Image by Emma Kumer

Mortality Wars | Estimating Life and Death in Iraq and Gaza

Shaan Sachdev

On October 25, 2023, less than three weeks after Israeli forces began dropping bombs on the Gaza Strip in response to the October 7 Hamas attack, President Joe Biden was asked at a press conference whether the six thousand Palestinian deaths reported by Gaza’s Ministry of Health meant Prime Minister Benjamin Netanyahu was “ignoring” American directives to minimize civilian casualties. “I have no notion that the Palestinians are telling the truth about how many people are killed. I’m sure innocents have been killed, and it’s the price of waging a war,” Biden replied, standing next to the Australian prime minister in the White House Rose Garden. “But I have no confidence in the number that the Palestinians are using.” 

For years Gaza’s Ministry of Health had been the standard source of epidemiological information coming out of the Strip. In 2022, Biden’s own State Department cited the ministry in a human rights report. Michael Milshtein, former head of the Department for Palestinian Affairs in Israeli Military Intelligence, once referred to Hamas as “an organization of numbers and accuracy.” Biden’s skepticism prompted a chorus of attestations of the ministry’s reliability from the United Nations, Human Rights Watch, and other groups. Researchers from Johns Hopkins University said they found “no evidence of inflated rates,” adding that the ministry had “historically reported accurate mortality data.” Epidemiologists from the London School of Hygiene & Tropical Medicine indicated it was plausible the ministry’s tallies were undercounts, almost certainly excluding bodies that never made it to morgues or were not found at all. For its part, Gaza’s Ministry of Health responded to the president the following day with a list of the dead — 6,747 names, each with a corresponding age, sex, and official identification number. It separately tallied 281 bodies that had not yet been identified. 

Two weeks after Biden’s press conference, when the Gaza Ministry of Health’s tabulation had grown to nearly 11,000, Barbara Leaf, the State Department’s highest-ranking official for Near Eastern Affairs, signaled that the U.S. government had swayed in the opposite direction. In testimony before the House Foreign Affairs Committee, Leaf suggested that the ministry’s body count might actually have been an underestimate. “We think they’re very high, frankly, and it could be that they’re even higher than are being cited,” she said. “We’ll know only after the guns fall silent.” In his State of the Union address in March, Biden finally ordained the U.S.’s about-face. “This war has taken a greater toll on innocent civilians than all previous wars in Gaza combined,” he said, before unleashing a stream of statistics that matched the numbers from the ministry he’d cheapened only five months before. “More than thirty thousand Palestinians have been killed, most of whom are not Hamas. Thousands and thousands of innocents — women and children.” Ironically, by then Biden had less reason to trust the accuracy of the ministry’s data, because in the intervening months, Israeli forces had destroyed much of Gaza’s medical and electronic infrastructure — not just hospital computers, but entire hospital buildings — through which death records were centralized and processed.

Biden’s acknowledgment that “most” of the Palestinians killed “are not Hamas” contradicted what Israel was telling the world, as well as its own citizens, about its military’s fantastic onslaught. “The army of Israel has done more to minimize civilian casualties than any other army in modern times,” Netanyahu said at a press conference in March. Months earlier, he had garishly summed up Israel’s casus belli: “It’s the battle of civilization against barbarism,” he told CNN. In order to rid the world of such barbarism, the Israeli military enlisted artificial intelligence programs to generate targets at lightning speed. The IDF seems to have coolly marked vast numbers of fighting-age men as combatants (or “terrorists” or “barbarians,” depending on one’s preferred flavor of propaganda), despite the fact that, as political scientist Sarah E. Parkinson has pointed out, only a third of all adults in Gaza had expressed support for Hamas before the war. Many of Israel’s targets were systematically bombed while at home with their families because they were easier to locate there, according to a remarkable investigation by the Israeli-Palestinian magazine +972. With the press of a button, entire families, miles away, were deliberately but anonymously wiped out. 

