Why news outlets and the U.N. rely on Gaza’s Health Ministry for death tolls

Since the Hamas attack on Israel on Oct. 7, Gaza has been closed to outside journalists. Palestinian reporters there are under extreme risk due to the conflict. Israel controls all but one crossing into Gaza, which is controlled by Egypt.

Where we get our data about the Israel-Gaza war

The Gaza Strip and West Bank — part of the Palestinian territories that Israel occupied in 1967 — have two governments: the Ramallah-based Palestinian Authority, which controls pockets of the West Bank and is led by the Fatah party, and its rival Hamas in the Gaza Strip. Hamas, a militant group, ousted the Palestinian Authority from Gaza in 2007 following a disputed election. The United States had designated Hamas a terrorist organization a decade earlier.

The Gaza Health Ministry releases updates on death tolls, which The Post cites. The Post also cites official Israeli figures for Israel’s death toll in the conflict.

After over two weeks of strikes, the Gaza Health Ministry said more than 5,000 people in Gaza had been killed. Israeli authorities have said the Hamas attack on Oct. 7 killed at least 1,400 people. Neither number differentiated between civilians and combatants.

In conflict coverage, official numbers often provide the only view of casualty levels. In the war in Ukraine, The Post reports death tolls issued by official Ukrainian and Russian sources.

International organizations including the United Nations usually rely on these same figures as they are seen as the best available. The partial exception is the database of the U.N. Office for the Coordination of Humanitarian Affairs (OCHA), which checks both Gazan and Israeli numbers with at least one other source, according to its website. This takes time, however, and OCHA has not updated its database with tolls from the current war.

The United States does not directly provide funding to the Gaza Health Ministry because of its ties with Hamas. However, the State Department cited its death toll statistics in a report published only a few months ago.

How reliable is the Gaza Health Ministry?

Hamas appointed its own health minister after it took control of Gaza in 2007, separating the ministry from the Palestinian Health Ministry in the West Bank, which is controlled by the Palestinian Authority. After the takeover, some officials accused Hamas of ousting doctors linked to Fatah.

Many experts consider figures provided by the ministry reliable, given its access, sources and accuracy in past statements.

“Everyone uses the figures from the Gaza Health Ministry because those are generally proven to be reliable,” said Omar Shakir, Israel and Palestine director at Human Rights Watch. “In the times in which we have done our own verification of numbers for particular strikes, I’m not aware of any time which there’s been some major discrepancy.”

Shakir said Human Rights Watch would not use figures provided by parties with “a propensity to misrepresent information.”

“We know that a health ministry is going to base [death tolls] on assessments coming from hospitals, morgues, etc.,” he said. “They have an ability to collect that in a way that other sources not there can’t do.”

President Biden, meanwhile, said on Oct. 25 that he has “no notion that Palestinians are telling the truth about how many people are killed” in Gaza. The U.S. leader said that he was sure that “innocents have been killed” and called on Israel to be “incredibly careful” to avoid civilian casualties, but cast doubt on the reliability of Palestinian figures.

“I have no confidence in the number that the Palestinians are using,” Biden said.

The Gaza Health Ministry has continued to perform its core services. Hamas received support in the 2006 elections in part by promising better social services, and some analysts say the group has improved certain areas of access.

However, the health sector in Gaza remains dependent on donor support, with groups such as the United Nations Relief and Works Agency for Palestinian Refugees in the Near East (UNRWA) providing medical support. Despite its split with Hamas, the Palestinian Authority in the West Bank also provides a portion of its budget for health care and other services.

The Israeli-led blockade on Gaza has had a vast impact on the work of the ministry and aid groups. The World Health Organization found in a 2023 report that “bureaucratic obstacles” limited access to medicines and that there also were restrictions that impacted the supply of “X-ray machines, computed tomography scanners, magnetic resonance imaging scanners, oxygen cylinders, communications equipment, nuclear medicine technology, and materials used in limb prostheses.”

Official accounts sometimes differ

Tensions over the Gaza Health Ministry were heightened after a blast at the al-Ahli Hospital on Oct. 17. In a statement shortly after the attack, the health ministry said 500 people had been killed in the strike. The next day, the ministry revised the figure down to 471.

Some Israeli officials have questioned those figures. “If so many people were killed, where are the bodies?” Lt. Col. Jonathan Conricus, a spokesman for the Israel Defense Forces, said in a video statement released Thursday. The Israeli government has not offered its own estimates.

The United States reached a separate estimate. “We estimate the number of deaths is probably at the low end of the 100-to-300 spectrum,” a U.S. intelligence analysis shared with The Washington Post found, adding that even the lower death toll still represented “a staggering loss of life.”

The health ministry blamed an Israeli strike for the deaths at the hospital. The Israeli government, however, has said it was not responsible and suggested that a misfired Palestinian rocket hit the site, an assessment supported by the United States.