As I've noted, the independent analyses based on extrapolating UNRWA data from the first several weeks of the war are bad science. It used bad assumptions, a poor sample and a demonstrably wrong conclusion. If you us the same methodology for later months in the war, you find that the proportion of UNRWA workers killed are far fewer than the numbers reported by the ministry of health. Science that is not reproducible is not science. Yet this study is still referred to as proof positive of MoH accuracy months after anyone can see that its conclusions were simply wrong with five minutes of math.
By June 19, 2024, 37 396 people had been killed in the Gaza Strip since the attack by Hamas and the Israeli invasion in October, 2023, according to the Gaza Health Ministry, as reported by the UN Office for the Coordination of Humanitarian Affairs. The Ministry's figures have been contested by the Israeli authorities, although they have been accepted as accurate by Israeli intelligence services, the UN, and WHO. These data are supported by independent analyses, comparing changes in the number of deaths of UN Relief and Works Agency (UNRWA) staff with those reported by the Ministry, which found claims of data fabrication implausible.
But the authors of this article not only claim that the ministry of health numbers are accurate, but they are an underestimate of wartime deaths. They wave away the incompatibilities between the two sets of numbers by the MoH. They ignore that the same MoH has been provably lying about women and children deaths and injuries.
Setting aside that absurd assumption, the main point of the article is this:
Armed conflicts have indirect health implications beyond the direct harm from violence. Even if the conflict ends immediately, there will continue to be many indirect deaths in the coming months and years from causes such as reproductive, communicable, and non-communicable diseases. The total death toll is expected to be large given the intensity of this conflict; destroyed health-care 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.In recent conflicts, such indirect deaths 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 entire basis of this estimate of four indirect deaths for every direct death is a 2008 document called the Geneva Declaration: Global Burden of Armed Violence.
Yet even that paper, and studies since then, note that the most significant factor on estimating the number of indirect deaths is how developed the medical system is in the war zone - how well fed and immunized the children are beforehand.
A 2023 monograph describes the Geneva Declaration as being accurate for worldwide estimates, but not accurate in countries that had a relatively developed medical infrastructure:
For instance, a recent mortality survey in a high conflict region of the Central African Republic, one of the world’s poorest countries, documented that violent deaths accounted for about 13% of total mortality, as people were also dying at high rates from illnesses such as malaria and diarrhea and maternal and newborn complications. By contrast, in the 1990s war in wealthier Bosnia, evidence suggests that the majority, about 67%, of war-related deaths, were due to violence.
And later the paper says:
The author’s review suggests that a lower ratio may be accurate in Iraq, while a higher ratio is likely in today’s humanitarian crisis situations such as in Afghanistan and Yemen.
Gaza's health infrastructure before October 7 was more comparable in maturity to Iraq and Syria than to Afghanistan, Yemen and Somalia. There was (and still is) far less malnutrition in Gaza then in the countries that had the highest death rates due to war, namely CAR, DRC, Afghanistan and Yemen.
The four to one ratio that the Lancet bases its analysis on is from an outdated paper, and even worse, it generalizes all conflicts to be the same ratio of direct to indirect death, when the reality is far more variable.
Which means that yet again, the Lancet is publishing biased data as if it is science, and referencing old studies that have been superseded as if they are accurate. Like social scientists, it is pretending to use the scientific method to publish anti-Israel propaganda.
Furthermore, the authors seem to be saying that the absurd estimate of 186,000 dead is the current amount, not the expected future amount of excess mortality from the healthcare crisis in Gaza - which is what the other studies concentrate on. In fact, based on previous Gaza wars, chances are very high that those who die from natural causes are being counted as part of the total war deaths. We would have expected that about 5,000 Gazans would have died over the past nine months without a war.
I'm not saying there will not be excess mortality of Gaza as a result of the war. There most certainly will be. But there are field hospitals being built as quickly as possible; thousands of Gazans have been able to exit the sector to get treatment abroad (something that had not happened to the same extent in other war zones,) and - most importantly, - there is a dedicated unit of the attacking army whose entire job is to protect and aid enemy civilians, something that is practically unprecedented in the other wars that the inflated statistics come from.
When it comes to Israel, the Lancet has a real problem with the scientific method, objectivity and reporting reality.
Where are the honest scientists and statisticians who are willing to expose the Lancet for consistently publishing anti-Israel articles that make a joke of the scientific method?
(By the way, I had emailed a couple of the prominent authors who wrote or referred to the Lancet UNRWA article justifying the MoH numbers, asking them to comment on my analysis showing the same methodology contradicts its conclusions for later months. Not one responded. Real scientists would care about the truth, either to refute me or to admit I am right.)
(h/t JW)
