Research published in the Lancet medical journal estimates that the death toll in Gaza during the first nine months of the Israel-Hamas war was about 40% higher than numbers recorded by the Palestinian territory’s health ministry.
The peer-reviewed statistical analysis was conducted by academics at the London School of Hygiene and Tropical Medicine, Yale University and other institutions, using a statistical method called capture-recapture analysis.
The researchers sought to assess the death toll from Israel’s air and ground campaign in Gaza between October 2023 and the end of June 2024, estimating 64,260 deaths due to traumatic injury during this period. The study said 59.1% were women, children and people over the age of 65. It did not provide an estimate of Palestinian combatants among the dead.
Up to 30 June last year, the health ministry in Gaza reported a death toll of 37,877 in the war, which began on 7 October 2023 after the Hamas-led attack on southern Israel in which 1,200 people were killed and more than 250 taken hostages.
According to Palestinian health officials, a total of more than 46,000 people have been killed in the Gaza war, from a pre-war population of around 2.3 million.
It has not been possible for international media to independently verify the death toll in Gaza as Israel does not allow foreign journalists into the territory.
A senior Israeli official, commenting on the study published on Friday, said Israel’s armed forces went to great lengths to avoid civilian casualties. “No other army in the world has ever taken such wide-ranging measures,” the official said.
“These include providing advance warning to civilians to evacuate, safe zones and taking any and all measures to prevent harm to civilians. The figures provided in this report do not reflect the situation on the ground.”
The Lancet study said the Palestinian health ministry’s capacity for maintaining electronic death records had previously proven reliable, but deteriorated under Israel’s military campaign, which has included raids on hospitals and other healthcare facilities and disruptions to digital communications.
Israel accuses Hamas of using hospitals as cover for its operations, which the militant group denies.
The study used death toll data from the health ministry, an online survey launched by the ministry for Palestinians to report relatives’ deaths, and social media obituaries to estimate that there were between 55,298 and 78,525 deaths from traumatic injuries in Gaza up to 30 June 2024.
The study’s best estimate was 64,260 dead, which would mean the health ministry had under-reported the number of deaths to that point by 41%. The estimate represented 2.9% of Gaza’s pre-war population, “or approximately one in 35 inhabitants”, the study said.
The figure is only for deaths from traumatic injuries and does not include deaths from a lack of healthcare or food, or the thousands believed to be buried under rubble.
The Palestinian Central Bureau of Statistics (PCBS) estimates that, on top of the official death toll from the health ministry, another 11,000 Palestinians are missing and presumed dead.
The researchers scoured the three lists, searching for duplicates. “We only kept in the analysis those who were confirmed dead by their relatives or confirmed dead by the morgues and the hospital,” said Zeina Jamaluddine, an epidemiologist at the London School of Hygiene and Tropical Medicine and the lead author of the study.
“Then we looked at the overlaps between the three lists, and based on the overlaps, you can come up with a total estimation of the population that was killed,” Jamaluddine told Agence France-Presse.
However, the researchers cautioned that the hospital lists did not always provide the cause of death, so it was possible that people with non-traumatic deaths could have been included, potentially leading to an overestimate.
Patrick Ball, a statistician at the US-based Human Rights Data Analysis Group not involved in the research, has used capture-recapture methods to estimate death tolls for conflicts in Guatemala, Kosovo, Peru and Colombia.
Ball told AFP the well-tested technique had been used for centuries and that the researchers had reached “a good estimate” for Gaza.
Kevin McConway, a professor of applied statistics at Britain’s Open University, said there was “inevitably a lot of uncertainty” when making estimates from incomplete data, but it was “admirable” that the researchers had used three other approaches to check their estimates.
Agence France-Presse and Reuters contributed to this report
