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Nearly 40,000 and Counting: The Struggle to Keep Track of Gaza Deaths

A man carries the shrouded body of a child killed in an Israeli bombardment to the hospital morgue in the south Gaza city of Rafah - AFP
A man carries the shrouded body of a child killed in an Israeli bombardment to the hospital morgue in the south Gaza city of Rafah - AFP
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Nearly 40,000 and Counting: The Struggle to Keep Track of Gaza Deaths

A man carries the shrouded body of a child killed in an Israeli bombardment to the hospital morgue in the south Gaza city of Rafah - AFP
A man carries the shrouded body of a child killed in an Israeli bombardment to the hospital morgue in the south Gaza city of Rafah - AFP

With much of Gaza reduced to rubble by 10 months of war, counting the dead has become a challenge for the health ministry, as the death toll nears 40,000.

Israel has repeatedly questioned the credibility of the daily figures put out by the ministry and US President Joe Biden did so too in the early stages of the war.

But several United Nations agencies that operate in Gaza have said the figures are credible and they are frequently cited by international organizations.

Two AFP correspondents witnessed health facilities enter deaths in the ministry's database.

Gaza health officials first identify the bodies of the dead, by the visual recognition of a relative or friend, or by the recovery of personal items.

The deceased's information is then entered in the health ministry's digital database, usually including name, gender, birth date and ID number.

When bodies cannot be identified because they are unrecognisable or when no one claims them, staff record the death under a number, alongside all the information they were able to gather.

Any distinguishing marks that may help with later identification, whether personal items or a birthmark, are collected and photographed.

Gaza's health ministry has issued several statements setting out its procedures for compiling the death toll.

In public hospitals under the direct supervision of the territory's Hamas government, the "personal information and identity number" of every Palestinian killed during the war are entered in the hospital's database as soon as they are pronounced dead.

The data is then sent to the health ministry's central registry on a daily basis.

For those who die in private hospitals and clinics, their information is taken down on a form that must be sent to the ministry within 24 hours to be added to the central registry, a ministry statement said.

The ministry's "information center" then verifies the data entries to "ensure they do not contain any duplicates or mistakes", before saving them in the database, the statement added.

Gaza residents are also encouraged by Palestinian authorities to report any deaths in their families on a designated government website. The data is used for the ministry's verifications.

The ministry is staffed with civil servants that answer to the West Bank-based Palestinian Authority as well as to the Hamas-led government in Gaza.

An investigation conducted by Airways, an NGO focused on the impact of war on civilians, analysed the data entries for 3,000 of the dead and found "a high correlation" between the ministry's data and what Palestinian civilians reported online, with 75 percent of publicly reported names also appearing on the ministry's list.

The study found that the ministry's figures had become "less accurate" as the war dragged on, a development it attributed to the heavy damage to health infrastructure resulting from the war.

For instance, at southern Gaza's Nasser Hospital, one of the few still at least partly functioning, only 50 out of 400 computers still work, its director Atef al-Hout told AFP.

Israeli authorities frequently criticize the ministry's figures for failing to distinguish between combatants and civilians. But neither the army nor Israeli Prime Minister Benjamin Netanyahu deny the scale of the overall toll.

The press office of Gaza's Hamas government estimates that nearly 70 percent of the roughly 40,000 dead are women (about 11,000) or children (at least 16,300).

Several UN agencies, including the agency in charge of Palestinian refugees (UNRWA), have said the ministry's figures are credible.

"In the past -- the five, six cycles of conflict in the Gaza Strip -- these figures were considered as credible and no one ever really challenged these figures,", the agency's chief Philippe Lazzarini said in October.

A study by British medical review The Lancet estimated that 186,000 deaths can be attributed to the war in Gaza, directly or indirectly as a result of the humanitarian crisis it has triggered.

