David Feldman (3:06)

David Dr. Faro Sidwa is a trauma general and critical care surgeon. He has volunteered twice in Gaza since 2024 and three times in Ukraine since 2022. He has published on humanitarian surgical work in the New York Times, Politico and the Journal of the American College of Surgeons. Welcome back to the Ralph Nader Radio Hour. Dr. Feroz Sidwa.

Dr. Firoz Sidwa (3:32)

Hi Dave, thanks for having me.

Ralph Nader (3:33)

Welcome indeed, Faroz and for our listeners, this is going to be a very special presentation by Dr. Sidwa on the factors involved in the massive death and injury undercount in Gaza since October 7th. And listeners should know that under international law, the Fourth Geneva Convention, if you conquer a territory of your opponent, you are required to protect them, to provide them with food, with health care. And what is happening in Gaza obviously is just the opposite. They're being blown apart every day and they're stripped of any kinds of health care and other protections, including having adequate water, food, electricity and fuel. I've made my point clear month after month that I believe the death toll is now well over 500,000. And it's important to have an accurate death toll to respect the Palestinian dead and, and to intensify diplomatic, political and civic pressures from around the world, and particularly from the White House and Congress to cease fire, to let the humanitarian trucks that are ready at the border in with food, medicine, water, hospital supplies and to make sure that this conflict is resolved safely, including allowing children who have been amputated, who've been burned horribly to be airlifted to ready enable hospitals in Europe and the United States and to open up Gaza to foreign journalists which have been blocked from chronicling the devastation and the genocide. With that background, Feroz educate all of us about the parameters of estimating death tolls and injury tolls.

Dr. Firoz Sidwa (5:24)