Without producing evidence, Israeli officials have offered varying tallies of how many Hamas fighters have been killed. It’s possible no such evidence exists. “In practice, a terrorist is anyone the IDF has killed in the areas in which its forces operate,” a reserve officer told Haaretz in March. “It’s not that we invent bodies,” another reserve officer said, “but no one can determine with certainty who is a terrorist and who was hit after entering the combat zone of an IDF force.” In the face of the World Health Organization’s repeated insistence that nearly seventy percent of the deaths are women and children, and the Euro-Med Human Rights Monitor’s finding that ninety percent of the people killed have been civilians, the Israeli army has maintained that it is Hamas’s use of human shields that causes innocent people to die. The problem, of course, is that if any civilian in a combat zone — any civilian the IDF decides to target — is a human shield by definition, Israel can kill as many civilians as it likes, with total impunity.

Needless to say, Biden’s clearer-eyed reference to the Palestinian death toll was a political calculation. International backlash to the war quickly became the most inflamed reaction to Israeli military action in living memory, and Biden’s swing from doubt to ratification of the Gaza Health Ministry’s numbers betrays the extent to which death tolls can be instrumentalized in the service of political agendas. It followed that Biden’s eventual willingness to enumerate the cost of the war in human lives did little to undercut his decisive support of Israeli military operations. Instead, in the weeks after the State of the Union, his administration approved some of the largest arms packages sent to Israel in recent years — billions of dollars’ worth of F-35 jets and more of the two-thousand-pound MK-84 bombs that had been leaving forty-foot-wide craters in Gaza, in an intensity of skyborne batteries that one former Pentagon official said hadn’t been seen since the U.S.’s own bomb-happy offensives during the Vietnam War. In mid-May, after a few days of well-publicized announcements that it was withholding further weapons transfers to save Rafah from catastrophic bloodshed, the Biden administration approved a billion-dollar arms sale to Israel. The U.S.’s free-flowing pipeline of armaments, amid mounting evidence of civilian massacres, offers a grim dilemma to scientists, scholars, activists, and others who believe in the clarifying power of a wartime death toll. If acknowledging it changes nothing, how much does the number matter?


Every afternoon for nearly a decade during the Vietnam War, American reporters in Saigon were treated to U.S. press briefings so dependably filled with narrative and numerical fictions that disgruntled attendees took to calling them the “five o’clock follies.” Often conducted by spokesman Barry Zorthian (who once vouched for the Vietnam War’s transparency, rating it “the most open war in history”), the briefings embellished body counts of Viet Cong and North Vietnamese combatants — “We might count the same guy five times,” combat veteran Dallas Owens told The New Republic in 2011 — to conjure illusions of battlefield success. But the ploy backfired. The American public, horrified at the death on all sides, turned against the war. In later years, politicians and pundits termed Americans’ diminished appetite for conflict “Vietnam Syndrome.”

In the nineties, the stomach for wartime casualties was evaluated by what came to be called the “Dover Test” — an allusion to Dover Air Force Base in Delaware, where the flag-draped coffins of American service members killed overseas are unloaded. Anticipating public squeamishness, President George H.W. Bush banned news cameras at Dover in 1991, during the Gulf War. In 2003, on the eve of the next Bush’s invasion of Iraq, a Pentagon internal directive made similarly clear that there would be “no arrival ceremonies for, or media coverage of, deceased military personnel” at either Dover or Ramstein Air Base in Germany. By this time, the federal government had forsworn wartime tallies of foreign combatant and civilian casualties. “You know we don’t do body counts,” General Tommy Franks, who oversaw the invasion of Iraq, curtly reminded reporters at Bagram Air Base in 2002. In 2006, President Bush affirmed that his administration had “made a conscious effort not to be a body-count team,” even when it cost him the opportunity to make proud proclamations about American military advancements. “We don’t get to say that — a thousand of the enemy killed, or whatever the number was,” he said. “It’s happening; you just don’t know it.” But, amid the Iraq War’s raging violence, which continued for years after Bush delivered his famous “Mission Accomplished” speech, the president couldn’t always avoid direct questions about the war’s price in Iraqi lives. The U.S. government’s reluctance to publicly issue civilian death tolls for a conflict as politicized as the one in Iraq left a void that was bound to be filled by a cadre of entrepreneurial auditors, generating conflicting estimates that differed by nearly a million deaths — numbers that, alongside their corresponding debates over how deaths in Iraq should be counted, still have not been reconciled.