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Gaza Burns Cases Surge as Medical Supplies Dwindle

Palestinian Nisrine al-Najar receives treatment at a clinic set up by Doctors Without Border (MSF) in Rafah, in March Medical facilities have in the past weeks reported increasing numbers of burn victims. According to Muhammad al-Mughayyir, of Gaza's civil defence agency, Israeli forces have been using "new weapons that cause increased ignition and burning". © MOHAMMED ABED / AFP/File
Palestinian Nisrine al-Najar receives treatment at a clinic set up by Doctors Without Border (MSF) in Rafah, in March Medical facilities have in the past weeks reported increasing numbers of burn victims. According to Muhammad al-Mughayyir, of Gaza's civil defence agency, Israeli forces have been using "new weapons that cause increased ignition and burning". © MOHAMMED ABED / AFP/File
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Gaza Burns Cases Surge as Medical Supplies Dwindle

Palestinian Nisrine al-Najar receives treatment at a clinic set up by Doctors Without Border (MSF) in Rafah, in March Medical facilities have in the past weeks reported increasing numbers of burn victims. According to Muhammad al-Mughayyir, of Gaza's civil defence agency, Israeli forces have been using "new weapons that cause increased ignition and burning". © MOHAMMED ABED / AFP/File
Palestinian Nisrine al-Najar receives treatment at a clinic set up by Doctors Without Border (MSF) in Rafah, in March Medical facilities have in the past weeks reported increasing numbers of burn victims. According to Muhammad al-Mughayyir, of Gaza's civil defence agency, Israeli forces have been using "new weapons that cause increased ignition and burning". © MOHAMMED ABED / AFP/File

In Gaza City's Al-Ahli Hospital, five-year-old Amir Habib al-Habeel screams out in pain from the burns he suffered from an Israeli air strike on his home in Shujaiya a fortnight earlier.
He occupies a bed far from his mother, who also suffered burns, and who cannot move to be by her son's side.

Instead, her brother cares for him, the only available guardian after his "father was martyred", as the tearful child says, struggling to remove one of many IV tubes.

"We receive daily cases of second- and third-degree burns as a result of rocket attacks and the use of internationally banned weapons by the Israeli army," Amjad Eleiwa, an emergency doctor at the hospital, told AFP.

"Most of the cases that come to us are children and women. We don't have any capacity to deal with these burns," he said, explaining that they could not access any of the medical supplies needed to treat burns and had to resort instead to whatever was available in private warehouses and pharmacies.

"We are in dire need of medical and logistical support and medicine to deal with these cases and save them."ch
Medical facilities have in the past weeks reported increasing numbers of burn victims. According to Muhammad al-Mughayyir, of Gaza's civil defence agency, Israeli forces have been using "new weapons that cause increased ignition and burning".
Medical facilities have in the past weeks reported increasing numbers of burn victims.

Julie Faucon, a medical coordinator at Doctors Without Borders (MSF), told AFP some of the charity's specialists have been working for two months in Nasser Hospital in the southern city of Khan Yunis, "supporting what we call the trauma auto burn unit".

In that time, they have received "more than 69 cases with burns. One case out of five is related to explosions", the burns specialist said.

"Three out of four" of the patients they have received are children, she said, adding that 10 of the patients have had burns on more than 20 percent of their bodies.

According to Muhammad al-Mughayyir, of Gaza's civil defence agency, Israeli forces have been using "new weapons that cause increased ignition and burning".

Mughayyir said the weapons reach extremely high temperatures and are "capable of melting bodies".

They often target "tent areas made up of nylon containing primitive materials such as wood and plastic, all of which directly affects the speed and rate of ignition", he added.

"These burns have a direct impact on people's lives and appearances. They affect skin layers and burn nerves, and there are people who become disabled as a result of that."

- No medical supplies

Access to treatment abroad has been blocked as most Palestinians cannot leave the besieged Gaza Strip
The World Health Organization has said that out of 36 hospitals in the territory, only 15 are partially functional, adding that medical facilities have been targeted more than 1,000 times since war broke out on October 7.

Mohammed Zaqout, the head of hospitals in the Gaza Strip, said "there is only Nasser Hospital in the southern areas, with 12 operating rooms, all of which are overcrowded".

"There are 16 beds in the intensive care units, all of which are occupied, and we have added a capacity of 24 beds but they are now full," he said.

"We try to distribute these cases to field hospitals, but the occupation's massacres against unarmed civilians occur on a daily and hourly basis, and no one in the world intervenes."

Access to treatment abroad has been blocked as most Palestinians cannot leave the besieged territory, as has the entry of most medical supplies, particularly since Israeli forces seized the Palestinian side of the Rafah border crossing with Egypt since early May.

Faucon similarly highlighted the urgent need for medical supplies, pointing to surging demand among extremely meagre stocks.