Mortality in the Gaza-Israel War

Based on reported and estimated mortality, it appears clear that the Palestinian death toll in Gaza is among the highest civilian mortality rates of the 21st century. Credit: WHO

By Joseph Chamie
PORTLAND, USA, Oct 17 2024 (IPS)

Following the 7 October 2023 attack on Israel by Hamas-led militants, Israel’s response has led to unprecedented high mortality levels in the Gaza Strip. The Palestinian death toll over the twelve month period is believed to be among the highest such civilian casualty rates in the 21st century.

During the first seven months of the war, Israel is estimated to have dropped more than 70,000 tons of bombs on Gaza, far surpassing that of Dresden, Hamburg, and London combined during World War II. In addition, some have concluded that Israel’s bombing of the Gaza Strip, which included 900-kilogram (2,000 pound) “bunker-busters”, is one of the most intense civilian punishment campaigns in history.

During the first seven months of the war, Israel is estimated to have dropped more than 70,000 tons of bombs on Gaza, far surpassing that of Dresden, Hamburg, and London combined during World War II

U.S. President Biden warned Israel that it was losing international support, which has become increasingly evident worldwide, because of its “indiscriminate bombing” of Gaza. The president described Israel’s military response in Gaza as “over the top”.

And despite President Biden’s declarations of red lines, calls for restraint and ultimatum for Israel to limit Palestinian civilian deaths, the president has experienced a moral failure with his unwavering backing of Israel with unequal treatment and oppression of Palestinians. While seeking peace, the president has facilitated the Israel-Gaza war.

In addition to the president’s expressed concerns about Israel’ military operations, dozens of U.S. officials resigned over the Biden administration’s position in the conflict. They were critical of Israel’s actions in Gaza and accused the administration of not telling the truth about Israel’s obstruction of humanitarian aid to Gaza.

Although the numbers of deaths continue to rise and are being updated, the current reported levels of mortality provide an intelligible picture of the war’s lethal consequences on human life in Gaza and Israel. In addition to the mortality based on official reported deaths by Israeli and Palestinian authorities, higher levels of mortality have been estimated by health experts.

According to Israeli officials, the number of Israeli deaths resulting from the attack in southern Israel on 7 October 2023 is 1,163, with close to 70 percent of the victims identified as civilians. The attack is considered to be the country’s worst loss of life in a single day since its founding in 1948 (Table 1).

In addition to those deaths on 7 October, no less than 728 Israeli soldiers are reported to have been killed in combat since the Gaza ground invasion began and 33 Israeli deaths occurred in the West Bank.

Given Israel’s total population of nearly 10 million, the number of Israeli deaths on 7 October and the subsequent twelve months represents about 0.02 percent of the Israeli population, or 20 deaths per 100,000 population.

As reported by the Gaza Ministry of Health, the death toll in the Gaza Strip from Israeli military operations after one year following the 7 October attack is 41,909 Palestinians. That number of deaths represents about 2 percent of the Palestinians in Gaza.

According to the Israeli Shin Bet, the proportion of Hamas fighters among the Palestinian deaths is approximately 40 percent. While the Gaza Ministry of Health does not identify whether the deaths are civilian or combatant, approximately two-thirds are reported to be women and children. According to Oxfam, the war in Gaza killed more women and children than any other war in the last two decades.

The reported number deaths of Palestinians are deemed generally accurate and widely accepted by international monitoring organizations, including Israeli and US intelligence agencies. Independent studies of the deaths reported by the Gaza Ministry of Health show no evidence of inflated mortality figures.

In addition to the nearly 42 thousand Palestinian deaths, Israel’s military action in Gaza has left many more wounded, exposed to famine and disease and most of Gaza’s population homeless.

With an estimated total population of approximately 2.1 million in Gaza, the Palestinian death rate from the war after one year is 1,957 deaths per 100,000 population. That Palestinian death rate in Gaza is 100 times greater than the Israeli death rate.

Applying the Israeli and Palestinian death rates to a third population, i.e., the United States, illustrates the striking differences in the mortality levels and their demographic impacts. When the death rate in Gaza is applied to America’s population, the resulting mortality would be nearly 6.6 million deaths. Similarly, applying the Israeli death rate to the U.S. population yields close to 66 thousand deaths (Figure 1).

It is widely recognized that the true death toll in Gaza is likely to be higher than being reported by the Gaza Ministry of Health. A major contributing factor to higher mortality is the humanitarian catastrophe in Gaza with more than 10,000 missing, untold numbers buried under rubble and many experiencing disease and malnutrition, as humanitarian assistance is limited by Israel’s blockade.

One group of 99 American health care workers returning from Gaza estimated that the true death toll in Gaza is at least four times higher than the official reported count, or approximately 119 thousand. In a published open letter dated 2 October 2024, the group transmitted their estimated number of Palestinian deaths in Gaza and their concerns over the mortality level to President Biden and Vice-President Harris (Figure 2).

A second analysis by a team of three researchers, which was published in The Lancet, estimated that the number of deaths in Gaza by mid-year was about 186 thousand. The researchers estimated that the actual death toll in Gaza could conservatively be about four times the reporting figure at that time. Their estimated level of mortality includes direct deaths due to bombings as well as indirect deaths due to the destruction of the health, food and sanitation systems in Gaza.

A third analysis of the deaths in Gaza by the chair of global public health at the University of Edinburgh estimated the death toll to be even higher. Building on the mortality figure that appeared in The Lancet, the number of deaths in Gaza twelve months after the 7 October attack is estimated at approximately 336 thousand. That mortality level also took into account indirect deaths due to widespread disease and starvation.

One year after the 7 October 2023 Hamas-led attack on Israel, the resulting mortality levels of the Israelis and the Palestinians in Gaza are both high and strikingly dissimilar.

For Israel, the deaths from the attack represent the highest loss of life in a single day since the country’s founding. For the Palestinians, the reported number of deaths represents an alarming proportion of the Gaza resident population.

Over the past year of conflict, the reported number of Palestinian deaths in Gaza is about 20 times greater than the number of Israeli deaths. Also, the mortality rate of the Palestinians is 100 times greater than the Israeli mortality rate.

In addition to direct reporting of deaths due to bombing and military operations, the crisis in Gaza has led to high levels of indirect deaths. Those deaths are mainly due to malnutrition, wasting, stunting and trauma reaching famine thresholds largely due to the Israeli blockade. UNICEF has warned that the lack of water, food, medicine, sanitation, road and electricity infrastructures is a bigger threat than bombs to the lives of thousands in Gaza.

The true death toll in Gaza may not be known for many years, especially as indirect deaths are expected to exceed the direct death toll. However, based on reported and estimated mortality, it appears clear that the Palestinian death toll in Gaza is among the highest civilian mortality rates of the 21st century.

Joseph Chamie is a consulting demographer, a former director of the United Nations Population Division and author of numerous publications on population issues, including his recent book, “Population Levels, Trends, and Differentials”.