Gaza: Israel kept up its airstrikes and ground operations across the Gaza Strip, even as the death toll here crossed 20,000 people on Thursday. The Gaza Health Ministry says thousands more dead remain buried beneath the rubble. About 70 per cent of those killed are women and children.
The ministry's figures have drawn international attention to the high number of civilians being killed in the Israeli military's offensive, which it launched after Hamas' October 7 attack on Israel, the bloodiest in the country's 75 year history.
Authorities struggle to keep count
In the morgue of the Nasser Hospital, in southern Gaza, workers wrap the corpses of people killed in Israeli airstrikes in white cloth amid the stench of death. They record whatever basic facts they can about the dead: name, identity card number, age, sex.
Some of the bodies are badly mutilated. Only those that have been identified or claimed by relatives can go for burial and be included in the Gaza Health Ministry's death toll for the war. The rest are stored in the morgue's refrigerator, often for weeks.
But with most hospitals across Gaza now closed, hundreds of doctors and other health workers killed, and communications hampered by lack of fuel and electricity, it's becoming increasingly difficult to compile the casualty figures.
The morgue workers at the Nasser Hospital are part of an international effort – including doctors and health officials in Gaza as well as academics, activists and volunteers around the world – to ensure the toll doesn't become a casualty of the increasingly dire conditions of the war.
The workers, some of them volunteers, do not have enough food or water for their families, but they keep going because recording the number of Palestinians dying matters to them, said Hamad Hassan Al Najjar.
He said the psychological toll of the work was immense. Holding a piece of white paper with handwritten information about one of the dead, the 42-year-old said he was often shocked to find the badly damaged corpse of a friend or relative brought in.
The Israel Defense Forces (IDF) has expressed regret for civilian deaths but blamed Hamas – the Palestinian militant group that ran the Gaza Strip - for sheltering in densely populated areas. Hamas gunmen killed 1,200 people in the October 7 attack, most of them civilians, and seized some 240 hostages.
Israel says it will continue its offensive until Hamas is eliminated, the hostages returned and the threat of future attacks on Israel removed. An Israeli military spokesperson said in response to a comment request for this article that the IDF "follows international law and takes feasible precautions to mitigate civilian harm".
UN vouches for the data
The data recorded by Al Najjar and his colleagues is collated by workers at an information centre set up by the health ministry at the Nasser Hospital, in the city of Khan Younis. Ministry staff fled their offices at Al-Shifa Hospital in northern Gaza after Israeli forces entered it in mid-November.
Ministry spokesperson Ashraf Al-Qidra, a 50-year-old doctor, reads the numbers at press conferences, or posts the figures on social media if communications are hampered by the hostilities. The head of the ministry's information centre did not respond to requests for comment.
Since early December, the ministry has said it was unable to collect regular reports from morgues at hospitals in northern Gaza, amid the collapse of communications services and other infrastructure in Gaza due to the Israeli offensive.
According to the World Health Organization (WHO), only six of Gaza's 36 hospitals were receiving casualties as of Wednesday, all of them in the south.
The WHO cited this as one reason it believes the ministry's tally may be an undercount; the toll also excludes dead who were never taken to hospitals or whose bodies were never recovered. The WHO and other experts said it was not possible for now to determine the extent of any undercounting.
US President Joe Biden said on October 25 he had "no confidence" in the Palestinian data. The ministry's figures say nothing about cause of death, and they don't distinguish between civilians and combatants.
Following Biden's remark, the ministry released a 212-page report listing 7,028 people killed in the conflict until October 26, including identity cards, names, age and sex. Since then, the ministry has not released such detailed data, making it hard for researchers to corroborate the latest figures.
However, the United Nations – which has long-standing cooperation with Palestinian health authorities - continues to vouch for the quality of the data.
Israeli officials this month said they believe the data released to date is broadly accurate; they have estimated that one third of those killed in Gaza are enemy combatants, without providing detailed figures.
The Palestinian Health Ministry, which is located in the occupied West Bank and pays the salaries of Gazan ministry workers, said it has lost almost all contact recently with hospitals in the enclave. It also has no information on the fate of several hundred health workers arrested by Israeli forces, it added.
Asked about the arrests, the IDF said it had detained some hospital staff based on intelligence that Hamas was using medical facilities for its operations. Those not involved in these activities were released after questioning, it said, without providing the number of detainees.
International efforts
Academics, advocates and volunteers across Europe, the United States and India are working to analyse the data provided by the Gaza Health Ministry, to corroborate the details of those killed and determine the numbers of civilian casualties.
Much of this is based on the October 26 list that includes names, identity card numbers, and other details. Some other researchers, meanwhile, are "scraping" social media to preserve accounts posted there for future analysis.
Researchers use methods such as surveys of households after a conflict is over to estimate the overall toll. Household surveys could be difficult following this conflict because in some cases entire families have been killed by bombardments – sometimes dozens of members, according to the October 26 list. More than four-fifth of Gaza's pre-war population has fled their homes - 1.9 million people, according to UN figures - and may be difficult to locate, experts say.
But given how close-knit Gazan society is, there is hope that such studies could eventually be conducted in a meaningful way, said Hamit Dardagan of the Iraq Body Count (IBC), an organisation that records violent deaths resulting from the 2003 US-led invasion of Iraq. The IBC has already published an analysis on age and other characteristics of those killed in Gaza, based on the ministry's October 26 data.
UN report says nearly 577,000 people are starving in Gaza
The United Nations says more than half a million people are starving because not enough food has entered the besieged territory. That's roughly one out of every four Palestinians in Gaza. Tens of thousands of people are crammed into shelters and tent camps facing shortages of food, medicine and other basic supplies. A World Health Organization official who visited two hospitals in northern Gaza said they were doing more amputations because staff, electricity and other essentials are in extremely short supply.
An interagency UN and NGO report finds that a staggering half a million people in Gaza one quarter of the population are starving due woefully insufficient quantities of food entering the territory since the outbreak of hostilities on October 7.
It is a situation where pretty much everybody in Gaza is hungry. More than 500,000 people, half a million people, are starving. That means that one in every four people is starving in Gaza as we speak," said World Food Programme chief economist Arif Husain.
He warned that if the war continues at the same levels and food deliveries are not restored that the population could face a full-fledged famine within the next six months with widespread outbreaks of disease.
The report released Thursday by 23 UN and nongovernmental agencies found that the entire population of 2.2 million Gazans are in a food crisis or worse: 478,000 are at crisis levels, 1.17 million are at emergency levels and 576,600 are at catastrophic that is starvation levels.
It doesn't get any worse. I have never seen something at the scale that is happening in Gaza. And at this speed. How quickly it has happened, in just a matter of two months,” Husain said.
(With inputs from Reuters, AP.)
