Quick summary:
• A Lancet study estimates the true Gaza death toll from traumatic injuries at 64,260, which is 41 percent higher than the 37,877 deaths reported by Gaza’s Ministry of Health (MoH) between October 7, 2023, and June 30, 2024.
• The study found women, children, and the elderly accounted for nearly 60 percent of the deaths for which demographic details were available.
• The death toll is likely even higher when accounting for deaths from starvation, cold, and disease, which were not included in the study’s traumatic injury count.
• Researchers used a three-list capture-recapture method, combining hospital morgue data, online surveys, and social media obituary pages to identify deaths missed by official counts.
• Israel’s bombing of Gaza’s hospitals and communications infrastructure severely disrupted data collection, making it difficult for officials to track casualties accurately.
• In December 2024, President Joe Biden signed a law barring the Pentagon from citing Gaza’s official death toll, despite calls from human rights advocates to recognize the figures.
• The study highlights urgent humanitarian needs and calls for international accountability to prevent further loss of life in Gaza.
A peer-reviewed analysis published in The Lancet on Thursday reveals that the official Gaza death toll reported by the Palestinian Ministry of Health (MoH) between October 7, 2023, and June 30, 2024, was likely a 41 percent under count. The findings underscore the devastation caused by Israel’s ongoing military assault on Gaza and the immense challenges of tracking casualties amid incessant bombings, infrastructure collapse, and communication blackouts.
The Ministry of Health reported 37,877 deaths during the period studied, but The Lancet analysis estimates that 64,260 people died due to traumatic injuries, with women, children, and the elderly making up nearly 60 percent of the deaths for which demographic details were available.
The study’s findings have sparked renewed scrutiny of official death toll figures, which have been questioned and dismissed by U.S. and Israeli officials. The Lancet analysis challenges those dismissals, presenting a data-driven estimate based on three distinct casualty tracking methods.
The official Gaza death toll reported by the Palestinian Ministry of Health has been the subject of intense debate since Israel began its military campaign in response to the October 7, 2023, Hamas-led attack. The Lancet study shows that the true number of deaths may be significantly higher than reported, with tens of thousands of victims still unaccounted for due to infrastructure collapse and the destruction of homes.
The Palestinian Ministry of Health reported 37,877 deaths from traumatic injuries between October 7, 2023, and June 30, 2024. However, The Lancet study found that the actual number of deaths during that period is closer to 64,260—a 41 percent discrepancy.
According to the study, women, children under 18, and elderly individuals accounted for 59 percent of the identified deaths. This demographic breakdown highlights the disproportionate impact of the conflict on vulnerable populations.
The study focused on deaths from traumatic injuries, meaning the actual death toll is likely even higher when factoring in deaths caused by starvation, disease, and cold. Humanitarian groups have repeatedly warned that thousands of people remain missing under the rubble of destroyed buildings, making it difficult to compile a complete death toll.
Methodology: Combining hospital data and social media obituaries
To arrive at their estimate, the study’s authors—academics from the United Kingdom, the United States, and Japan—used a three-list capture-recapture method to track casualties. The methodology involved cross-referencing three separate data sources to identify overlapping and unique records of deaths.
The three lists used were:
1. Hospital morgue data collected by the MoH.
2. An MoH online survey conducted to document deaths during the conflict.
3. Social media obituary pages, which included specific pages dedicated to Gaza martyrs, where friends and family post death announcements and tributes.
The study’s authors note that social media obituaries played a crucial role in documenting deaths that were missed by hospital records. They manually scraped data from platforms such as X (formerly Twitter), Instagram, Facebook, WhatsApp, and Telegram, creating a comprehensive third list to improve accuracy.
“These pages are widely used obituary spaces where relatives and friends inform their networks about deaths, offer condolences and prayers, and honor people known as martyrs (those killed in war),” the study notes. “The platforms span multiple social media channels… Obituaries typically included names, age at death, and date and location of death, and were often accompanied by photographs and personal stories.”
Disrupted data collection amid relentless bombing
The study highlights how Israel’s assault on Gaza has made accurate casualty tracking nearly impossible. The destruction of hospitals, communication networks, and government buildings has forced the Ministry of Health to rely on less structured data collection methods, resulting in under reporting.
The authors explain that prior to the conflict, Gaza’s Ministry of Health was known for accurate mortality reporting. The study notes that “the MoH had achieved good accuracy in mortality documentation, with under reporting estimated at 13 percent” before October 7, 2023.
However, since Israel launched its campaign, the escalation of ground operations and attacks on healthcare facilities has severely disrupted Gaza officials’ ability to track deaths accurately. The Ministry of Health was forced to rely on manual record keeping and ad-hoc surveys, which likely resulted in geographically biased and incomplete reporting.
The study further notes that infrastructure collapse and telecommunication blockades have made it difficult to document casualties in northern Gaza and other hard-hit areas. Thousands of people are believed to be buried under the rubble of homes and buildings, but lack of equipment and constant bombing have made recovery efforts nearly impossible.
The accuracy of Gaza’s death toll figures has become a political flashpoint, particularly in the United States, where lawmakers have cast doubt on the MoH’s reports.
In December 2024, the U.S. Congress passed a military policy bill that included a provision barring the Pentagon from citing Gaza’s death toll figures as authoritative. President Joe Biden signed the bill into law on Dec. 23.
“This is an alarming erasure of the suffering of the Palestinian people, ignoring the human toll of ongoing violence,” said Rep. Ilhan Omar (D-Minn.) in a statement to The Intercept. Omar was one of the few lawmakers to vote against the legislation, warning that dismissing Gaza’s death toll undermines accountability efforts and erases the reality of the conflict’s human cost.
The Lancet study directly challenges this narrative by providing a peer-reviewed estimate of casualties based on multiple data sources.
The Lancet study highlights the devastating impact of Israel’s assault on Gaza, with an annualized crude death rate of 39.3 per 1,000 people during the study period. This represents a 14-fold increase in mortality compared to 2022.
“The escalation of Israeli military ground operations and attacks on healthcare facilities severely disrupted the latter’s ability to record deaths electronically,” the study notes.
While official figures focus on deaths from traumatic injuries, humanitarian organizations warn that indirect causes of death—such as starvation, lack of medical care, and freezing temperatures—are also claiming lives.
Humanitarian groups have called for international accountability efforts to address the scale of the violence in Gaza and ensure accurate casualty tracking.
“Our findings show an exceptionally high mortality rate in the Gaza Strip during the period studied,” the study’s authors write. “These results underscore the urgent need for interventions to prevent further loss of life and illuminate important patterns in the conduct of the war.”
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