How Israel’s war on Gaza has cut Palestinian life expectancy

It is 18 months since Israel declared war on Gaza, following the Hamas-led attacks on southern Israel in October 2023, which killed more than 1,100 people.

At the time of writing, more than 51,000 Palestinians have been killed and more than 100,000 injured from a pre-war population of 2.2 million. At least 10,0000 more are missing and presumed dead under the rubble. 

Ninety percent of people have been displaced, usually more than once. A ceasefire that came into force on 15 January was broken by Israel on 18 March. Israel has also blockaded supplies of aid and other essentials into Gaza since 2 March.

The Palestinian dead have come from all age groups: women, children and the elderly account for 56 percent of those killed.

That high level of fatalities has also slashed the average life expectancy of Palestinians, according to a study in The Lancet.

For Palestinian men, the drop in average life expectancy has been 51.6 percent to 40.5 years during the first 12 months of the war - that’s a loss of 34.9 years of life. 

For Palestinian women, it has been a cut of 38.6 percent to an average life expectancy of 47.5 years - a loss of 29.9 years. The authors of the study concluded: “Our approach to estimating life expectancy losses in this study is conservative as it ignores the indirect effect of the war on mortality… Actual losses are likely to be higher.”

That the true number of dead has been under-reported was echoed in a separate study in February 2025. It calculated that the death tolls issued by the Palestinian Ministry of Health were likely to have been under-reported by 41 percent from October 2023 to June 2024. 

Instead, it put the number of dead as close to 64,620 (compared to the ministry figure at the time of 37,877). 

The study's authors said that part of the discrepancy was due to issues with collecting data.

The figures from the Palestinian Ministry of Health were “more likely to underestimate than overestimate mortality” because secondary causes of death, including lack of food and sanitation, had been excluded.

Below, we look at how the conflict has hit some of the necessities for life in Gaza during the past 18 months. Statistics are correct at the time of publication.

Food in Gaza

Lack of food and malnutrition have been an enduring feature of Israel’s war on Gaza. Before the war, agriculture, according to the UN Food and Agriculture Organisation, accounted for “approximately 10 percent of Gaza’s economy, with more than 560,000 people relying entirely or partially on cropping, herding, or fishing for their livelihoods”.

More importantly, agriculture allowed Palestinians to feed themselves. 

That stopped with the war, as fishing fleets, fields, greenhouses and other necessities for food production were devastated by Israeli attacks.

The scarcity of food has been reflected in high prices: for example, in Deir al-Balah Governorate in central Gaza, food prices soared between October 2023 and December 2024, including a kilogram of flour (1,058 by percent), tomatoes (956 percent), cucumbers (752 percent), lentils (360 percent) and rice (142 percent) among others.

In April 2025, Gaza’s bakery owners’ association, announced that they had all shut due to a lack of flour and fuel because of Israel’s blockade.

Likewise, livestock has been hit: milk production, for example, has almost halted on occasion, while meat is hard to come by.

Farmer Faraj Jarudat, a farmer from northern Gaza, told The Guardian in November 2024 that he used to own three cows and 60 sheep. Now none were left, killed through Israeli bombardments, lack of food or other causes.

“Some died of starvation, some were eaten by people who were hungry, some just disappeared,” he said. “There is not a single one left.”

The farm and his home, he was told by friends and former neighbours, had been bulldozed by Israeli forces.

Malnutrition in Gaza

The lack of food that has been a constant during Israel’s war on Gaza has brought with it malnutrition.

In April 2024, Oxfam reported that Palestinians in northern Gaza were surviving on an average of 245 calories per day, or less than one can of fava beans. This is less than 12 percent of the recommended daily 2,100 calories needed for the average person.

In June, Rania, a mother in Gaza City, told Middle East Eye that the only food available was either unaffordable or limited. “There are no vegetables, fruits, or milk in the markets. Nothing that has any nutritional value,” she said. 

Halva, beans, hummus, peas and cold cuts from the World Food Programme had helped, she said, but needed to be rationed. 

“I’ve been rationing them because if I run out I will have nothing to eat. I feel dizzy and weak. My face is pale and I’ve lost a lot of weight.”

The Palestinian population has often been driven to extreme measures, such as eating grass, which is indigestible for humans, causes diarrhoea and vomiting, and has negligible nutritional value. On other occasions, animal fodder has been used to make bread.

Many NGOs, charities, and other agencies use the Integrated Food Security Phase Classification or IPC to analyse food security and nutrition. The scale runs from 1 (none/minimal) to 5 (catastrophe/famine).

In February 2025, it was estimated that at least 60,000 children in Gaza will need treatment for acute malnutrition in the coming year.

There have already been instances of child fatalities, including Azzam al-Shaer, who died in June 2024; and Yazan al-Kafarna, who died in March 2024.

Yazan was born with cerebral palsy, meaning he had to follow a special diet and take supplements. However, his family said that since the start of the war, he had not had not been able to access such essentials.