Yeah, thanks for the introduction, Ralph. I just want to say a few things before we get started. What I'm going to talk about, it's a lot of technical details about studies, so I hope people's eyes don't glaze over too much. But Ralph thought that this information from the medical literature and also from le, from non medical literature would be useful for people to know. But just some caveats to start with. The first is that right now we just don't know how many people have been killed in Gaza. And that I think is one of the most shocking things about this destruction and this, this assault on the territory. It's a territory of half children. It's been under siege for 17 years, and it's right in the heart of the most newsworthy region in the entire world, right next to one of the US's biggest allies in the region. And all of the weapons, everything that's being used to destroy the place, is coming from the United States. So that's why I think people should have an understanding of this, so that we can know what we're doing and we can maybe decide if we want to stop doing it. The second caveat I just want to make sure everybody understands is that how many people have been killed in Gaza and doesn't have anything to do with whether or not genocide is being carried out in Gaza. I'm not an international legal expert, so I personally don't try to make an opinion on that. But it certainly seems that every single international expert on the topic does think that this is a genocidal attack. So I don't see any reason to disbelieve what they're saying. But that doesn't have to do with how many people are killed. So what I'm just trying to point out is that even if the numbers of people that we talk about here today, or like Ralph said, half a million or whatever number of people have been killed, nobody disputes that huge numbers of mass killings have taken place. And it doesn't seem that anybody who knows what they're talking about disputes that it's genocidal. At this point, there's a few things about Gaza that people should understand. Even people who follow it closely may not fully appreciate the setting in which this violence is happening. So the Gaza Strip, it's the panhandle of the Sinai Peninsula. It's this very, very small geographic entity that was created in 1948 after the 1948 Arab Israeli War. And it's just an armistice line. There's nothing natural about the Gaza Strip. The border between it and Israel is just demarcated by a fence. If that fence wasn't there, you would have no way of knowing that you've walked in or out of the Gaza Strip. Like, even today, people in Gaza don't refer to the Gaza Strip as an entity. If somebody in Gaza says, I'm from Gaza, what they mean is, I'm from Gaza City. Otherwise they'll say, I'm from Khan Younis, I'm from Beit Lahia, I'm from Rafah, whatever it might be. No one says, I'm from the Gaza Strip because that's not a thing that exists. But in this territory called The Gaza Strip, it's been under siege, literal siege, for 17 years. It's been under Israeli military occupation for almost 60 years, and before that it was under Egyptian military occupation from 1949 onwards. From 1949 to 1967. During that time, from 1949 onwards, people who. And Norman Finkelstein has a good breakdown of this in his book that is upcoming soon, I think it's called Gaza's Gravediggers. But what he points out is that over and over and over again, American and Israeli diplomats, military personnel, all sorts of others who've gone to the Gaza Strip, not just since it was under Israeli military occupation, but even under Egyptian military occupation. So a long, long time ago, have repeatedly described Gaza as something like a concentration camp. One of the first people to do it was a guy, if I remember correctly. His name was Elm Burns. He was an American military fellow, fought in World War II. So he knows what a concentration camp is. The next very prominent person to do it was Al Gore's father when he was a senator, he had gone to the Gaza Strip just after the Israeli conquest in 1967. When he came back, he described Gaza and the Senate as something like a huge concentration camp. The next person was one of the Israeli new historians. He was the head of the sociology department at the Hebrew University of Jerusalem. His name was Baruch Kimmerling. And he described Gaza as the largest concentration camp ever to exist. And this was in 2001, if I remember correctly. And then a few Years later, in 2003 or 4, Yora Island. Who is the Israeli general, who, if people have heard of the general's plan for northern Gaza, Giora island, is the general that came up with it. He described Gaza as a huge concentration camp. So it's been very widely understood by lots and lots of people of a huge variety of political leanings, a huge variety of life experiences, of professions, et cetera, that this is the image that springs to mind when they go to the Gaza Strip. It's something like a gigantic concentration camp. And on October 6th of 2023, the day before the Hamas attack, what Gaza was, was a besieged territory. It had been under literal strict military siege for 17 years, which is about the same length of time that half of its population had been alive. Half of people in the Gaza Strip, 51%, were under the age of 18. On October 7th of 2023, 15% of the population was under the age of 5. This is extremely unusual in the world. I don't know if it's the youngest territory in the world, but it's among the youngest territories in the world. Since the early 2000s, Israel had had, with US backing, had a policy of restricting how much food can go into Gaza under what's called a starvation plus diet. In fact, the Israelis kind of regularly joked about it in Hebrew. They didn't publish it in English usually, but they would joke. What they would say is that we're putting the Palestinians on a diet. They said it was like an appointment with a dietitian. They'll get thinner but won't die. Repeatedly also, Gaza's entire food production system has been destroyed. The first time was the massive Israeli assault of 2008 and 9. That was called Operation Cast Lead. And during that attack, eastern Gaza is fertile and western Gaza is not. Western Gaza is basically a beach. Eastern Gaza is fertile land. That land was repeatedly destroyed by tracked vehicles just going back and forth over and over. No military reason for it at all. The soil was compacted and destroyed. That was done again in 2014. And after that, Sarah Roy, who's definitely the world's leading expert on the Gaza Strip and especially in its economy, wrote that that attack, the 2014 attack, Operation Protective Edge, had basically destroyed Gaza's economy completely. There was nothing left of it. And Gaza's economy was only fishing, agriculture and furniture building. So that's the situation that you're going into on October 6th of 2023. Well, obviously on October 7th, there's this big Hamas attack on southern Israel and then there's this massive air campaign that starts and then afterwards there's a huge Israeli ground invasion. And the consequences of that have been studied now by professional, medical and public investigators. I'm going to try and go through this systematically to explain what's going on. And you guys, please ask if there's anything I can clarify, please let me know. So the thing that we all read in the newspapers is what the Gaza Ministry of Health or the Hamas Ministry of Health, however people want to describe it, the Gaza Ministry of Health is more accurate, but who cares? We always read that they've reported this number of people, like I think it's about 62,000 dead today. The question is, where do those numbers come from? So if you look at kind of right wing or what are called pro Israel circles, they'll claim that these numbers are inflated. They're not reliable. Joe Biden, you said he had no confidence in them, et cetera, et cetera. Well, there are two academic level studies in of this question. The first was published, if I remember correctly, in the British Medical Journal. And the second was in the Lancet, which is the most prestigious medical journal in the world. The first one was done by a fellow named Hyun in 2024. And what they did was they took the Ministry of Health database. And they didn't just look at men, women, children, but they looked at it line by line, person by person. So Muhammad so and so was killed on this day. He's this old. And this is his Palestinian identification number, just like we have ID numbers on our licenses.

Ralph Nader (13:05)

Right.

Dr. Firoz Sidwa (13:06)

So they took that database and then they cross referenced it with the unrwa, which is a big UN agency in the Gaza Strip. It actually feeds clothes, educates a lot of people in Gaza, and they maintain a separate database of their own employees who have been killed. What they did was they compared the unrwa, the rate of death of people who work for unrwa, versus the rate of death in the Ministry of Health. And they also compared individual people on those lists, and they found that there's no reason to doubt the Ministry of Health numbers. In fact, they pointed out that the Ministry of Health numbers are probably under counting deaths compared to the unrwa.

Ralph Nader (13:42)

You're talking about the United Nations Group.

