Number of Palestinians killed in Gaza may reach 186,000, three academics say

Correspondence published by the Lancet warns ‘conservative estimate’ could be exceeded amid destroyed infrastructure, shortages of food, water and shelter, and losses of funding for Unrwa

A Palestinian child looks at the graves of people killed in the Israeli bombardment of the Gaza Strip and buried inside Al-Shifa Hospital grounds. Photograph: Mohammed Hajjar/AP

As many as 186,000 Palestinians may be killed directly or indirectly by the Gaza war, correspondence pubished by the British medical journal, the Lancet, has predicted*.

“Even if the conflict were to end immediately, many indirect deaths will continue to be recorded in the coming months and years due to causes such as reproductive, communicable and non-communicable diseases,” stated the correspondence from three authors, Rasha Khatib, Martin McKee and Salim Yusuf.

The death toll could exceed this figure, they said, “given the intensity of this conflict; destroyed healthcare infrastructure; severe shortages of food, water and shelter; the population’s inability to flee to safe places; and the loss of funding to [the UN agency for Palestinian refugees] Unrwa, one of the very few humanitarian organisations still active in the Gaza Strip”.

Dr Rasha Khatib is described on the Lancet website as affiliate of the Advocate Aurora Research Institute, Milwaukee, US, and the Institute of Community and Public Health, Birzeit University, Birzeit, Palestine; Prof Martin McKee is an affiliate of the Department of Public Health and Policy, London School of Hygiene & Tropical Medicine, London; and Dr Salim Yusuf is an affiliate of the Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.

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Their prediction is based on a June 19th report by the Hamas-run Gaza health ministry that 37,306 Palestinians had been killed since Israel launched its war on Gaza in response to the October 7th attack on it by Hamas, in which 1,200 people were killed and more than 250 taken hostage, according to Israel.

The authors said the figure adopted as the base for their projection was “likely an underestimate” due to the thousands of bodies under rubble. The health ministry collects data on “people dying in its hospitals or brought in dead” as well as from “reliable media sources and first responders”, the correspondence said.

In recent conflicts, the authors said, “indirect deaths range from three to 15 times the number of direct deaths”. Their projected figure of 186,000 overall deaths was reached by applying “a conservative estimate of four deaths per one direct deathThey said this would amount to 7.9 per cent of Gaza’s 2.3 million Palestinians.

Although Gaza health ministry data is contested by Israeli authorities, the three authors said the ministry’s figures had been accepted by “Israeli intelligence services”, the United Nations humanitarian agency and the World Health Organisation.

They said a ceasefire was essential, “accompanied by measures to enable the distribution of medical supplies, food, clean water and other resources for basic human need”. It said it was necessary to “record the scale and nature of suffering in this conflict”.

Documentation was crucial “for ensuring historical accountability and acknowledging the full cost of this war [and] is a legal requirement”. The authors pointed out that in January the International Court of Justice required Israel to “‘take effective measures to prevent the destruction and ensure the preservation of evidence related to allegations of acts” governed by the Genocide Convention.

As the Gaza health ministry was the only organisation counting the dead, its data and other documentation were “crucial for postwar recovery, restoring infrastructure, and planning humanitarian aid”.

The Israel government press office did not reply to the Irish Times’s request for comment.

* This article was amended on July 10th to correct an earlier version that said the projections for Palestinian fatalities in Gaza were made by the Lancet, rather than in correspondence published by the Lancet. Such correspondence is not normally externally peer reviewed.

Michael Jansen

Michael Jansen

Michael Jansen contributes news from and analysis of the Middle East to The Irish Times