Report

Questionable counting: Analysing the death toll from the Hamas-run Ministry of Health in Gaza

This report from UK think tank the Henry Jackson Society looks at the numbers used in reporting on the Gaza conflict.

On 7 October 2023, Hamas militants launched a war on Israel. After Israel launched its military response, media outlets around the world began to report on death tolls in Gaza, frequently citing numbers from the ‘Gaza Ministry of Health’ as though it was a fully independent, unbiased source.

In reality, the Ministry of Health (MoH) is under the full control of Hamas. It was established by Hamas in 2007 after it took full control of the Gaza Strip following its violent clashes with the Fatah faction of the Palestinian Authority. Since then, Hamas has managed governmental functions in Gaza, including health care services through the MoH.

Given that Hamas is a direct party to the conflict, this creates an obvious conflict of interest. These MoH figures have been repeatedly cited by major news organisations throughout this conflict. For example, an April 2024 headline in The Observer stated: ‘Gaza death toll passes 34,000 as Israel and Iran missile strikes grab global attention’. In August 2024, this toll passing 40,000 was the focal point of much of the day’s BBC News coverage, as catalogued by the Cohen report of September 2024.

The reporting of these figures has been analysed by a group of international scholars, who meticulously analysed reports of Gaza war fatalities from February 2024 through May 2024. They examined 1,378 articles from major English-language newspapers and media outlets, specifically The New York Times, The Washington Post, The Guardian, CNN, the BBC, Reuters, The Associated Press and the Australian ABC. Over that four-month period, 84% of those publications failed to make the critical distinction in total numbers between combatant deaths and civilian deaths. Only 5% of the surveyed media organisations cited numbers released by the Israeli authorities, while 98% cited fatality figures provided by the Hamas-run Gaza Ministry of Health. In 19% of media reports examined, numbers provided by Hamas-run institutions were used without citing any source, thereby suggesting those figures were undisputed.

Furthermore, fewer than one in every 50 articles mentioned that the figures provided by the MoH were unverifiable or controversial. Strikingly, the Israeli statistics had their credibility questioned in half of the few articles that incorporated them.

This report raises serious concerns that the Gaza MoH figures have been overstated. The data behind their figures contains natural deaths, deaths from before this conflict began and deaths of those killed by Hamas itself; it contains no mention of Hamas combatant fatalities; and it overstates the number of women and children killed. Serious errors have been discovered on the Ministry’s lists of fatalities. These errors include a 22-year-old registered as a four-year-old, a 31-year-old registered as a one-year-old and several men with male first names registered as female – artificially increasing the numbers of women and children reported killed. The lists also include people who died before the war and people who died from attacks by Hamas rather than the Israel Defence Forces (IDF). They likely include around 5,000 natural deaths per year, including cancer patients who were listed by the Ministry for hospital treatment after they had already appeared on fatality lists. Hamas also claimed hundreds of fatalities from attacks which turned out to be misfired rocket launches by Gaza factions.

It is indisputable that natural deaths which occur in times of peace would also occur during a war. The pre-war rate of natural deaths in Gaza is known from relevant mortality data presented by the Palestinian Central Bureau of Statistics, based in Ramallah in the West Bank. Media reports claiming totals killed in Gaza by IDF action have not verified the figures cited and fail to account for the deaths of upwards of 17,000 Hamas and affiliated combatants as part of that toll.

This report also shows that the methodology of data collection by the Ministry of Health is not scientifically valid, and that its reports from previous conflicts have also concealed combatant deaths. This fatality analysis recognises the immense toll of the war on Palestinians in Gaza. Even as fatalities are discussed as quantifiable numbers, it is important to remember that innocent people are suffering, and each number represents a human life. Many of those lives were innocent people caught in the middle of a brutal war started by Hamas on 7 October. The suffering, death and destruction are very real for actual human beings. An understanding of the Gaza fatality data is critical in understanding the conduct of the war by the Israel Defense Forces and the State of Israel’s leadership. International humanitarian law does not require that no harm happen to civilians. Rather, it demands that parties to war use their best efforts to mitigate harm to civilians. All parties to a war are required to adhere to certain rules of war. As the United Nations frequently posits: “even war has rules”. When one party in a war disregards the rules, the consequences do not convict the other party or prevent them from prosecuting the war.

Global media outlets have, understandably, focused on the number of deaths in Gaza as a lens of critique of Israeli operations. Many media outlets give the proviso that the Gaza Ministry of Health is Hamas-run, but few give the same level of attention to IDF reports of the numbers of fighters killed as part of the overall Israeli fatality total. Nor do media outlets give the methodology, reporting or content of the lists of names the scrutiny they deserve. A definitive figure of fatalities is impossible, due to the lack of transparency from the MoH, a general lack of access to the Palestinian Population Registry and the challenges of counting militants killed in combat.

However, this report finds numerous errors that cannot be explained by a lack of access to the Ministry of Health computer network that went offline in November 2023. We have identified distortion of statistics, misreporting of natural deaths, deaths from before the war started and a high likelihood of combatant deaths being included on the list.

This report also challenges the assumption that MoH fatality reports from previous conflicts are reliable and reveals evidence of efforts to hide militant fatalities. We also identify critical differences in the demographic breakdowns reported by the MoH and the Hamas Government Media Office.