10,000. 20,000. 30,000. Now, over 42,000 dead. Since the start of Israel's war in the Gaza Strip, the local authorities have been keeping tallies of the deaths on a daily, or almost daily basis. Used everywhere, by everyone, the count produced by the Hamas-controlled Ministry of Health has been the subject of several controversies since the war began. In a bid for transparency, the publication in September of a list of the names of the victims paradoxically rekindled criticisms. But many experts and media organizations agree that the figures are reliable, and maybe even underestimated.
Every day, the ministry publishes the number of people killed in Israeli bombardments, whom it describes as "martyrs," and provides statistics on those who have died, the proportion injured, the number of hospitals destroyed, and those that remain functional. A 649-page document published in mid-September lists the 34,344 people identified as of August 31, with their name, gender, date of birth and age. Without making distinctions between fighters and civilians, it establishes that people over 60 years old, women, and children under 18 account for more than 60% of the deceased. The list marks "a significant improvement in the accuracy and quality of casualty reporting," noted British economics professor Mike Spagat, a researcher specializing in armed conflict.
To make this assessment, the ministry relies on data from Gaza's public and private hospitals. When a wounded or dead person is taken to hospital, the medical staff records their personal details in a computerized register. If a body is not identifiable due to injuries or is not reported by relatives (sometimes entire families are killed), health professionals register the deceased with an identification number. According to the local Ministry of Health, more than 7,600 people declared dead on arrival at the emergency room have still not been identified since the start of the conflict.
All this information is then forwarded to the Ministry of Health's "Central Martyrs Register" before being verified by a dedicated information unit. Made up of five employees, according to a ministry document sent to Le Monde, this team "makes great efforts to update this data, verify it and ensure that it is complete." But this count has sometimes been prevented or even interrupted by the Israeli army's destruction of several hospitals. According to the World Health Organization, only 17 of Gaza's 36 hospitals are partially operational.
To overcome this difficulty, the ministry relies on first-aid sources (Red Crescent, Palestinian Civil Defense) and "reliable media sources." It has also set up a "martyrs and missing persons" reporting form to count victims buried under rubble or those who could not be transported to hospitals. The information unit is responsible for verifying each testimony, and then, based on the evidence gathered, a judicial committee decides on the death tolls.
However, this methodology has been criticized for its opacity and the difficulty of accurately identifying deaths with this type of source. Not to mention the victims who go unreported – those who have been buried without passing through morgues, or whose relatives are unaware that they are dead. The Gaza Ministry of Health now distinguishes between identified and unidentified victims.
Criticism of this count crystallized around the October 17 explosion at Al-Ahli Hospital. The ministry announced 500 dead before revising the death toll to 471. Israel accused the ministry of manipulating the figures. US intelligence services put the death toll at between 100 and 300.
Israeli authorities have warned against believing any statement from Hamas. Since 2007, the Islamist movement has controlled the Palestinian enclave, but its political rival, the Fatah-led Palestinian Authority, retains its prerogatives in terms of health care in the territory. It pays the salaries of the ministry's civil servants, some of whom are affiliated with Hamas, others with Fatah. Yet media have reported that the Israeli army has relied on the ministry's figures in its briefings. Publicly, it now claims "17,000 terrorists" have been killed. Israeli Prime Minister Benjamin Netanyahu referred in May to "14,000 fighters killed and probably around 16,000 civilians," without further details.
Another episode fueled the confusion. The United Nations Office for the Coordination of Humanitarian Affairs (OCHA), which has been sharing the death toll in Gaza since the start of the conflict, changed the presentation of its figures between May 6 and May 8. While the total number of people killed remained the same (around 35,000), the details showed 4,959 women compared with 9,500 previously, and 7,797 children compared with 14,500. The press and social media deduced that the number of men (and therefore potential combatants) had suddenly been revised upwards. OCHA had to explain that it was now publishing details only of deaths identified by the Ministry of Health, rather than relaying estimates from the Gaza government's press office, which mixed identified and unidentified victims and proved more confusing, as explained by French and international media. The revision nevertheless highlighted clear inconsistencies between different government sources in Gaza.
Like most humanitarian organizations, the Office of the United Nations High Commissioner for Human Rights considers the government source to be reliable. "We have been working with the Palestinian Ministry of Health for many years, particularly during previous conflicts. Our assessments are very close to theirs, and in some cases, we even had higher figures," its spokesperson assured Le Monde. The assessments carried out by the UN over the last 15 years are more or less similar to the ministry's figures.
The official figures are backed up by several independent analyses. British public health specialists found that the mortality rates reported by the Ministry of Health in Gaza followed similar patterns to those of deaths among staff of the UN agency responsible for Palestinian refugees. Meanwhile, researchers at Johns-Hopkins University estimated that there is "no evidence of inflated excess mortality by the Gaza Ministry of Health," and that "difficulties in obtaining accurate mortality figures should not be interpreted as intentionally erroneous data."
The Airwars NGO published in July a survey studying 3,000 victims listed by the ministry during the first 17 days of the war. After cross-checking these names with other sources of information, the investigators found that over 70% of the identities matched the official lists. "We found the ministry's figures to be broadly reliable," commented the NGO's director, Emily Tripp. "Making thousands of names public, along with biographical details, allows us to verify the balance sheet independently. The ministry is saying, 'If you don't believe our figures, then here's a starting point to do your own research.'"
Other organizations are also carrying out this verification work. The Swedish University of Uppsala, through its database on armed conflict, has identified over 30,000 deaths in Gaza between October 2023 and May 2024 – figures comparable to those of the Ministry of Health.
But some of these surveys focus on the early weeks of the war when the flow of hospital data was not yet too hampered. "Today, there is no way to verify the number of deaths for which the ministry does not have complete information," pointed out independent Israeli researcher Mark Zlochin in the scientific journal Nature. While he believes that the deaths reported in morgues are credible, the researcher thinks that the total number of deaths is probably overestimated, as the figures may include people who died for reasons unrelated to the war.
On the other hand, experts are calling for these "indirect" deaths to be taken into account. Over the past year, the health situation in Gaza has deteriorated considerably. The violence of the ongoing conflict, the lack of drinking water, food and healthcare, the destruction of hospital infrastructures and the displacement of the population are inevitably leading to further deaths. A letter published in July in The Lancet medical journal estimated that this conflict could cause the deaths of 186,000 Palestinians. Of the 2.3 million residents counted in 2022, this would represent 7.9% of Gaza's total population.
Translation of an original article published in French on lemonde.fr; the publisher may only be liable for the French version.