The death toll from bombs and other traumatic injuries during the first nine months of the war in Gaza may be underestimated by more than 40 percent. A new analysis published in The Lancet.
Led by epidemiologists from the London School of Hygiene and Tropical Medicine, the peer-reviewed statistical analysis used modeling to provide an objective third-party assessment of casualties. The United Nations cited a figure provided by the Hamas-led Health Ministry, which it said was largely accurate, but which Israel criticized as exaggerated.
But a new analysis shows that estimates by Hamas' health ministry are significantly lower. The researchers concluded that between October 2023 and the end of June 2024, the death toll from Israeli airstrikes and ground operations in Gaza was about 64,300, rather than the 37,900 reported by the Palestinian Ministry of Health.
The analysis estimates that 2.9 percent of Gaza's pre-war population, or one in 35 residents, died from traumatic injuries. The analysis did not take into account other war-related losses, such as malnutrition, water-related diseases or the breakdown of the health system, due to the development of the conflict.
As a result of the investigation, it was found that 59 percent of the dead were women, children and people over 65 years old. It was not determined which part of the dead were fighters.
Mike Spagat, an expert on war casualty estimates who was not involved in the study, said the new analysis convinced him that Gaza casualties had been underestimated.
“This is good evidence that the real number is higher than the official figures from the Ministry of Health, probably more than I thought in the last few months,” he said. Royal Holloway College, University of London.
But the presentation of exact numbers, such as 41 percent underreported deaths, is less helpful, he said, because the analysis actually suggests the real total may be lower or significantly higher. “Quantitatively, I think it's more uncertain than it appears on paper,” said Dr. Spaghetti.
The researchers said their estimate of 64,260 deaths from traumatic injuries had a “confidence interval” of 55,298 to 78,525, meaning the actual number of casualties was within that range.
If the estimated low data level of deaths through June 2024 is extrapolated to October 2024, the total number of Gazan casualties in the first year of the war would exceed 70,000.
Epidemiologist Francesco Checchi said: “Deaths from war injuries matter because it speaks to the question of whether the campaign was proportionate, whether sufficient measures were actually taken to prevent civilian casualties.” Professor at the London School of Hygiene and Tropical Medicine, specializing in conflict and humanitarian crises and authoring research. “I think it's important to remember the memories. There's value in just trying to find the right number.”
The analysis uses a statistical method called capture-recapture analysis, which has been used to calculate casualties in other conflicts, including the civil wars in Colombia and Sudan.
For Gaza, the researchers are working on three lists: The first is a registry maintained by the Palestinian Ministry of Health, which includes estimates of the number of people who died in hospital morgues and were not saved under the rubble. The second is deaths reported by family or community members through an online survey created by the ministry on January 1, 2024, when the pre-war death registration system was discontinued. He asked Palestinians inside and outside Gaza to report the name, age, national identity number and location of the dead. A third source was obituaries of people who died of injuries posted on social media, which did not all contain the same biographical details and were compiled manually by the researchers.
Researchers have analyzed these sources to look for individuals on multiple lists of those killed. A high level of overlap would indicate that several deaths were not counted; the small amount they found showed the opposite. The researchers used models to calculate the probability that each individual would appear on any of the three lists.
“The models allow us to actually count the number of people who are generally not listed,” said Dr. This, along with the listed number, gave analysts an overview.
Patrick Ball, director of research at the Human Rights Data Analysis Group and a statistician who has made similar estimates of violent deaths in conflicts in other regions, said the study was powerful and well-founded. But he cautioned that the authors may have underestimated the amount of uncertainty caused by the ongoing conflict.
The authors used different variations of mathematical models in their calculations, but Dr. Ball said it would have been more appropriate to put the death toll at 47,457 to 47,457 rather than provide a single figure – 64,260 deaths – as an estimate. 88,332 deaths, a range that covers all estimates obtained by modeling the overlap between the three lists.
“It's really hard to do something like this in the middle of a conflict,” said Dr. Honey. “It takes time and it takes input. I think the range is wider and it would be believable.”
Although Gaza had a robust death registration process before the war, it now has limited functionality after the destruction of much of the health system. Deaths are not counted when entire families are killed at once, no one reports, or an unknown number of people die when a large building collapses; Dr. Checchi said Gazans are increasingly being buried near their homes without going through a morgue.
The authors of the study acknowledged that some of those presumed dead may actually be missing, most likely captured in Israel.
Roni Caryn Rabin and Lauren Leatherby contributed to the report.