next steps

Israel has been signaling it is preparing for a ground invasion of Gaza, even as a humanitarian crisis grows inside the coastal Palestinian enclave. Biden has called for the protection of civilians, and the United States has been working to alleviate shortages of food, water, and gas. Biden said in the interview he believes that there needs to be a humanitarian corridor to help civilians trapped amid the fighting and that Israel will abide by the “rules of war.”

“I’m confident that Israel is going to act under the measure … the rules of war,” Biden said in the interview. “There’s standards that democratic institutions and countries go by. And so, I’m confident that there’s gonna be an ability for the innocents in Gaza to be able to have access to medicine and food and water.”

American officials want humanitarian plans for Gaza fully signed off on and implemented before start of the invasion, multiple people familiar with the matter told CNN, describing that task as among Biden’s main objectives during his visit to Tel Aviv on Wednesday.

“We want to see humanitarian assistance flow in – and it’s not just a one and done – we want to see it be able to be sustained: food, water, obviously electrical power, medicine, all the things that the people of Gaza are going to continue to need as this conflict continues to go on. So he’ll make that case very, very clearly,” National Security Council spokesman John Kirby said ahead of the visit.

While many Americans feel deep sympathy for Israelis in the wake of the attacks, according to a CNN poll released Sunday, Biden also faces political pressure at home over how he responds to the attacks and how much support he offers Netanyahu’s government. Americans are split on whether the Israeli government’s response to the attacks are fully justified, including just 38% of Democrats, according to CNN’s poll.

The same poll shows the public is mixed over how much trust it has in Biden to make the right decisions on the fighting between Israel and Hamas – 47% have at least a moderate amount of trust. And about half of Democrats are also feeling a lot of sympathy for the Palestinian people who are feeling the brunt of Israel’s response to the attack, the poll shows, which could further complicate Biden’s decision-making on how much support to provide the Israelis.

Biden deeply affected by the conflict

The decision to travel to Israel so soon after the Hamas attack signals just how affected Biden has been by the violence in the region.

Advisers to the president told CNN that the days after the attack were a deeply emotional time for him, as he grappled with the second major outbreak of a war during his presidency and as the images and stories of Hamas’ reprehensive actions poured in.

During his trip, Biden will meet with some families impacted by the violence of the past week, including some who have lost loved ones in Israel, and some who “still don’t know the fate of their loved ones,” Kirby said. Some of those family members have loved ones who are being held hostage, though it was not immediately clear whether they are Americans.

But despite ongoing discussions with Israel and other partners, sources downplayed the expectation that the visit would result immediately in a refugee deal or the release of American hostages in Hamas custody.

The president spoke forcefully throughout the week about his horror at Hamas’ actions, frequently comparing the violence to some of the things European Jews experienced during the Holocaust. Biden has taken family members on trips to the Dachau concentration camp to learn about horrors of the Holocaust, and he emphasized in the “60 Minutes” interview how important it is for the world to learn about past persecution of the Jewish people.

“The Jews have been subject to abuse, prejudice and attempts to wipe them out for, oh, God, over a thousand years,” Biden told interviewer Scott Pelley. “For me, it’s about decency, respect, honor. It’s just simply wrong. Wrong, wrong, wrong. It violates every religious principle I have and … every single principle my father taught me.”