At an October 2006 press conference, CNN reporter Suzanne Malveaux asked Bush about a new study of post-invasion Iraqi mortality published in the British medical journal The Lancet, which estimated that 654,965 people had died as a consequence of the conflict — 601,027 of them violently. The new number was “twenty times the figure that you cited in December,” Malveaux pointed out to Bush, who a year earlier had determined that the number of Iraqi civilians killed was really “thirty thousand, more or less.” She asked, “Do you care to amend or update your figure?” Bush replied, “Six hundred thousand, or whatever they guessed at, is just, it’s not credible.” The researchers’ methodology, he added, was “pretty well discredited.” Shrugging off the numbers as unscientific was a convenient way to ignore the possibility that Operation Iraqi Freedom might have achieved what was, as the study concluded, “the deadliest international conflict of the 21st century.”

The authors of the Lancet study belonged to one of two methodological camps into which the world of mortality measurement can be divided: “active” and “passive.” Active data collectors like the Lancet researchers rely on survivors — generally the close family members of those who have died — to describe how, when, and where the deaths happened, and, if possible, to corroborate their testimonies with death certificates. Because surveyors cannot visit every family in a war-torn country, they (“actively”) seek out representative samples of interviewees that, if chosen carefully, will theoretically allow the surveyors to compare pre-war and wartime death rates to extrapolate nationwide excess mortality statistics. (Extrapolation, for better or for worse, is how most polls and surveys make approximations.)

After Bush dismissed the Lancet study, over two dozen scientists signed an open letter pointing out that “the same methodology has been used in recent mortality surveys in Darfur and Democratic Republic of Congo, but there has been no criticism of these surveys.” In Iraq, eight field researchers interviewed members of 1,849 households, knocking on doors in 47 neighborhoods across the country. By comparing the mortality rates before and after the invasion, the surveyors aspired to count not only deaths from bullets and shrapnel, but also the ones that came about due to potentially indirect consequences of the war: malnutrition, cardiovascular stress, disease, destitution, depression. The researchers’ second objective was to estimate the violent deaths that had been covered up, misrecorded, or — given the turbulence of post-invasion Iraq — never recorded at all. The organization Physicians for Social Responsibility argued that “only a small fraction of those killed ever reached an institution where they would or could be registered.” The U.N. Committee on Enforced Disappearances has said that hundreds of thousands of Iraqis are still believed to be missing today.

“Passive” researchers make up the more conservative of the two camps. They stake their faith in records and registries, counting only the deaths that have been verified by journalists, hospitals, morgues, health departments, police stations, NGOs, or eyewitnesses. When it comes to Iraq, the passive collector par excellence is Iraq Body Count (IBC), a London-based organization that maintains the world’s largest and longest-running database of violent Iraqi deaths post-invasion. As of June 2024, IBC puts the number of civilian deaths between 187,214 and 210,690 and total deaths at about 300,000. The organization’s website makes painstakingly clear that its database is restricted to “documented (not inferred, extrapolated, or otherwise estimated) deaths of civilians from post-invasion violence in Iraq.” Each death has been verified by at least one independent source, usually an English-language press report. Yet media reports depend on journalists’ access to notoriously inaccessible war zones. A 2008 study by the British Medical Journal found that media reports from thirteen countries affected by war between 1955 and 2002, including Vietnam, Bosnia, and Ethiopia, captured only about a third of all deaths estimated by surveys. Another report, by the American Association for the Advancement of Science, found that newspaper accounts documented over fifty percent of political deaths that could be counted during relatively peaceful periods in Guatemala, but fewer than five percent of such deaths during heavily violent months.

