Gaza Health Ministry

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Gaza Health Ministry (GHM)
Gaza Health Ministry seal.jpg
Agency overview
Formed2007;17 years ago (2007)
Jurisdiction Government of Hamas
Headquarters Gaza City, Gaza Strip, Palestine
Agency executive

The Gaza Health Ministry (GHM) is responsible for managing healthcare and medical services in the Gaza Strip. It operates under the jurisdiction of the territory's Hamas government, which is independent of the Palestinian National Authority, and was headquartered in Gaza City before the outbreak of the Israel–Hamas war in October 2023.

Contents

The GHM's casualty reports have received significant attention during the course of the Gaza–Israel conflict. GHM's casualty reports are considered credible by two scientific studies published in The Lancet. [1] [2]

History

The Palestinian territories (the West Bank and the Gaza Strip) used to be served by a single government ministry of health. Following Hamas' takeover of Gaza in 2007, the Hamas government in the Gaza Strip has appointed its own alternate health ministers than those in the West Bank.

Following the 2007 Hamas takeover of Gaza, a month-long doctors' strike ensued due to political disputes. The new Gaza government, with Basem Naim as Health Minister, replaced Fatah-affiliated hospital directors and staff with Hamas loyalists. Jomaa Alsaqqa, a 20-year surgeon at al-Shifa Hospital, lost his job due to his Fatah support and faced arrests and assaults since the Hamas takeover. In response, Naim stated "the hospital managers weren't fired for political reasons: they were fired because of managerial, financial, and moral corruption in the hospitals." [3]

The current director-general of the Gaza Health Ministry is Medhat Abbas. [4]

On November 17, 2023, amid the Israeli invasion of the Gaza Strip, the head of Médecins Sans Frontières in Palestine stated the Gaza Health Ministry had been "decimated", and Gaza's health sector had been "systematically destroyed". [5]

Casualty reports

Gaza Health Ministry (GHM) fatality reportage deviation2008–2021. [6]
ConflictAccording to GHMAccording to the UNDeviation
Gaza War (2008–2009) 1,4401,3854.0%
2014 Gaza War 2,3102,2512.6%
2021 Israel–Palestine crisis 2602561.6%

As of 26 October 2023, the Gaza Health Ministry (GHM) was the sole official source of data on Palestinian casualties in Gaza during the 2023 Israel-Hamas war, [7] although these numbers are also published by the West Bank-based Palestinian health ministry, which confirms them with its Gaza-based staff. [6] The health ministry's numbers have historically been considered reliable by the United Nations, the World Health Organization, Human Rights Watch. [8] [9] [10] The United States Department of State cited its numbers in a public report in March 2023. [11]

The casualty figures provided by the ministry do not distinguish the difference between civilians and combatants or provide the cause of death. The percentage of civilian deaths is only calculated post-conflict by the UN and various rights groups. [12]

Methodology

The GHM released a full list of the people killed at the time since October 7, a 200-page document with 6,747 identified individuals listing their names, ages, and ID number as well as 281 unidentified victims. Omar Shakir, Israel and Palestine director at Human Rights Watch, said "the numbers coming out of the ministry are not beyond reason", and noted a grey area in differentiating combatants from civilians among the dead, as well as emphasized that immediately released figures may often be different from those ultimately based on recorded data. [13]

Palestinian political analyst Nour Odeh has asserted the process of issuing death certificates is not done by political figures, but by health professionals, insisting "this process enables families to deal with issues such as inheritance and custody of children whose parents have died." [14] Director of Kamal Adwan Hospital, Ahmed al-Kahlot, denied that the GHM was unduly influenced by Hamas' control, stating that "Hamas is one of the factions. Some of us are aligned with Fatah, some are independent." and "More than anything, we are medical professionals." [15]

As of February 29th, the Gaza Health Ministry stated that its daily tallies now rely upon "a combination of accurate death counts from hospitals that are still partially operating, and on estimates from media reports to assess deaths in the north of Gaza", but did not "cite or say which sources those are." [16] On March 31st, it stated that 15,070 fatalities (45.8% of the then total) had been compiled via "reliable media sources" instead of direct reporting. [17] [18] The Ministry further clarified in reports made on April 1st and April 4th that it had “incomplete data” for 12,263 (later reduced 11,371) of its 33,091 reported fatalities. [19] [20]

