Biden admin should check Hamas' Ministry of Health death stats, expert warns

The Hamas-run Gaza Ministry of Health released an infographic on April 24 through social media site Telegram indicating that it lacked identifying data for more than 10,000 of the 34,183 so-called martyrs who had been killed in the 200 days following Hamas’ brutal Oct. 7 attack on Israel.

Despite growing concerns over the Ministry of Health’s figures, the Biden administration continues to cite the ministry's data with no reference to its origin. In October, President Biden claimed that he had "no confidence" in Ministry of Health figures. In his March, State of the Union address, Biden shared the ministry’s data with a global audience without referencing its origin, noting that "more than 30,000 Palestinians have been killed, most of whom are not Hamas."

David Adesnik, senior fellow and director of research at the Foundation for Defense of Democracies, told Fox News Digital that the incompleteness of data entries for 10,152 victims in an earlier April 21 data set should be "a flashing red light" for onlookers who have previously trusted ministry calculations of the death toll in Gaza.

Adesnik has called on the Biden administration to "ask the intelligence community to evaluate the data’s sources and accuracy" prior to citing Ministry of Health figures in the future.

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Adesnik explained that until the end of March, the Ministry of Health grouped victims of alleged "Israeli aggression" into two categories. In one category were the victims whose deaths have been reported by the Gazan hospital system. This category also includes thousands of deaths registered by family members who believe their loved ones’ bodies remain buried under rubble, or are otherwise inaccessible. For victims in this category, the ministry says it can provide names, identification numbers, ages and genders of the deceased. 

The second category were victims whose deaths were reported through what the ministry referred to as "reliable media sources." Adesnik says the Ministry of Health has "never specified what the sources are, or how they determine if the information in these sources is credible. And of course, Gaza doesn’t have independent media," he added. These entries lack at least one of five categories of identifying information: an identification number, full name, gender, birthdate, or date of death. Adesnik says there is no clarification of what information is lacking that renders entries incomplete.

He noted that the proportion of deaths reported through media sources has increased from about 30% in December to nearly 80% in the first quarter of 2024. There are irregularities in the death toll reported through media sources, like the gender breakdown of victims, which he says is "so skewed that it is almost hard to believe."

If one combines both categories of victims, he says, it appears that around 70% of victims are women and children, as Hamas has claimed. Utilizing only the first category of individuals, whose records the health ministry labels as "complete," about 60% of victims are women and children. 

Adesnik referenced the work of economist Michael Spagat, a longtime proponent of the accuracy of the Ministry of Health’s data. Spagat recently found 3,407 records within the data set of supposedly complete records that have been duplicated, have missing or invalid identification numbers, or lack an age for the deceased. When these records are removed from the first category’s count, Spagat found that 53.3% of victims were women and children. 

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In its April 21 update, the Hamas-run Ministry of Health shifted its moniker for the second category of deaths, no longer referring to them as having been collated through media sources, but rather as sources that lack complete data. "It’s just a relabeling," Adesnik said. 

Adesnik has sounded the alarm about multiple other irregularities in the the numbers. He previously reported for FDD that the ministry’s death toll vacillates on occasion. He told Fox News Digital that additional aspects of the ministry’s reporting have yet to be verified, including whether it truly differentiates between naturally-occurring deaths among Palestinians, and deaths that occur due to violence.

Adesnik also questions whether the ministry counts deaths from misfired Palestinian rockets, such as the rocket that hit Al-Ahli Arab hospital on Oct. 16, in its toll. The Times of Israel reported in November that the Israel Defense Forces estimated 12% of Palestinian rockets landed in Gaza.

Adesnik also encouraged closer scrutiny of children in Hamas’ death figures, explaining that many Hamas fighters are under the age of 18. "If you look at the gender breakdown of people who died under the age of 18, you can see the teenagers have a surplus of men," he explained. 

Gabriel Epstein, a research assistant at The Washington Institute’s Koret Project on Arab-Israel Relations, reported in January the "many reasons to treat Gaza Ministry of Health and [Government Media Office] fatality numbers with skepticism," including their underreporting of male deaths. By March 26, Epstein noted that "discrepancies in official Palestinian counts and their growing reliance on questionable data" have ensured the ministry’s "numbers themselves have lost any claim to validity."

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In response to questions about whether the State Department is looking into the sources of Ministry of Health death data for the more than 10,000 victims for whom the ministry lacks essential identifying information, a spokesperson said the department is not able to independently assess actions in Gaza. The spokesperson noted that thousands of civilians, and a significant number of children, have been killed in Gaza. "Every one of those losses is a tragedy, whether it’s the number that has been released from Gaza or whether it’s some other number, every one of them is a tragedy, and we mourn the loss of every one of those civilians."

The stakes in getting the numbers correct are high. As Epstein explained in his January report, "although thousands of Palestinian noncombatants, including military-age males, have undoubtedly been killed in the Hamas-initiated conflict, the world must also recognize that the group has manipulated and exploited civilian fatality claims for its strategic benefit, in an attempt to truncate Israel’s air and ground operations and stir international outrage. The international media and NGOs have repeated such claims without proper scrutiny and in turn validated and reinforced Hamas propaganda efforts." 

Another gap in Ministry of Health death counts is the lack of differentiation between military and civilian casualties. Terrorist casualty rates are disputed. In February, a Hamas official told Reuters that the group had lost around 6,000 of its estimated fighters. The IDF estimated they had killed double that amount, or 12,000. By late March, Israeli Prime Minister Benjamin Netanyahu claimed that 13,000 Hamas terrorists had been killed. 

Fox News Digital reached out to the IDF and to Hamas leadership for comment about the Ministry of Health’s incomplete records, and for an updated count of the losses that Hamas has incurred on the battlefield. Neither responded.

Even utilizing Ministry of Health data, the ratio of civilian to militant deaths demonstrates significant Israeli efforts to minimize casualties, according to information that John Spencer, chair of Urban Warfare Studies at West Point’s Modern War Institute, recently shared on the social media platform X. 

Based on the ministry’s estimate that 34,000 have died in the war and the IDF’s claim it has killed 13,000 Hamas fighters, Spencer calculated a 1 to 1.5 or 1.6 ratio of combatant to civilian deaths in Gaza. He compared this to the 1 to 2.5 combatant to civilian death rate "when U.S.-led Iraqi Security Force killed 10,000 civilians to destroy 4,000 ISIS" between 2016 and 2017 during the Battle of Mosul, and the 1 to 6 combatant to civilian death rate when "the American military killed 100,000 civilians to destroy 17,000 Japanese defenders" at the 1945 Battle of Manila. 

Spencer also described the numerous methods that Israel has employed to protect the civilian population of Gaza, including but not limited to evacuating civilians before beginning ground invasions, providing safe routes and humanitarian zones for evacuations, notifying civilians of combat areas with flyers, direct phone calls and text messages, imposing use of force restrictions, and using legal advisers in their targeting process. 

In sum, Spencer explained that "all available evidence shows that Israel has followed the laws of war, legal obligations, best practices in civilian harm mitigation and still found a way to reduce civilian casualties to historically low levels."