Statisticians and epidemiologists are, for the most part, a conciliatory bunch. They tend to cooperate across the “active” and “passive” camps. When it comes to Iraq’s mortality estimates, however, there is a long-running feud. Les Roberts, coauthor of the Lancet study, told me the schism was “vindictive on a level that no one has ever seen” in the field. Hamit Dardagan, cofounder of IBC, said the vitriol among researchers “was extraordinary at times.” Today, the Lancet study remains the active side’s cause célèbre, even as its numbers have been gradually scrubbed from the mainstream narrative. When it was first published in 2006, the study was featured on 25 American news shows and in 188 news articles. Yet last year, as the national media marked the invasion’s twentieth anniversary, The Lancet’s mortality estimate was nowhere to be found. Nor were the body counts, one as high as 1,033,000, of the other five major active surveys published since 2004. In the weeklong surge of press, The New York Times, The Washington Post, the Associated Press, NBC News, ABC News, USA Today, and CNN all used passive IBC estimates, firmly stationing the number of deaths somewhere between two hundred thousand and three hundred thousand. The lowermost conceivable mortality estimates helped cast the war’s legacy in a curiously forgiving light. The New York Times called today’s Iraq “a freer place.” The answer to whether or not the invasion was “worth it,” Peter Bergen wrote for CNN, “isn’t straightforward.” The Iraqi people “have gained a chance,” David Frum argued in The Atlantic, vaunting the volume of Iraq’s present-day oil exports. Would the formalization of more than a million Iraqi deaths have chastened the coverage?

In the end, it seems, the Bush administration’s strategy was successful: in endorsing lower numbers, it handed a victory to one side of the highly politicized chasm between mortality researchers. The conservative estimates endured, while the higher numbers, though drawn from established methods and reputable researchers, were recast as unreliable. Sarah Sewall, former director of Harvard’s Carr Center for Human Rights Policy, recalled that even IBC’s numbers were politically unwelcome until they were eclipsed by larger ones. “It wasn’t until the first Lancet survey came out that everyone said, ‘Oh, well, goodness! The Iraqi Body Count is so much more reliable,’” she told NPR in 2008. This remains a bitter downside of competing measurements: smaller numbers tend to attain an aura of forgivability when juxtaposed with bigger numbers.


The Gaza Strip is less than half the size of New York City and a thousandth the size of Iraq. During the first month of the Israeli bombing, health administrators throughout the Strip strove to keep track of every injured person in a bed and every dead body in a morgue, according to an A.P. report. The administrators would daily send their data to health ministry officials, who would issue aggregative death tolls. As Israel destroyed Gaza’s health facilities, gaps in the daily counts had to be filled in with information from press reports. Zeina Jamaluddine, a research fellow at the London School of Hygiene & Tropical Medicine, told me in an email that after the November 10 strikes on Al-Shifa hospital, medical facilities in northern Gaza stopped publishing names and identification numbers of the dead due to “the increasing inability of hospitals to record such data.” By April, Al-Shifa was left “an empty shell,” according to a WHO report. “Numerous shallow graves have been dug just outside the emergency department, and the administrative and surgical building.” In May, the International Rescue Committee announced that “there are no fully functional hospitals in Gaza and only 12 of 36 hospitals remain partially functional.”

In Gaza, professional debates like the ones that developed over Iraq’s death toll have had neither the time nor space to emerge, since the Strip remains closed to foreign journalists and researchers and too dangerous for aid workers who might otherwise tally up the dead. Half a year into the war, the U.N. said that at least 224 humanitarian workers had been killed. Displaced Palestinians continue to flee one enclave after another under the threat of Israeli military incursions. Thousands of Palestinians remain unaccounted for, believed to have been buried under rubble. Dr. Yaser Bozya, the health ministry’s director of international cooperation in the West Bank, told NPR in February that a low estimate of missing people presumed to be dead stood at ten thousand. “Because of the continued, brutal war going on there, we could not have the real number,” he said. “It will be after the war has been finished.” This sort of retrospective measurement amid mass displacement is not impossible for those in the active camp: according to Roberts, excess mortality surveys have been conducted before in Rwanda and Syria, where interviews with refugees were used to deduce the scope of death. But the scale of disorder in this case is formidable: with eighty percent of Gaza’s population displaced and vast swathes of the Strip destroyed, one can only wonder how doors will be knocked upon when none exist and nobody’s home.

