The death toll from Israel’s war against Hamas militants in Gaza is far higher than official figures, according to an analysis by researchers at the London School of Hygiene and Tropical Medicine published in The Lancet.

The analysis, published Thursday in the medical journal, estimates that between October 2023 and June 2024, there were more than 64,000 Palestinian deaths caused by violence in Gaza, suggesting that the Hamas-run Ministry of Health in the territory underreported the death toll by 41%. The official figure for that period was 37,877 deaths.

Some 59% of the dead were women, children or the elderly, according to the peer-reviewed Lancet report, which is roughly in line with other estimates. The analysis did not identify the number of Hamas fighters among the dead.

A separate United Nations analysis of more than 8,000 verified deaths between November 2023 to April 2024 concluded that 44% of victims were children and 26% were women.

Sources

The researchers in the Lancet report used a scientific technique called capture-recapture analysis, whereby three different sources were cross-referenced. The less overlap between the sources, the more likely it is that many deaths have gone unrecorded.

“This method … uses multiple data sources (lists) with sufficient identifying information to accurately link records, identify overlapping cases, and infer the true number of cases (deaths), including those not featured within any list, based on statistical models,” the report said.

The first source was the Palestinian Ministry of Health’s list of bodies identified in hospitals and morgues; the second source was an online survey distributed by the Ministry of Health asking relatives to record deceased family members; and the third list was compiled from obituaries posted on social media sites such as Instagram and Facebook.

Indirect deaths

The data did not include Palestinians who had died from causes indirectly related to the war.

“So in reality, the number of mortalities might be higher if we also include the issue of not accessing health care, heart attacks … infectious diseases, maternal care, pregnant women not being able to get access to proper delivery, and so on,” said report co-author Zeina Jamaluddine of the London School of Hygiene and Tropical Medicine.

The analysis also excluded missing people. The United Nations Office for the Coordination of Humanitarian Affairs estimates that 10,000 Palestinians are missing under rubble and presumed dead.

The capture-recapture technique has been used to estimate deaths in other conflicts, Jamaluddine said. “It has been used in Sudan and Yemen. It has also been used in Kosovo — and some of this evidence has been used in the ICJ [International Court of Justice].”

Israel offensive

Israel launched its war on Hamas in Gaza following the militant group’s cross-border attack on October 7, 2023, which killed more than 1,200 people, mostly civilians. More than 240 hostages were taken back to Gaza. There are still almost 100 hostages being held by Hamas, with about one-third of them believed dead.

Israel accuses Hamas of using civilians as human shields in Gaza.

In a statement, Israel’s embassy in London told VOA, “As has already been proven countless times before, any information that derives from Gaza cannot be trusted, nor can you ignore the Lancet’s history of anti-Israel bias. For this reason, we would strongly encourage readers to question their source and validity. We urge that the continual spread of misinformation about Israel is stopped. Such activity only serves Hamas, is irresponsible, and dangerously contributes to rising anti-Jewish hatred.”

Reuters quoted an unnamed senior Israeli official saying, "No other army in the world has ever taken such wide-ranging measures. These include providing advance warning to civilians to evacuate, safe zones, and taking any and all measures to prevent harm to civilians. The figures provided in this report do not reflect the situation on the ground.”

VOA was unable to independently verify the figures. Israel does not allow foreign journalists to enter Gaza.