Dr. Firoz Sidwa (13:45)

Yes, exactly. The UN Relief and Works Agency. Exactly. UNRA or unrwa, however people want to pronounce it. So, in other words, that study showed that the Ministry of Health is not inflating their numbers. It's not just making them up from nowhere, et cetera, et cetera. The second study that was done was a little bit more sophisticated. It was done by a doctor at the London School of Hygiene. If I remember correctly, her last name is Jamal Uddin. This was done in late 2023. What they did was they looked at the Ministry of Health's death toll, again, line by line, person by person. And they said that there have been some periods in Gaza's history because normally ID numbers are just handed out one after the other. 101, 102, 103. Right. That's perfectly normal. But they said there have been some periods in Gaza's history. For example, right after a long Israeli war, like 2008 and 9, 2014, where during the war there were babies born but they weren't registered because it was just too dangerous to go to a hospital or to move around. So during those times, they then used a different set of numbers to give people IDs so that people didn't have overlapping IDs. And so they found people who had been killed in the Ministry of Health database. And they said, did people who have the birthdays that would be included in those separate types of those separate registration periods. Did they actually have those separate registration numbers? And in fact, they did. So in other words, it would be. Everybody in Gaza would have to know which dates of birth correspond to which unusual ID numbers in order to fake this data, which, again, is just totally ridiculous. You know, like, could the CIA maybe do it if they devoted 100 people for a year to doing it? Yeah, possibly. But the idea that Hamas is doing this in the middle of a war is very, very silly. So those are the two main studies about the Minister of Health data that come out of the medical literature. But there's a few others that I just want to mention because they're actually really important as well. The first was, it's not actually a study, but it was a mention in the Washington Post from 2024. The Post was looking at deaths that had not been recorded by the Ministry of Health. It's actually a very good article. It's in October of last year, if anybody wants to look it up. But they were looking at deaths of people in Gaza that they knew full well were dead, but who were not included in the Ministry of Health database. Usually it was because they were killed while people were evacuating, for example. So they were on a long trek from northern to southern Gaza. Especially somebody was killed. They just had to bury them and move on. And the only way you actually get counted in the Ministry of Health database is if you show up at a hospital or a morgue. That's the only way that you get onto that database. So they found that in one, Air wars, which is a British research firm that looks at how air attacks affect civilians in conflict zones, Air wars was able to confirm that even in the first 17 days of the attack, which is when the Minister of Health was at its best, Right, it was actually still functioning. Most of the hospitals in Gaza were still functioning. So just the first 17 days after October 7th, even then, 30% of deaths weren't being recorded by the Ministry of Health. So you already know it's a major undercount. Because when again, the Ministry of Health was at its best, you know, now almost every hospital in Gaza is out of service. It's been destroyed. And this has happened over and over and over again in Gaza. You know, the hospitals just keep getting obliterated. Even when the Ministry of Health was at its best, it was still undercounting violent deaths by 30%. The second thing I want to mention about that is a really. It's kind of a hard article to read, to be honest. It's by a group called Action on Armed Violence. And there was a moment last year, I believe it was early last year, I think, when the Ministry of Health revised some of its numbers downward. And of course, everybody, all these right wing people lost their minds and said, see, we knew they were lying. And you know, it's kind of, you have to ask, why would somebody revise their numbers if they're lying in the first place? That doesn't make any sense. But leaving that aside, what they did was they removed a large number of children. I think it was about a thousand children's names from the database. And the Ministry of Health said that we can't prove for certain that these children are dead. We believe they are, but we can't prove it. Well, the folks at Action Unarmed Violence actually went through and they were able to confirm, and I forget the exact numbers, but I think they were able to confirm that about 80% of those children were actually dead at this point.

Ralph Nader (18:01)

For listeners to realize that all these figures that are being presented reflect violent deaths from bombardment, artillery, snipers. They don't deal with the secondary effects of contaminated water. No food, disease, infectious disease, no health care, which is even a larger portion of the death tolls.

Dr. Firoz Sidwa (18:21)

