Explainer: What is Gaza’s Ministry of Health and how does it calculate the war’s death toll?

JERUSALEM: How many Palestinians have been killed in the Gaza Strip since the war between Israel and Hamas started?

With Israel besieging and bombing territory at a scale never seen before, arriving at a precise answer isn’t easy. Cell service is spotty. Internet and power are out. Airstrikes have pulverized roads and leveled neighborhoods, slowing rescue work.

Doctors scribble on notepads in overflowing morgues and hospital halls, struggling to account for bodies trapped under rubble and tossed in hastily dug mass graves. The chaos has added to the likelihood of errors. Yet the Gaza-based Ministry of Health — an agency in the Hamas-controlled government — continues to tally casualty numbers.

An Israeli army self-propelled artillery howitzer fires rounds from a position near the border with the Gaza Strip in southern Israel on November 6, 2023 amid the ongoing battles between Israel and the Palestinian group Hamas in the Gaza Strip.

(AFP)The ministry is the only official source for Gaza casualties. Israel has sealed Gaza’s borders, barring foreign journalists and humanitarian workers. The AP is among a small number of international news organizations with teams in Gaza. While those journalists cannot do a comprehensive count, they’ve viewed large numbers of bodies at the sites of airstrikes, morgues and funerals.

The United Nations and other international institutions and experts, as well as Palestinian authorities in the West Bank — rivals of Hamas — say the Gaza ministry has long made a good-faith effort to account for the dead under the most difficult conditions.

“The numbers may not be perfectly accurate on a minute-to-minute basis,” said Michael Ryan, of the World Health Organization’s Health Emergencies Program. “But they largely reflect the level of death and injury.”

In previous wars, the ministry’s counts have held up to UN scrutiny, independent investigations and even Israel’s tallies. But an outlier is the ministry’s death toll from an explosion at Al-Ahli Hospital in Gaza City in mid-October. There were conflicting accusations of who was responsible, with Hamas officials blaming an Israeli airstrike and Israel saying it was caused by a an errant rocket launched by Palestinian militants. US and French intelligence services also concluded it was likely caused by a misfired rocket. An AP analysis of video, photos and satellite imagery, as well as consultation with experts, showed the cause was likely a rocket launched from Palestinian territory that misfired and crashed. However, a definitive conclusion couldn’t be reached. There have also been conflicting accounts of the explosion’s death toll. Within an hour, Gaza’s ministry reported 500 Palestinians killed, then lowered that to 471 the next day. Israel says the ministry inflated the toll.

American intelligence agencies estimate 100 to 300 people killed, but haven’t said how they arrived at the numbers. The confusion has called into question the ministry’s credibility in the Hamas-ruled territory. Here’s a look at how Gaza’s Health Ministry has generated death tolls since the war started.


Gaza’s most widely quoted source on casualties is Health Ministry spokesperson Ashraf Al-Qidra. From an office at Shifa Hospital in Gaza City, Al-Qidra receives a constant flow of data from every hospital in the strip. Hospital administrators say they keep records of every wounded person occupying a bed and every dead body arriving at a morgue. They enter this data into a computerized system shared with Al-Qidra and colleagues. According to screenshots hospital directors sent to AP, the system looks like a color-coded spreadsheet divided into categories: name, ID number, date of hospital entry, type of injury, condition. Names aren’t always available, Al-Qidra said. He and colleagues face disruptions because of spotty connectivity but say they call to double-check the numbers. The ministry collects data from other sources, too, including the Palestinian Red Crescent.“Every person entering our hospital is recorded,” said Atef Alkahlout, director of Gaza’s Indonesian Hospital. “That’s a priority.”The ministry releases casualty updates every few hours, providing the number of dead and wounded with a breakdown for men, women and minors. The ministry generally doesn’t provide names, ages or locations of those killed. That information comes from reporters on the ground or the Hamas-run government media office. But on Oct. 27, in response to US doubts over its figures, the ministry released a 212-page report listing every Palestinian killed in the war so far, including their names, ID numbers, ages and gender. A copy of the report shared with the AP named 6,747 Palestinians and said an additional 281 bodies have not yet been identified. The list did not provide a breakdown by location. The ministry never distinguishes between civilians and combatants. That becomes clearer after the dust settles, when the UN and rights groups investigate and militant groups offer a tally of members killed. The Israeli military also conducts post-war investigations. The Health Ministry doesn’t report how Palestinians were killed, whether from Israeli airstrikes and artillery barrages or other means, like errant Palestinian rocket fire. It describes all casualties as victims of “Israeli aggression. ”That lack of transparency has drawn criticism.“ When the Hamas health agency comes out with the numbers, take it with a pinch of salt,” Lt. Col. Richard Hecht, Israeli military spokesman, said in a briefing. But he repeatedly declined to offer any alternative number of Palestinian casualties. Israel says more than 1,400 civilians and soldiers were killed and over 200 hostages seized when Hamas invaded Israel.


