‘IT IS NOT implausible to estimate that up to 186,000 or even more deaths could be attributable to the current conflict in Gaza,’ declares an article in the British health journal The Lancet.
The article, ‘Counting the Dead in Gaza: Difficult but Essential,’ was written by Rasha Khatib, Martin McKee and Salim Yusuft.
It states: ‘By June 19, 2024, 37,396 people had been killed in the Gaza Strip since the attack by Hamas and the Israeli invasion in October, 2023, according to the Gaza Health Ministry, as reported by the UN Office for the Coordination of Humanitarian Affairs.
The Ministry’s figures have been contested by the Israeli authorities, although they have been accepted as accurate by Israeli intelligence services, the UN, and WHO.
These data are supported by independent analyses, comparing changes in the number of deaths of UN Relief and Works Agency (UNRWA) staff with those reported by the Ministry, which found claims of data fabrication implausible.
Collecting data is becoming increasingly difficult for the Gaza Health Ministry due to the destruction of much of the infrastructure.
The Ministry has had to augment its usual reporting, based on people dying in its hospitals or brought in dead, with information from reliable media sources and first responders.
This change has inevitably degraded the detailed data recorded previously. Consequently, the Gaza Health Ministry now reports separately the number of unidentified bodies among the total death toll.
As of May 10, 2024, 30% of the 35,091 deaths were unidentified.
Some officials and news agencies have used this development, designed to improve data quality, to undermine the veracity of the data.
However, the number of reported deaths is likely an underestimate.
The non-governmental organisation Airwars undertakes detailed assessments of incidents in the Gaza Strip and often finds that not all names of identifiable victims are included in the Ministry’s list.
Furthermore, the UN estimates that, by February 29, 2024, 35% of buildings in the Gaza Strip had been destroyed, so the number of bodies still buried in the rubble is likely substantial, with estimates of more than 10,000.
Armed conflicts have indirect health implications beyond the direct harm from violence.
Even if the conflict ends immediately, there will continue to be many indirect deaths in the coming months and years from causes such as reproductive, communicable, and non-communicable diseases.
The total death toll is expected to be large given the intensity of this conflict; destroyed health-care infrastructure; severe shortages of food, water, and shelter; the population’s inability to flee to safe places; and the loss of funding to UNRWA, one of the very few humanitarian organisations still active in the Gaza Strip.
In recent conflicts, such indirect deaths range from three to 15 times the number of direct deaths.
Applying a conservative estimate of four indirect deaths per one direct death to the 37,396 deaths reported, it is not implausible to estimate that up to 186,000 or even more deaths could be attributable to the current conflict in Gaza.
Using the 2022 Gaza Strip population estimate of 2,375,259, this would translate to 7·9% of the total population in the Gaza Strip. A report from February 7, 2024, at the time when the direct death toll was 28,000, estimated that without a ceasefire there would be between 58,260 deaths (without an epidemic or escalation) and 85,750 deaths (if both occurred) by August 6, 2024.
An immediate and urgent ceasefire in the Gaza Strip is essential, accompanied by measures to enable the distribution of medical supplies, food, clean water, and other resources for basic human needs.
At the same time, there is a need to record the scale and nature of suffering in this conflict.
Documenting the true scale is crucial for ensuring historical accountability and acknowledging the full cost of the war.
It is also a legal requirement.
The interim measures set out by the International Court of Justice in January, 2024, require Israel to ‘take effective measures to prevent the destruction and ensure the preservation of evidence related to allegations of acts within the scope of … the Genocide Convention’.
The Gaza Health Ministry is the only organisation counting the dead.
Furthermore, these data will be crucial for post-war recovery, restoring infrastructure, and planning humanitarian aid.
MM is a member of the editorial board of the Israel Journal of Health Policy Research and of the International Advisory Committee of the Israel National Institute for Health Policy Research.
MM was co-chair of the Institute’s 2016 6th International Jerusalem Conference on Health Policy, but writes in a personal capacity.