Scientific studies

Two studies published in The Lancet concluded that the GHM numbers were plausible and credible: [21] the first was authored by scholars at the London School of Hygiene and Tropical Medicine and the second by scholars at Johns Hopkins University. The Johns Hopkins University study verified GHM reported deaths by looking at the UNRWA's reported deaths of its staff members. [22] The UNRWA reported deaths are also publicly available, and independent of the GHM casualty reports. The study found GHM reported death rate (5.3 deaths per 1000) was consistent with that reported by UNRWA (7.8 deaths per 1000, as of Nov 10, 2023). [22] It also found temporal consistency between the two independent reports. [22]

The London School of Hygiene and Tropical Medicine conducted several analyses on the data and concluded it was "implausible" that GHM engaged in data fabrication. [23] The study found that GHM's reported crude mortality rate in the age bracket of 20-59 years was broadly similar to the mortality rate of UNRWA employees and the mortality rate of Gaza's health-care workers (reported by the World Health Organization). [23] The study also found that the number of buildings reported damaged by the Hamas-run Gaza Ministry of Public Works was consistent with satellite imagery-based estimates conducted by Sky News (both arrived at the figure of 7%). [23] The study looked at 7,028 reported deaths (Oct 7 to Oct 26), and found only one case of a duplicated identification number and one case of implausible age. [23]

Pennsylvania professor Abraham Wyner wrote in Tablet that the GHM casualty figures were "faked"; [24] to which Columbia professor Les Roberts responded that GHM numbers were accurate and probably even an underestimate. [21] Wyner's main argument was that from Oct. 26 - Nov. 10, the number of deaths per day is 270 with "strikingly little variation". [24] CalTech statistician Lior Pachter responded that Wyner had cherrypicked a particular period, outside of which the variance was higher; even within Wyner's picked window the daily deaths had a standard deviation of 42.25 and variance of 1,785. [25] Wyner also argued that data showed lack of temporal correlation between total deaths, and those of women and children. In response, Marine Corps professor James Joyner quoted an opinion that GHM updates total deaths immediately, but there is a lag in updating the proportion of women and children, making time correlations "meaningless". [26]

On 17 April, 2024, Professor Michael Spagat stated that Gaza MoH provides very detailed and real-time information about casualties in the war, that far exceeds the quality of reporting from conflicts such as Ukraine. [27] He did note that this quality has declined over time, due to Israeli attacks on hospitals, and thus the MoH is relying on first responders and media sources. [27] Many reported deaths by Gaza MoH don't have a valid ID number entered.

American and Israeli governments

Historically, the US State Department has relied on the GHM data for its annual human rights reports. [13] For example, it cited GHM numbers in a public report in March 2023. [11] On 26 October, 2023, US President Joe Biden stated he had "no confidence" in the casualty numbers being reported. [28] [29] Subsequently, National Security Council spokesperson John Kirby asserted that the death toll cannot be taken "at face value". [14] However, the US Assistant Secretary of State said that actual death toll was most likely "even higher" than what the GHM reported. [30] On 10 November 2023, the Wall Street Journal reported that the US intelligence community has growing confidence that death toll reports from the Gaza Health Ministry are roughly accurate. The article also reported that despite US officials had growing confidence, they did not have enough information to confirm for sure. [31]

In January 2024, Israeli news magazine Mekomit reported that Israeli intelligence officials had concluded that Health Ministry casualty reports are generally reliable and are used in briefings to senior officials. [32] In follow-up reporting, an unnamed official told Vice News, "The numbers are heavily relied up for official briefings on civilian casualties because with the exception of strikes on high-value targets, where senior officials are briefed on collateral damage, no civilian casualty figures or estimates are collected [by the Israeli military]." [33]

List of GHM health ministers

#NamePartyTime in office
1 Basem Naim [3] Hamas June 2007 – January 2009
2Mufiz al-Makhalalati [34] Hamas April 2009 – unknown
3Medhat Abbas Hamas Unknown – present

