Palestinian health authorities report that Israel's ground and air campaign in Gaza has resulted in the deaths of over 41,500 people, with the majority of identified victims being women and children. The recent escalation in the Israeli-Palestinian conflict began on October 7 when Hamas militants crossed the border into Israeli communities. Israel claims that the militants killed over 1,200 people, mostly civilians, and took around 250 people captive in Gaza.
As of September 29, the Palestinian Health Ministry recorded 41,595 Palestinian deaths, which is approximately ten times the number of casualties in all previous Gaza conflicts since 2008. This analysis explores how the Palestinian death toll is calculated, its reliability, the breakdown of civilian and fighter deaths, and the perspectives of both sides. How do Gaza health authorities calculate the death toll? In the initial months of the war, the death toll was calculated by counting bodies brought to hospitals, with data including names and identity numbers for most of the deceased. As the conflict continued and fewer hospitals and morgues remained operational, the authorities adopted additional methods. Starting in early May, the Palestinian Health Ministry updated its total fatality count to include unidentified bodies, which accounted for nearly a third of the overall toll. Since then, health authorities have been working to identify these bodies, reducing the unidentified portion to less than 15 percent.
Zaher Al Waheidi, director of the information unit at the Gaza Ministry of Health, attributed the progress in identifying bodies to the restoration of a central database from Shifa Hospital and a new system allowing families to provide information on victims, which is then verified by medics and police. Of the identified dead, about 56 percent are estimated to be women and children, according to a Reuters calculation based on Palestinian data.
Is the Gaza death toll comprehensive? The Palestinian Health Ministry acknowledges that the numbers may not reflect all victims, as many bodies remain under rubble. It estimates that around 10,000 bodies have not been counted in this manner. The Humanitarian Research Lab at the Yale School of Public Health suggests that the true figures are likely higher than those published, without providing specifics. The UN human rights office also believes the Palestinian authorities' figure is likely an undercount. In past conflicts between Israel and Hamas, their own tally has sometimes exceeded the Palestinian count. They declined to share their toll for this war as it is incomplete but confirmed to Reuters that the majority of verified deaths are women and children.
How credible is the Gaza death toll? Pre-war Gaza had robust population statistics and better health information systems than most Middle Eastern countries, according to public health experts. A study by London-based Airwars, a non-profit compiling casualty lists from open source material, found a correlation of at least 75 percent between its lists and those of Gazan authorities for thousands killed in the early weeks of the war. The United Nations regularly cites the ministry's death toll figures, and the World Health Organisation has expressed full confidence in them. However, questions remain over the inclusion of 471 people reportedly killed in an October 17 blast at Al Ahli Al Arab Hospital in Gaza. An unclassified US intelligence report estimated the death toll 'at the low end of the 100 to 300 spectrum'.
Does Hamas control the figures? Although Hamas has governed Gaza since 2007, the enclave's Health Ministry also reports to the overall Palestinian Authority ministry in Ramallah in the West Bank. Gaza's Hamas-run government has paid the salaries of all those hired in public departments since 2007, including in the Health Ministry. The Palestinian Authority still pays the salaries of those hired before then. The extent of Hamas' control in Gaza is difficult to assess with Israel occupying most of the territory and ongoing fighting.
What does Israel say? Israeli officials have questioned the figures due to Hamas' control over government in Gaza. Foreign Ministry spokesperson Oren Mamorstein stated that the numbers were manipulated and 'do not reflect the reality on the ground'. However, Israel's military has acknowledged in briefings that the overall Gaza casualty numbers are broadly reliable. The Israeli military reports that 346 of its soldiers were killed in combat since its Gaza ground operation began on October 27.
How many of the dead are fighters? The Palestinian Health Ministry figures do not distinguish between civilians and Hamas combatants, who do not wear formal uniforms or carry separate identification. Israel periodically provides estimates of how many Hamas fighters it believes have been killed. The most recent estimate is 17,000-18,000, about half the Hamas force estimated before the war. Israel claims that roughly one civilian has been killed for every fighter, a ratio it blames on Hamas for using civilian facilities. Israeli officials say such estimates are reached through a combination of counting bodies on the battlefield, intercepts of Hamas communications, and intelligence assessments of personnel in targets that were destroyed. Hamas has disputed Israeli estimates of its losses, without specifying how many of its fighters have been killed. The Health Ministry's Al Waheidi stated that men of fighting age represent only a fraction of all identified victims.