Correct. This is all about violent deaths. We're definitely going to talk about what are usually called indirect causes of death in war, but in this, in this case, that's not an appropriate terminology. Not only are we still talking about violent deaths, but we're still just talking about the validity of the Ministry of Health's numbers. In other words, just trying to point out to people that the idea that the Ministry of Health is making up people who didn't die is just completely crazy. So like I said, there are these two studies in the medical literature that both show that, that every death that is on the Ministry of Health registry, with, you know, maybe some statistical exception, maybe one person here, one person there, mistakes happen when you're counting things, but with vanishingly few exceptions, everybody listed in the Ministry of Health database is dead and was killed by us Israeli violence. So that's one question out of the way. The Ministry of Health's numbers are perfectly reliable and everybody actually knows that. The people who pretend they don't know that are just lying to you. But the second question is, are the Ministry of Health numbers accurate? We know that each person on that list is actually dead, but are they actually counting most of the dead? And the answer to that is definitely not. There are two studies that address this question in the medical literature and there's a whole bunch in the non medical literature that we can get to, but the first study is by the same doctor in London who did the ID number based analysis of the Ministry of Health database, Dr. Jamal Ledeen. And in 2025, I think it was January, she published an article in the Lancet, which again is the most prestigious medical journal in the world, doing what's called a capture recapture analysis. And this is a well validated technique of statistical manipulation to figure out what the death toll is in places where it's very difficult to go on the ground and actually go from house to house to house and just ask people who died in this house recently, who died in this house recently. So what this capture recapture analysis is, is they took the Ministry of Health's database, then they took an online survey from the Ministry of Health in which they asked people, is there anyone in your household who has died but has not been brought to a hospital or a morgue for whatever reason? And then they also combed the Internet for news and social media obituaries of people. And again, like I said, the technical details don't matter that much. But those are the three lists that they compare. That's what's called a capture recapture analysis. And what they found is that again, just talking about violent deaths, the Ministry of Health is undercounting violent deaths by about 41%, which means that today the number of violent deaths in Gaza would be 104,000. The second study, it hasn't undergone peer review yet, but it's in that process, but it was pre printed ahead of time so that people could read it. The second one is a household survey. Now normally this is the gold standard for assessing the number of people who've died in a conflict zone. And just put very, very simply, you figure out where people are living in a certain territory, you go house to house and you, you know, you don't ask every single person, but you ask every 10th or 20th house, you sit down, you say how many people in this house were alive on October 6, how many are alive now, when did they die, how did they die, things like that. This has been done in every conflict zone on earth. And it's usually a very reliable way of determining how the overall level of death, not only from violence, but also from again, what are called indirect causes of war, starvation, displacement, homelessness, contaminated water, et cetera, et cetera. That study was done by a fellow named Michael Spigot, I believe is a political scientist, and it was pre Printed earlier this year as well. Now, this study also finds that violent deaths are being undercounted by the Ministry of health by about 40%. So this is like the baseline of what I want people to understand. Nobody should say at least 60,000 people have been killed in Gaza. That's the Ministry of Health number. What people should be saying is that at least 100,000 people have died of violence in Gaza. That is absolutely indisputable per the medical literature. Now the question is, is that number accurate? Is 100,000 accurate? Well, there's actually a major problem with both of these studies, and I don't want to impugn the researchers themselves. They were doing the best they could with what they had. But there is a major problem with both of these studies. The first one, the capture, recapture analysis, the problem with this study is that to be counted on any of the three lists that they use, you either have to have access to a hospital in Gaza or the Internet. And everything we see from Gaza, I mean, not me, because I've been there, but everybody else. Everything you see from Gaza is something that someone filmed on their phone. Like 99.9% of it. Like when the media overflew with the airdrops and you could see the air, you know that, okay, that was filmed on a media camera, sure. But almost everything else comes from someone's phone. So the impression that gives everybody is that everyone in Gaza has a phone that's fully charged. They have it. And. No, that's absolutely incorrect. In fact, the number one thing that even physicians who remember are pretty privileged are relatively privileged people in the. In the society, even physicians. The number one thing they all ask me to bring them when I come to Gaza is a phone, because they're usually the only person in their family that has one. One of them, the first things the Israelis actually do when they capture anybody is, is they take and you often destroy their phone. The availability of phones in Gaza is actually not as high as it certainly was before October 7th, and it's nowhere near as high as you get the impression of from scrolling through Instagram. The second issue there is that Internet access is extreme, especially cellular Internet access. Cellular data is extremely hard to get in Gaza. The Palestinian, I think it's called palnet, if I remember correctly. The Palestinian cell network is only up for about an hour every day in the morning. And it's only cellular connection. It's not a data connection at all. People desperately call each other, just try to make sure everyone in their family is alive. And then the Cell connection gets cut. Again, there are a few places, actually. It's mostly hospitals and the media tents that the Israelis keep destroying, or like the seaside cafe that they bombed the other day. There are a few places that still have Internet connection, either based on a connection to an Israeli cell tower or based on a satellite link that existed before October 7th. But those places are just systematically being destroyed. Like, I'm pretty sure, I can't prove it, obviously, but I'm pretty sure, for example, that that's why the Israelis keep killing these journalists in their tents, because in their tents they actually have Internet access. And they're just. They're getting the added benefit of destroying that equipment, which obviously can't be replaced while the territory is under siege like it is. So that's the major problem with the Jamal Ad Din study, which is that to be counted on one of those lists, you have to be able to access a hospital or access the Internet. And that is just not the case for a lot of Gaza. I don't know if it's the majority. Nobody has any idea, but a lot of people in Gaza have no access to the Internet and no access to a hospital. So they can't get onto one of those lists even when their family member dies or they die. The problem with Dr. Spagat's study, and again, this is not to impugn them, they did the best they could with what they had. And again, the full thing hasn't been published because it hasn't gone through peer review yet. Maybe the finer details are not as well known. But in their methods section, what they say is that their researchers were only able to interview people in Khan Younis and Deir el Bolla. Those are the two cities right in the middle of Gaza. So Gaza City to the north of that, and then to the north of that, Bayt Lahia and the other environs north of Gaza, what was what used to be called Northern Gaza and then also Rafah, those areas that they couldn't go to make up about 80% of Gaza. So they tried to make up for this by saying, okay, well, we're going to interview people who are in shelters in Khan Yunis and Deir El Bollah, but are from Gaza City, from Beit Lahiya, from Beit Hanun, from Rafah. But that obviously raises a major problem. Obviously, the people who are stuck in Gaza City are stuck in Beit Lahiya and surrounded by Israeli troops and suffering under bombardment and have received no food for months and months at this point, no water, nothing. Obviously they are much more vulnerable to death than the people who did make it down to Khan Yunis. Right. So those are the two major problems with both of those studies, is that it's basically a sampling problem. And again, just, just to be clear, the researchers did the best they could, but these are huge limitations to these studies. And that's why I'm very comfortable saying that their conclusions that again, the Ministry of Health violent death toll is a 40% undercount. What we should say is it's at least a 40% undercount.