His father said: “Before the war he was healthy, he had access to all the food and medical care he needed. When the war started, everything was cut off… this happened to him from the lack of nutrition and him not having important foods.”

Water and sanitation in Gaza

Even before the war, water and sanitation in Gaza were at crisis point, with groundwater exposed to sewage and most tap water not fit for human consumption.

But that situation has worsened since October 2023: by the end of 2024, water supplies of even unclean water had been drastically curtailed.

What limited clean water is available is reliant on desalination plants.

But during the past few weeks, Israel has cut off power to the South Sea desalination plant, which in November 2024 was the only such facility to be connected, cutting its capacity to produce clean drinking water by 85 percent.

The population also has limited or no access to sanitation. Human waste is one of the many forms of pollution in Gaza, attracting mosquitoes that in turn can spread disease.

Homeless Palestinians, who usually live in tents, have little protection against insect bites and their serious effects.

In May 2024, Omar Nasser described to MEE how his daughter Gada, then aged nine, had contracted hepatitis A, a liver infection that is transmitted through solid human waste and can be caught from coming into contact with unclean water or eating food handled by an infected person.

Nasser took his daughter to hospital, where a doctor prescribed some medications and a nutritional diet, which Nasser could not provide as he is unemployed.

"The doctor said she must not eat canned food, but it's the only food we get from the aid organisations," he said. “I’ve had to ask people for food to provide for my daughter.”

Others speak of living in makeshift tents close to raw sewage and regularly being bitten by mosquitoes, despite attempts to fend them off.

“We walk through sewage puddles daily and the awful smells fill the place,” Magdy al-Zaanen told MEE. “We are exposed to all kinds of pollution all the time.”

The UN-led Wash Cluster, which focuses on water, sanitation and hygiene, estimated that in August 2024, one million people were at risk, due to poor sanitation, from rodents and pests (76 percent), solid waste (54 percent), sewage (46 percent), and human waste (34 percent).

Pregnancy in Gaza

One of the groups most vulnerable to poor sanitation and malnutrition during wartime are pregnant women.

The lack of nutrition and adequate healthcare can have severe consequences: by January 2025, approximately 10-15 percent of screened women suffered from malnutrition.

In June 2024, Israa, a mother, told MEE how, throughout her pregnancy she was constantly on the move by foot amid Israeli bombardments and military advances by Israeli troops.

"I never imagined I would give birth to my first child away from home and surrounded by air strikes," she said.

"The place where I gave birth was without any forms of sanitation and hygiene. Yet, I couldn't blame the hospital as the pressures inflicted on doctors and nurses were beyond their abilities."

Other pregnant women miscarried, either when forced to flee by order of Israeli forces under traumatic circumstances; or after being attacked by a trained army dog.

The war means that when children need medical attention, there is not adequate medical provision.

In a February 2024 UN FPA report, Dr Ahmed Al Shaer, at al-Helal al-Emirati maternity hospital in Rafah, said they had so few incubators and so many preterm babies that “we have to put four or five babies in one incubator ... Most of them don’t survive.”

Medical care in Gaza

Before Israel’s war on Gaza, medical care in the Palestinian enclave was in a perilous state.

The blockade, imposed since 2007, meant that essential medical supplies often did not reach those in need, including those living with disabilities. Patients, even children, were often unable to leave for necessary treatment in East Jerusalem and the West Bank. Living in Gaza has seen huge incidences of post-traumatic stress disorder and other mental health conditions.

But since October 2023 Unrwa, the UN agency responsible for supporting Palestinian refugees in the region, has been banned by Israel. Its workers number among Gaza’s dead.

The enclave’s Ministry of Health reported in April that an estimated 80,000 diabetic patients and 110,000 patients with high blood pressure were no longer under care.

On 23 March, Israel's army killed 15 emergency workers responding to an Israeli attack in the Rafah area. The military then buried the bodies, including medical staff belonging to the Palestinian Red Crescent Society.

Palestinian doctors have been found dead in Gaza, while surgeons have died in Israeli custody amid allegations of torture. And on 13 April, Israel bombed al-Ahli al-Arabi Baptist Hospital, Gaza’s last fully functioning hospital.

More than 90 percent of health facilities in Gaza sustained some damage throughout 2024.

Witnesses to the attack on the al-Ahli al-Arabi Baptist Hospital said the Israeli military gave staff and patients, some of who were in intensive care, 18 minutes to leave.

A doctor from the Red Crescent told MEE that medical staff now had to send displaced patients to other hospitals which themselves had limited care.

"All the hospitals are overcrowded and are unprepared for providing full medical services,” he said. “This will surely reflect on the health of the wounded, the patients, and it could result in the loss of their lives, the loss of their body parts or could cause long-term disability.”

WHO chief Tedros Adhanom Ghebreyesus condemned the attack on al-Ahli al-Arabi Baptist Hospital and reminded that medical facilities are protected under international humanitarian law.

“Attacks on healthcare must stop,” he said. “Once again we repeat: patients, health workers and hospitals must be protected. The aid blockade must be lifted.”

Daniel Tester contributed to this report.