As the Gaza conflict continues into its tenth month, the human toll remains staggering. According to the Gaza Ministry of Health (MoH), over 40,000 people have been killed, and another 92,401 have been injured since the war began, affecting nearly one in every seventeen residents. The scale of devastation is nearly incomprehensible, with an estimated 59% of buildings damaged or destroyed, including over 215,000 homes.
While the numbers paint a grim picture, they also tell a story of relentless efforts by the MoH to document and identify the dead, even as the conflict severely hampers these efforts. The MoH has faced significant challenges in maintaining accurate and reliable casualty data, particularly in a landscape where infrastructure has been decimated, and the usual medical processes have been severely disrupted.
Zaher Al Wahaidi, Director of the MoH’s Health Information Centre (HIC), provided Sky News with new insights into these operational difficulties. Before the recent escalation in hostilities, the HIC maintained a robust, real-time computer network that tracked deaths across hospitals in Gaza. This system, which had proven accurate during previous conflicts, was praised for its reliability, with figures that closely matched those later produced by the UN and the Israel Defence Forces (IDF).
However, this system collapsed following Israeli raids on key hospitals in Gaza City last November, which destroyed critical data centres and severed vital connections to Gaza’s civil registry. This breakdown forced the MoH to rely on outdated, manual methods for recording deaths, further complicating efforts to provide accurate casualty data amidst the chaos.
Challenges in Data Recording and Identification
In the southern regions of Gaza, hospitals lost access to the national database of names, ID numbers, and birth dates. This meant that every new entry had to be manually logged, a process prone to human error. Thousands of ID numbers, names, and birth dates were either missing or incorrectly entered, adding to the confusion and difficulty of maintaining an accurate death registry. In the northern regions, the situation was even more dire; there were no computer systems available, and hospital staff relied on pens and paper to record the details of the deceased. When the hospitals were overwhelmed with casualties, even this basic method proved impossible.
Instead, a simple headcount was taken by hospital spokespersons, and bodies were tagged and photographed for potential later identification. This rudimentary method led to a rapid increase in the number of unidentified fatalities. In March, for example, 81% of all new additions to the death toll were unidentified. The health ministry’s reports attributed these body counts to “reliable sources,” a term which had previously been mistranslated as “reliable media sources.”
“It’s not from journalists,” Al Wahaidi clarified to Sky News. “We don’t depend on any press sources for data – this is the policy of the Ministry of Health.” Instead, these “reliable sources” were, in fact, hospital spokespersons and media staff who were drafted to help count the dead during times when medical staff were overwhelmed.
Restoration Efforts and Ongoing Challenges
Since February, the situation has slowly begun to improve. Hospitals in the north have gradually restored computer systems, allowing for more accurate data entry and reconnection to the central database. This restoration has enabled better recording and reduced the number of unidentified fatalities significantly, from 15,070 in March to 7,200 by early August.
Much of this progress has been attributed to an entirely new system implemented by the MoH, allowing families to register deaths even when bodies are not recovered. This system requires families to fill out an online form with the deceased’s details, including whether their body was received by a hospital. If a death is confirmed through this process, it is added to the MoH database, and if the body passed through a hospital, one entry is also removed from the tally of unidentified deaths.
To date, 6,187 deaths have been confirmed via this online form system, providing much-needed clarity and closure to grieving families and reducing the number of unidentified bodies in Gaza’s hospitals.
“While the Ministry of Health’s efforts to document casualties under such dire conditions are commendable, there is still much work to be done to ensure accuracy and transparency,” says Dr. Iain Overton, Executive Director of Action on Armed Violence. “The ongoing challenges highlight the need for robust systems and international support to document the true human cost of this conflict accurately. Only with transparent and reliable data can we fully comprehend the scale of suffering and begin to seek accountability and justice.”
Efforts to Identify the Dead and Address Criticisms
Despite the ongoing challenges, the MoH’s work has been recognised by experts as a significant attempt to document and identify the dead under extreme circumstances.
“It’s all very challenging and chaotic and you would expect there to be plenty of mistakes,” Professor Michael Spagat, chair of Every Casualty Counts, an independent civilian casualty monitoring organisation, told Sky News. “But it looks like they’re in there fighting the battle to record all this information, and they seem to be doing it in a serious and reasonable way.”
However, there remain criticisms of the MoH for failing to differentiate between combatants and civilians in their casualty counts. The MoH has responded that its role is to document all deaths without distinction, as its staff are not equipped to make such legal and military determinations.
The Path Ahead: A Commitment to Transparency
The road ahead for Gaza’s MoH is fraught with challenges. While they have reconnected major hospitals to their central database, much work remains to be done in identifying the dead and ensuring all fatalities are recorded accurately. Mr. Al Wahaidi has emphasised that the MoH intends to provide a conservative figure based only on those deaths confirmed by medics or a judicial process.
“The way that the health ministry has reported deaths in past conflicts deaths is quite strong – much stronger than other settings that I’ve worked in,” says Professor Paul Spiegel, director of the Center for Humanitarian Health at Johns Hopkins University.
“And the health ministry is only reporting trauma deaths. There’s clearly been an exacerbation of indirect deaths – cardiovascular diseases, diabetes, maternal deaths. If anything, I think it’s an underestimate.”
Despite these challenges, the MoH’s ongoing efforts are crucial in maintaining a record of the conflict’s impact on civilians. The transparency and robustness of this process remain essential for ensuring that the true human cost of the conflict is recognised, both for historical record and for fostering international accountability and justice.
As Dr. Overton of AOAV states, “Accurate casualty recording is not just a matter of counting the dead; it is a vital tool in the pursuit of justice and accountability. For those who have lost loved ones, it is a step toward healing and recognition of their suffering.”