Hamas, as Gaza’s ruling authority, exerts control over the Health Ministry. But it’s different than political and security agencies that Hamas runs. The Palestinian Authority, which controlled Gaza before Hamas overran the area in 2007, retains power over health and education services in Gaza, though it’s based in the occupied West Bank. The ministry is a mix of recent Hamas hires and older civil servants affiliated with the secular nationalist Fatah party, officials say. The Fatah-dominated authority that administers Palestinian cities in the Israeli-occupied West Bank has its own health ministry in Ramallah, which still provides medical equipment to Gaza, pays Health Ministry salaries and handles patient transfers from the blockaded enclave to Israeli hospitals. Health Minister Mai Al-Kaila in Ramallah oversees the parallel ministries, which receive the same data from hospitals. Her deputy is based in Gaza. The Ramallah ministry said it trusts casualty figures from partners in Gaza, and it takes longer to publish figures because it tries to confirm numbers with its own Gaza staff. Hamas tightly controls access to information and runs the government media office that offers details on Israeli airstrikes. But employees of the Health Ministry insist Hamas doesn’t dictate casualty figures.“ Hamas is one of the factions. Some of us are aligned with Fatah, some are independent,” said Ahmed Al-Kahlot, director of Kamal Adwan Hospital in northern Gaza. “More than anything, we are medical professionals.”


Throughout four wars and numerous bloody skirmishes between Israel and Hamas, UN agencies have cited the Health Ministry’s death tolls in regular reports. The International Committee of the Red Cross and Palestinian Red Crescent also use the numbers .In the aftermath of war, the UN humanitarian office has published final death tolls based on its own research into medical records. In all cases the UN’s counts have largely been consistent with the Gaza Health Ministry’s, with small discrepancies.— 2008 war: The ministry reported 1,440 Palestinians killed; the UN reported 1,385.— 2014 war: The ministry reported 2,310 Palestinians killed; the UN reported 2,251.— 2021 war: The ministry reported 260 Palestinians killed; the UN reported 256.While Israel and the Palestinians disagree over the numbers of militants versus civilians killed in past wars, Israel’s accounts of Palestinian casualties have come close to the Gaza ministry’s. For instance, Israel’s Foreign Ministry said the 2014 war killed 2,125 Palestinians — just a bit lower than the ministry’s toll. Israeli Prime Minister Benjamin Netanyahu said Israel has killed “thousands” of militants in the current war, without offering evidence or precise numbers. International news agencies, including AP, as well as humanitarian workers and rights groups, have used the ministry’s numbers when independent verification is impossible.“ These figures are professionally done and have proven to be reliable,” said Omar Shakir, Human Rights Watch’s Israel and Palestine director, adding he remained “cognizant of different blind spots and weaknesses” such as the failure to distinguish between civilians and combatants.

