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

Palestinian children run as they flee from Israeli bombardment in Rafah in the southern Gaza Strip on November 6, 2023, amid continuing battles between Israel and the Palestinian militant group Hamas. (AFP)
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Updated 07 November 2023
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Explainer: What is Gaza’s Ministry of Health and how does it calculate the war’s death toll?

  • 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

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.
HOW DOES THE MINISTRY ARRIVE AT A DEATH TOLL?
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.
WHO WORKS IN THE MINISTRY?
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.”
WHAT IS THE TRACK RECORD FROM PAST WARS?
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.


Netanyahu says Israel offering $5 mn reward for each Gaza hostage freed

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Netanyahu says Israel offering $5 mn reward for each Gaza hostage freed

  • During Oct. 7, 2023 attack which triggered war in Gaza, Hamas took 251 hostages
  • Of those, 97 are still held in Gaza, including 34 who have been confirmed dead

JERUSALEM: Prime Minister Benjamin Netanyahu said on Tuesday that Israel was offering a reward of $5 million to anybody who brings out a hostage held in Gaza.
“Anybody who brings out a hostage will find with us a secure way for them and their family to leave” Gaza, Netanyahu said in a video filmed inside the Palestinian territory, according to his office.
“We will also give them a reward of $5 million for each hostage.”
Wearing a helmet and a bullet-proof jacket, Netanyahu spoke with his back to the Mediterranean in the Netzarim Corridor, Israel’s main military supply route which carves the Gaza Strip in two just south of Gaza City.
“Anyone who dares to do harm to our hostages is considered dead — we will pursue you and we will catch up with you,” he said.
Accompanied by Defense Minister Israel Katz, Netanyahu underlined that one of Israel’s war aims remained that “Hamas does not rule in Gaza.”
“We are also making efforts to locate the hostages and bring them home. We won’t give up. We will continue until we’ve found them all, alive or dead.”
During Hamas’s October 7, 2023 attack which triggered the war in Gaza, militants took 251 hostages. Of those, 97 are still held in Gaza, including 34 who have been confirmed dead.


Netanyahu says Israel offering $5 mn reward for each Gaza hostage freed

Updated 20 November 2024
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Netanyahu says Israel offering $5 mn reward for each Gaza hostage freed

  • “Anybody who brings out a hostage will find with us a secure way for them and their family to leave” Gaza, Netanyahu says

JERUSALEM: Prime Minister Benjamin Netanyahu said on Tuesday that Israel was offering a reward of $5 million to anybody who brings out a hostage held in Gaza.
“Anybody who brings out a hostage will find with us a secure way for them and their family to leave” Gaza, Netanyahu said in a video filmed inside the Palestinian territory, according to his office.
“We will also give them a reward of $5 million for each hostage.”
Wearing a helmet and a bullet-proof jacket, Netanyahu spoke with his back to the Mediterranean in the Netzarim Corridor, Israel’s main military supply route which carves the Gaza Strip in two just south of Gaza City.
“Anyone who dares to do harm to our hostages is considered dead — we will pursue you and we will catch up with you,” he said.
Accompanied by Defense Minister Israel Katz, Netanyahu underlined that one of Israel’s war aims remained that “Hamas does not rule in Gaza.”
“We are also making efforts to locate the hostages and bring them home. We won’t give up. We will continue until we’ve found them all, alive or dead.”
During Hamas’s October 7, 2023 attack which triggered the war in Gaza, militants took 251 hostages. Of those, 97 are still held in Gaza, including 34 who have been confirmed dead.


Turkiye’s Erdogan says Israel’s Herzog was denied airspace en route to Azerbaijan

Updated 20 November 2024
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Turkiye’s Erdogan says Israel’s Herzog was denied airspace en route to Azerbaijan

  • “In light of the situation assessment and for security reasons, the President of the State has decided to cancel his trip to the Climate Conference in Azerbaijan,” the Israeli presidency said

ANKARA: Turkish President Tayyip Erdogan said on Tuesday that Turkiye refused to allow Israeli President Isaac Herzog to use its airspace to attend the COP climate summit in Azerbaijan, highlighting Ankara’s stance amid tensions with Israel.
“We did not allow the Israeli president to use our airspace to attend the COP summit. We suggested alternative routes and other options,” Erdogan told reporters at the G20 Summit in Brazil.
Herzog ended up canceling the visit.
“In light of the situation assessment and for security reasons, the President of the State has decided to cancel his trip to the Climate Conference in Azerbaijan,” the Israeli presidency said. Israel launched a devastating war against Hamas in Gaza a year ago after the Palestinian Islamist group’s deadly cross-border attack.
Turkiye withdrew its ambassador in Israel for consultations after the Gaza war broke out, but has not officially severed its ties with Israel and its embassy remains open and operational.
“But whether he was able to go or not, I honestly don’t know,” Erdogan said on Herzog’s visit to Baku.
“On certain matters, as Turkiye, we are compelled to take a stand, and we will continue to do so,” he said.

