Gaza hospital massacre raises stakes for Biden’s trip to Israel

U.S. President Joe Biden landed in Israel on Wednesday. Since speculation about his visit began earlier this week, the trip has been seen as key to unblocking the negotiations for an agreement that would allow the entry of humanitarian aid to Gaza, which lacks water, fuel and electricity; help Gazans with double nationality leave the enclave; and facilitate the release of the at least 199 Israelis who were taken hostage by Hamas. But Tuesday’s massacre of 500 civilians in a hospital in Gaza City has raised the stakes of the visit even more.

Immediately after the attack on Tuesday afternoon, the president of the Palestinian National Authority (PNA), Mahmoud Abbas, announced that he was canceling his meeting with Biden, Jordan’s King Abdullah II and Egyptian President Abdel Fattah el-Sisi, which was set to take place in Amman on Wednesday. In the evening, the Jordanian government announced that the summit between the four leaders was cancelled. “There is no use in talking now about anything except stopping the war,” said Jordanian Foreign Minister Ayman Safadi.

The Al Ahli hospital massacre sparked anger in the region, with tensions rising throughout the afternoon. Abbas’ refusal to participate in the summit with Biden has occurred amid a flood of condemnations from two other participating countries — the host, Jordan, and Egypt — as well as other Arab and Muslim countries such as Turkey and Qatar. The outrage has also triggered riots in various Palestinian towns and in Amman, where protesters surrounded the Israeli Embassy. “This [the attack on the Gaza hospital] confirms that this Israeli government does not respect any international standards or laws,” said the spokesman for the Palestinian presidency, Nabil Abu Rudeina. Israel, however, blames the massacre on a failed Islamic Jihad attack.

U.S. Secretary of State Antony Blinken has been clear about Washington’s position on the Hamas attacks and the Israeli military response in Gaza. On Sunday, in a statement, he said that Israel has the right (and even the obligation) to defend itself, but in accordance with international law. “The way that Israel does this matters. It needs to do it in a way that affirms the shared values that we have for human life and human dignity, taking every possible precaution to avoid harming civilians,” he said.

The massacre — the deadliest in memory of all wars involving Israel — increases the risk of a refugee crisis. This issue has been looming since the conflict began after the October 7 Hamas attack on Israel, which left around 1,400 people dead, mainly civilians. In the past 11 days, Israel has been bombing Gaza, with some 3,000 people killed in the strikes, almost a third of them minors. In addition to the bombardment, Israel has demanded that Gazans in the north evacuate to the south, with 600,000 residents forced from their homes. Meanwhile, pressure is growing on Egypt to open the Rafah border crossing, the only one not controlled by Israel.

With Biden about to arrive in Israel, more than 140 trucks loaded with Egyptian humanitarian aid are in Rafah. During the early hours of Tuesday, the aid was moved from the city of Al Arish — designated by Cairo as a logistics center to receive and dispatch assistance to Gaza — to the border crossing. The convoy was detained all day on the Egyptian side of the border, waiting for Israel — which on Monday bombed the Rafah crossing for the fourth time in a week — to offer security guarantees to allow the aid to enter the enclave.

Late on Monday, Hamas — which has ruled Gaza since 2007 — published the first proof of life of one of the between 200 and 250 hostages it claims to have taken, in addition to the dozens that are in the hands of other armed groups. The hostage’s family confirmed that the victim was Mia Schem, a young French-Israeli woman. In a video, Schem says that she is in Gaza, that she was injured when she arrived and has received medical attention. “I just ask that I am returned as fast as possible to my family, to my parents, and to my siblings,” she pled.

Negotiations had halted the ground invasion of Gaza, which Israel suggested was imminent last week. International support for such an offensive will foreseeably be affected by the massacre at the Gaza hospital. An Israeli military spokesman clarified that, although “everyone is talking about a ground offensive, it might be something different.” Israel is aiming to “destroy Hamas” both politically and militarily, which is impossible to achieve without a ground offensive.

Managing the crisis from Gaza and the West Bank

Jordan and Egypt, the two Arab countries that border the Palestinian territories, made it clear on Tuesday that they are not willing to receive a wave of refugees due to the Israeli offensive in Gaza. “There will be no refugees in Jordan and no refugees in Egypt,” stated King Abdullah II at a press conference in Berlin with the German Chancellor Olaf Scholz.

“This is a situation that has to be handled within Gaza and the West Bank. And you don’t have to do it on the shoulders of others,” he continued. “I think I can speak here on behalf of Jordan … but also our friends in Egypt: this is a red line.”

“If you are asking me if Egypt can host 2.5 million inhabitants; I believe you can equally ask if the U.K. or any EU country can adopt this policy,” said Egyptian Foreign Minister Sameh Shoukry, in statements to the British radio station BBC, shared by the Egyptian Foreign Ministry on X (formerly Twitter). British Prime Minister Rishi Sunak is one of the world leaders who have called on Egypt to allow Gaza residents to cross through Rafah.

As a matter of principle, Cairo and Amman are against receiving Gazan refugees because they see it as a way of transferring a problem that they have not created, for the benefit of Israel, which is technically still the occupying power and therefore responsible for the population of Gaza. A mass exodus of Gazans would further remove the creation of a Palestinian state as an option for resolving the Middle East conflict. El-Sisi has said that Palestinians must “stay steadfast and remain on their land,” while the Jordanian king opposes “any attempt to forcibly displace Palestinians from all Palestinian territories [the West Bank and Jordan share a border, controlled by Israel] or cause their internal displacement.” Jordan and Egypt are allies of the United States and are the only neighbors of Israel that recognize the Jewish state.

Each one also has their particular interests. Egypt is immersed in one of its worst economic crises and fears a population flow into the Sinai peninsula, which went from a lawless territory to a battle zone between security forces and Islamist groups. Tens of thousands of Palestinians crossed into Rafah in 2008, after blowing up part of the border wall (which has since been rebuilt). For years, Egypt has compounded Israel’s siege of Gaza, with Rafah becoming synonymous with long lines, security checks and bribes to exit.

Jordan is the country with the most Palestinian refugees from the Nakba — “the catastrophe” in Arabic. The term refers to the mass expulsions of 750,000 Palestinians — two thirds of whom lived in the current territory of Israel — and the destruction of more than 400 towns between 1947 and the end of the first Arab-Israeli war, in 1949. Jordan is often defined as an “island of stability” in a turbulent Middle East, but on that island, there is a delicate balance between the Palestinian population and the population of Bedouin origin.

For Palestinians, the prospect of a new forced displacement has all the echoes of the Nakba, the most defining element of their national identity. Hamas has asked the population to stay.

All this is taking place while the humanitarian crisis in Gaza worsens. The last seawater desalination plant in Gaza closed on Tuesday, according to UNRWA, the U.N. agency for Palestine Refugees. The United Nations Humanitarian Aid Coordination Office denounced that Israel is only allowing the supply of less than 4% of the water that the population of Gaza consumed before the attack. The population is “is at imminent risk of death or infectious disease outbreak if water and fuel are not immediately allowed to enter.”

Gaza’s authorities have also called on gas station owners and residents with “any liter” of fuel to help supply medical centers and hospitals, which will be left without power if there is no fuel for generators.

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