More than 40,000 killed in Israel’s war in Gaza, Health Ministry says

JERUSALEM – More than 40,000 Palestinians have been killed in Israel’s military campaign in the Gaza Strip, the local Health Ministry said Thursday – a bleak indicator of the war’s toll even as a full count remained out of reach amid a near-total collapse of the enclave’s health care system.

The official figure of 40,005 killed since October does not distinguish between civilians and combatants. But the Gaza Health Ministry, which has operated for years under the Hamas-led government, says the majority of the dead are women and children. At least 92,401 have also been injured over more than 10 months of war.

Israel launched its assault Oct. 7 after Hamas militants attacked southern Israel, killing about 1,200 people and taking around 250 others back to Gaza as hostages. More than 300 Israeli soldiers have also died in combat since a ground invasion began in late October.

At times, Israeli officials have accused Palestinians of exaggerating the civilian toll. On July 16, however, the Israel Defense Forces said in a statement that about 14,000 militants had been “eliminated or apprehended,” meaning combatants potentially make up less than half of those killed.

Then, on Thursday, Rear Adm. Daniel Hagari, the IDF spokesman, provided a new number for militant deaths, saying 17,000 had been “eliminated” in Gaza since the start of the war. He did not say how the military arrived at that estimate, which suggests thousands of fighters were killed since the IDF’s last update in July. Over that period, the Gaza Health Ministry reported 1,340 deaths.

But Palestinian journalists, first responders, international aid workers and war casualty watchdogs all say that the official death toll in Gaza is probably an undercount, with the chaos of war upending what experts and researchers say was once a robust reporting system for tracking and identifying the dead.

After months of bombardment and siege, thousands of bodies are still believed to be buried under the rubble, according to Gaza’s civil defense force. Others were never brought to a morgue or reported as deceased, and in some cases, shelling or airstrikes have rendered bodies unrecognizable, with only parts or pieces recovered from the scene.

Earlier this week, journalist Talal al-Arouqi was at al-Awda Hospital in Nuseirat, central Gaza, when an ambulance arrived carrying victims from a nearby strike. He captured a photo of one of them: a decapitated child whose arms were also severed. The toddler was one of seven members of the Abu Nada family killed on Tuesday, according to a neighbor.

The IDF did not immediately respond to a request for comment on the strike. Medics brought in two bags filled with body parts of the Abu Nada family, Arouqi said, in what he described as a familiar scene.

But the strain on the system – including attacks on hospitals and the detention of health-care workers – has opened the door for criticism of the Gaza Health Ministry’s tally, despite the fact that its casualty counts from previous wars have been largely corroborated by independent experts and the United Nations. The State Department has also used the ministry’s figures in its reports.

The Gaza Health Ministry’s protocol for reporting deaths was “quite reliable” at the start of the war, “which is not to say it captured everything,” said Michael Spagat, an economics professor at the University of London and researcher on casualties in armed conflict.

The ministry updated its daily death toll based on the number of bodies in hospital morgues, he said. Medical staff logged the personal information of each casualty, including name, age, gender and identification number.

But as the violence spiraled and Israeli forces besieged several hospitals, including al-Shifa, the territory’s largest, the system buckled. The majority of the population was displaced, cellphone and internet networks went down, and the IDF divided northern and southern Gaza, making it increasingly difficult for health-care workers to figure out who died, where and when.

“The quality deteriorated,” Spagat said.

Still, in a December article in the Lancet, a peer-reviewed medical journal, researchers from Johns Hopkins University’s School of Public Health said that in Gaza, “difficulties obtaining accurate mortality figures should not be interpreted as intentionally misreported data.”

“The Gaza MoH has historically reported accurate mortality data,” the researchers wrote, adding that they “found no evidence of inflated rates.”

In the months since, the ministry has expanded its tally to include vetted cases of people reported dead by family members or local media and has broken down the official toll to include what authorities say is a subset of bodies that are unidentified, or whose identities are only partially confirmed.

It has also released multiple, detailed lists of Palestinians killed in the fighting, the most recent including verified names up until June 30.

“The information we have for this conflict is much better than probably all of the most recent high-profile conflicts,” Spagat said, including in Ukraine, Ethiopia, Syria and Sudan, where there are no comparable detailed or publicly available lists of the dead.

In July, the civilian harm watchdog Airwars released a report that used open-source analysis to identify nearly 3,000 Palestinian casualties in the first 17 days of the war. They compared their findings to the Health Ministry’s list for the same period and found that 75 percent of the names they found and verified online were a match – meaning that other casualties had probably gone uncounted by Gaza health officials, said Airwars director Emily Tripp.

The number of deaths excluded from the ministry’s official toll is “probably very high,” she said, but difficult to determine.

“We have captured incident after incident where people are killed in their homes, are trapped under rubble for days at a time,” Tripp said.

In other cases, she added, entire families have been killed in single strikes, leaving no one to report their deaths.

“We are now increasingly finding cases of bodies being identified but we can’t tie them to a specific incident,” Tripp said. “They are being discovered as people move around to different areas in Gaza.”

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