What are Conditions in Gaza Like?
Activist Narratives and Basic Health Metrics Tell Two Different Stories
Disclaimer: This post is not about *current* conditions in Gaza, which has become a war zone and a hellscape. This post is about *pre-war* conditions in Gaza––the conditions that, according to some, provoked Hamas to begin this war in the first place.
Like many people, I have been consuming lots of Norman Finkelstein content lately, including his book on Gaza. According to Finkelstein and other critics of Israel, pre-war conditions in Gaza were beyond hellish. Finkelstein regularly calls it the “Gaza concentration camp.” And the phrase “open-air prison” has been used widely for over a decade.
Descriptions like this one, from Finkelstein’s book, seem to justify such terms:
If Gazans lacked electricity for as many as 16 hours each day; if Gazans received water only once a week for a few hours, and 80 percent of the water was unfit for human consumption; if one of every two Gazans was unemployed and “food insecure”; if 20 percent of “essential drugs” in Gaza were “at zero level” and more than 20 percent of patients suffering from cancer, heart disease, and other severe conditions were unable to get permits for medical care abroad—if Gazans clung to life by the thinnest of threads, it traced back, ultimately, to the Israeli siege.1
After reading these hellish descriptions, I decided to look up what are generally considered the best proxies for population-level health: (1) life expectancy at birth, (2) under-5 mortality, and (3) infant mortality.
I expected to find numbers that more or less gelled with Finkelstein’s picture of a “concentration camp” or “open-air prison”. To my surprise, I did not find that. What I found were numbers that make Gaza look like a typical developing nation.
According to the CIA World Factbook, 2023 life expectancy at birth in Gaza is 75.7 years. If Gaza were a country, that would put it in the 46 percentile of nations worldwide. If we instead consider all of humanity as one group (not separated by country), life expectancy on Earth in 2023 was 73 years, which would put Gaza well above the global average.
The CIA World Factbook puts infant mortality in Gaza at 14.9 (per 1,000). That would put it in the 43rd percentile of nations worldwide, and much better than the global average (which was 28 in 2021).
But let’s not blindly trust the CIA World Factbook. For one thing, you can’t double-check their work because they don’t reveal their sources. So let’s look at other sources––in particular Palestinian ones.
A paper authored by a scholar at the University of Gaza put life expectancy at 72.5 years in 2006 (admittedly dated). Comparing that to the UN’s data on global life expectancy between 2005-2010, Gaza would have been around the 50th percentile of nations at the time.
The Palestinian Central Bureau of Statistics (located in the West Bank), in partnership with UNICEF, the UN Population Fund, and the Arab League, did two extensive studies of Palestinian Health in 2006 and 2010––(dated by now, but still worth looking at). For the 2010 study, they interviewed 15,355 families in the West Bank and Gaza.
According to the 2010 study, Gaza had an under-5 mortality rate of 26.8 (per 1,000). At the time, the World Bank put the overall under-5 mortality rate for the Middle East and North Africa at 27.6––which would make Gaza slightly better than average for the region. Today, the global population average is around 38.
The same 2010 PCBS study puts Gaza’s infant mortality rate at 20.1 (per 1,000). If it were its own country, that would have put Gaza in the 45th percentile among nations at the time. The global average was 37 in 2010 and is 28 today. Either way, this suggests that Palestinians in Gaza were doing better than average relative to the world.
Finkelstein’s 500-page book about Gaza does not mention life expectancy or under-5 mortality––at least not that I could find. It does, however, cite one study about infant mortality among Palestinian refugees in Gaza, noting that it rose between 2008 and 2013. Let’s take the higher number from 2013, which was 22.4 (per 1,000), according to this study. If Gaza were a country, that would have put it in the 39th percentile among nations at the time. And looking at the world’s population as one group, that would put Palestinians in Gaza significantly above the global average, which was 34 in 2013, and was 28 in 2021.
(Update: Another Palestinian source published in Lancet puts infant mortality in 2009 at 21.5, in line with all the other data in this post.)
That’s all the data I could find (from prima facie credible sources) summarizing three of the basic proxy measures for population-level health. And these data converge on a similar picture: Gaza, if it were its own country, would be somewhere between the 39th and 50th percentile of nations in terms of living conditions––in the neighborhood of Egypt, Mexico and Vietnam (rather than, say, Haiti and Somalia). Furthermore, considering the world’s population as one group, the basic health conditions in Gaza appear to be significantly better than average according to every one of the above metrics, including the ones from Palestinian sources.
You’d be right to point out that the Palestinian sources cited in this post are dated by now (I could not find any after 2013). However, I’d reply that these sources are well within the period of Israeli-Egyptian blockade, and more importantly, they are well within the period that Gaza has been described as among the worst places on Earth. The trend of calling Gaza an “open-air prison” began with Prime Minister David Cameron’s comment way back in 2010. And Finkelstein’s apologia for the 10/7 Hamas fighters––who were presumably in their late teens and 20s––is that they were “born into a concentration camp” and have known nothing else–– which suggests that Gaza has been a concentration camp for almost two decades.
So either one of two things is true:
(1) These data are basically correct, and the (pre-war) conditions in Gaza were that of a middling developing nation. If true, the descriptions of Gaza as similar to a “concentration camp” or “open-air prison” begin to sound absurd. We should assume that the laundry list of facts seeming to support that picture stem from bad scholarship and/or cherry-picking. Surely, a “concentration camp” or “open-air prison” would not yield a population with health metrics above the global average––and on par with all the Arab nations surrounding it.
Or:
(2) The data here are wrong or misleading in some way. This is hardly impossible, considering how sparse they are to begin with. But if they are misleading, it would behoove Finkelstein and others who describe Gaza as a hellhole to explain in detail why these data––largely from Palestinian sources––are misleading.
My hunch is that (1) is the right interpretation. If nothing else, it would help explain this rather rosy Al-Jazeera segment from 2017.
Gaza: An Inquest into Its Martyrdom, Finkelstein, pg. 40.
You may have come across claims that Gaza is the most densely populated place in the world. I've been seeing it for years and sending in corrections, but it doesn't stop the claim, which is too tempting to make if your goal is to propagandize.
A New York Times story “Gaza is tiny, crowded and hard to escape” (Oct. 10, 2023, on their running blog on the war) qualified it a little, calling the Gaza Strip is "one of the most densely populated areas of the world." In fact, the population (2022) is 2,375,259 in 365 km2 for a density of 6,507/km2. About 20 cities in the NYC area alone are more densely populated. Gaza is about as densely populated as Cambridge, MA, which is not generally considered an overcrowded dystopia. I'm no longer seeing the claim made since early in the war, probably because too many people pointed out that it's nowhere near true. The Times stealth-edited the reference I pointed to.
Gaza may be "densely populated" as an abstract matter, making civilian casualties inevitable in a war. Still, many cities in Israel are much more densely populated (Bnei Brak is 30,000/km2), cities at which Hamas has been indiscriminately firing rockets for many years.
Thanks for doing this work to push back against the Finkelstein and Cameron narrative, Coleman! One commentator said it was a strange concentration camp with beaches and shopping malls. And enormous financial and messaging/propaganda support from the international community via the UN, particularly the UNRWA, the organization that has ensured Gazans are kept in refugee status since 1948 (the world’s only permanent refugees).
Defund the UNRWA is a cause to promote!