Ralph Nader (26:32)

And.

Dr. Firoz Sidwa (26:33)

And it's almost certainly a much bigger undercount than that. And then the next thing that I just want people to understand is how much of an impact this war has had, even if you just go by the Ministry of Health's numbers. Another study done in the Lancet by a fellow named Gillot published this year as well, showed that the decrease in life expectancy in Gaza is 40 to 50% just because of violent deaths. Forget everything else, right? That is absolutely insane. That has never happened in any other war zone. That is such a massive drop. It's just totally unprecedented. So again, just to emphasize that is going by the Ministry of Health numbers, not going by the actual numbers that you could get, say, from these two studies that I just mentioned, and certainly not going by the real numbers, which are unknown. So just what we're describing has had such an incredible impact on Gaza. And now, like Ralph was just saying, we want to get to the question of. Everything we've talked about so far was violent deaths, deaths from Israeli, us, Israeli bombs, bullets, et cetera. The next question is what are normally called indirect deaths in the public health literature. So like I said, deaths from starvation, from displacement, from homelessness, from disease, et cetera, et cetera. Well, there's only one real estimate of that, and that comes from Dr. Spigot's study and what he estimates is 8,500 excess deaths since October of 2023. Now, everybody that I have talked to finds this to be utterly absurd. And the reason for it is exactly what I mentioned before, which is that he was only able to interview people in the least vulnerable parts of Gaza. Khan Yunis and Dir. Albulla, the people in this area are the people who are least affected by this assault, by the starvation, by the displacement, by the lack of clean, clean water, by the destruction of the healthcare system, et cetera, et cetera. So I just want to point a few things out to people quickly. According to Oxfam, 70% of Gaza's sewage pumps have been destroyed. And 100% of its wastewater treatment plants have been destroyed. According to survey data, the World Health Organization and plenty of other places. 25% of people in Gaza at any given time have diarrhea. And this was, this was last year. Now it's almost certainly worse. And I don't just mean they have the runs. I mean they have, you know, serious diarrhea, which is going to continuously dehydrate them. And again, remember, they have no access to clean water. 50% of people in Gaza have a productive cough, which is a sign of, again, a weakening immune, quickly weakening immune system. 20% of people in Gaza had no access to any, any kind of toilet, not even a shared latrine, and they just literally had to defecate in the street. And 1/5 of people in Gaza had no access to soap. Okay, 94% of the water that used to come into Gaza is gone. What Oxfam estimates is that since October 7th through June of last year, and certainly decreased since then, There were only 4.7 liters of water available to every person every day in Gaza. And that's not for drinking. That's for drinking, cooking, cleaning, bathing, toileting, everything that human beings use. Water for.1% of the, what's called the water, sanitation and hygiene infrastructure in Gaza, 1% of it has been destroyed every day since October 7th. There's no water. Laboratory testing and waterborne disease, which was already the number one killer of children in Gaza before October 7th, has skyrocketed. It's gone up several orders of magnitude in how widespread it is. 96% of households are water insecure, meaning they have nowhere to actually get water. And so then, according to the un, shelter clusters, that's the people that look at housing, basically 34% of housing in Gaza is completely destroyed, meaning the building just does not exist anymore. 60% of the housing in Gaza is so badly damaged as to be uninhabitable. And I personally saw that people are still living in these uninhabitable structures, but it's not, you know, it hardly provides any shelter. And 1.4 million people are in need of emergency shelter and have been for almost two years. A study done at the Hebrew University of Jerusalem by an Israeli researcher named Adi Ben Nunn shows that 70% of buildings in Gaza, which is. This is a much higher estimate than the UN's. 70% of buildings in Gaza are damaged or destroyed to the point of being uninhabitable. And he says even that is almost certainly an underestimate, because he's basing it on satellite data, whereas when you look at the overflights that were just done in the footage that came out from them, it actually seems to be much, much worse than that. And then getting specifically to starvation. There are two articles that have looked at weight loss in the Gaza Strip since October 7, 2023. The first one was published by a fellow named al Nabi. In 2024. He looked at people in