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Is the Hamas-run Ministry of Health data on fatalities in Gaza to be trusted?

On October 26, U.S. President Joe Biden heaped scepticism on the Palestinian death figures emanating from the Gaza Ministry of Health (MoH) during the ongoing Israel-Hamas war. “I have no notion that the Palestinians are telling the truth about how many people are killed,” Biden said to reporters. “I have no confidence in the number that the Palestinians are using.”

Biden’s comments immediately touched off a major political firestorm. Supporters of the Palestinian cause decried what they saw as a denial of Palestinian suffering after weeks of siege and heavy bombardment by Israel. Debates about how the numbers are produced and their reliability proliferated online, with some arguing that they reflect careful work by medical professionals and others that they are politicized and controlled by Hamas. The Gazan MoH – the official organ in Gaza responsible for the figures – responded by releasing an unprecedented document listing the name, ID number, sex, and age for each of the fatalities it had recorded up to that point.

What can we say about the reliability of the fatality numbers from Gaza, and what can digging into those numbers tell us about who has been killed? We examined these questions statistically.

We began by looking at MoH data from past Israel-Hamas wars and comparing it to other relevant sources. Shortly after the 2014 Gaza War, the MoH reported that 2,310 Gazans had been killed – 1,802 males and 508 females. A subsequent and exhaustive enumeration project by the Israeli human rights organization B’tselem ultimately found that there were 2,185 deaths – 1,694 males and 491 females. Both these overall figures and the gender breakdowns within them are broadly consistent. To be sure, B’tselem’s numbers are not free from any controversy, with critics providing 14 cases that they claim are combatants B’tselem mischaracterized as not “killed while fighting.” Yet the overall totals have stood up well over time, and there is even close consistency for MoH and UN totals for the 2008, 2014 and 2021 Gaza Wars. In short, the MoH figures for the total numbers of Gazan fatalities in previous Israel-Hamas confrontations have proven reliable.

However, the total death toll is not the only number that attracts scrutiny in wars between Israel and Hamas – the ratio of civilians to combatants is often an even greater bone of contention. Ascertaining an accurate understanding of the share of civilian casualties in these conflicts is difficult, not least of all because the MoH does not distinguish between civilians and militants and B’tselem has eschewed categorizing militants in favor of a narrower category (“killed while fighting”) that is more easily observed. And the proportion of civilians vs. militants killed has been an issue of controversy in prior Israel-Hamas conflicts such as the 2008 Gaza War.

We analysed the detailed data just released by the MoH in the current conflict to shed light, to the extent possible, on these issues. We first checked the data’s integrity, finding only one duplicate entry and one other entry with an error for the individual’s age. Our cleaned dataset contains 6,745 people (with the MoH unable to identify 281), breaking down into 3,844 males and 2,901 females.

The table below compares the current fatalities to those from the 2008 and 2014 Gaza Wars. It should come as no surprise that the scale of the current war already far surpasses those fought in 2008 and 2014. At least as striking is the sharply increasing percentages of boys, girls, and women across the three wars which is, of course, accompanied by decreasing percentages of men. The percentage of elderly also increases steadily across the three wars. In 2014, a fairly high percentage of military aged men among the dead was cited as a feature of the Israeli campaign, but this is much less the case in the current war.

WarsTotal Deaths in Gaza% Boys% Girls% Women% Men% ElderlySource
2008-091,3919.95.87.872.54.0B’tselem
20142.18511.38.012.363.35.2B’tselem
Ongoing6,74518.015.824.135.36.8Gaza MoH

Note – We define children as 14 or younger and the elderly as 60 and older.

We also compared the current fatalities to the demographics of Gaza overall using the latest MoH population data from 2022. The graphs below show the age distribution of deaths in the ongoing war against the age distribution of the overall Gaza population, for both men and women. These graphs do show some limited evidence of a bump of “fighting age males” – men between the ages of about 20 and 40 – in the current fatalities relative to their share of the overall population. However, this bump is fairly modest, and the overall demographics of the deaths track those of the population rather closely.

Ultimately, if we make the (rather safe) assumption that most fighters of Hamas and Palestinian Islamic Jihad are relatively young adult males, we can draw several conclusions. First, since the MoH total fatalities numbers have proven to be relatively reliable in the past, it is safe to say that roughly 8,000 Gazans (and counting) have indeed been killed in the current war – much more than in the previous rounds of conflict. Second, we can say that a large proportion of the Gazans killed in the ongoing conflict must be civilians, given the considerable representation of adult women (24.1%), children of both sexes (33.8%), and the elderly (6.8%) among the dead. Third, with this same demographic logic, the proportion of civilians amongst all Gazans killed in the ongoing war must be substantially higher than it was in the 2014 and 2008 wars. Fourth, while there is a fighting age male bump in the current deaths, it is relatively modest in size – and the current fatalities are demographically broadly representative of the overall Gazan population. This too points towards the deaths being heavily civilian.

In sum, analysis of the fatalities data in the current war provides no reason to doubt the MoH. Instead, it suggests that the MoH is a reputable source of information for total fatality numbers and its most recent estimate that over 8,000 Gazans have been killed so far should be viewed as credible. In addition, an analysis of the demographics of those fatalities and a careful comparison of them to overall Gazan population suggests that – at least so far – most of the dead have almost certainly been civilians.

In short, while Joe Biden may have no confidence in the numbers the Palestinians are using, he probably should. Biden was right to react strongly against the heinous Hamas attack that can have no possible justification. But he was wrong to question the MoH figures, which are credible and give us good insight into the tragic consequences of Israel’s response.

Michael Spagat is a Professor of Economics at Royal Holloway University of London, Co-Chair of Action on Armed Violence and Chair of Every Casualty Counts. His current research is about accounting for death in war, the possible long-run decline in war, fabricated data in surveys conducted in war zones and the impact of drone strikes in Pakistan.

Daniel Silverman is an Assistant Professor of Political Science in the Carnegie Mellon Institute for Strategy and Technology (CMIST) at Carnegie Mellon University. His research focuses on international security, political psychology, and the politics of the Middle East and wider Islamic world.