Research published in the Lancet medical journal suggests the Palestinian death toll from the war in Gaza may be much higher than the official figure reported by Hamas’ health ministry.

British-led study covers first nine months of warwhich began when Hamas gunmen attacked Israel on October 7, 2023.

It used data from the ministry, an online survey of relatives who reported deaths and obituaries. An estimated 64,260 Palestinians died from trauma as of June 30, 2024, meaning deaths were underreported by 41%.

While the United Nations considers the health ministry figures to be reliable, the Palestinian death toll has been a source of controversy.

The ministry’s data does not differentiate between combatants and civilians, although recent United Nations report It said the majority of verified victims within six months were women and children.

Israel says Hamas’s data cannot be trusted. In August, the Israel Defense Forces (IDF) said it had “neutralized more than 17,000 terrorists,” but it was unclear how that figure was arrived at. The IDF insists it targets only combatants and seeks to avoid or minimize civilian casualties.

Israel does not allow international journalists from media organizations such as the BBC independent access to Gaza, making it difficult to verify facts on the ground.

The team behind the latest study used a statistical method called capture-recapture, which has been used to assess deaths in other conflicts.

The researchers looked at how many people showed up repeatedly in different attempts to count deaths. The degree of overlap between the lists suggests that the number of deaths as a direct result of trauma in the conflict may be significantly higher than the hospital figures published by the Ministry of Health.

Gaza’s health ministry releases the latest war death toll every day. It compiles deaths recorded by hospitals, deaths reported by family members and deaths reported by “reliable media.”

The Lancet report estimated the death toll at 55,298 to 78,525, while the Department of Health reported 37,877 deaths.

The reported number could be significantly higher or lower depending on the technical details of the analysis.

For example, identifying deaths by “traumatic injury” in each set of data can be tricky. Errors can make a study’s estimate higher or lower.

The study also said that of the victims for whom gender and age data were available, 59 per cent were women, children and the elderly.

The war in Gaza was triggered by a Hamas attack that left about 1,200 people dead and 251 others taken back to Gaza as hostages. In response, Israel launched a massive military offensive against Gaza.

Israel’s actions resulted in the deaths of 46,006 people, the majority of whom were civilians, the health ministry said.