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Lancet: 186,000 Palestinians or more killed in Gaza

By denying the world access to the true death toll in Gaza, Israel is acting, once again, as a complete rogue state

Middle EastWar ZonesHuman Rights

Peer-reviewed medical journal The Lancet has just published an article “conservatively” estimating that the death toll from Israel’s assault on Gaza could be 186,000 people or more. Photo by Humberto Patrick/Wikimedia Commons.

A new study by the peer-reviewed medical journal The Lancet estimates that the current death toll from Israel’s brutal assault on the Gaza Strip—which the International Court of Justice (ICJ) has described as “plausible genocide”—is at least 186,000. This would translate to nearly eight percent of Gaza’s population.

The bombshell death toll estimate is roughly 150,000 more than current numbers offered by the Gaza Ministry of Health. If The Lancet figure is accurate, then the Israel Defense Forces (IDF) has killed 169 Palestinians for every Israeli killed on October 7, 2023.

The Lancet notes that between October 7, 2023 and June 19, 2024, the Israeli military has killed 37,396 Palestinians in the Gaza Strip, per the Gaza Ministry of Health. While the Israeli government has attempted to discredit the Ministry of Health’s casualty figures, the report’s authors, Rasha Khatib, Martin McKee, and Salim Yusuf, write that “[the numbers] have been accepted as accurate by Israeli intelligence services, the UN, and WHO,” as well as independent analyses.

Data on Palestinians killed by the IDF has become increasingly difficult to collect due to the IDF’s destruction of Gaza’s infrastructure. Even so, the authors argue that “the number of reported deaths is likely an underestimate”:

The nongovernmental organisation Airwars undertakes detailed assessments of incidents in the Gaza Strip and often finds that not all names of identifiable victims are included in the Ministry’s list. Furthermore, the UN estimates that, by Feb 29, 2024, 35% of buildings in the Gaza Strip had been destroyed, so the number of bodies still buried in the rubble is likely substantial, with estimates of more than 10000.


The Lancet distinguishes between “direct” and “indirect” deaths—Palestinians directly killed by the IDF, and those killed as a result of health implications caused by Israeli violence. As the authors note, the combined total of direct and indirect deaths is already enormous due to the IDF’s destruction of health care infrastructure; food and water shortages caused by Israel’s blockading of aid into the strip; the IDF’s bombing of supposed “safe zones”; and Western countries cutting funding to the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA).

“In recent conflicts,” the authors write, “indirect deaths range from three to 15 times the number of direct deaths.” Therefore, a conservative estimate of “indirect” deaths—four “indirect” deaths for every Palestinian directly killed by the IDF—brings total deaths up to over 186,000. The actual number may be much higher.

In March of this year, former US presidential candidate Ralph Nader argued that the death toll published by the Gaza Ministry of Health is a substantial undercount. Significantly, the Ministry of Health only reports the deaths of those named deceased by hospitals and morgues—but Israel bombs Gaza’s hospitals as a matter of policy, kills health care workers, and abducts and tortures hospital administrators, as the case of Dr. Muhammad Abu Salmiya shows.

Israel’s nine-month assault has sent Gaza’s health care infrastructure teetering on the brink of nonexistence. The rubble continues to pile up with no end in sight, burying untold thousands of unidentified victims while aid is barred from entering Gaza and humanitarian agencies are deterred by targeted assassinations of aid workers.

Last month, Save the Children reported nearly 21,000 children missing in Gaza, “trapped beneath rubble, buried in unmarked graves, harmed beyond recognition by explosives, detained by Israeli forces, or lost in the chaos of conflict.”

There is simply no way the Ministry of Health’s death toll has kept up with the actual number of dead. And yet media outlets continue to report it, ignoring evidence that the actual number of Palestinians killed by Israel is likely much higher. As a result, many observers are left with a faulty impression of the magnitude of Gaza’s devastation.

As Nader wrote in March:

It matters greatly whether the aggregate toll so far, and counting, is three, four, five, six times more than the Health Ministry’s undercount. It matters for elevating the urgency for a permanent cease-fire, and direct and massive humanitarian aid by the US and other countries, bypassing the sadistic cruelty against innocent families of the Israeli siege. It matters for the columnists and editorial writers who have been self-censoring themselves, with some… fictionally claiming that Israel’s military doesn’t “intentionally target civilians.” It matters for accountability under international law.


Nader is right: the death toll resulting from Israel’s invasion is a matter of international law. As The Lancet authors note, the Israeli government is legally required to document the full cost of its war on Gaza:

The interim measures set out by the International Court of Justice in January, 2024, require Israel to ‘take effective measures to prevent the destruction and ensure the preservation of evidence related to allegations of acts within the scope of … the Genocide Convention.’ [But] the Gaza Health Ministry is the only organisation counting the dead.


By denying the world access to the true death toll in Gaza, Israel is acting, once again, as a complete rogue state. But Western governments, including Canada, don’t see it this way. Because they are supporting Israel’s war on Gaza, they seem to believe that international law no longer applies.

Canada, for its part, has offered steadfast military and diplomatic support for Israel since the Hamas attacks of October 7.

In fact, Ottawa is an accessory to the epochal humanitarian disaster in Gaza. The Canadian government accelerated weapons shipments to Israel as the IDF launched its invasion of coastal enclave, and since then, Ottawa has declined to suspend military exports to Israel despite the ICJ’s genocide ruling. At the same time, Ottawa has offered consistent rhetorical support for the Israeli invasion while refusing to condemn IDF atrocities against Palestinians.

The Canadian government has demonized Palestine solidarity actions across the country. Canadian media has whitewashed Israeli crimes. Across Canada, police departments have targeted pro-Palestine activists and violently torn down peaceful encampments on university campuses—all while the death toll in Gaza has climbed to horrific proportions.

By pressing forward with the mass killing of Palestinians despite international calls for a ceasefire, Israel stands condemned before the world—a criminal pariah state. And Canada, by supporting the bloodshed and repressing domestic resistance to its blindly pro-Israel orientation, will forever be marked as an active participant in the genocide of Palestinians.

This is undeniable right now, but as The Lancet’s death toll estimate shows, the scale of Israeli violence will become clearer—and more reprehensible—with time.

As the death toll increases, so does Canadian complicity in the eradication of Gaza, one of the most documented, shocking, and abhorrent crimes against humanity this century.

Owen Schalk is a writer from rural Manitoba. He is the author of Canada in Afghanistan: A story of military, diplomatic, political and media failure, 2003-2023 and the co-author of Canada’s Long Fight Against Democracy with Yves Engler.

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