Ten months after the war in Gaza began, local health authorities report the death toll has surpassed 40,000, with most casualties being civilians. When Dalia Hawas was 24, an Israeli airstrike in February destroyed the apartment building she called home, trapping her and her 10-month-old daughter, Mona, under the rubble. Because rescue teams couldn’t reach their bodies, they aren’t counted among the dead in Gaza. This number represents nearly 2% of the prewar population, equivalent to about one in every 50 residents.
Yet, this figure doesn’t fully capture the extent of the Palestinian losses. Dr. Marwan al-Hams, who heads the field hospitals for the Palestinian Ministry of Health, noted, “The number of 40,000 only accounts for the bodies we’ve received and buried.” The authorities are working on new procedures to account for the missing or those believed to be trapped under rubble, but these have not been finalized. Dr. Hams estimates that around 10,000 people are still buried under collapsed buildings, as there is insufficient heavy machinery and fuel to excavate the steel and concrete debris.
Fatima Hawas, Dalia’s mother, shared her grief, saying, “Every time I think of Dalia, I start crying and trembling. I imagine her destroyed home and feel like I’m suffocating because we couldn’t even retrieve her body for a proper burial.” Dalia, a graduate in Arabic language and literature, had aspirations of becoming a teacher. Her mother shared, “Sometimes I see her in my dreams, which brings some comfort, although I wake up in tears.”
Beyond the official death toll, many Palestinian victims go uncounted as war casualties. The war has led to mass displacement, leaving many in overcrowded shelters and temporary tents, suffering from hunger due to diminishing aid and a lack of clean water and sanitation, which have caused the spread of diseases. Bombings and blockades of hospitals have resulted in severe shortages of medicines, equipment, and fuel, and many medical staff have been detained or killed, leading to overwhelmed medical facilities.
“Those who died due to indirect effects of the war, such as diseases, starvation, and the collapse of the healthcare system, are not counted among the war dead,” Dr. Hams explained. “A committee will be formed to count these victims after the war ends.”
Among the likely entries on this list are Rania Abu Samra’s grandmother, Hania Abu Samra, 75, and her father, Adnan Abu Samra, 59. Hania died in November, collapsing after walking from northern to southern Gaza due to an evacuation order and lack of transport, Rania recounted. Adnan passed away from a chest infection after being repeatedly turned away from crowded hospitals. Rania described her father as an active man who had managed his diabetes and high blood pressure well before the war. However, the conditions during the war, including exposure to the cold and cooking on fires made from scrap materials, destroyed his health. “If it weren’t for the war, he wouldn’t have died so soon. He wasn’t even 60,” she lamented. “His death has deeply affected us. He was the pillar of our family, always there to help.”
Rania also noted, “I am sure there are thousands like my father who go unrecognized and uncounted as war casualties. They aren’t just numbers; they had lives, families, and friends but left us without a chance to say goodbye.”
Israeli officials challenge the death toll reported by Gaza authorities, arguing that since Hamas controls the government, the figures provided by its health officials lack credibility. However, the doctors and civil servants managing Gaza’s hospitals and health system have established a credible track record from previous conflicts. United Nations investigators have consistently found that their casualty figures align closely with those provided by Gaza.
UN Secretary-General spokesperson Farhan Haq stated, “Unfortunately, we have the sad experience of coordinating with the Ministry of Health on casualty figures every few years. Their figures have generally been accurate.”
The overall death toll from Gaza is not categorized by combatant and civilian status, but by mid-August, 32,280 victims had been identified by name. The majority are civilians, including 10,627 children, 5,956 women, and 2,770 elderly individuals. The count also includes 168 journalists, 855 medical staff, and 79 paramedics, totaling over 20,000 civilians and excluding many adult male civilians. Israel does not provide estimates of civilian casualties in Gaza but reports having killed approximately 15,000 fighters. Israel launched the war following cross-border Hamas attacks on October 7 that killed about 1,200 people, mainly civilians, and led to 250 hostages being taken into Gaza.
The rate of casualties in Gaza has slowed this year compared to 2023. By the end of December, Israeli attacks had killed over 22,000 people, as reported by health officials, a higher toll than in 2024 to date. Nonetheless, the scale of the conflict remains unprecedented and historically significant. Large-scale bombings occur daily, often resulting in dozens of deaths. Recently, an airstrike hit a school that had become a shelter.
Those who survive each attack face not only the grief of loss but also the ongoing trauma and fear of future attacks. In November, Ali Abbas’s apartment building was struck by an airstrike, killing two of his children, Fatima, 17, and Omar, 5, as well as his brother and two nieces, one just 20 days old. There was no warning or evacuation order.
Ali was severely injured and spent two weeks in intensive care, shielded from the news of his children’s deaths. When informed, he attempted to remove the medical equipment keeping him alive. His family now lives in a tent. Ali shared, “I always suggest we stay at my mother’s house, but my son refuses. He has developed a fear of buildings and darkness after being trapped under the rubble during the bombing. He often has nightmares where he cries for help, thinking he’s still buried.”
