An international study showed that the real number of victims who fell directly as a result of the Israeli war on the Palestinian Gaza Strip may be greater than the official Palestinian census by about 41% until mid-2024 in light of the collapse of the health care infrastructure in the Palestinian Strip.
A research study published by the Lancet medical journal on Friday reported that the death toll in Gaza during the first nine months of the war between Israel and Hamas is about 40 percent higher compared to the figures of the Ministry of Health in the Palestinian Strip.
The death toll in Gaza has been the subject of intense controversy since Israel launched its military campaign against Hamas in response to the unprecedented attack launched by the Palestinian movement against the Hebrew state on October 7, 2023. As of June 30 of last year, the Ministry of Health in the Hamas-controlled Strip reported, The toll of the war amounted to 37,877 deaths.
However, the new study, which was based on data from the ministry, an online survey, and obituary data on social media sites, concluded with estimates that the death toll from war injuries in Gaza ranged between 55,298 and 78,525 dead during that period. The best estimate of the death toll in the study is 64,260, which means it is 41% higher than the numbers published by the Ministry of Health for that period. The study indicated that this number represents 2.9 percent of Gaza’s population before the war, “or about one in every 35” Gazans.
According to estimates by a group of researchers led by the United Kingdom, 59 percent of the dead were women, children and the elderly. The number is limited to injuries resulting from the war, meaning it does not include deaths resulting from other factors such as lack of health care or food, nor the thousands of missing persons who are believed to be buried under the rubble. Agence France-Presse was unable to independently verify the death toll. On Thursday, the Ministry of Health in Gaza announced that 46,006 people had been killed in the war that has been going on for 15 months.
On October 7, 2023, Hamas launched an unprecedented attack on Israel, killing 1,208 people, most of them civilians, according to a census conducted by Agence France-Presse based on official Israeli data. Israel doubts the credibility of the death tolls announced by the Ministry of Health in Gaza, but the United Nations considers these numbers reliable.
The researchers used a statistical approach called “capture-recapture,” which has previously been used to estimate the death toll in other conflicts around the world. The analysis was based on data from three different lists, the first provided by the Ministry of Health in Gaza for bodies identified in hospitals or morgues. The second list was taken from an online survey launched by the Ministry of Health in which Palestinians report the death of their relatives. The third list was based on obituary data published on social media networks such as X, Instagram, Facebook, and WhatsApp, whenever the identity of the deceased could be verified.
“We only kept in the analysis those whose death was confirmed by their relatives, morgues or hospitals,” said the study’s lead author, Zeina Gamal El-Din, an epidemiologist at the London School of Hygiene and Tropical Medicine. The researchers checked the three lists for any duplicate data. Jamal Al-Din added, “Then, we looked at the overlap between the three lists, and based on the overlap, you can get an overall estimate of the population who were killed.”
Patrick Ball, a statistician at the US-based Human Rights Data Analysis Group who was not involved in the research study, used capture-recapture methods to estimate the death tolls in conflicts in Guatemala, Kosovo, Peru and Colombia. Paul said the well-tested technique had been used for centuries and that researchers had made a “good estimate” regarding Gaza.
In turn, Kevin McConway, professor of applied statistics at the Open University in Britain, said that there is “inevitably great uncertainty” when making estimates based on incomplete data. But he said it was “impressive” that the researchers used three other approaches to statistical analysis to verify their estimates. “Overall, I find these estimates reasonably convincing,” he added.
The researchers warned that hospital lists do not always indicate the cause of death, so they may include people suffering from health problems, such as a heart attack, which could lead to higher estimates than reality. However, there is something that would reinforce the assumption that the declared outcome of the war is less than the reality. The research study did not include missing persons. The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) says that it is believed that about ten thousand missing Gazans are buried under the rubble.
War can also cause indirect losses of life, including lack of health care, food, water, sanitation, or disease outbreaks. All of these factors have been affecting the Gaza Strip since October 2023. In a controversial letter, published in the journal The Lancet in July, another group of researchers relied on the indirect death rate recorded in other conflicts to suggest that the death toll In Gaza, it could eventually be estimated at 186,000.
The new study considered that these estimates “may be inappropriate due to clear differences in the burden of diseases before the war” in Gaza compared to conflicts in countries such as Burundi and East Timor. Jamal Al-Din said that she expects “criticism to come from various parties” regarding this new research study. She denounced what she considered an “obsession” with arguing about the numbers of deaths, and said, “We already know that there are too many deaths.”
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