Despite its veneer of finality, the death toll proposes only one answer to the sum of warfare’s suffering and ruin. In the end, Iraq and Gaza’s oceans of suffering comprise not just the dead, but also the injured, the traumatized, the sick, the grieving, the displaced, and the impoverished. The 1990 Gulf War and ensuing U.S.-led sanctions killed an unknown number of Iraqis, and they set the stage for Iraq’s collapse in 2003, blurring one invasion’s end and the other’s beginning. By Iraq’s macabre yardstick, the majority of war-related Palestinian deaths are still to come. Catherine Lutz, cofounder of Brown University’s Costs of War Project, pointed out that, in 2018, a handful of Americans who were children of Spanish-American War veterans were still receiving benefits related to their parents’ service. In Iraq, she said in an interview, “it is even more expansively true that the war won’t be over for those who lost family members, livelihood, and mental and physical health until well into the 22nd century.” Diseases continued to spread long after coalition troops had abandoned the smoldering remains of Iraqi towns and cities. Some people bore the symptoms of exposure to weapons-grade depleted uranium, a Pentagon speciality that diffuses into easily breathable radioactive dust. Third-degree burns to the bone, odorous secretions, and organ failures suggested the use of white phosphorus. In Fallujah, leukemia in children and young adults increased by a factor of nearly forty. And by the mid-aughts, Iraq ranked high on the list of countries contaminated by unexploded ordnance, in part as a result of the U.S. and U.K.’s penchant for using cluster bombs.

When an infant died of leukemia, or a woman of breast cancer, or a teenager of lymphoma, or a child by the septic amputation wound induced by the cluster bomb buried behind her house, or a father by electrocution after trying to adjust the destroyed power lines on his roof, IBC did not count them. Their deaths didn’t make it into newspapers. Their death certificates bore none of warfare’s martyr-ish verbiage. For all their risks — to numerical accuracy, to the safety of their researchers, to the very distinguishability of warfare’s consequences — surveys of excess deaths, like The Lancet’s, endeavor to account for all the people who might have lived had there been no war, thus documenting the furthest reaches, the full toll, of political violence. This May, Charles Birch, representative of the U.N.’s mine-removal arm in Gaza, told The New Yorker that much of the estimated 37 million tons of rubble in Gaza — more than exists in all of Ukraine — was likely contaminated with explosive ordnance, making a conceivably habitable postwar Gaza a colossal financial and logistical venture. With nearly two million Palestinians displaced, most of Gaza in ruins, sewage running openly through refugee camps, a storm of infectious diseases, little to no medication, fuel, or anesthesia, and, worst of all, the onset of famine, it seems inconceivable that the deathly echoes of this war will subside any time soon.

Numbers don’t necessarily bring clarity or even urgency to the costs of armed conflict. They don’t stop to tell the tale of the mother and her six children who were reportedly killed when an Israeli airstrike hit a building near Al-Shifa on March 29, or to elaborate upon the doting thirty-year-old father who spent four days trying to unearth his daughter’s body from the rubble of their home in Rafah. Rather, death tolls consist in magnitudes. They are the tools and benchmarks by which we who stand outside the horrors of war can appraise suffering and injustice. This might be why a photo of one person — such as Sharbat Gula of Afghanistan, whose “haunted eyes,” National Geographic said, told the tale “of an Afghan refugee’s fears,” or Phan Thị Kim Phúc, the so-called “napalm girl” depicted fleeing her village in Vietnam — has from time to time more effectively stirred public passion than the pronouncement of some abrasively vast statistic. Numbers, to be sure, are essential markers of scale — of the force of a catastrophe, the intensity of humanitarian exigencies, the gravity of emerging truths. But by keeping narratives at bay, numbers preserve war’s remoteness. They enclose what’s incomprehensible in digestible configurations that can be negotiated and even rendered familiar. Moreover, by obscuring individual horrors, they can deaden our sympathy receptors — “180,000” can become a bargain, “605,000” the index of some slatternly experimental design. One can find oneself perversely hungering for bigger numbers just to win the argument.

Still, in one, five, or ten years, a methodically enumerated death toll, though indeed cold to narrative individualization, might, in serving up Gaza’s scale of loss, its magnitude of human suffering, help us confront and rank the inhumanity of 21st-century warfare as it stands among the nadirs of human depravity — all those impassive pushes of a button, all that retroactive revisionism, all those ever-confounding chasms between trigger and carnage, between antipathy and death.

Shaan Sachdev is a cultural essayist based in New York. He writes about ontology, city life, the military-industrial complex, and his two favorite divas: Hannah Arendt and Beyoncé.