A study published Friday in The Lancet medical journal estimates that the Palestinian death toll during the first nine months of the Israeli rampage on Gaza was approximately 40% higher than previously reported by the enclave's health ministry.
As of June 30, 2023, the health ministry in Gaza had recorded 37,877 deaths.
However, the peer-reviewed study, which used data from the ministry, an online survey and social media obituaries, estimates that between 55,298 and 78,525 people died from traumatic injuries during the same period.
The study's most accurate estimate places the death toll at 64,260, indicating a 41% underreporting by the health ministry.
This number represents 2.9% of Gaza's pre-war population, or approximately one in 35 inhabitants, according to the study.
Researchers found that 59% of those who died were women, children and the elderly.
It is important to note that the toll only includes deaths from traumatic injuries and does not account for fatalities due to lack of healthcare, food, water or sanitation, nor the thousands of missing individuals thought to be buried under rubble.
Gaza's health ministry reported 46,006 deaths for the entire 15-month duration of the war.
In Israel, the Hamas incursion on Oct. 7, 2023, resulted in 1,208 deaths.
The researchers used a statistical method called "capture-recapture," which has been applied in conflict zones around the world to estimate death tolls.
This method combined three data sources: the health ministry’s list of identified bodies, an online survey through which Palestinians reported deceased relatives and obituaries on social media platforms like X, Instagram, Facebook and WhatsApp.
Lead study author Zeina Jamaluddine, an epidemiologist at the London School of Hygiene and Tropical Medicine, emphasized that only confirmed deaths were included in the analysis.
The researchers also identified and removed duplicate entries across the lists.
Patrick Ball, a statistician at the Human Rights Data Analysis Group, who was not involved in the research, praised the study’s use of capture-recapture methods.
He said the technique is well-tested and provides a "good estimate."
Kevin McConway, a professor at Britain’s Open University, also found the estimates “reasonably compelling” despite acknowledging the inherent uncertainty in working with incomplete data.
Despite the rigorous methodology, the researchers noted the potential for both overestimation and underestimation.
For example, hospital records may not specify causes of death, meaning some non-traumatic deaths, such as those from heart attacks, may have been included.
However, the study did not factor in missing persons – approximately 10,000 people are believed to be buried under rubble, according to the United Nations.
The study also did not include deaths from indirect causes, such as the lack of healthcare, food and water or the spread of disease.
Humanitarian groups have raised concerns about these indirect effects, which have worsened since October 2023.
A separate, non-peer-reviewed study published in The Lancet earlier suggested that 186,000 deaths could be attributed to the war when factoring in indirect causes.
However, the new study disputes this projection, citing significant differences between Gaza's pre-war health burden and that of countries with similar conflict-related estimates.
Jamaluddine acknowledged that the new findings might draw criticism from all sides.
Nevertheless, she pointed out that the focus on death tolls often overshadows the broader issue: "We already know that there is a lot of high mortality."
