The death toll in the Gaza Strip reached 30,000

How Gaza’s Health Ministry Counts the Death Toll: A Case Study in the First Day of the September 11 Israeli-Israeli War

Eman Abusaeda struggled to protect her children in Gaza during the days after the attack on Israel.

We awoke with gunpowder and dirt on our bodies and faces. My kids crying and shouting all the day because of the bombing from the F-16 war airplanes,” she said in a call with NPR on Oct. 9. “We’re trying to escape but we don’t know where to go.”

NPR received a report from the health ministry about the death toll. A close look at how Gaza’s health ministry counts the dead reveals a system that is unable to provide an accurate toll of those who have died.

Thousands remain unaccounted for — either missing under the rubble, buried hastily in side streets or decomposing in areas that can’t be safely reached.

The Gaza health ministry says that it now uses accurate death counts from partially operating hospitals and estimates from media to assess deaths in the north of Gaza where Israeli forces control access. The system for counting the dead was disrupted on Nov. 12 when communications were lost with three major hospitals in the north.

In late October, after President Biden said he had “no confidence” in the figures reported by Gaza’s health ministry, which falls under Hamas’ administration, the ministry published the database with thousands of victims’ names.

The health ministry relies on hospital emergency rooms for most of their data. Hospitals tally the number of people dying in their overflowing hallways and operating rooms each day.

The ministry says that more than 17,000 Palestinian deaths have been recorded this way, with the victims’ names and other information recorded in the database if the body can’t be identified.

There have been other breaks in the system. In November, Israeli forces struck and raided Al-Shifa, Gaza’s largest hospital, which Israel’s military said was being used by Hamas. People at the hospital were burying bodies in shallow graves on its premises, with no staff able to record the deaths as the Israeli raid was closing in and the hospital was besieged.

Health workers have also been hit — injured, displaced and killed. The health ministry says more than 300 medical staff have been killed since the beginning of the war. Others have been wounded, including the director-general for Gaza’s health ministry, Dr. Munir al-Bursh, who was hurt and lost a young daughter in an Israeli air strike in December, according to Al Jazeera footage showing him speaking as he was being transported in an ambulance and cradling his daughter’s body.

On Oct. 31, Israeli warplanes targeted the five-story building the family was in. Abusaeid, 40, was killed. So were her husband and children. 23 of her family’s members were killed in the attack.

Only one person in the apartment survived, a younger sister whose six children were among those killed, according to relatives who confirmed the details.

Family of the Israeli Airstrike Fighter Abusaeid, killed in the attack on the Ras Al-Aharonov-Bezgin Square, Gaza

NPR reached out to the Israeli military multiple times, including with coordinates of the building, with questions about why it was bombed, but did not receive a response.

Relatives say Abusaeid’s husband, Iyad, her brother, Mahmoud, her son, Ziyad, and three other children in the family are still missing under the rubble. Their bodies were never recovered.

The names and information of people still under the rubble and those who have been recovered from under the rubble will not be recorded, al-Qudra says.

The health ministry in Gaza publishes death counts, but Bozya and doctors say many of the people who have died from a lack of adequate treatment are not included.

Bozya says a colleague in Gaza told him the only way to really know how many people have died is to count the number of people still alive compared with the population of Gaza before Oct. 7.

These casualty figures are important for people who have lost a loved one in the war. Someone who worked hard, had dreams and was loved is what each one represents.

Abusaied’s brother, Mohammed, who lives in the U.K., says his sister Taqwa, who survived the airstrike but lost her six children, is hardly able to speak when he calls her now in southern Gaza.

He misses being able to call his parents in Gaza and share photos of his children in the U.K. over WhatsApp with them. He doesn’t like looking at the pictures of his parents, siblings, nieces and nephews who were killed in the attack.

“When I look at pictures, it’s very painful,” he says. “Ten years, I was praying to Allah, you know, to reunite with my family. But this will never happen.”

Thousands of Dead Palestinians are in danger: Israel and Hamas will fight in a campaign to halt the offensive on Gaza, according to the World Health Organization

Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, said on Thursday in a social media post marking the 30,000 deaths that most of those killed in Gaza were women and children.

The health ministry has said infants have died from dehydration and malnutrition in recent days. The lack of basic medical supplies in the Gaza Strip left people dying in a treatable situation, according to a physician who was there at the end of January.

On Wednesday, Hamas’s political leader said in a televised speech that while the group was open to making a deal with Israel, it was also ready to continue fighting. He called on Palestinians to march to the Aqsa mosque compound in Jerusalem in March, raising the prospect of fresh clashes with Israeli security forces around a site holy to both Muslims and Jews.

Israel has come under growing international pressure to stop its offensive, and even President Biden, its strongest ally, has expressed growing frustration with the rising death toll and worsening humanitarian crisis in Gaza. Israeli leaders insist they’ll continue fighting in order to eliminate Hamas, the military group that attacked Israel and killed over a thousand people.