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References

  1. ↑
  2. ↑
  3. 1 2 Merav, Sarig (3 November 2007). "Striking medics in Gaza temporarily return to work after talks with Hamas". BMJ (Clinical Research Ed.). 335 (7626). National Institutes of Health: 904–905. doi:10.1136/bmj.39384.458935.DB. PMC   2048866 . PMID   17974666.
  4. ↑ Daniel, Ari (13 October 2023). "Doctors in Gaza describe the war's devastating impact on health care — and civilians". NPR. Retrieved 18 October 2023.
  5. ↑ Chotiner, Isaac (17 November 2023). "The Trauma of Gaza's Doctors". The New Yorker. ISSN   0028-792X . Retrieved 18 November 2023.
  6. 1 2 Isabel Debre (26 October 2023). "What is Gaza's Ministry of Health and how does it calculate the war's death toll?". Associated Press.
  7. ↑ David, Folkenflik. "News outlets backtrack on Gaza blast after relying on Hamas as key source". NPR.
  8. ↑ "UN says Gaza Health Ministry death tolls in previous wars 'credible'". Al Jazeera. Retrieved 27 October 2023.
  9. ↑ Harb, Ali. "Gaza death toll from health ministry is 'reliable': Rights expert". Al Jazeera. Retrieved 26 October 2023. Human Rights Watch has been working in the occupied Palestinian territories for three decades. We've covered rounds of escalations and hostilities, and we've always found the numbers from the Ministry of Health to be generally reliable.
  10. ↑ Taylor, Adam (24 October 2023). "Why news outlets and the U.N. rely on Gaza's Health Ministry for death tolls". The Washington Post. Retrieved 25 October 2023.
  11. 1 2 https://www.washingtonpost.com/world/2023/10/24/gaza-death-toll-palestinian-health-ministry/
  12. ↑ "What is Gaza's Ministry of Health and how does it calculate the war's death toll?". AP News. 26 October 2023. Retrieved 6 November 2023.
  13. 1 2 McGreal, Chris (26 October 2023). "Can we trust casualty figures from the Hamas-run Gaza health ministry?". The Guardian . Retrieved 26 October 2023.
  14. 1 2 "What Experts Say About the Palestinian Death Toll Figures". Time. 26 October 2023. Retrieved 28 October 2023.
  15. ↑ Isabel Debre (26 October 2023). "What is Gaza's Ministry of Health and how does it calculate the war's death toll?". Associated Press. The ministry is a mix of recent Hamas hires and older civil servants affiliated with the secular nationalist Fatah party, officials say.... 'Hamas is one of the factions. Some of us are aligned with Fatah, some are independent,' said Ahmed al-Kahlot, director of Kamal Adwan Hospital in northern Gaza. 'More than anything, we are medical professionals.' The Ramallah ministry said it trusts casualty figures from partners in Gaza, and it takes longer to publish figures because it tries to confirm numbers with its own Gaza staff.
  16. ↑ Batrawy, Aya (29 February 2024) [February 29, 2024]. "Gaza's death toll now exceeds 30,000. Here's why it's an incomplete count". www.npr.org. National Public Radio . Retrieved 12 April 2024.
  17. ↑ Bermudez, Krystal (9 April 2024). "Hamas-Run Gaza Health Ministry Admits to Flaws in Casualty Data". FDD. Retrieved 12 April 2024.
  18. ↑ "Health Sector Emergency Report". Gaza Health Ministry Telegram. State of Palestine Health Ministry - Gaza (published 2 April 2024). 31 March 2024. Retrieved 12 April 2024.
  19. ↑ "Health Sector Emergency Report". Telegram. Palestinian Ministry of Health (Gaza) (published 1 April 2024). 3 April 2024. Retrieved 12 April 2024.
  20. ↑ "Health Sector Emergency Report". Telegram. Palestinian Ministry of Health (Gaza) (published 4 April 2024). 6 April 2024. Retrieved 12 April 2024.
  21. 1 2 "The Science Is Clear. Over 30,000 People Have Died in Gaza". TIME. 15 March 2024. Retrieved 11 April 2024.
  22. 1 2 3 Huynh, Benjamin Q.; Chin, Elizabeth T.; Spiegel, Paul B. (6 December 2023). "No evidence of inflated mortality reporting from the Gaza Ministry of Health". The Lancet. 403 (10421): 23–24. doi:10.1016/S0140-6736(23)02713-7. PMID   38070526. S2CID   265664650 . Retrieved 12 December 2023.
  23. 1 2 3 4 Jamaluddine, Zeina (2023). "Excess mortality in Gaza: Oct 7–26, 2023". The Lancet. 402 (10418): 2189–2190. doi:10.1016/S0140-6736(23)02640-5.
  24. 1 2 Wyner, Abraham. "How the Gaza Ministry of Health Fakes Casualty Numbers".
