Nearly 40 Palestinians in Rafah will die each day due to traumatic injuries if Israel continues and escalates its incursion, according to a new analysis by Johns Hopkins University’s Center for Humanitarian Health and the London School of Hygiene and Tropical Medicine. That’s a total of 3,509 people killed by just violent traumatic deaths — not including sickness or hunger — by August 17.
The report underscores the dire conditions in an area that was supposed to be the last refuge for Palestinians fleeing the carnage in Gaza and the urgent need for Israel and Hamas to agree to the ceasefire proposal currently in negotiations. US President Joe Biden recently announced Israel has a ceasefire plan it has endorsed, but Israeli leaders have disputed this claim, creating confusion about whether passing the deal is actually feasible.
As it stands now, Israel’s Rafah invasion is killing an average of 16 people per day. The projections — which were calculated using data from Israel’s assault on the southern city of Khan Younis from December 2023 to March of this year — make clear that without a ceasefire, a conflict that has already left at least 35,000 Palestinians dead could kill thousands more in the coming months.
According to the researchers’ calculations, if the Rafah operation continues according to Israel’s stated plans, the death tolls will mirror those of Khan Younis, which saw similar conditions including evacuation orders and large-scale population displacement. Ultimately, the number of deaths due to physical trauma in Rafah could be as high as 3,946 by mid-August.
The total number of deaths will likely be much higher. The report notes the calculations don’t include “deaths due to infectious diseases, non-communicable diseases, and maternal and child health,” as a previous report on excess deaths in Gaza did, though those deaths are undoubtedly happening. The reality, this analysis shows, is that thousands more people will die unless the fighting stops and that it’s up to political leaders to do everything possible to see the deal through and prevent those deaths.
Given the stakes, a ceasefire is critical
The point of the Johns Hopkins project, said Paul Spiegel, director of the Center for Humanitarian Health, is to show the consequences of continued fighting and save civilian lives.
To do so, the team collected death data from sources including Gaza’s Ministry of Health, the United Nations, and the Armed Conflict Location and Event Data project (ACLED) — an organization that tracks armed conflict and political violence throughout the world — for a period of the war in which combat conditions in Khan Younis mirrored those currently seen in Rafah. They extrapolated their estimates using available fatality data, which had some limitations; for instance, the estimates don’t distinguish between Palestinian fighters and civilians.
“If you already have 37,000 deaths, give or take, in terms of the reporting, it’s interesting how suddenly 3,500 may not seem a lot, but it’s a massive amount,” Spiegel said. “So it’s still nearly 10 percent more deaths that would occur just in Rafah, just due to trauma, and, most importantly, if more of a full-scale invasion occurs — which there’s every indication that that may occur according to what Netanyahu states.”
The recent push for a ceasefire agreement seems to acknowledge the dire consequences of continued Israeli operations and the crucial need for an end to the war, Michael Hanna, head of the International Crisis Group’s US program, told Vox.
“This proposal goes much further than previous proposals in terms of the language regarding the permanence of the ceasefire — that this, if followed through, will lead to a permanent cessation of hostilities,” he said. “And it has the additional feature of the language that makes clear that the ceasefire will continue within each of the phases, as long as the parties continue to negotiate. These are some new tweaks, but tweaks that are really, really quite important and make it much, much more possible for Hamas to agree to the proposal as well. “
A permanent ceasefire is the most crucial element of any agreement from a humanitarian standpoint. It’s the point about which there has been fundamental disagreement between Israel and Hamas. Since talks began, Hamas has pushed for a permanent ceasefire arrangement, but Netanyahu and other elements of the Israeli government have insisted a permanent ceasefire is antithetical to their war aim of completely eliminating Hamas.
According to a Pew Research Center poll conducted during failed ceasefire talks in March and April and released last week, a large portion of Jewish Israeli society — 76 percent — believes that Israel will achieve its war aims.
“I think it’s a very interesting poll that suggests that Netanyahu is not an outlier in Israeli public opinion on this war,” Jon Alterman, director of the Middle East Program at the Center for Strategic and International Studies, told Vox. “Netanyahu is firmly in the mainstream of Israeli thinking, and especially Israeli Jewish thinking.”
Achieving that goal is all but impossible, however: Having governed Gaza for nearly two decades, Hamas is firmly enmeshed in the fabric of everyday life there, and some of its most important leaders are outside of Palestinian territory. That’s a reality Biden alluded to when unveiling the latest ceasefire proposal, declaring Israel had essentially won as Hamas “no longer is capable of carrying out another October 7” and that it’s “time for this war to end.”
Israel is continuing its assault on Rafah as well as its ground and air operations in other parts of Gaza. As it does so, critical aid remains bottlenecked outside of Gaza due to border closures and other logistical problems. Unless the war ends soon and humanitarian aid can enter Gaza, many more Palestinians — not just the 3,500 projected in the analysis — will die this summer.
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