northern Gaza, so the environs north of Gaza City, Bid Lahiya, Beit Hanun, places like that. And this was done in April of last year. So more than a year ago, about a year and a half ago now. And in April of last year, the average weight of a person that they interviewed, these are adults, by the way, and had dropped from 85 kilos to 66 kilos, a 19 kilogram drop. Right. That's huge. That is absolutely enormous. And again, this was more than a year ago. The second one was published a little bit later in 2024. They interviewed people throughout the Gaza Strip and they found that 98% were severely food insecure and the average weight had dropped 10 kilos. So again, a 10 to 20 kilo weight drop for the population as a whole. But you have to remember that starvation never affects an entire population equally. It's not like everybody is losing weight at the same rate. Just to give you a personal example, I met a nurse named Mohammed when I was at Nasser Medical Complex last year. And he had four boys. I think. I think it was four boys, four children, all of whom were boys. And when we went to his house, which had been destroyed, and he was lucky that he still had a physical structure to live in, I noticed that his youngest son, who I think had just turned five or six, his youngest son was much, much smaller than he should have been. The rest of the kids were about normal, maybe a little bit on the smaller side. But his youngest son was much, much smaller. And I asked him, have you noticed that your son is so much smaller? He said, yes, he has had gastroenteritis, meaning diarrhea, about 50 times since October 7th. 50 different episodes of this. Now, of course, that is going to continuously SAP this one child. Now, the older kids happen to be robust enough that they can, even though they're interacting with this child and cleaning his poop and all sorts of stuff, that their bodies are healthy enough to resist that virus or that bacteria that's causing him to get sick over and over again. But this small child can't, no matter what you do, right? Because we don't have the antibiotics needed, the food needed, the IV rehydration, all of that's not available in Gaza even to a nurse that works in the hospital. And this is what explains why some people die of starvation while others, even in the same family, seem to be, you know, at least visibly from the outside, seem to be okay. And then when Alex De Waal, who is the leading expert on famine, at least in the United States, he's the president of Tufts World Peace foundation or something like that, he wrote a blog in which he went through all of the estimates that have been given for starvation in Gaza. And what he said is that, and again, this was in the middle of last year. What he said was that it does not make sense to believe that fewer than tens of thousands of people have died of starvation related causes in Gaza. And again, this I want to emphasize, this was last year. This is not something that just started happening now. People might say, well, you know, I'm only starting to hear about this now, right? Like we heard about some cases last year. But one thing to remember is that in every starvation zone that's ever been studied, the number of starvation deaths that are captured by the medical system, and that's what's being reported publicly, the number of deaths that are actually reported by the medical system and is less than a tenth of what is actually found when you do household surveys later. Right? And that kind of makes sense because being starved to death and having access to good healthcare don't go hand in hand. Those are not two things that you can normally have at the same time. The nutrition cluster, it's another part of the UN estimates that 92% of children under 23 months, so two years and younger and pregnant breastfeeding women do not meet their nutritional requirements. And this is imposing a major, major problem in Gaza. Birth rates seem to have decreased by about 40% in the last. And then on top of that, and still talking about indirect deaths on top of that, nobody has been able to estimate the number of deaths because of lack of treatment for chronic diseases. So like if you had end stage renal disease and you needed dialysis on October 6th of 2023, good luck getting that now. Right? There's just nowhere near enough of it. Even when people can access dialysis, it's usually about once a week because it's just for obvious reasons, they have to spread the treatment around as much as they can. And then the other thing is that the whole health care system has been completely destroyed. It's basically doesn't exist anymore.

Ralph Nader (35:23)

Just to get some numbers, about 45,000 people in Gaza before October 7th were serious diabetics needing insulin, and there were 75,000 with serious cancer receiving some sort of medicine. What kind of survival rate if you can't have insulin, you're a diabetic?

Dr. Firoz Sidwa (35:41)