  25. ↑ "A note on "How the Gaza Ministry of Health Fakes Casualty Numbers"". Bits of DNA. 8 March 2024. Retrieved 11 April 2024. Patcher writes: "Again, the baseline model for count data posits a Poisson distribution on the numbers, which in this case would represent a variance of 270. A compound Poisson process makes more sense in this case, and such a process would have even higher variance. Here we see exactly that, a variance of 1785, which is more than 6x what one would see in a Poisson process. If the author thinks the variance should be even higher than *that*, he needs to provide an argument for why, and point to historical data. Of course in this case the variance is even higher, because he appears to have "cherry" picked the 15 days."
  26. ↑ "Are Hamas Death Figures Fake?". Outside the Beltway. 18 March 2024. Retrieved 11 April 2024. Additionally, commenter Ken M adds this insight: "If you look at the numbers, it's very clear that they update fatalities faster than the update #women or #children (and they don't specify #men, that is just (#fatalities – #women-#children)). On some days fatalities update but there is no change in the #w or #c; on other days the increase in (#w+#c) exceeds the increase in #f. In other words, in the conditions of war, it is hard to get information. The Gazan Ministry of Health (GMH) makes a list of the name and ID # of every identifiable death; Israel maintains the registry of ID #'s so GMH can't fake that. That's why their numbers come out accurate. But in real time, they may get a number of fatalities from a hospital and get the names, which allow identification of #w or #c, only later, maybe much later. And if they get the list of names, they have to go through the registry to determine who is a child or an adult, and maybe for ambiguous names who is a woman or a man, and that probably takes time too. So #w and #c get updated with arbitrary lags, sometimes multiple days worth may suddenly get updated at once. So looking at day-by-day movements of these #'s is meaningless."
  27. 1 2 Spagat, Mike. "Analysis of new death data from Gaza's Health Ministry reveals several concerns". Action on Armed Violence. Retrieved 21 April 2024.
  28. ↑ "Italian minister disputes death toll of Gaza hospital blast". Reuters. Retrieved 26 October 2023. The Gaza health ministry has put the death toll at 471. An Israeli official has said the toll appeared to be 'several dozen'. A U.S. intelligence report estimated the number of those killed to be 'probably at the low end of the 100 to 300 spectrum'. 'We need to avoid the negative impact of propaganda. Because that missile, which was said to have caused 500 deaths – in reality it was around 50 people – and which inflamed Arab masses in big cities, was not however launched by Israel,' Tajani told the Sky TG24 news channel.
  29. ↑ Dobkin, Rachel. "Biden Accuses Palestinians of Lying About Civilian Death Tolls". Newsweek. Retrieved 26 October 2023. What they say to me is that I have no notion the Palestinians are telling the truth about how many are killed ... I'm sure innocents have been killed and it's the price of waging a war ... The Israelis should be incredibly careful to be sure that they're focusing on going after the folks that are propagating this war against Israel and it's against their interest when that doesn't happen but I have no confidence in the number that the Palestinians are using.
  30. ↑ "Gaza deaths likely 'higher than is being cited,' says senior US diplomat". www.aa.com.tr. Retrieved 10 November 2023.
  31. ↑ Youssef, Nancy A.; Malsin, Jared; Salama, Vivian. "U.S. Officials Have Growing Confidence in Death Toll Reports From Gaza". WSJ. Archived from the original on 10 November 2023. Retrieved 3 January 2024.
  32. ↑ אברהם, יובל (24 January 2024). "הצבא בדק ומצא שדיווחי ההרוגים במשרד הבריאות בעזה – מהימנים". שיחה מקומית (in Hebrew). Retrieved 1 March 2024.
  33. ↑ Prothero, Mitchell (25 January 2024). "Israeli Intelligence Has Deemed Hamas-Run Health Ministry's Death Toll Figures Generally Accurate". Vice. Retrieved 1 March 2024.
  34. ↑ "Hamas announces cabinet reshuffle in Gaza". Hürriyet Daily News. 2 September 2012. Retrieved 29 October 2023.
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