The human cost of Israel’s war on the Gaza Strip has significantly surpassed previous estimates, with independent research now verifying more than 75,000 “violent deaths” by early . The findings, published in leading medical journals, suggest that official figures released by the Gaza Ministry of Health (MoH) represent a conservative estimate, providing a more robust understanding of the scale of Palestinian loss.
The Gaza Mortality Survey (GMS), a population-representative household study published in The Lancet Global Health, estimated 75,200 “violent deaths” between , and . This figure accounts for approximately 3.4 percent of Gaza’s pre-conflict population of 2.2 million and is 34.7 percent higher than the 49,090 “violent deaths” previously reported by the MoH for the same period.
As of , the Gaza Health Ministry estimates at least 71,662 people have been killed since the start of the war, with an additional 488 deaths occurring since the declaration of a ceasefire on .
While Israel has consistently questioned the MoH’s figures, an Israeli army official acknowledged in that approximately 70,000 people had been killed in Gaza during the conflict – a significant shift in position.
Scientific validation of the toll
Researchers noted that the demographic composition of casualties – with women, children, and the elderly comprising 56.2 percent of those killed – aligns with official Palestinian reporting, bolstering the credibility of the data.
The GMS, based on interviews with 2,000 households representing 9,729 individuals, provides a rigorous empirical foundation for the death toll. Michael Spagat, a professor of economics at Royal Holloway University of London and the study’s lead author, found that while MoH reporting is reliable, it is inherently conservative due to the collapse of infrastructure necessary for accurate documentation.
This research builds upon earlier findings published in The Lancet in , which used statistical modelling to estimate 64,260 deaths during the war’s first nine months. While the previous study relied on probability to identify undercounts, this report shifts to empirical verification through direct household interviews, extending the timeline to and quantifying “non-violent excess mortality” for the first time.
A commentary published alongside the GMS in The Lancet Global Health highlighted a “central paradox”: the more devastating the harm to the health system, the more difficult it becomes to accurately assess the total death toll. Verification is further complicated by the thousands of bodies still buried under rubble or beyond recognition.
The survey estimated 16,300 “non-violent deaths,” including 8,540 “excess” deaths caused by the deterioration of living conditions and the collapse of the medical sector due to the blockade. Researchers concluded that the MoH figures are likely conservative and reliable, dismissing misinformation campaigns aimed at discrediting Palestinian casualty data.
A decade of reconstructive backlogs
Beyond the immediate death toll, survivors face an unprecedented burden of complex injuries that Gaza’s decimated healthcare system is ill-equipped to manage. A predictive model published in eClinicalMedicine quantified 116,020 cumulative injuries as of .
The study, led by researchers from Duke University and Gaza’s al-Shifa Hospital, estimated that between 29,000 and 46,000 of these injuries require complex reconstructive surgery. Over 80 percent of these injuries were caused by explosions, primarily from air attacks and shelling in densely populated areas.
The scale of the backlog is immense. Ash Patel, a surgeon and co-author of the study, noted that even with a miraculous restoration of pre-war surgical capacity, it would take approximately a decade to address the estimated backlog of reconstructive cases. Prior to the escalation, Gaza had only eight board-certified plastic and reconstructive surgeons for a population exceeding 2.2 million.
The collapse of the health system
The disparity between reconstructive need and capacity is exacerbated by the “systematic destruction” of medical infrastructure. By , only 12 of Gaza’s 36 hospitals were capable of providing care beyond basic emergency triage, with approximately 2,000 hospital beds available for the entire population – a reduction from over 3,000 beds before the war.
“There is little to no reconstructive surgery capacity left within Gaza,” the research concluded, warning that specialized expertise, such as microsurgery, is almost entirely absent. The clinical challenge is further compounded by Israel’s use of incendiary weapons, which cause severe burns alongside blast-related fractures.
Without prompt medical treatment, patients face high risks of wound infection, sepsis, and permanent disability. The data suggest that tens of thousands of Palestinians will live with surgically addressable disabilities for life unless there is a substantial international increase in reconstructive capacity and aid.
The ‘grey zone’ of mortality
Authors Belal Aldabbour and Bilal Irfan, writing in The Lancet Global Health, observed a growing “grey zone” in mortality where the distinction between direct and indirect death becomes blurred. Patients dying of sepsis months after a blast, or from renal failure after a crushing injury due to lack of access to clean water or surgery, represent a lethality often underestimated in official tallies.
Conditions have continued to deteriorate since the data collection periods. By late , forced evacuations covered more than 80 percent of Gaza’s area, with northern Gaza and Rafah governorates facing complete razing by Israeli forces. A famine was declared in northern Gaza in , further reducing the physiological resilience of injured survivors and complicating surgical recovery.
This series of independent studies serves as an urgent call for accountability and an immediate cessation of hostilities. “The healthcare infrastructure in Gaza is being repeatedly decimated by attacks despite protection under international humanitarian law,” researchers stated, underscoring that the only way to prevent the reconstructive burden from growing further is an immediate end to attacks against civilians and vital infrastructure.