Nobody knows, because no one has ever studied the question of what happens if you let people develop diabetes and, and then take all of their food and medicine away. That's just not a thing that is normally done. So, honestly, nobody has any clue how many of these people are still alive. We saw lots and lots of diabetic foot ulcers in Gaza. So, for example, a person who has bad diabetes, they're not going to heal a wound on their foot very well. If you have a family member with diabetes, you might have experienced this. But now these people are being forced to walk miles and miles and miles and miles on a moment's notice in sandals and over rubble and with ordinance and just filthy streets, et cetera, et cetera. And it's not surprising that they're getting ulcers on their foot, which they literally cannot heal. Well, they need constant good wound care, which again, is just not available. So a lot of these people are certainly dying of sepsis, but nobody has any clue. You know, but then just the last point I was going to make about this is that nobody has any idea how many people have died from a lack of treatment of chronic diseases, but also acute diseases. Right. Like kids in, in Gaza still get asthma. They still have asthma attacks. People die of. Children die of asthma attacks in the United States. Not on mass, obviously, but like they do. People still get appendicitis, they still get cholecystitis, they still get cancer, like Ralph mentioned. They still get diarrhea like we've talked about. They still get pneumonia like we've talked about. All of the normal diseases that affect human health are still happening to people in the Gaza Strip. So all of that was to say that Dr. Svigat's estimate of 8,500 indirect deaths in the last two years on the Gaza Strip is ludicrous.

Ralph Nader (37:11)

Let's not forget the daily bombardments, blowing up buildings with huge air pollution, all kinds of toxics and particulates that people and children and babies are breathing, whether they have asthma or not. The incidence of respiratory ailment must be staggering.

Dr. Firoz Sidwa (37:28)

Yeah, you know, I'll tell you. And again, nobody studied it, so nobody knows. But when you come back from Gaza, like, again, I've been there twice, when you come back, you're coughing up black crack for about a week. Again, it's pretty dramatic. Now, nobody there is physically bothered by it at all, but it's obviously affecting their biology. There's no doubt about that. So all of this was to say that. I just want people to understand one thing. If we wanted to know how many people we have killed in Gaza through various means, we could find out in about two weeks. And by spending about $10,000, it's such an easy study to do. I just want people to know that is not an exaggeration. Two weeks, $10,000 is all it would take. That is an easy two weeks.

Ralph Nader (38:08)

$10,000. Elaborate that well.

Dr. Firoz Sidwa (38:11)

Yeah. So all you have to do is design a household study that actually does go throughout Gaza and does interview people everywhere that they're living. The reason this isn't happening is because Israel will not allow researchers to go into Gaza. And even if there are some people in Gaza who can conduct the field research while us, you know, fancy folks sit in the west and analyze the data and get credit for it, there's no freedom of movement in the Gaza Strip even for a deconflicted research team, right? So this team can't go from household to household in Gaza City, in Bait Lahia, in Rafah, because they'll just be killed. These are closed military zones, just like what happens when people try to access the Gaza Humanitarian Foundation. They're going into a closed military zone and they're shot down by the hundreds. If the US Or Israel cared at all about how many people, including, remember this is a territory that is half children. If we cared how many people, including children, we have starved to death, have shot dead, have blown up, et cetera, we could figure it out in two weeks. And with 10 grand, the Israelis wouldn't even have to stop their assault. They could keep doing it. They could just agree to deconflict this group of a few people. But they won't do it for obvious reasons, and I shouldn't say they we won't do it for obvious reasons. We could force them to.

Ralph Nader (39:23)

Let's put this in a little larger context. You know, there have been all kinds of estimates of the slaughter in Rwanda that they didn't have detailed data or names. They estimated about 800,000 killed in that genocide. There's no problem estimating deaths and injuries in Ukraine. They even estimate without any real detail that 500,000 people were killed under the civil war and the dictatorship of Assad in Syria and so forth. So people might be listening to this program. People listening to this program. I wonder what's going on in Gaza. Well, what's going on is that Hamas is not interested in an accurate figure because they don't want to arouse the hatred and assaults of their own people for not protecting them, not providing them with air raid shelters or safe rooms or anything. They have no homes. They're all out in the open or in tents. And of course, Netanyahu loves an undercount because that reduces the intensity of coverage of the size of the genocide. And of course, Biden and Trump had no problem with an undercount, and the press didn't unleash its investigatory analysis, as you're hearing on this program, in order to come up with more reasonable range of estimates. Ted Posto, who we are interviewing on this program, who's an expert on devastation from bombs and missiles, retired professor, mit, said, well, we don't really know the figures, but hundreds and hundreds of thousands. And he said 3004-005000-00100,000 people and children have died easily. He used the word easily. So that is why we're having so much difficulty since October 7th in coming up with estimates that, that everybody covering other conflict zones didn't have to deal with because all the parties on both sides want an undercount. And what you're proposing for OZ is a simple household study, maybe with three people, you said, who can conduct this in a scientific manner. If they were protected.

Dr. Firoz Sidwa (41:30)

Yeah, if Israel just agreed not to kill them or if the US Told the Israelis not to kill them, either one would work.

Ralph Nader (41:35)

Now, you focused on the lack of accurate estimates for injuries. I think once when you came back from Gaza, you mentioned that just about everybody in Gaza is either sick, injured or dying. Explain the under kind of injuries.

