As researchers attempt to count the dead in Gaza, United Nations human rights experts warn that “Israel’s intentional and targeted starvation campaign against the Palestinian people is a form of genocidal violence and has resulted in famine across all of Gaza”, reports Marie McInerney.
Marie McInerney writes:
The death toll from both direct and indirect causes in the Gaza conflict may have reached 186,000 or more since the Israeli bombardment began on October 7, according to an estimate published in The Lancet this week that has made headlines globally.
That figure represents around eight percent of the total population in the Gaza Strip – a massive toll that experts warn is increasing, amid devastating warnings of famine.
The estimate comes in a letter to the journal’s editor titled ‘Counting the dead in Gaza: difficult but essential’, which says documenting the true scale and nature of suffering in the conflict is “crucial for ensuring historical accountability and acknowledging the full cost of the war”, as well as being a legal requirement.
It is written by Rasha Khatib, from the Advocate Aurora Research Institute in Milwaukee, USA and the Institute of Community and Public Health at Birzeit University; Professor Martin McKee, from the Department of Public Health and Policy at the London School of Hygiene and Tropical Medicine; and Salim Yusuf, from the Population Health Research Institute at Canada’s McMaster University.
McKee is a member of the editorial board of the Israel Journal of Health Policy Research and of the International Advisory Committee of the Israel National Institute for Health Policy Research.
Their letter estimates that, by 19 June 2024, 37,396 people had been killed in the Gaza Strip since the attack by Hamas and the Israeli invasion and says that, given the massive destruction of buildings in the enclave, “the number of bodies still buried in the rubble is likely substantial, with estimates of more than 10,000”.
The researchers also calculate the number of indirect deaths from the conflict, saying that these tend to range from three to 15 times the number of direct deaths.
“Applying a conservative estimate of four indirect deaths per one direct death to the 37,396 deaths reported, it is not implausible to estimate that up to 186,000 or even more deaths could be attributable to the current conflict in Gaza.”
The total toll, they say, is “expected to be large given the intensity of this conflict; destroyed healthcare infrastructure; severe shortages of food, water, and shelter; the population’s inability to flee to safe places; and the loss of funding to UNRWA, one of the very few humanitarian organisations still active in the Gaza Strip”, they say.
Khatib, McKee and Yusuf say their numbers on direct deaths come from the Gaza Health Ministry, as reported by the UN Office for the Coordination of Humanitarian Affairs.
They note that the Ministry’s figures have been contested by the Israeli authorities (and commentators), but say they have been accepted as accurate by Israeli intelligence services, the United Nations and World Health Organization, and supported by independent analyses.
Famine has taken hold
The indirect costs of the conflict continue to mount.
A group of independent UN Human Rights experts issued a statement on 9 July, declaring that famine has now spread throughout Gaza strip.
The group says that 34 Palestinians have died from malnutrition since 7 October, with the majority being children. This is significant, they say, with the death of a child from malnutrition and dehydration indicating that “health and social structures have been attacked and are critically weakened”.
“When the first child dies from malnutrition and dehydration, it becomes irrefutable that famine has taken hold,” they said, detailing the deaths of three children, one barely six months old, the others 9 and 13 years.
The experts include Special Rapporteurs Michael Fakhri (right to food), Balakrishnan Rajagopal (adequate housing), Tlaleng Mofokeng (physical and mental health), Francesca Albanese (human rights in the Palestinian Territory); Pedro Arrojo-Agudo (safe drinking water and sanitation) Paula Gaviria Betancur (human rights of internally displaced persons); independent expert George Katrougalos (promotion of a democratic and equitable international order); and Barbara G. Reynolds (Chair), Bina D’Costa, Dominique Day and Catherine Namakula from the Working Group of Experts on People of African Descent.
Together they urged international action, saying “inaction is complicity”.
“We declare that Israel’s intentional and targeted starvation campaign against the Palestinian people is a form of genocidal violence and has resulted in famine across all of Gaza.”
In separate statements, World Health Organization spokesperson Tarik Jasarevic told media that 60 cases of severe acute malnutrition were detected in northern Gaza’s Kamal Adwan hospital alone last week.
“Malnutrition is definitely one of the factors that reduces the immunity, especially of the vulnerable population, elderly and children, who then can’t really cope with any disease, any pathogen that they can get,” he said, describing a “vicious circle of not having access to enough food, to clean water, to clean sanitation, not having access to basic health services”,
Beyond the direct consequences of the Israeli bombardment and shelling, “everyone in Gaza” is at risk of getting sick and dying for lack of care, he said.
The situation was particularly dire for pregnant women, people living with chronic diseases such as cancer or diabetes, injured people who are not treated on time and children threatened by waterborne diseases, urging the opening of border crossings to enable desperately needed medical evacuations.
“More than 10,000 people need to receive specialised medical care outside of Gaza. These people cannot wait,” he said.

In Australia
Prime Minister Anthony Albanese this week announced that he had appointed Jillian Segal AO as Special Envoy to Combat Antisemitism, as part of the Federal Government’s “ongoing efforts to preserve social cohesion in Australia”.
Albanese foreshadowed the Federal Government will also appoint a Special Envoy for Islamophobia with details to be “announced shortly”.
As others have observed, that appointment may want to investigate the way Senator Fatima Payman continued to come under fire and racist slurs in the wake of her decision to quit the Labor Party over its stance on Gaza and Palestine.
While there has been support for the appointments of special envoys, others are critical.
The Australian Greens say the Government needs to urgently implement and fund its existing anti-racism mechanisms, including adequately funding to ensure all forms of racism are combated, instead of “trying to reinvent the wheel” and “making policy up on the run”.
