On October 25, 2023, US President Joe Biden made the stunning and unprecedented statement that he had “no confidence in the number that the Palestinians are using” for documenting the devastating civilian death toll in the Gaza Strip. The next day, his administration doubled down, with US National Security Council spokesperson John Kirby smearing the Ministry of Health in Gaza as “a front for Hamas.” Neither Biden nor Kirby offered any evidence for these claims that came at a time when the administration is wholly supporting Israel, militarily, financially, and politically, in its pursuit of the current destructive assault on Gaza that has already produced several violations of international law and war crimes, as documented by multiple human rights groups and scholars.
Health Coordination between Authorities in Gaza and the Palestinian Authority
While Hamas has been considered the de facto governing body of the Gaza Strip since winning legislative elections in 2006, and exerts control over many aspects of civil and political functions, several aspects of the health and education systems remain under the umbrella of the Palestinian Authority (PA). For example, all students across occupied Palestine take the same standardized test during their senior year of high school, known as the tawjihi, administered by the Ministry of Education based in Ramallah. Palestinian teachers in both the Gaza Strip and the occupied West Bank receive their certifications from the same entity.
Similarly, although the Gaza Strip has its own health ministry and director general to manage local administration, doctors there are licensed through the PA’s Ministry of Health, and the PA oversees public hospitals in Gaza (which make up the minority of health care centers, the rest of which are private or funded with humanitarian aid). While the government in Gaza appointed its own alternate health minister, the PA’s Health Minister, Mai al-Kaila, has a deputy minister as well as staff on the ground. The PA pays the salaries of the employees at public facilities and is responsible for overseeing the transfer of pharmaceuticals and medical supplies to Gaza from the West Bank. In times when the PA was unable to pay back medical debts, this transfer of medical goods was temporarily paused, causing significant shortages. The PA is also responsible for paying for the medical transfers of Palestinians in Gaza to receive care in Israel or the West Bank.
Do All Health Workers in Gaza Belong to Hamas?
The physicians, nurses, paramedics, midwives, and other health workers in Gaza belong to no specific party; some may be affiliated politically with Hamas, others with its rival Fatah, and others do not consider themselves politically aligned, or may just be affiliated with a third party. Regardless, it is dangerous to assume, without presenting evidence, that any specific actor may be purposefully misrepresenting data based solely on their political affiliation. Israel has long used political affiliation to destroy or shut down Palestinian institutions, including those providing health care, such as when it deemed six Palestinian civil society organizations terrorist groups because of the political affiliation of certain members. Israel also raided the Palestinian Health Work Committees office and arrested the director, a nurse, without a warrant, due to purported political ties, and kept her in prison for more than a year. Many medical permits for patients needing care unavailable in Gaza are denied by Israel based on loose claims of political association with Hamas. The attempt to discredit all data from Gaza thus does not seem to be based on genuine evidence, but a continuation of Israeli policies, now seemingly adopted by the United States, to devalue Palestinian narratives and cast doubt about civilian casualties, which will likely prove deeply unpopular if validated.
No Reason to Doubt the Numbers
Although Israel has barred foreign journalists and independent investigators from entering Gaza to make their own assessments, historical as well as contemporary evidence presents no major discrepancies between the figures reported by Gazan officials and numbers confirmed by the United Nations or Israel itself. Indeed, the United States Department of State has long used and cited figures released by the Ministry of Health in Gaza, as do a large number of humanitarian organizations, many of whom have staff working there. In one such State Department report, the author actually believed that “The numbers are likely much higher, according to the UN and NGOs reporting on the situation.” In the past multiple major assaults on Gaza, the internally reported death tolls almost exactly matched those confirmed by the United Nations in the aftermath, and even those confirmed by Israel’s Foreign Ministry.
Like other countries’ health systems, the Ministry of Health in Gaza receives its mortality numbers directly from hospitals and other health centers, as well as morgues, that report casualties regularly. Some bodies remain unidentified due to the level of trauma. Many hundreds of others remain missing, but are assumed dead, after being trapped under rubble after Israeli bombardment. These numbers are harder to include in regular counts and may lead to a higher toll upon later review.
Regardless, after being so publicly questioned, the Ministry of Health in Gaza released a table with the names, ages, and identification numbers of every person who had been killed so far in an effort to validate its numbers.
Indeed, Israel itself has offered many reasons to cast doubt on its own accounting of Palestinian casualties, based on dozens of cases investigated by NGOs and media organizations. High profile cases in point are those of Rouzan al-Najjar, a nurse who was killed by an Israeli sniper in Gaza, Shireen Abu Akleh, a journalist who was assassinated in the same fashion in Jenin, or Iyad Halaq, a man with special needs who was gunned down by Israeli gunfire in East Jerusalem. In these and other cases, Israel initially blames Palestinian militants, then claims the incident was an accident, then asserts that the killing resulted from the military’s genuine security concern. In each incident, investigations found that the Israeli forces were responsible, and the acts were purposeful. Furthermore, Israel’s top ally, the United States, itself has a checkered track record when accounting for the civilian casualties resulting from its own military actions, having been credibly accused multiple times of undercounting. It has also been accused of ignoring the significant civilian death toll of so-called precision drone strikes, as well as classifying all males killed in combat as terrorists.
The history of American military operations over the years, in which countless civilians in Afghanistan, Iraq, and elsewhere are killed as so-called “collateral damage,” should give American officials, most of all the president, pause before they cast doubt about the verified numbers of Palestinians killed in Gaza by Israel. Indeed, President Biden’s remark expressing this doubt only confirms that the United States is in full agreement with Israel, not only on its siege of Gaza and the violent assault on everyone living there, but also on questioning the humanity of its victims.
The views expressed in this publication are the author’s own and do not necessarily reflect the position of Arab Center Washington DC, its staff, or its Board of Directors.
Featured image credit: Shutterstock/Anas Mohammed