The British medical journal Lancet published a letter on July 5 by three public health policy experts. They warn that the actual civilian death toll, resulting from Israel’s war in Gaza, could be 3 to 15 times higher than the body count reported by the Gaza health ministry. This is due to the second-and-third-order effects on the population of the destruction of civil infrastructure, medical facilities, the disruption of food supplies, the inability to pull bodies from the rubble of destroyed buildings, and even the collapsing capability to even keep an accurate count of the dead. Using a ratio of four indirect deaths for every death caused by military action, the authors calculate that the death toll could be 186,000–and it could be even higher than that.
“An immediate and urgent ceasefire in the Gaza Strip is essential, accompanied by measures to enable the distribution of medical supplies, food, clean water, and other resources for basic human needs,” the authors write. “At the same time, there is a need to record the scale and nature of suffering in this conflict. Documenting the true scale is crucial for ensuring historical accountability and acknowledging the full cost of the war. It is also a legal requirement. The interim measures set out by the International Court of Justice in January, 2024, require Israel to ‘take effective measures to prevent the destruction and ensure the preservation of evidence related to allegations of acts within the scope of … the Genocide Convention.’”
