Counting Ghosts
The Lancet Study of Gaza
On January 09, the Lancet issued an updated report from the summer of 2024 approximating the total number of deaths in Gaza that were caused by traumatic injury (bombs and bullets). In the Interpretation section, the authors stated they found an “exceptionally high mortality rate in the Gaza Strip during the period studied,” as though they happened upon the stats without knowing about the siege. The summary is clinical, stating that the results underscore the need for interventions to prevent further loss of life.
The study participants found that the Palestinian Ministry of Health (MoH) under-reported mortality by 41%. Given that the Israeli stance on such statistics is that they are exaggerations or outright fantasy, the idea that an independent organization has determined that the MoH under-reported the killing is significant, not only in the context of the raw data but for the credibility of the MoH.
In the first Lancet study of war fatalities in Gaza, published last summer, the authors stated, “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.” Israeli authorities disagreed with the totals although, as reported by Vice, Israeli intelligence concurred, as did 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.”
To be specific, the report refers to consistent patterns of accounting, comparison, and recounting, from multiple data sets, which they deemed implausible to have been derived from fabricated data.
Civilian mortality rates are a critical metric for two reasons. One, the sheer number of civilian casualties may serve as a proxy for estimating the totality of destruction, with civilians being the collateral damage of an AI-assisted inventory of targets. Two, a higher percentage of civilian dead to armed combatants highlights the recklessness of the war’s prosecution, the disregard for the rules of war and most important, the intent to kill civilians.
What has evolved over the decades of occupation is a collective psychopathy of one belligerent’s political leaders and their military commanders, as seen in their greenlighting of war crimes willingly and eagerly committed by their personnel. This intent is a primary factor in considering whether the actions of a military or para-military force or government are genocidal.
Cornell Law School stated in its explanation of genocide, “Genocidal intent requires that acts must be committed against members of a group specifically because they belong to that group, but it does not require that the acts be perpetrated solely because they belong to that group. Genocidal intent can, “in the absence of direct explicit evidence , be inferred from” circumstantial evidence. When proving genocidal intent based on an inference, “that inference must be the only reasonable inference available on the evidence.”
The mission to make Gaza unlivable for the Palestinians cannot reasonably be inferred any other way but genocide as a means of ethnic cleansing.
Once intent is demonstrated, the probative burden falls on the accused nation or entity to show otherwise. Mere assertion isn’t good enough, even if it’s seasoned with fake indignation and the corroborative sympathies of a hegemonic power and its western allies.
The Lancet, in dissecting the numbers, stated, “Overall, women, children and people aged 65 years or older accounted for 16,699 (59.1%) [of] deaths due to traumatic injury.” This, despite Israel’s repeated claim that they make every effort to spare civilians. If we play along and take Israel at their word, it prompts the question, what would the civilian death toll be if they weren’t so careful?
In December, 2024, the NY Times reported, “Israel Weakened Civilian Protections When Bombing Hamas Fighters.” This report noted eight examples of how the IDF endangered more civilians than the laws of war might dictate but also in ways unprecedented in other conflicts in which Israel participated. The list includes:
· Raised threshold for civilian harm
· Expanded list of targets
· Frequently used a crude assessment
· Often dropped large, inaccurate bombs
· Lifts caps on how many civilians could be endangered each day
· Struck too fast to vet all targets properly
· Used artificial intelligence to search for targets
· Often relied on outdated intelligence
According to the Lancet, in 2021, the Palestinian Ministry of Health accurately documented mortality and even under-reported by 13%. In a previous operation by Israel in 2014, the MoH published death tolls that were within 4% of the UN’s count and 8% of Israeli military estimates. Given Israel’s historically loose definition of an enemy combatant, lately referred to as “Hamas affiliates,” that 8% difference was likely a stretch. If the MoH stats were considered credible in the past, the only reason to question them now is the extent of the onslaught. The people who count the dead are displaced and trying to survive, and the infrastructure and records management systems with which they could accurately compile and corroborate the data have been mostly destroyed.
Counting indirect deaths is vital to understanding the overall war. Indirect deaths are those caused by war (hunger, disease, inhuman treatment) but are not as a direct result of explosions, shrapnel, shelling or bullets. US Doctor Mimi Syed, who did two tours of humanitarian care in Gaza said children were dying of simple things like dehydration. It’s not believable that the Israeli government did not know this was happening. They did, and they let it happen. It’s intentionally cruel to have the power to stop small children from dying of exposure, malnutrition and thirst but do nothing to end their suffering. It’s unforgivable.
The downward bias in the reporting from MoH, Lancet and various NGOs is due in part to the difficulty in quantifying those who died as a result of the existence of war in the region, those who died because of no access to treat their chronic diseases such as diabetes, cancer, cardiac issues and other pathologies that could be treated or possibly cured with proper access to medical care.
The report demonstrates how the number of deaths by traumatic injury could well be in excess of 70k, but of course that doesn’t account for the number of indirect deaths that must be added. The previous Lancet study used a ratio of four indirect deaths to one direct. That same ratio is recommended by the Geneva Declaration Secretariat. Using a round figure of 70K direct deaths added to the 4X indirect deaths of 280,000 brings the total to 350,000. Conflicts from around the globe in recent decades have used a ratio from 3X to as much as 15X. There are numerous environmental and pre-war situations that guide that determination so the conservative 4X is not only reasonable, but harder to refute by the occupying force. The history books will update the records, but the annihilation will have been long metabolized by the news cycles and our fleeting memories, but not the memories of the amputees and orphans, the burn victims and those tortured in Israeli prison camps for the sin of being Palestinian.