“The Government should adequately fund the Race Discrimination Commissioner to urgently complete and implement the national anti-racism strategy rather than meddling with its mandate by creating new positions that eat into its remit,” Greens Deputy Leader Senator Mehreen Faruqi said in a statement.
“You can see how little Labor has considered this approach by the fact that the Islamophobia Register wasn’t consulted and the anti Islamophobia envoy was hastily added on to the announcement without even a candidate. Muslims facing Islamophobia in this country should not be an afterthought,” she said.
“We need a united effort to defeat racism in this country, which is so pervasive and deep seated, especially against First Nations people. The best way to dismantle Antisemitism, Islamophobia or any other type of racism is by working in solidarity with groups facing hate and racism.”
Faruqi said Australia still hasn’t reckoned with the Christchurch mosque massacre where an Australian man killed 51 Muslims.
“If the Albanese Government was serious about tackling racism, they would drop their Trump style immigration policies, stop blaming international students and migrants for their own policy failures and end their own Islamophobic crusade against Senator Payman.”
Addressing racism
Meanwhile, a new research report released by the Australian Human Rights Commission brings timely and important reading for governments, highlighting failures in efforts to address racism at multiple levels.
Conducted by PwC Indigenous Consulting and Jumbunna Institute, to inform the development of a National Anti-Racism Framework, the ‘Mapping government anti-racism programs and policies’ makes 12 key findings.
One is the reluctance of government to even use the term ‘racism’ (preferring ‘social cohesion’ – see Albanese above on the appointment of an Anti-Semitism envoy) which, the report says, “has weakened approaches to anti-racism work”, as has recent conservative governments stepping away from traditional bipartisan approaches in this space.
It also finds that:
- equity approaches for First Nations communities are aimed at addressing disadvantage in those communities versus addressing the racism they experience from external forces
- there is little to no direct focus on addressing racism in the workplace, with effort instead on diversity, equity and inclusion strategies and programs
- a ‘blame the victims’ environment puts the focus on victims and/or those communities experiencing racism to ‘fix the problem’ with little or no focus on the broader community to address the issue
- the current policy approach contributes to an ‘either/or’ situation between First Nations and CALD communities, “leading to victimised communities competing with each other for funding”
- anti racism work that is being done is “failing to enter public awareness in any meaningful way”, with government efforts appearing to be be ad-hoc, disjointed, often disconnected other similar approaches, and frequently reactive to situations arising domestically or internationally”, and
- there is a disconnect between emerging academic research and government practice.
Importantly, the report highlights areas of good practice, including projects led by All Together Now and the Scanlon Institute, the University of Western Sydney Challenging Racism project, the Australian Reconciliation Barometer, and cross-sectoral work in Victoria.
Listen: Gaza doctor speaks out: https://www.abc.net.au/listen/programs/radionational-breakfast/gaza-doctor-speaks-out/104083678
Previously at Croakey
- Gaza really is hell on earth: heat and water shortages add to the unbearable toll
- New reports document an “unconscionable level of death and suffering” among children and civilians in Gaza
- Counting the environmental toll of war – and why peace is a climate solution
- Protecting healthcare from the violence of war must become a public health priority
- From Gaza: “We did not have time to bury them”
- Urgent calls for Gaza aid crossings to reopen as humanitarian access disintegrates
- Doctors call for greater pressure on Israel over Gaza
- Calls to stop the siege of Gaza, halt the arms supply, and end the health sector’s silence
- Gaza medical staff working under ‘profound psychological strain’ as further threats loom
- World medical leaders call for Gaza ceasefire amid mass graves horror
- New publication documents the terrible toll on women in Gaza
- “Silence becomes complicity”: MPs and other health professionals urged to take stand on Gaza
- “The question is no longer whether Palestinians will starve to death in a famine, but how many will do so”
- World leaders put on notice over Gaza, amid “war on children”
- As children starve to death in Gaza, health and medical academics urge colleagues to speak up
- Australian academics call on their universities to demand ceasefire, amid fears about famine, disease and scholasticide in Gaza
- “To those speaking out for the people of Gaza – thank you for not looking the other way”: Dr Sophie Scamps
- As Australia and other countries put pressure on Israel, health and medical organisations describe horrific conditions in Gaza
- As humanitarian nightmare escalates in Gaza, and the world enters “an age of chaos”, we must work harder for peace
- As global leaders and aid groups speak up about “catastrophic crisis” in Gaza, health professionals are under pressure to remain silent
- Health workers and agencies document the war’s wide-ranging impacts on people in Gaza
- From Gaza: finding words for the unimaginable
- Health leaders join growing calls for permanent ceasefire in Gaza and Israel
- As the people in Gaza experience a “living hell”, medical and humanitarian leaders step up pressure for a permanent ceasefire
- This doctor is urging medical leadership on ceasefire in Gaza and Israel, as United Nations warns of threat to global security
- Amid catastrophic health threats in Gaza, health leaders urge a permanent ceasefire
- Amid ongoing health catastrophe in Gaza, why the silence?
- As Gaza hospitals become “scenes of death, devastation, and despair”, global community urged to act for peace
- Doctors who work with refugees urge medical organisations to speak up for a ceasefire in Gaza
- “Worse every day”: toll mounts in Gaza, including for children and health workers
- “This cannot go on” – a cry for an end to intolerable suffering
- Medical organisation publishes open letter expressing “extreme concern” at Australia’s failure to support ceasefire in Gaza
- Health sector urged to speak out for ceasefire in Gaza
- Calls for ceasefire amid catastrophe in Gaza – “every child everywhere deserves peace”