“Indiscriminate Killings” in Gaza? The Facts Suggest Otherwise.

Our analysis of reported deaths in Gaza in the 2014 and 2023 conflicts rules out any allegations of “indiscriminate killing” of civilians; it suggests rather that the opposite is true.

[additional-authors]

Prof. Benjamin Fox, MD, Prof. David Langleben, MD and Prof. Samy Suissa, PhD

December 6, 2023

Israeli artillery unit fires toward the Gaza Strip on December 4, 2023 in Tel Aviv, Israel. (Photo by Amir Levy/Getty Images)

The current war between Israel and Gaza has tragically suffered many non-combatant deaths. A common allegation in many media reports is that Israel engages in “indiscriminate” killings of civilians. While the loss of innocent lives is tragic and deplorable, such claims are common yet unsupported by data. Indeed, during exacerbations of this ongoing conflict, even scientific journals have published articles with political allegations, devoid of data or scientific analysis.[1,2]

The claim of indiscriminate killing of civilians can be simply verified using published data. Such indiscriminate killing would be expected to be random and result in an age and sex distribution of deaths which follows the distribution of the civilian population. For example, we would expect a comparable number of deaths in men and women. Similarly, targeted combat operations in Gaza would be expected to show a “bulge” of excess deaths in men, particularly in the younger ones of “combatant” age. We looked at the data from the first three weeks of two Israel-Gaza wars, namely the “Protective Edge” operation of 2014 and the current “Swords of Iron” war of 2023.

The data show the opposite of what much of the media usually claim. Let’s go through it in detail.

During the 2014 “Protective Edge” operation, the names and ages of casualties between 1-24 July 2014 were extracted from a website set up by the “Gaza-Deaths” non-governmental organization (NGO).[3] For the current 2023 “Swords of Iron” war, the data were extracted from the Gazan Ministry of Health’s published information on all casualties inside Gaza between 7-26 October 2023.[4] The 2023 data do not include the Hamas deaths inside Israel around the 7 October 2023 attack. The Gaza overall population distribution was extracted from a “Middle East Monitor” NGO publication.[5] For both wars, we classified age as 0-19 years (children), 20-39 (“combatant” age) and 40 or over (older age) and calculated rates of death per 100,000 population for each age and sex stratum.

The data highlight a clear and significant excess of deaths amongst males, and particularly those aged 20-39 who would be the most likely in the combatant population.

The 2016 population of Gaza included 925,164 women and 955,971 men.[6] In the first three weeks of the conflicts, there were 513 reported deaths in 2014 and 6,746 in 2023. “Indiscriminate killings” would result in a rate of death during these three weeks of 27 per 100,000 in 2014 and 358 per 100,000 in 2023, similarly for both sexes and all ages. The figures show that this is clearly not the case. Mortality was higher among males by 31 and 88 deaths per 100,000 compared with females in both 2014 and 2023, respectively. The higher mortality among males is evident across all three age groups. The figures also show that the higher mortality for men is particularly in the 20-39 “combatant” age group, with 76 and 171 more deaths than women per 100,000 population, in 2014 and 2023 respectively.

Our analysis of reported deaths in Gaza in the 2014 and 2023 conflicts rules out any allegations of “indiscriminate killing” of civilians; it suggests rather that the opposite is true. The data highlight a clear and significant excess of deaths amongst males, and particularly those aged 20-39 who would be the most likely in the combatant population. This finding was consistent in both the 2014 and 2023 conflicts, which refutes any such allegation in both wars.

It is unfortunate that scientific journals such as The Lancet declined to publish this analysis but this same Journal published papers containing allegations that are unsupported by data and with no scientific foundation.[1,2] We believe that scientific publications should inform and influence political debate and never the opposite.

Figures: Mortality in Gaza per 100,000 population among females and males, stratified by age, during the first three weeks of the 2014 and 2023 Gaza wars. The red line represents the expected mortality for both sexes and all ages if deaths occurred indiscriminately.

Benjamin Fox is professor in Department of Internal Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

David Langleben is professor in Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.

Samy Suissa is professor inDepartment of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.

Acknowledgments

In writing this letter we are reminded of our colleague Dr Avi Shimony who contributed to the acquisition and analysis of the 2014 data and died tragically in 2018. This letter is dedicated to the victims of terrorism and war. May their memory and sacrifice never be sullied by unscientific allegations.

References

[1] Smith J, Kwong EJL, Hanbali L, et al Violence in Palestine demands immediate resolution of its settler colonial root causes. BMJ Global Health 2023;8:e014269.

[2] Paola Manduca, Iain Chalmers, Derek Summerfield, Mads Gilbert, Swee Ang. An open letter for the people in Gaza. The Lancet 23 July 2014 DOI: 10.1016/S0140-6736(14)61044-8

[3] http://gazadeaths.com/. Accessed 27 July 2014