Human Rights Watch (HRW) said on Sunday that evidence suggested a misfired rocket was the likely cause of an explosion that resulted in heavy casualties at a hospital in Gaza on October 17.
The explosion at the Al-Ahli hospital triggered outrage across the Arab world. Palestinians blamed an Israeli air strike, while Israel said it was caused by a misfiring Palestinian rocket launch.
The health ministry in Gaza said 471 people were killed. Israel disputes this figure. An unclassified US intelligence report estimated the death count "at the low end of the 100 to 300 spectrum".
"The explosion that killed and injured many civilians at Al-Ahli Arab Hospital in Gaza on October 17, 2023, resulted from an apparent rocket-propelled munition, such as those commonly used by Palestinian armed groups..," HRW said.
It said the findings of its investigation into the explosion were based on a review of photos and videos, satellite imagery and interviews with witnesses and experts.
The Al-Ahli hospital blast was one of the most fiercely disputed incidents in a war marked by accusations from both sides of disinformation and war crimes.
Senior Hamas official Basem Naim told Reuters all indications pointed to Israel's responsibility, adding that the HRW report was biased towards Israel and was not "decisive".
"HRW hasn't come up with any evidence to support their findings nor eyewitness testimonies nor opinion of independent military exports," he said, adding that Hamas received questions from HRW two weeks ago but asked it to delay its report until after the war had ended.
Emmanuel Nahshon, deputy director general for public diplomacy at Israel's Foreign Ministry, criticised the time it took HRW to release its opinion.
"More than a month to reach half heartedly the conclusion the whole world reached after two days," he said on X social messaging network.
Naim said Hamas had offered HRW or any other international investigation committee full cooperation if they were willing to visit Gaza and conduct a thorough probe.
HRW said reports of 471 dead and 342 injured "displays an unusually high killed-to-injured ratio" and appeared to be "out of proportion" with the damage visible on the site.
"Authorities in Gaza and Israel should release the evidence of munition remnants and other information they have regarding the Al-Ahli hospital explosion to allow for a full investigation," HRW crisis and conflict director Ida Sawyer said.
Hospitals have come under bombardment in the Israel-Hamas conflict and all those in the northern part of the enclave have effectively ceased functioning normally, although they continue to house some patients who could not flee as well as people displaced from their homes.
Palestinians accuse Israel of targeting hospitals and schools, while Israel says Hamas uses ordinary Gazans as human shields by placing military positions in civilian buildings.
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