 


Hospital chief decries ‘extreme catastrophe’ in north Gaza

Updated 19 November 2024
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Hospital chief decries ‘extreme catastrophe’ in north Gaza

  • Kamal Adwan Hospital director Hossam Abu Safiyeh told AFP by phone: “The situation in northern Gaza is that of an extreme catastrophe

GAZA CITY, Palestinian Territories: The World Health Organization expressed grave concern on Tuesday for hospitals still partly operating in war-stricken northern Gaza, where one hospital director described the situation as an “extreme catastrophe.”
“We are very, very concerned, and it’s getting harder and harder to get the aid in. It’s getting harder and harder to get the specialist personnel in at a time when there is greater and greater need,” WHO spokeswoman Margaret Harris told journalists in Geneva.
She said the organization was “particularly concerned about Kamal Adwan Hospital” in Beit Lahia, where Israeli forces launched an offensive against Hamas and other Palestinian militant groups last month.
Kamal Adwan Hospital director Hossam Abu Safiyeh told AFP by phone: “The situation in northern Gaza is that of an extreme catastrophe.
“We’re beginning to lose patients because we lack medical supplies and personnel,” he said.
Abu Safiyeh added that his hospital had been “targeted many times by the occupation forces, most recently” on Monday.
“A large number of children and elderly people continue to arrive suffering from malnutrition,” the doctor said.
He accused Israel of “blocking the entry of food, water, medical staff and materials destined for the north” of the Gaza Strip.
The WHO’s Harris estimated that between November 8 and 16, “four WHO missions we were trying to get up to go were denied.”
“There’s a lack of food and drinking water, shortage of medical supplies. There’s really only enough for two weeks at the very best,” she said.
A statement from COGAT, the Israeli defense ministry body responsible for civil affairs in the Palestinian territories, said Tuesday: “COGAT-led humanitarian efforts in the medical field continue.”
It said that on Monday, “1,000 blood units were transferred” to Al-Sahaba hospital in Gaza City, outside the area where Israel’s military operations are taking place.
In its latest update on the situation in northern Gaza, the UN humanitarian office OCHA said Tuesday that “access to the Kamal Adwan, Al Awda and Indonesian hospitals remains severely restricted amid severe shortages of medical supplies, fuel and blood units.”
 

 


Turkiye asks export group to help snuff out Israel trade

Updated 19 November 2024
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Turkiye asks export group to help snuff out Israel trade

  • Ankara has faced public criticism that trade may be continuing with Israel since a ban in May

ISTANBUL: Turkiye’s government has asked one of the country’s top export associations to help enforce a ban on trade with Israel, slowing the flow of goods in recent weeks, according to three people familiar with the matter.

Ankara has faced public criticism that trade may be continuing with Israel given a spike in exports to the Palestinian territories since the ban in May. So it turned to the Central Anatolian Exporters’ Association, the sources said.

The Trade Ministry has asked the association to require more checks and approvals of proposed shipments, including vetting with Palestinian authorities, they said.

One of the sources, from an export association, said the new system began in mid-October, causing an initial backlog. The “main concern was goods still going to Israel, so there is a procedural change in exports to Palestine,” he said.

In response to a query, the Trade Ministry said goods were only shipped if approved by Palestinian authorities under a bilateral trade mechanism. “The destination is Palestine and the importer is a Palestinian,” it said.

According to official Turkish Statistical Institute data, Turkiye, among the fiercest critics of Israel’s war in Gaza, has cut exports there to zero since May, from a monthly average of $380 million in the first four months of the year.

But at the same time exports to Palestinian territories — which must flow through Israel — jumped around 10-fold to a monthly average of $127 million in June-September, from only $12 million in the first four months of the year, the data show.

The top goods leaving Turkish ports and earmarked for Palestinian territories in recent months are steel, cement, machinery, and chemicals, according to the Turkish Exporters Assembly, also known as TIM.

The jump in such exports raised suspicions the trade ban was being circumvented, sparking street protests that questioned one of the main policies President Tayyip Erdogan’s government imposed to oppose Israel’s war with Palestinian militant group Hamas in Gaza.

Opposition lawmakers have also sought answers in parliament.

Trade Minister Omer Bolat said this month that, before the ban, some $2 billion of Turkiye’s $6.5 billion annual trade with Israel was goods ultimately purchased by Palestinian buyers.

Last week, Bolat told parliament that the Palestinian Economy Ministry vetted all shipments. Turkiye’s Trade Ministry said that Palestinian confirmations then run through an electronic system, after which customs declarations require a separate approval.

The Central Anatolian Exporters’ Association is an umbrella body for sector-specific export groups. In the past, they all usually quickly approved shipments with little question, the sources said.

Under the new instructions from the government, the association is the main approval body, two sources said. It must first confirm receipt of information about the proposed export including the Palestinian authorities’ approval, and then approve a separate application for export, they said.

The first source said the system was working now, but slower than in the past due to relevant checks.

In the first 10 months of the year, exports to Palestinian territories were up 543 percent from a year earlier, TIM data show. In the first four months, before the Israel ban was imposed, they were up only 35 percent.