Lancet journal: Gaza war death toll may have reached 186,000

Report suggests that 7.9 per cent of Gaza population has died since the war began on October 7

The Tuffah district east of Gaza city on July 8, 2024. A study by medical journal The Lancet estimates Palestinian deaths in war may reach 186,000. AFP

Live updates: Follow the latest news on Israel-Gaza

The Lancet medical journal reported that it is “not implausible” for the Gaza death toll to have reached 186,000 or more since the Israeli bombardment began on October 7, considering direct and indirect causes.

The report, titled Counting the Dead in Gaza: Difficult but Essential, said that using the 2022 Gaza Strip population estimate of 2,375,259, the death toll would be equivalent to 7.9 per cent.

The estimate published on Friday includes direct deaths from the conflict as well as indirect deaths from causes such as reproductive, communicable and non-communicable diseases.

“Applying a conservative estimate of four indirect deaths per one direct death to the 37,396 deaths reported, it is not implausible to estimate that up to 186,000 or even more deaths could be attributable to the current conflict in Gaza,” the Lancet report said.

“The number of reported deaths is likely an underestimate.”

Tamara Al Rifai, the head of communications for the UN Palestinian Refugee agency, UNRWA, told The National that the agency takes figures from public sources including the Ministry of Health in Gaza.

“But if we compile all figures that credible entities, including the UN, have been issuing, then the scale and scope of death, injuries and life-changing accidents [including loss of limbs for children] are devastating,” Ms Rifai said.

Francesca Albanese, the UN’s special rapporteur on Palestine, wrote on X, “That's one in every 12 Gaza inhabitants killed in the last nine months of genocide.”

Gaza's health authorities said on Monday that 38,193 Palestinians have been killed and 87, 903 injured in Israel's military offensive that followed Hamas' attacks.

The Lancet report pointed out to the UN estimates that, by February 29, 2024, 35 per cent of buildings in the Gaza Strip had been destroyed.

“So the number of bodies still buried in the rubble is likely substantial, with estimates of more than 10,000,” said the Lancet.

The report said that Gaza's death toll is “expected to be large given the intensity of this conflict; destroyed health care infrastructure; severe shortages of food, water, and shelter; the population's inability to flee to safe places; and the loss of funding to the UNRWA, one of the very few humanitarian organisations still active in the Gaza Strip.”

In May, the UN said more than 10,000 Palestinians were dead in the rubble and retrieval could take three years.

The Lancet is one of the world's most quoted medical journals.

Nadav Shoshani, the international spokesman for the Israeli army, rejected the report's estimated numbers and said “there is no correlation between the report's estimated numbers and reality”.

“No one should take seriously claims that do not meet the minimal standards of fact-checking,” he wrote on X.

In February, Johns Hopkins University estimated 70,000 “excess deaths”, including 10,000 from disease.

The Johns Hopkins study, Crisis in Gaza: Scenario-Based Health Impact Projections, looked at conflicts in the Middle East and “similar” settings.

Tak Igusa, one of the study’s authors, said their work “projected multiple health impacts, including non-communicable and infectious diseases, malnutrition, and maternal and newborn mortality. One of our findings is that there is a steadily increasing possibility of cholera, famine, and other humanitarian disasters that may result in higher mortality than the trauma deaths from the conflict”.

The projections and estimates are particularly complex because they involve multiple areas of study – including nutrition and the most vulnerable in a given population.

Since the start of the conflict, humanitarian organisations have repeatedly said that Gaza is getting only a fraction of its daily food and medical aid requirement, even during attempts to increase supplies.

Gaza’s humanitarian situation has worsened in some areas, as fighting shifted to a land crossing point at Rafah on the Egyptian border in May.

Hundreds of lorries loaded with food and water have been stranded there, some for nearly two months, awaiting permission to deliver supplies.