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An Israeli army transports a 155mm artillery shell near a self-propelled howitzer deployed at a position near the border with Lebanon in the upper Galilee region of northern Israel on Oct. 18.JALAA MAREY/AFP/Getty Images

Joe Biden, in the first visit by a U.S. President to Israel in a time of war, has thrown his weight behind the Israeli government in its fierce battle with the Hamas militant group. But it remains unclear whether Mr. Biden’s efforts to ensure humanitarian aid enters Gaza will be successful.

Thousands of tonnes of emergency relief supplies have been piled up at Egypt’s border with the Gaza Strip for the past five days, blocked from entering the Palestinian territory, even as the 2.3 million people of Gaza struggle with severe shortages of food, medicine, water and fuel.

The United Nations estimates that the average Gazan is now getting only three litres of water per day for all purposes, including cooking and hygiene, and the water is often brackish or dirty, which could cause diseases. Gaza has been kept under siege by Israel since Oct. 7, when Hamas attacked towns and villages in southern Israel, killing more than 1,400 people by the government’s latest count.

Mr. Biden told journalists in Tel Aviv on Wednesday, after a meeting with Israel’s war cabinet, that he had asked it to agree to open the Egyptian border for humanitarian aid to Gaza. He also promised military aid to Israel and lent his support to the government’s assertion that a militant group in Gaza was responsible for an explosion that reportedly killed hundreds of people at a Gaza hospital on Tuesday night.

Hamas political leader in West Bank says he believes some hostages could be released if Israel agrees to ceasefire

Israel-Hamas war updates

Mr. Biden later told journalists that Israel had agreed that “humanitarian assistance can begin to move from Egypt to Gaza.” But a subsequent statement by Israeli Prime Minister Benjamin Netanyahu said there were several restrictions on this agreement, including a requirement that the aid be provided only to southern Gaza, and that it be limited to food, water and medicine.

It is unclear how relief workers could guarantee the aid would remain in southern Gaza, since there are large numbers of civilians still in desperate need of help in northern Gaza, despite an Israeli evacuation order for the north.

In a televised speech to Israelis after his meeting with the U.S. President, Mr. Netanyahu made no mention of any promise to allow aid to enter from Egypt. Instead, he emphasized that no food or medicine will enter Gaza from Israeli territory as long as Hamas continues to hold about 200 hostages in Gaza.

A group of families of the hostages told Israeli media that they objected to the Egypt aid agreement, calling it a “horrible decision.”

In a similar move last week, Israel had promised to restore the water supply to southern Gaza. But UN officials later reported that the restored pipeline was supplying less than 4 per cent of the water that Gaza had used before the war, and even this water could not be fully distributed because of a lack of electricity.

Since last week, U.S. officials have repeatedly told journalists that the Rafah crossing between Egypt and Gaza would be reopened soon, but it has not yet happened. Egyptian officials say the Rafah crossing is closed because of damage inflicted by four Israeli air strikes around the crossing over the past 10 days.

On Wednesday evening, Mr. Biden told journalists on his plane, Air Force One, that he had spoken by phone to Egyptian President Abdel Fattah el-Sisi, who had agreed to allow up to 20 trucks of humanitarian aid into Gaza through the Rafah crossing.

But Mr. Biden also disclosed that the road from Egypt is filled with potholes and will require eight hours of patching work, so the gate cannot be finally opened until Friday at the earliest.

British Prime Minister Rishi Sunak will arrive in Israel on Thursday, his office said. Mr. Sunak will share his condolences for the loss of life in Israel and Gaza and will also urge the opening up of a route to allow humanitarian aid into the territory as soon as possible.

Gaza’s Health Ministry said almost 3,500 people have been killed in the territory as a result of Israeli bombing attacks since the war began. About 12,000 have been injured, and about 1,300 are still missing under the rubble of destroyed buildings, it said.

“The situation in Gaza is desperate,” Pope Francis said in a message on Wednesday. “Please let everything be done to avoid a humanitarian catastrophe. The possible widening of the conflict is disturbing. Let the weapons be silenced … .”

The UN humanitarian affairs office, UNOCHA, said there were rising tensions in Gaza because of the “critically short supply” of food, water and medicine.

“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,” UNOCHA said in its latest report on the Gaza situation this week.

