By Nidal al-Mughrabi and Emma Farge
(Reuters) -Palestinian health authorities say Israel’s ground and air campaign in Gaza which resumed last week has killed more than 50,000 people, with nearly a third of the dead under 18.
After a ceasefire characterised by two months of relative calm in the 18-month war, Israel resumed an all-out air and ground campaign against Hamas last Tuesday. Palestinian health officials say nearly 700 have been killed since.
The war began on Oct. 7, 2023 when Hamas militants stormed across the border into Israeli communities. Israel says the militants killed more than 1,200 people, mostly civilians, and took some 250 people into captivity in Gaza.
A new list released by the Palestinian Ministry of Health that includes the names, age and gender of those killed up until March 22 includes 50,021 people, ranging from a newborn baby to a 110-year-old. Of those, 15,613 or 31% were under 18.
The official Palestinian Health Ministry death toll dwarfs those killed in previous bouts of fighting between Israelis and Palestinians in Gaza since 2005, according to data from Israeli human rights organisation B’Tselem.
This explainer examines how the Palestinian toll is calculated, how reliable it is, the breakdown of civilians and fighters killed and what each side says. For more information, Reuters Graphics has produced a multi-media exploration of the deaths.
HOW DO GAZA HEALTH AUTHORITIES CALCULATE THE DEATH TOLL?
In the first months of the war, death tolls were calculated entirely from counting bodies that arrived in hospitals and data included names and identity numbers for most of those killed.
As the conflict ground on and fewer hospitals and morgues continued to operate, the authorities adopted other methods too.
From early May 2024, the ministry updated its breakdown of fatalities to include unidentified bodies which accounted for nearly a third of the overall toll. Since then, health authorities have been working to identify them and none are now listed in the death toll.
Zaher Al-Waheidi, Director of the Information Unit at the Gaza Health Ministry, attributed progress in identifying bodies to the restoration of a central database from Shifa Hospital and a system allowing families to provide input on victims, which is then verified by medics and police.
In the two months of relative calm during the ceasefire that began in January, 2025, work accelerated, he said.
A Reuters examination of an earlier Gaza Health Ministry list of those killed showed that more than 1,200 families were completely wiped out, including one entire family of 14 people.
IS THE GAZA DEATH TOLL COMPREHENSIVE?
The numbers do not necessarily reflect all victims, as many are still under rubble, the Palestinian Health Ministry says. It estimates some 10,000 bodies were uncounted in this way, with only a few dozen of them recovered since the ceasefire.
Official Palestinian tallies of direct deaths in the Gaza war likely undercounted the number of casualties by around 40% in the first nine months of the war as Gaza’s healthcare infrastructure unravelled, according to a peer-reviewed study published in The Lancet journal in January.
The U.N. human rights office also says the Palestinian authorities’ figure is probably an undercount. In past Gaza wars, the U.N. tally sometimes exceeded the Palestinian count.
The deaths it has verified so far show that nearly 70% were women and children.
HOW CREDIBLE IS THE GAZA DEATH TOLL?
Pre-war Gaza had robust population statistics and better health information systems than in most Middle East countries, public health experts told Reuters.
A study of open sources by the UK-based Airwars non-profit found a correlation of at least 75% between its lists and those of Gazan authorities for thousands killed early in the war.
The U.N. often cites the ministry’s death figures and the World Health Organization has voiced full confidence in them.
DOES HAMAS CONTROL THE FIGURES?
While Hamas has run Gaza since 2007, the enclave’s Health Ministry also answers to the overall Palestinian Authority ministry in Ramallah in the West Bank.
Gaza’s Hamas-run government has paid the salaries of all those hired in public departments since 2007, including in the Health Ministry. The Palestinian Authority still pays the salaries of those hired before then.
WHAT DOES ISRAEL SAY?
Israeli officials have said the figures are suspect because of Hamas’ control over government in Gaza. Foreign Ministry spokesperson Oren Mamorstein said the numbers were manipulated and “do not reflect the reality on the ground”.
However, Israel’s military has also accepted in briefings that the overall Gaza casualty numbers are broadly reliable.
The Israeli military says 407 of its soldiers were killed in combat since its Gaza ground operation began on Oct. 27, 2023.
The Israeli military says it goes to great lengths to avoid civilian casualties. It says Hamas uses Gaza’s civilians as human shields by operating within densely populated areas, humanitarian zones, schools and hospitals, which Hamas denies.
HOW MANY OF THE DEAD ARE FIGHTERS?
The Palestinian Health Ministry figures do not differentiate between civilians and Hamas combatants, who do not wear formal uniform or carry separate identification.
Israel periodically estimates the number of Hamas fighters killed. Recent assessments put the number of Palestinian militant dead at 20,000. It says about one civilian was killed for every fighter, a ratio it blames on Hamas for using civilian facilities.
Israeli officials say such estimates are reached through a combination of counting bodies on the battlefield, intercepts of Hamas communications and intelligence assessments of personnel in targets that were destroyed.
Hamas has said Israeli estimates of its losses are exaggerated, without saying how many of its fighters have been killed.
(Compiled by Emma Farge, Nidal al-Mughrabi, Ali Sawafta, James MacKenzie and Angus McDowall, Editing by William Maclean and Peter Graff)
