Mona Chalabi writes:

Even if Israel’s bombing campaign were to stop, the death toll in Gaza is expected to soar. A letter published in the medical journal the Lancet claims that the final figure could eventually be about 186,000. Written by scientists who model how war affects health, the letter lays out the importance of an accurate count – and the difficulty of achieving one.

For the past nine months, Israeli forces have waged an intense military campaign that has killed about 38,000 people in Gaza, according to Gaza’s health ministry. Over time these numbers (acknowledged by the United Nations, the World Health Organization and Israeli intelligence services) have become more difficult to assess, with officials less able to keep pace with the killings. An additional 10,000 people are believed to be buried under the rubble in Gaza. They have not been counted among the dead.

If a permanent ceasefire were declared today, you might think the death toll would stop there. But warfare doesn’t just kill people through direct violence. In recent years, epidemiologists who study the spread of disease during armed conflict have begun to count what they call the indirect casualties of war. These deaths are caused by factors such as malnutrition, lack of medication, and unsanitary living conditions – the reverberations of warfare, which follow inevitably and predictably from it.

The number of indirect casualties often vastly exceeds direct ones. In East Timor, about 19,000 people were either killed or disappeared between 1974 and 1999, most of them during an Indonesian invasion and occupation that some scholars have called a genocide. But that count doesn’t come close to capturing the full human cost: an estimated 84,000 additional people eventually died after an Indonesian campaign of mass displacement and starvation. That’s four indirect deaths for every direct death. [Continue reading…]