“Bread supply is running low, and people are lining up for hours to get bread,” it said. “Bakeries are unable to operate due to the shortage of essential ingredients, particularly wheat flour, which is expected to be depleted in less than a week.”

Most of the 65 sewage pumping stations in Gaza are not operational, the UN office said. “In some areas, sewage and solid waste have been accumulating in the streets, posing health and environmental hazards. All five wastewater treatment plants in Gaza have been forced to shut down due to lack of power.”

The explosion at the hospital, meanwhile, has caused a barrage of accusations and counter-accusations about who was responsible. Thousands of displaced people from across Gaza had been sleeping at the hospital courtyard where the blast occurred. Reports by witnesses continue to emerge, with horrific details of the devastation.

In remarks from Tel Aviv, President Joe Biden vows the US will not repeat the world's inaction after the Holocaust, insisting ‘we will not stand by and do nothing again' as Israel responds to the recent attack by Hamas.

The Associated Press

“We could see bodies of children piled up, both dead, not moving, and wounded,” said Ghassan Abu Sittah, a doctor in Gaza for Médecins Sans Frontières (Doctors Without Borders), at a press conference after the explosion.

“There were several who had been amputated. I tended to a man whose leg had been blown off at the thigh. One of the wounded had shrapnel in his neck. As I was walking toward the ambulance, there were body parts everywhere, and there were bodies piled up in the courtyard of the hospital.”

During his visit on Wednesday, Mr. Biden said he had seen Pentagon data that supported Israel’s assertion the explosion was caused by a misfire in a rocket launched by a militant group in Gaza.

Senator Mark Warner, chairman of the U.S. Senate intelligence committee, made a similar statement after his committee reviewed intelligence on the matter. “Based on this information, we feel confident that the explosion was the result of a failed rocket launch by militant terrorists and not the result of an Israeli air strike,” he said.

Israel’s ambassador to Canada, Iddo Moed, accused Hamas of conducting a misinformation campaign to blame Israel for the explosion. The blast was caused by a misfired rocket by Palestinian Islamic Jihad, he said.

“They deliberately launch rockets from within civilian areas, placing them directly in the line of fire, and making them especially vulnerable to misfires,” the ambassador said in a statement released by the Israeli embassy in Ottawa.

Across the Palestinian territories and neighbouring countries, however, there is widespread belief the hospital explosion was caused by an Israeli missile that deliberately targeted the hospital. The angry response has led to demonstrations across the region, sparking fears of further violence.

Liberal MPs call for ceasefire in Israel-Hamas war

In Lebanon, militant group Hezbollah used the hospital bombing to stoke further anger toward Israel at a large demonstration it organized in Beirut.

“Their objective is to commit massacres and kill the innocent,” Hashem Safi al-Din, head of Hezbollah’s executive council, told a crowd of thousands, threatening retaliation.

“We have tens of thousands of militants who are willing to carry arms and go to war,” he said.

Lebanese anger over the hospital deaths brought a violent crowd to the U.S. embassy in Beirut, where state security forces used tear gas and water cannons to repel demonstrators attempting to storm the diplomatic compound.

But the tense border between Lebanon and Israel saw no sign of additional escalation, with exchanges of small arms fire, anti-tank missiles and an Israeli drone attack that were little different from previous days.

In the West Bank capital of Ramallah, a day of expected protests was largely muted by Palestinian president Mahmoud Abbas’s call for three days of mourning and a general strike in response to the explosion at the al-Ahli hospital.

A crowd of several hundred protesters nevertheless gathered in the city’s central Manar Square and chanted slogans in support of Gaza, and against Mr. Abbas.

Radi Jarai, a retired professor of political science, said there was mounting pressure on Mr. Abbas’s Palestinian Authority – which is lightly armed, and generally co-operates with Israel on security matters – to take some kind of action to support the Palestinians under siege in Hamas-ruled Gaza.

Mr. Jarai said Mr. Abbas’s secular Fatah movement was losing support to Hamas, which was seen as taking action to combat the Israeli military occupation that began after the Six-Day War in 1967. “It’s dangerous for Abu Mazen,” he said, using Mr. Abbas’s nickname.

With reports from Steven Chase in Ottawa and Reuters

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