Above photo: Hungry children waiting for food in Gaza. Abed Rahim Khatib/ Anadolu via Getty Images.
Leading medical journal says ‘indirect deaths’ of Palestinians from Israel’s destruction of civilian infrastructure would far exceed those killed directly by the bombing.
Israel’s assault on Gaza could lead to between 149,000 and 598,000 Palestinian deaths if it were to end immediately, as estimated by experts for The Lancet.
The medical journal published a research correspondence between physicians and public health experts on 5 July on the difficulty of accounting for the number of those killed by Israel’s war on Gaza, highlighting that both direct and indirect deaths should be considered.
The Gaza Health Ministry has reported over 38,000 Palestinians killed since the beginning of the war.
But counting the dead and injured has become increasingly difficult for the ministry as the war drags on, now entering its tenth month, the contributors wrote.
The ministry traditionally relies on data from hospital officials in the besieged enclave, who receive the injured and bodies of the dead. However, Israeli bombing has destroyed many of Gaza’s hospitals and brought its entire health system to the brink of collapse.
Confirming the number and identities of the dead is also difficult because many are buried under the rubble of homes and apartment buildings bombed by Israeli forces, often in the middle of the night as Palestinians sleep.
As a result, the ministry has begun reporting identified deaths, where the victim’s name is known, and unidentified deaths, where it is not.
The contributors note that although some have disputed the accuracy of the Health Ministry’s count, international rights organizations and even Israeli intelligence have accepted it as broadly accurate.
Further, the Gaza Health Ministry count is likely an underestimate, the authors argue.
For example, Airwars, a non-governmental organization that became known for tracking deaths during the 2003 US war in Iraq, has found that not all names of identifiable victims are included in the Gaza Health Ministry’s list.
Additionally, the UN estimated that as of 29 February, Israeli bombing had destroyed 35 percent of buildings in the Gaza Strip, with an estimated 10,000 bodies buried under the rubble, including many that were never found.
The writers point to another crucial factor in determining the number of those killed by Israel’s assault on Gaza: indirect deaths.
“Even if the conflict ends immediately, there will continue to be many indirect deaths in the coming months and years” due to disease, destroyed healthcare infrastructure, and severe shortages of food and water, the authors write.
For example, “Children in Gaza have been dying from starvation-related complications since the Israeli government began using starvation as a weapon of war,” Human Rights Watch noted in April.
“In recent conflicts, such indirect deaths range from three to 15 times the number of direct deaths. 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 authors concluded.
Such a “conservative estimate” of the death toll would amount to 7.9 percent of Gaza’s population of 2.3 million.
If the conflict were to end immediately with 37,396 direct deaths, and the upper bound of 15 indirect deaths per direct death is used, a total death toll of 598,336, or 26 percent of the population, would be expected. The lower bound of 3 indirect deaths per direct death would result in an estimated 149,584 total deaths.
Because Israel’s bombing campaign in Gaza is deliberately destroying the infrastructure needed to support human life, the mortality rate among Palestinians may remain high long after the assault has stopped.
The authors concluded their letter by calling on Israel to heed the provisional rulings issued by the International Court of Justice (ICJ), which require Israel to “take effective measures to prevent the destruction and ensure the preservation of evidence related to allegations of acts within the scope of … the Genocide Convention.”