GAZA CITY: In the morgue of Nasser Hospital, in southern Gaza, workers wrap the corpses of people killed in Israeli air strikes in white cloth amid the stench of death. They record whatever basic facts they can about the dead: name, identity card number, age, gender.

Some of the bodies are badly mutilated. Only those that have been identified or claimed by relatives can go for burial and be included in the Gaza health ministry’s death toll. The rest are stored in the morgue’s refrigerator, often for weeks.

The toll reached 20,057 people on Friday, amid renewed international calls for a fresh ceasefire in Gaza. According to the ministry, thousands more dead remain buried beneath the rubble. About 70 per cent of those killed are women and children, it said.

The ministry’s figures have drawn international attention to the high number of civilians being killed in the Israeli military’s offensive.

But with most hospitals across Gaza now closed, hundreds of doctors and other health workers killed, and communications hampered by lack of fuel and electricity, it’s becoming increasingly difficult to compile the casualty figures.

The morgue workers at the Nasser Hospital are part of an international effort that includes doctors and health officials in Gaza as well as academics, activists and volunteers around the world to ensure the toll doesn’t become a casualty of the increasingly dire conditions at hospitals.

The workers do not have enough food or water for their families, but they keep going because recording the number of Palestinians dying matters to them, said Hamad Hassan Al Najjar.

He said the psychological strain of the work was immense. Holding a piece of white paper with handwritten information about one of the dead, the 42-year-old said he was often shocked to find the badly damaged corpse of a friend or relative brought in.

The body of the morgue’s director, Saeed Al Shorbaji, and those of several of his family members, arrived in early December, after they were killed in an Israeli air strike, Al Najjar said.

“He was one of the pillars of this morgue,” said Al Najjar, his face worn with sadness and fatigue.

Preparing the bodies of dead children, some of them missing heads or limbs, was the most painful task: “It takes you hours to recover your psychological balance, to recover from the effects of this shock.”

UN vouches for data

The data recorded by Al Najjar and his colleagues is collated by workers at a central information centre set up by the health ministry at Nasser Hospital, which pools information from the functioning emergency departments and hospitals across Gaza. Ministry staff fled their offices at Al Shifa Hospital, in northern Gaza, after Israeli forces entered it in mid-November.

Ministry spokesperson Ashraf Al Qidra, a 50-year-old doctor, said the team uses a computerised data system established in consultation with the World Health Organisation (WHO), which obliges hospital workers to fill in mandatory information before a death can be registered.

“The numbers used by the ministry of health reflect verified data,” said Al Qidra, noting that many bodies were not being recorded due to lack of information or because they did not pass through hospitals before burial. In Al Shifa hospital, for example, since there are no staffers at present, no deaths were being registered, he said. “The real numbers (of casualties) are much greater than this.”

According to the WHO, only six of Gaza’s 36 hospitals were receiving casualties as of Wednesday, all of them in the south. The UN health agency cited this as one reason it believes the ministry’s tally may be an undercount; the toll also excludes dead who were never taken to hospitals or whose bodies were never recovered

The WHO and other experts said it was not possible for now to determine the extent of any undercounting.

US President Joe Biden said on Oct 25 he had “no confidence” in the Palestinian data.

Following Biden’s remark, the ministry released a 212-page report listing 7,028 people killed in the conflict until Oct 26, including identity cards, names, age and gender. Since then, the ministry has not released such detailed data, making it hard for researchers to corroborate the latest figures.

However, the United Nations which has long-standing cooperation with Palestinian health authorities, continues to vouch for the quality of the data. The WHO noted that compared to previous conflicts in Gaza, the figures show more civilians have been killed, including a greater proportion of women and children.

Open wounds

Dr Ghassan Abu Sitta, a British-Palestinian surgeon who volunteered in two hospitals in northern Gaza for the first six weeks after Oct 7, said some people were dying because of lack of treatment of open wounds.

“The death toll is a poor proxy of human suffering,” said Dr Annie Sparrow, a pediatrician who has worked with medics treating the wounded in the Syrian civil war for more than a decade.

But the use of records to fight the fear of erasure runs deep in Palestinian culture, said Abdel Razzaq Takriti, associate professor of Modern Arab History at Rice University in Texas. He quoted from a poem by prominent Palestinian poet Mahmoud Darwish: “You will be forgotten as if you never were.”

According to Takriti, Palestinians see the Israeli offensive as part of a history of conflict and displacement by the Jewish state dating back

to the Nakba, when more than 700,000 Palestinians left their homes or were expelled from what is now Israel after formation of the country in 1948.

“For the sake of the present, future, and the past, we need to have an accurate rendition of numbers,” Takriti said.

Published in Dawn, December 23rd, 2023