By Nidal al-Mughrabi and Emma Farge
(Reuters) -Palestinian health authorities say Israel’s ground and air campaign against Hamas militants in the Gaza Strip has killed more than 60,000 people, with nearly a third of the dead under the age of 18.
After a two-month ceasefire earlier this year, Israel resumed an all-out air and ground campaign against Hamas in March. Palestinian health officials say more than 8,500 have been killed since then.
The war began on Oct. 7, 2023 when Hamas militants stormed across the border into Israeli communities. Israel says the militants killed 1,200 people, mostly civilians, and took 251 people into captivity in Gaza.
A new update released by the Palestinian Ministry of Health on Tuesday put the number of those killed in Gaza during the war at 60,034 people, ranging from a newborn baby to a 110-year-old. Of those, 18,592 or 30.8% were under 18.
The official Palestinian Health Ministry death toll dwarfs those killed in previous bouts of fighting between Israelis and Palestinians in Gaza since 2005, according to data from Israeli human rights organisation B’Tselem.
An international monitoring group warned on Tuesday a worst-case scenario of famine is now unfolding in Gaza and immediate action is needed to avoid widespread death.
This explainer examines how the Palestinian toll is calculated, how reliable it is, the breakdown of civilians and fighters killed and what each side says.
HOW DO GAZA HEALTH AUTHORITIES CALCULATE THE DEATH TOLL?
In the first months of the war, death tolls were calculated simply by counting bodies that arrived in hospitals and data included names and identity numbers for most of those killed.
In May 2024, the ministry included unidentified bodies, which accounted for nearly a third of the overall toll. However, since October 2024, it has only included identified bodies.
A Reuters examination in March of an earlier Gaza Health Ministry list of those killed showed that more than 1,200 families were completely wiped out, including one family of 14 people.
IS THE GAZA DEATH TOLL COMPREHENSIVE?
The numbers do not necessarily reflect all victims, as the Palestinian Health Ministry estimates several thousand bodies are under rubble.
Official Palestinian tallies of direct deaths in the Gaza war likely undercounted the number of casualties by around 40% in the first nine months of the war as Gaza’s healthcare infrastructure unravelled, according to a peer-reviewed study published in The Lancet journal in January.
The U.N. human rights office also says the Palestinian authorities’ figure is probably an undercount.
The deaths the U.N. has verified up to March this year show that nearly 70% were women and children.
HOW CREDIBLE IS THE GAZA DEATH TOLL?
Pre-war Gaza had robust population statistics and better health information systems than in most Middle East countries, public health experts told Reuters.
The U.N. often cites the ministry’s death figures and the World Health Organization has voiced full confidence in them.
DOES HAMAS CONTROL THE FIGURES?
While Hamas has run Gaza since 2007, the enclave’s Health Ministry also answers to the overall Palestinian Authority ministry in Ramallah in the West Bank.
Gaza’s Hamas-run government has paid the salaries of all those hired in public departments since 2007, including in the Health Ministry. The Palestinian Authority pays the salaries of those hired before then.
WHAT DOES ISRAEL SAY?
Israeli officials have said previously that the death toll figures are suspect because of Hamas’ control over government in Gaza and are manipulated. The government did not immediately respond to a request for comment on the Palestinian health authorities’ toll passing 60,000.
The Israeli military says 454 of its soldiers were killed in combat, and 2,840 others wounded since its Gaza ground operation began on Oct. 27, 2023.
The Israeli military also says it goes to great lengths to avoid civilian casualties. It says Hamas uses Gaza’s civilians as human shields by operating within densely populated areas, humanitarian zones, schools and hospitals, which Hamas denies.
HOW MANY OF THE DEAD ARE FIGHTERS?
The Palestinian Health Ministry figures do not differentiate between civilians and Hamas combatants, who do not wear formal uniform or carry separate identification.
The Israeli military said in January 2025 it had killed nearly 20,000 Hamas fighters. It has not provided an update since. Such estimates are reached through a combination of counting bodies on the battlefield, intercepts of Hamas communications and intelligence assessments of personnel in targets that were destroyed.
Hamas has said Israeli estimates of its losses are exaggerated, without saying how many of its fighters have been killed.
(Compiled by Emma Farge, Nidal al-Mughrabi, Ali Sawafta, James MacKenzie and Angus McDowall, Editing by William Maclean, Peter Graff, Alexandra Hudson)