He also collaborates with researchers in Israel, Palestine, and Lebanon. RK and SY declare no competing interests.
The authors would like to acknowledge ‘study team members Shofiqul Islam and Safa Noreen for their contribution to collecting and managing the data for this correspondence’.
Since the early hours of Monday, July 8, the Israeli army has been waging a war of terror and forcibly displacing the people living in Gaza City and North Gaza, causing another massive wave of forced displacement, Euro-Med Human Rights Monitor has said in a statement.
According to the Geneva-based organisation, tens of thousands of Gazans were displaced from multiple areas of Gaza City, and they have been left with nowhere to go without any safe passages, amid conflicting displacement orders issued by the Israeli army.
‘This came along with the systematic and widespread war of starvation and deliberate, indiscriminate killing against Palestinian civilians in the Gaza Strip.’
The Israeli occupation army launched a military operation with a ground incursion into areas southwest of Gaza City, housing tens of thousands of displaced people, a few hours after ordering residents of the ‘Al-Tuffah,’ ‘Al-Daraj’ and ‘Al-Shuja’iya’ neighbourhoods, east of the city, to head to those targeted areas.
Early on Monday morning, the Israeli occupation army issued new evacuation orders against residents of the Al-Darraj and Al-Tuffah neighbourhoods while simultaneously planning to expand its ground operation to the centre of Gaza City, where it has been stationed for over a week in the Shujaiya neighbourhood. Later on, it started a second military operation in the city’s western districts.
Under heavy rocket and shell fire, the Israeli occupation army launched a ground incursion in the Al-Sinaa area, directly targeting the headquarters of the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) and the headquarters of several destroyed universities west of Gaza, in total contradiction to the previous displacement orders given to tens of thousands of residents.
Later, the Israeli occupation army ordered residents of large areas in Gaza City to evacuate to Deir al-Balah in the central Gaza Strip, including the ‘Ahli Baptist’ Hospital medical staff, forcing the main hospital operating in Gaza for months to be out of service.
Many reports have surfaced of dozens of deaths and injuries caused by the Israeli army’s abrupt incursion into Gaza City’s east and then into the city’s southwest neighbourhoods under heavy fire. This action was taken without prior warning and in defiance of conflicting evacuation orders.
Coinciding with the ongoing ground incursion into large areas of Gaza City, the Euro-Med field team documented a series of Israeli raids with dozens of fire belts and the firing of artillery shells.
The ground incursion included searches, raids, and arbitrary arrests of civilians, as well as intentional killings around the clock.
Euro-Med raised concerns about the Israeli occupation army’s intentions to expand its ground operations and escalate the war of forced displacement to the central and southern areas of the Gaza Strip, which are already crowded with more than a million and a half people and suffer from extremely complex catastrophic humanitarian conditions.
On Monday, Euro-Md reported that residents of the ‘Al-Shuja’iya’ and ‘Al-Daraj’ neighbourhoods received phone calls and threats from the Israeli army, asking them to first head to the areas south west of Gaza City before they were asked to go to the ‘humanitarian shelters’ in the city of Deir Al-Balah.
According to UNRWA, Israel has bombed 190 – more than half – of the agency’s facilities in Gaza, some more than once since the war began. As a result, thousands of Palestinian civilians were killed and injured while looking for safe refuge.
According to UN estimates, 1.9 million people in the war-ravaged enclave are internally displaced – including people displaced up to nine or 10 times.
The Israeli evacuation orders, widespread damage to both public and private infrastructure, restrictions on access to essential services, and the ongoing hostilities, constitute the main causes of the mass displacement waves.
Based on the aforementioned, Euro-Med called on the international community to fulfil their international obligations by enacting strong sanctions against Israel and severing all other types of political, financial, and military support and cooperation.
This includes immediately halting arms transfers to Israel, including export permits and military aid; otherwise, these nations will be held accountable for the crimes that have been committed in the Gaza Strip, including genocide.
