Mortality in the Gaza Strip during the period July to September, 2014: a retrospective chart review study

Abstract

BackgroundThe Gaza war of July to August, 2014, killed 2260 Palestinians, including 612 children, and injured more than 11 000. Around 28% of the population was internally displaced. At the height of the conflict, 11 of 31 hospitals were unable to provide services, and 48 of 97 primary health care centres were closed. The strains on the population, infrastructure, supplies, and health services may have exacerbated existing diseases and influenced non-trauma mortality in vulnerable groups. We aimed to assess non-combat mortality in the Gaza Strip during the war. MethodsDate, sex, age, and cause and place of each death were collected from all death notification forms and death reports in hospitals in Gaza for the period July 7 to August 26, 2014. The primary outcomes were the overall mortality rate, sex and age-group mortality proportions, and the proportion of deaths that occurred outside a hospital ward. The study was approved by the Ministry of Health in Gaza and WHO. Findings718 people died of non-combat causes during the 51 days of warfare (4·0 per 10 000 population), of whom 165 (23%) were children (age <18 years). 14 (2%) died of infectious diseases and the same number of injuries. 86 (12%) died of unspecified causes. Of adults who died, 310 (56%) were aged 70 years or older and 288 (52%) were women. 271 (49%) adult deaths occurred in a hospital ward. InterpretationThe ratio of war-related trauma mortality to baseline crude mortality was higher than the internationally proposed threshold for major complex emergencies. For background mortality, the proportion of children dying was similar to that before the war, but a markedly reduced proportion of adult deaths took place in a hospital ward. The proportions of mortality caused by infectious diseases and injuries were low. However, misclassification of cause of death may have influenced the cause-specific findings. FundingNone.