More than 30,000 of the dead fully identified; thousands more pending identification.
In a recent blog post for ECC, Professor Mike Spagat explained how and why the reliability of casualty data from the Gaza Ministry of Health (MoH) has deteriorated over recent months. One of the key issues he identified was the lack of transparency around the methodology the MoH used to record casualty information from ‘media sources’.
ECC has now received, via Ben van der Merwe at Sky News, a detailed clarification of this issue directly from the Director of the MoH’s Health Information Centre, Mr. Zaher Al Wahaidi.
In this article, Professor Spagat analyses this newly available information and comments on what it means for our understanding of deaths in Gaza. The full explanation from Al Wahaidi can be downloaded below.
Key points:
- MoH’s Methodology: Since October 7, the MoH has released official death tolls and five detailed lists of individual fatalities. These public lists include names and details of those killed in the war, but there are gaps between these lists and the overall reported death tolls.
- Clarification of Processes: The document reveals that the MoH did not use media monitoring to fill gaps in casualty data. Instead, when regular systems failed, they relied on headcounts conducted by public relations and media staff, which were then added to the official totals.
- Data Processing: The MoH is working to convert these headcounts into documented deaths by processing hand-written records and a public reporting form that triggers judicial verification. These processes have reduced the number of unidentified deaths substantially.
- Identification Efforts: While converting unidentified bodies, the MoH has been photographing mortal remains to facilitate potential identification later, though detailed processes for matching names to remains were not outlined in the document. The MoH has fully identified more than 30,000 individuals killed to date.
- Exclusion of Non-Violent Deaths: The official MoH death tolls announced so far include only conflict-related deaths. There are, however, plans to publish comprehensive data, including non-conflict deaths, at the end of the year.
- A Serious Effort: The MoH is engaged in supremely challenging work so, inevitably, its output is far from perfect. The overall impression is that the MoH is striving, under the most difficult of circumstances, to accurately record the number of casualties and improve the records and their methodology over time.
Casualty recording in Gaza
As described in a previous blog post, the reliability of MoH casualty data has deteriorated since the start of the conflict in October 2023. This is due primarily to the decimation of the medical processes and infrastructure upon which accurate death registration relied.
To mitigate this, the MoH began using additional methods to document the continuing deaths. Unfortunately, this combination of approaches weakened the public credibility of the data produced, because of underexplained gaps between the numbers of deaths contained in the last four lists of individual victims published by the MoH and the officially announced fatality totals for the corresponding periods. For example, List 4 contains 24,653 deaths occurring between October 7 and April 30 while the official MoH death toll for this period is 34,535.
MoH characterisations of the gaps between individually documented deaths and claimed totals have been unclear and confusing, appearing to materialise from within a ‘black box’. This document from the Director of the MoH Health Information Centre, and his exchanges with Sky News, reveal what is inside the box.
MoH casualty recording methodology
MoH publications have repeatedly used the Arabic phrase “المصادر الإعلامية الموثوقة”, commonly translated as “reliable media sources”, to explain the source of certain casualty information. This terminology suggested that the MoH was filling the gaps in its normal hospital-based casualty recording systems with information on deaths gleaned from public media reports.
This new document clearly states that this interpretation is incorrect. The MoH never gathered casualty information via media monitoring. Rather, when normal casualty recording was rendered impossible due to the number of casualties and disruptions to the normal functioning of hospitals, the MoH deployed “Public Relations and Media Staff”, rather than the usual Patient Services staff, to count the dead arriving at hospitals. It seems that that the Arabic phrase that has been translated as “reliable media sources” was referring to these “public relations and media staff”.Under normal conditions a Patient Services employee would enter details of a new death into a local computer terminal that is networked into the central MoH casualty recording database. ECC confirmed that, during this process, the MoH employee could retrieve missing information on the deceased from the Gaza population registry database, such as national ID number, full name details, age and sex.
Al Wahaidi explains that after the Al-Shifa Medical Complex was taken over by Israeli forces on November 10, and both the main and alternative data centres at Al-Rantisi Complex were disrupted, the normal casualty recording system collapsed. Health staff were unable to connect to the civil registry or the central death registry. The problem intensified as further hospitals were destroyed. This lack of access to the population registry alone could result in incomplete or incorrect entries into the central database of deaths. Lack of access to the central database itself forced, in the first instance, deaths to enter official totals as headcounts rather than individualized listings.
It was at this point that the MoH began using their hospital spokespersons and media staff to help record casualty data. With no access to civil registry databases, bomb-damaged hospitals, displaced or dead medical staff, and up to 300 fatalities per day, these non-medical staff had to help count the dead as they passed through the hospital without being able to individually identify them.
The headcount numbers were sent to Mr. Al Wahaidi’s information systems unit within the MoH and added to the total numbers of deaths appearing on the detailed lists that the MoH releases periodically. These numbers are the “gaps” referred to above. Sometimes the headcounts were backed by hand-written records which were also sent to Mr. Al Wahaidi’s office and eventually integrated into the detailed list.
Bodies under the rubble
A second channel for converting body counts into individually recorded deaths is through a publicly available form through which Gazans can report deaths. Completed forms trigger a judicial verification proceeding which, if successful, yields a death certificate and entry onto the detailed list if it is not there already. If, in addition, the form indicates that the body of the deceased person passed through the hospital system then one unidentified death is subtracted from the total hospital headcount.
These forms can also indicate that the bodies of deceased individuals did not pass through hospitals. It appears that these deaths can still be included in the total fatality lists released periodically by the MoH, with full details of the fatality investigated and added later. If this is true, then these lists would include some – but not all – of the deaths commonly characterised as “under the rubble”.
Unidentified bodies in Gaza
These processes for converting unidentified body count deaths into individual victims appearing on the MoH’s detailed list has been highly active in recent months. Indeed, the MoH has driven unidentified fatalities down from 15,070 on March 31 to 7,200 on August 6.
Conversions of head-counted numbers into individualised deaths through the form cannot, unfortunately, attach names and identities to specific unidentified bodies. The document states that the MoH tries to facilitate the matching of bodies with identities by photographing prominent marks on unidentified bodies, but the document does not indicate whether such identification efforts are already underway.
Combatants and civilians
There have been criticisms of the MoH for failing to divide its fatality statistics into combatants and civilians. ECC maintains that it would not be appropriate for MoH employees to attempt to make such distinctions, as they are not qualified to do so. Determining combatant status is a complex matter of international humanitarian law which must be undertaken by legal and military experts. Mr Al Wahaidi confirms that the MoH ‘records everyone who comes to it without knowing whether they are civilians or fighters, as all come in civilian clothes’.
Finally, Mr. Al Wahaidi stated in his correspondence with Ben van der Merwe at Sky News that the official totals regularly announced by the MoH include only violent deaths, not those from natural causes. He added that the MoH plans to publish full accounts of deaths from all causes at the end of the year.
Image: UN School in Gaza Attacked, by UN Photo, licensed under CC BY-NC-ND 2.0.