RIYADH: A team from the Saudi aid agency KSrelief arrived in the Egyptian capital of Cairo on Tuesday to discuss the mechanism for delivering aid from the Kingdom to those affected by the Israeli action in the Gaza Strip. KSrelief, in line with the directives of King Salman and Crown Prince Mohammed bin Salman, has recently launched a national campaign on the Sahem platform to provide assistance to Palestinians in Gaza. The KSrelief team met Osama Nugali, the Saudi ambassador to Egypt, to discuss ways to expedite the transportation of shelter materials, food baskets, and medical supplies through the Rafah Crossing to those affected in Gaza. The Sahem platform had been accessed by more than 569,000 donors by Tuesday, and donations totaling more than SR404 million ($108 million) had been received. Contributions can be made to the campaign through the platform at sahem.ksrelief.org. Donors also have the option to transfer funds directly to the campaign’s Al-Rajhi Bank account or download the Sahem application on mobile devices from Apple’s App Store or Google Play.AL-MUKALLA: Yemen’s army accused the Houthis on Tuesday of using public fury over Israel’s Gaza conflict to organize fighters and military equipment outside key government-controlled cities under the guise of preparing to confront the Israelis. Rashad Al-Mekhlafi, a military official with Yemen’s Armed Forces Guidance Department, told Arab News that the Houthis amassed fighters and deployed military vehicles and heavy weapons outside the central city of Marib, in the northern parts of Jouf province, and outside the besieged city of Taiz in recent weeks. The Yemeni army is on high alert to deter predicted attacks on those fronts, he said, adding that the “Houthis took advantage of the situation in Gaza” to deploy personnel and equipment and to carry out training and military maneuvers. The Houthis recently announced military training across territories under their control in order to prepare to fight off Israelis. They also declared the launch of drones and missiles against Israel. According to the Yemeni army, the Houthis have used the Gaza conflict to plan a fresh military offensive against government-controlled territories. Fighting in Yemen has generally abated since early 2022, when a UN-brokered truce went into effect, despite frequent claims against the Houthis of launching lethal drone and missile strikes and ground attacks in the provinces of Dhale, Taiz, Marib, Saada, and others. Combatants, artillery emplacements, drone pad launchers, and bulldozers excavating trenches and erecting barricades were stationed in contested areas north of Jouf province and south of Marib city as a smaller number of Houthi fighters and military equipment have been moved outside the city of Taiz, Yemen’s army said. “We believe the Houthis are targeting Marib because of its importance to the national army as well as its oil fields, followed by northern areas of Jouf and the city of Taiz,” Al-Mekhlafi said. Yemen’s army has deployed military soldiers and weaponry in the three areas to counter any Houthi military activity. The army said on Monday that it had foiled a new Houthi onslaught on its positions in the Taiz province’s Al-Kadahah and Maqbanah regions. Meanwhile, the international organization Save the Children announced on Monday that it had restarted its humanitarian operations in Houthi-controlled areas following a 10-day halt, even as the Houthis continue to disregard the organization’s demands for an investigation into the death of a worker in their prison. Late last month, the organization ceased its activities in northern Yemen in an effort to compel the Houthis to provide an explanation for the death of Hisham Al-Hakimi, 44, the organization’s safety and security director, who was held captive by the Houthis. The reason for resuming the operations, the organization said in a statement, is to continue providing humanitarian aid to Yemen’s starving children.“ The needs of the children in Yemen are immense, and they continue to be our driving force. As we resume our operations, we remain dedicated to providing the lifesaving assistance children require,” David Wright, chief operating officer at Save the Children, said in a statement. The death of Al-Hakimi, who was kidnapped from Sanaa in September and held captive for 50 days, has triggered criticism and calls for an investigation from the UK, the EU, and other countries, as well as 20 international organizations operating in Yemen.

CAIRO: Egyptian former presidential hopeful Ahmed Al-Tantawi will face trial for circulating unauthorized endorsement forms for Egypt’s upcoming elections, a campaign member and rights defenders said Tuesday. Tantawi, who withdrew his bid for the presidency last month after failing to gather enough endorsements to run, will face criminal court on charges of “circulating election-related papers without official authorization,” leading human rights defender Hossam Bahgat wrote on X, formerly Twitter. A former member of his campaign confirmed the charges to AFP, saying their “lawyers were surprised to see his and the campaign manager’s name” among the defendants in the case. The former parliamentarian abandoned his bid for the presidency last month after alleging for months that the Egyptian authorities had harassed him and his campaign. He was ultimately able to collect only 14,000 endorsements out of the 25,000 required to run, but maintained that he could win against incumbent President Abdel Fattah El-Sisi in free elections. In an attempt to prove he had popular support, Tantawi had called on his supporters last month to print copies of the endorsement form and hand them in to the campaign in the place of the official forms provided by the election authority. He later rescinded the call after members of his campaign were arrested. Tantawi said over 100 members of his campaign had been arrested in the weeks before he withdrew his bid. The Egyptian Commission for Rights and Freedoms on Tuesday published a list of the defendants who will face trial over the same charges, now scheduled for November 28.The list includes Tantawi, his campaign manager Mohamed Aboul Deyar and 21 other former campaigners who are currently in detention. El-Sisi’s campaign had announced the former army chief had collected the endorsements of 424 of Egypt’s 596 MPs, as well as 1.135 million citizens. But Tantawi retorted that “if real elections were held, he would not gather more than one percent of the vote.”El-Sisi is widely expected to secure a third term in elections scheduled for December 10-12, where a largely decimated opposition has been unable to present a popular alternative.

