A new analysis has revealed that the death toll in Gaza could exceed 186,000 as a result of indirect effects from the ongoing conflict, highlighting a humanitarian crisis of staggering proportions. The study, published in the medical journal The Lancet on July 5, suggests that the true impact of the war extends far beyond the immediate casualties from violence.
The official death toll reported by Gaza health officials stands at 38,193, a figure that includes those killed directly by Israeli airstrikes and military actions. However, public health experts Rasha Khatib of the Advocate Aurora Research Institute, Martin McKee of the London School of Hygiene and Tropical Medicine, and Salim Yusuf of McMaster University and Hamilton Health Sciences argue that this number significantly underestimates the actual death toll. They cite the destruction of healthcare infrastructure, the blockade on humanitarian aid, and widespread starvation as contributing factors to a much higher number of deaths.
“Armed conflicts have indirect health implications beyond the direct harm from violence,” wrote the authors. They estimate that the total number of deaths could approach 200,000 when including indirect causes such as reproductive, communicable, and noncommunicable diseases. The experts point out that in recent conflicts, indirect deaths have ranged from three to 15 times the number of direct deaths. Applying a conservative estimate of four indirect deaths per one direct death to the reported figures, the study suggests a possible death toll of up to 186,000.
This projected toll represents approximately 7%-9% of Gaza’s population, which was estimated at over 2.3 million people in 2022. The destruction of Gaza’s healthcare system has had devastating consequences. Hospitals and medical facilities have been obliterated, severely limiting access to medical care for those in need. The blockade on humanitarian aid has exacerbated these conditions, leading to shortages of medical supplies, food, and clean water.
The study emphasizes that even if the conflict were to end immediately, the indirect deaths would continue to rise due to the prolonged impact on healthcare and living conditions. An untold number of Palestinians in Gaza have already died because they were unable to receive medical care, suffered from malnutrition, or were affected by the overall collapse of public infrastructure.
The authors also highlight the difficulty in accurately counting the dead in such a chaotic environment. U.S. President Joe Biden expressed skepticism about the reported death counts early in the conflict, and the U.N. revised its civilian death toll in May. However, the study’s authors argue that these figures are likely still underestimates. They note that thousands of Palestinians may remain buried under rubble from Israeli airstrikes. According to the U.N., by February 2024, 35% of buildings in Gaza had been destroyed, suggesting a substantial number of bodies could still be undiscovered.
Israeli intelligence services, the World Health Organization, and the United Nations have all agreed that claims of data fabrication by Palestinian authorities in Gaza are “implausible.” The study reiterates this point, dismissing allegations that the Gaza Health Ministry’s figures are inflated.
Political analyst Omar Baddar noted that statements from top-level Israeli officials regarding their intent to “thin the population” of Gaza lend credibility to the high death toll estimates. Prime Minister Benjamin Netanyahu has made remarks about reducing the population, which align with the grim projections provided by the Lancet study.
Additional reports have supported the findings of widespread and systematic violence. The Israeli news outlet +972 Magazine published interviews with six Israeli soldiers who described the routine execution of Palestinian civilians and the systematic policy of setting Palestinian homes on fire after occupying them.
The study calls for an immediate and urgent ceasefire in Gaza, accompanied by measures to distribute medical supplies, food, clean water, and other essential resources. “At the same time, there is a need to record the scale and nature of suffering in this conflict,” the authors wrote. “Documenting the true scale is crucial for ensuring historical accountability and acknowledging the full cost of the war.”
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