The Lancet ends the Interpretation section by slipping in the most important point, which is that the war-driven mortality rate served to “illuminate important patterns in the conduct of war.”
Those patterns of war mentioned above include the use of AI to acquire targets, something to fear in future wars, now that the IDF live-tested the systems on Palestinian civilians. More on this later.
The patterns to which Lancet refers are the age/sex of victims and the scale to which those traumatic injury deaths gave rise to “grave concerns about the conduct of the military operation in Gaza despite Israel stating that it is acting to minimise civilian casualties.”
The anecdotal evidence contributes to the sense of reliability of the data when the testimony for that evidence comes from experienced aid and medical workers who have previously worked in conflict zones and have a frame of reference for their opinions. Doctors Without Borders (MSF) has published several reports from the region and posted updates on their social media. They witnessed bodies in the streets being eaten by strays, children with head and heart wounds from snipers and quad-copters, starving infants and countless severely wounded orphans. The number of pediatric amputees is stunning and nauseous when you consider that many endured the surgery with no anesthesia or loved ones around to comfort them.
“Honestly, this situation is unprecedented,” said Mohammed Wadi, MSF deputy medical coordinator in Gaza. “I am 40 years old and throughout my life I have never seen such a level of aggression or conflict. It is a war that has annihilated many aspects of life. Drinking water is not available. Food, unfortunately, is not sufficiently available. This is extremely heartbreaking … It’s a sight that cannot be described.”
Claims of unreliability of data or sympathy for terrorists by the Israeli government are proclaimed to distract from the truth. Why else has media been blocked from reporting and why have so many journalists been arrested and killed for reporting on the conflict? The claim of the most moral army has become a meme in sarcastic commentary about the IDF tactics and post-attack gloating.
Evidence of genocidal intent and a blatant disregard for any rules of war were established in the reporting of the “where’s Daddy” software exposed by 972 Magazine. IDF soldiers stated that they use AI software to identify potential targets. The criteria for such a designation is nebulous and broad, in which a target is named by mere affiliation with another, perhaps known, Hamas fighter. The IDF has the opportunity to strike their target on the street but chooses to wait until he’s home in order to kill his family members in the strike. Hence the name, “where’s daddy.” The criminal psychosis of that thinking has been laid bare again and again.
The extensive use of and reliance on AI in target acquisition without human stop gaps speaks to an ambivalence toward the reliability of the system. Once a target is identified by the AI systems, his proximity to civilians should create hesitation, not an impetus for firing.
A Biased Dynamic
This report, although intended primarily to count the dead, helps to unseat the idea that this onslaught is directed at an armed enemy or is, in any way, a traditional war, in which there are generally accepted standards and rules of engagement. It can be used to support the evidence that the patterns of mortality and the type/age/sex of victims, as conservatively counted, demonstrate a not simply a lack of concern for civilians but an intent to exterminate the population.
How many innocents would have been spared had they not expanded the definition of what is considered a “Hamas affiliate” so that the AI system can choose as targets those individuals, and their families, who have no insurgent resistance history, yet because of a social media link or text message to a friend of a friend, become fair game for the target acquisition systems. Those systems are tasked with finding targets, and that they will, with increasing indifference on the part of the soldier who finally pulls the trigger but also with a broader definition of what constitutes a target as the machine is fed information created by it and other related systems. This is a phenomenon of AI hallucinations, in which the systems/models produce results they have learned on incomplete or biased data.
The Israeli defense minister, Yoav Gallant, called Palestinians human animals and members of the Knesset have said that even the children are enemies because they’ll just grow up to be terrorists. It’s a pre-crime adjudication made within the dynamic of anti-Arabism, not on direct evidence or an analysis of behavior that could be interpreted as criminal in intent. It’s based merely on ethnicity, something the US and other western nations have worked for decades to overcome but is somehow not applicable within the imaginary borders of greater Israel.
What Next
In 2023, Stephanie Savell published “How Death Outlives War” for Brown University. She wrote about the “reverberating effects of war,” such as disease. Ten years after the war, the blitz visited upon the Palestinian people will continue to take its toll on their capacity to flourish. Reports such as those published by the Lancet are vital to understanding the conflict and, we can only hope, punishing the perpetrators of crimes against humanity. Unfortunately, as Stephanie Savell said, “Ultimately, the impacts of the ongoing violence are so vast and complex that they are unquantifiable.”
Medical examiners determine the cause and manner of death. The cause is the instrument or result that directly caused a person to die. The manner is based on the proximate cause. It can be accidental, suicide, natural or homicide. In the end will it really matter if the numbers of dead or the exact causes of death are off by a few hundred, one way or another? No. But what will hover over Israel like a poison cloud for decades to come, tainting their future conduct, is the manner of death wrought on the innocents of Palestine - the homicidal, genocidal desire to destroy a people and take their land.