BEIRUT: A Hezbollah lawmaker said on Tuesday that the Lebanese militant group would respond “double” to any Israeli attacks on civilians after a strike that killed three children and their grandmother in south Lebanon. The remarks reflect the volatile situation on the Israeli-Lebanese border, where deadly clashes between Israeli troops and Iran-backed Hezbollah fighters are fueling fears of a wider regional war while Israel invades the Gaza Strip. “The resistance will respond double to any aggression that targets civilians,” Ali Fayyad said at the funeral of the four Lebanese killed in the south on Sunday.“ It hasn’t yet shown all its weight,” he said, referring to the powerful Iran-backed group. He did not elaborate. Lebanese authorities said an Israeli strike hit the car the family was traveling in on Sunday. Israel’s military said its troops engaged a vehicle in Lebanon which was “identified as a suspected transport for terrorists” and it was looking into reports there were civilians inside. At the funeral, the family cried over four coffins draped in the flags of Lebanon and of a local scouts organization. A banner of the three girls, who were aged between 10 and 14, said they were martyrs and featured the emblem of Hezbollah. Violence at the Lebanese-Israeli frontier is the deadliest there since 2006 as Israel bombards Hezbollah’s Palestinian ally Hamas in Gaza — a response to an Oct. 7 Hamas attack on Israeli towns. Hamas killed 1,400 Israelis, according to Israeli figures. Israel’s bombardment of Gaza has killed 10,000 Palestinians, health officials in the enclave say. Israel said on Monday it struck Hezbollah targets in response to a large barrage of rockets fired at northern Israeli cities. The violence along the Lebanese border has killed more than 60 Hezbollah fighters and 10 civilians, Lebanese security officials say. At least seven Israeli soldiers and one civilian have been killed.

<p> PARIS: Tens of thousands of Gaza’s residents live in eight refugee camps that were set up following the mass exodus of Palestinians during the war that followed the creation of Israel in May 1948.Over 760,000 Palestinians fled or were driven from their homes in what is referred to by Palestinians as the “Nakba” (catastrophe in Arabic).Around 180,000 fled to Gaza, with the rest scattered across the West Bank and neighboring Arab countries, specifically Jordan, Lebanon and Syria. In 1949, the United Nations set up a dedicated agency, UNRWA, to provide them and their descendants, who also have refugee status, with basic services, including health and education. More than two-thirds of the 2.4 million people living in Gaza are registered refugees. Israel has persistently rejected their “right of return,” which the UN backed in a 1948 resolution but has been a sticking point in past rounds of peace talks. While the term refugee camp conjures up images of people living in tents, multi-story cement-block buildings have long since replaced the tents in Gaza. But conditions in the eight camps dotted around the Gaza Strip were grim even before Israel began its relentless bombardment of the territory in response to Hamas’s attacks. Hamas gunmen stormed Israel on October 7, killing more than 1,400 people, and taking more than 240 hostages, according to Israeli authorities.Israel has responded with a relentless military campaign on Gaza that has so far killed over 10,000 Palestinians, mostly civilians, according to health authorities in the enclave.Gaza’s camps are among the most densely populated places on the planet, with over 620,000 people packed into less than 6.5 square kilometers of land, according to pre-war figures. The tight air, sea and land blockade imposed by Israel after Hamas’s takeover of Gaza in 2007 worsened their plight. Unemployment in the camps stood at 48.1 percent in the third quarter of 2022, according to UNRWA, compared to 46.6 percent in the rest of Gaza. Refugee campsTwo of the camps — Jabalia and Shati — are situated in the northern part of the territory which Israel on October 13 ordered civilians to evacuate as it pressed its war against Hamas.About 1.5 million people have fled their homes since the war began, according to the UN, but large numbers are believed to remain in the north. Jabalia — the biggest camp in Gaza, where the first intifada or uprising against Israel’s occupation of Palestinian territories began in 1987 — has been repeatedly bombed since the start of the offensive. The Israeli army claims it is targeting Hamas members and tunnels dug under the camp in the strikes which have damaged several UN-run schools hosting displaced people. Shati camp on the outskirts of Gaza City, has also been been a frequent target. In central Gaza, the Bureij and Al-Maghazi camps have been hit.Forty-five people were killed in an Israeli airstrike on Al-Maghazi camp on Saturday, according to the Gaza health ministry.The dead included four children and four brothers of video-journalist Mohammed Alaloul. Many of those who fled their homes in northern Gaza have crammed into the southern cities of Khan Yunis and Rafah, where the UN also runs refugee camps.UNRWA said that as of November 1, over 530,000 people were sheltering at its facilities in central Gaza, Khan Yunis and Rafah, adding that the shelters were full and that many people were sleeping in the street.Many are hoping to leave Gaza through the Rafah border crossing into Egypt — the only entry in and out of Gaza not controlled by Israel. But so far Egypt has only let through a few hundred foreigners, dual nationals and wounded Palestinians…</p>

Source: Middle-East


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