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Gaza death toll: How many Palestinians has Israel's campaign killed?

Of the identified dead, about 56 per cent are estimated to be women and children, according to a Reuters calculation based on Palestinian data

Palestinian health authorities say Israel's ground and air campaign in Gaza has killed more than 41,500 people, with the majority of identified victims being women and children. The latest round of Israeli-Palestinian conflict began on October 7 when Hamas militants stormed across the border into Israeli communities. Israel says the militants killed more than 1,200 people, mostly civilians, and took some 250 people into captivity in Gaza.

The official Palestinian Health Ministry count as of September 29, was 41,595 Palestinian dead, amounting to about 10 times its count of losses in all previous Gaza conflicts since 2008.

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 entirely from counting bodies that arrived in hospitals and data included names and identity numbers for most of those killed.

As the conflict ground on, and fewer hospitals and morgues continued to operate, the authorities adopted other methods too. From early May, the Palestinian Health Ministry updated its breakdown of total fatalities to include unidentified bodies which accounted for nearly a third of the overall toll.

Since then, health authorities have been working to identify them and that portion has shrunk to less than 15 per cent. Zaher Al Waheidi, director of the information unit at the Gaza Ministry of Health, attributed progress in identifying bodies to the restoration of a central database from Shifa Hospital and a new system allowing families to provide input on victims, which is then verified by medics and police.

Of the identified dead, about 56 per cent are estimated to be women and children, according to a Reuters calculation based on Palestinian data.

Is the Gaza death toll comprehensive?

The numbers do not necessarily reflect all victims, as many are still under rubble, the Palestinian Health Ministry says. It estimates some 10,000 bodies were uncounted in this way.

The Humanitarian Research Lab at the Yale School of Public Health has said that the true figures are likely higher than those published, without giving specifics.

The UN human rights office also says the Palestinian authorities' figure is probably an undercount. In past Israel-Hamas conflicts, its own tally has sometimes exceeded theirs.

It declined to share its toll for this war since it is incomplete but confirmed to Reuters that the deaths it has verified so far show that the majority are 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.

A study by London-based Airwars – a non-profit compiling casualty lists from open source material — found a correlation of at least 75 per cent between its lists and those of Gazan authorities for thousands killed in the early weeks of the war.

The United Nations regularly cites the ministry's death toll figures and the World Health Organisation has voiced full confidence in them. Questions remain over the inclusion of 471 people said to have been killed in an October 17 blast at Al Ahli Al Arab Hospital in Gaza. An unclassified US intelligence report estimated that death toll "at the low end of the 100 to 300 spectrum".

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 still pays the salaries of those hired before then. The extent of Hamas control in Gaza now is hard to assess with Israel occupying most of the territory and fighting continuing.

What does Israel say?

Israeli officials have said the figures are suspect because of Hamas' control over government in Gaza. Foreign Ministry spokesperson Oren Mamorstein said the numbers were manipulated and "do not reflect the reality on the ground".

However, Israel's military has also accepted in briefings that the overall Gaza casualty numbers are broadly reliable. The Israeli military says 346 of its soldiers were killed in combat since its Gaza ground operation began on October 27.

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.

Israel periodically gives estimates of how many Hamas fighters it believes have been killed. The most recent is 17,000-18,000, about half the Hamas force estimated before the war. It says roughly one civilian has been killed for every fighter, a ratio it blames on Hamas for using civilian facilities.

Israeli officials say 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. The Health Ministry's Al Waheidi said men of fighting age represent only a fraction of all identified victims.