Dr. Firoz Sidwa (41:50)

Yeah. So this depends on how you define an injury, which I know seems cheeky, but just think about it in this way. At any time an attack is carried out in Israel, the number of casualties, which means fatalities and injuries, casualties includes both. The number of casualties includes people who had mental health issues because of the attack. And I think that's probably appropriate. Right? I mean, if somebody has a panic attack, if somebody is, you know, just beside themselves and they need actual medical care for that, it seems reasonable to include them as, as part of the injured. Can you imagine doing that in Gaza? That would mean that every single human being in Gaza is injured every single day. It's completely crazy. And again, it's a territory of half children. Let me just give you an example. I met a cardiologist at Nasser Medical Complex. I forget his name now. He was describing something that had happened just the day before I met him, that he lived in Rafah because Rafa still existed at the time. And some bullets from the Philadelphia corridor were fired into his apartment. So he and his, I think he and his wife and his three children all hit the deck, right? But his four year old daughter just kept dancing in a circle and just singing to her. She's ta da da na. She's just amusing herself like little kids do. And so mom and dad looked at her and said, you know, sweetie, what are you doing? Come here, come here, get down. And she said, no, mommy, look, the bullets are all the way up there. Don't worry. They're all like the bullets were hitting above their refrigerator, you know, Mommy, the bullets are all the way up there. Don't worry. And like, in other words, this kid, if you think about it, a four year old child, has no conscious memories other than of this assault, right? So this kid, she's so used to bullets and bombing and et cetera, et cetera. It's like how a kid can walk into traffic if they live in New York City because they're just used to traffic. So they forget that it's dangerous. You know, she's forgotten that bullets are dangerous. I'll give you another example. One of my friends in Gazi, he's an anesthesiologist named Nazar. He's a very sweet man. He has five or six boys, I can't remember. Now, his youngest one is named Keenan. And he asked his son, he texted me this the other day. He asked his son, Keenan, tell me the different types of birds, you know, and you know what his answer was? His answer was Apache helicopter, F16, F35 and drone. What Nizar texted me after is, he says, he said, when Keenan grows up, how will I teach him?

Ralph Nader (44:04)

Talk about the long range stunting of these little kids, assuming they survive.

Dr. Firoz Sidwa (44:09)

Yeah. So just so everyone understands, it's nobody again, like I said, nobody has any idea how many people have actually been starved to death in Gaza. But the important thing to understand is that starvation is happening to literally everyone in Gaza. Everyone is now losing weight, with maybe some exception somewhere, but literally everyone is losing weight. And the reason is there just is no food. There's a bunch of food a mile away. Like there's a bunch of food waiting to be brought in. In fact, there's so much food waiting to be brought in that a lot of it's spoiling and having, having to be destroyed because it's been sitting out in the Jordanian sun for so long on trucks. But literally at this point, everyone in Gaza is severely malnourished. And what that means is that these children who again, even before October 7th were not eating normally. This is really important for people to understand, but they weren't starving to death. You know, stunting was already a big problem in Gaza before October 7th. Vitamin deficiencies, anemias, these were all very common nutritional problems in Gaza because of Israel's restrictions on farming in Gaza, fishing in Gaza and the import of humanitarian aid. But after October 7th, it's just been skyrocketed. So most of Gaza's population has been hungry and losing weight for basically since October 7th. And again half of the population is kids and 15% of the population is kids under 5. Their brains are still developing. There's, you know, so these kids, a lot of them, even what they have been eating is just flour or rice for a year, year and a half. They've had no protein, they've had no significant source of fat, especially not of essential fat, essential amino acids and essential fatty acids. And that is causing a huge problem for just the normal development of their brain and then of course their growth to a normal height there. But it's going to cause a huge problem. On top of that, the, the destruction of families in Gaza is so extensive, the number of orphans is so enormous that you're creating a, you're just creating a huge underclass of people who are going to be extremely stunted in their mental and physical capacities who are going to have no family structure to rely on. And it's outrageous. I mean, it's just, it's a crime. This is such a multi layered crime that is going to have effects for so long in the future. And I just want to make sure everyone understands it's not Israel doing it, it's us. We are doing this. Without our support, the Israelis can't do any of these things. It's a US Israeli project and we can stop it tomorrow. Alex De Waal had a good line the other day. He's that expert on famine that I mentioned. He said if Israel, you should have said the US and Israel, if the US and Israel decide that they want every kid in Gaza to eat breakfast tomorrow, the UN can make that happen, but they're refusing because of all the.

Ralph Nader (46:47)

Trucks ready on the border just a few miles away. Listeners, we're going to get a copy of Dr. Sidwa's survey proposal that could get a closer estimate of the death and serious injury toll in Gaza. And by the way, there were three researchers who are skilled in disaster estimates. Had a page in Lancet over a year ago where they said the lowest estimate of total deaths in Gaza was just under 200,000, and they thought it could be much higher. And that was over a year ago. Firoz, talk about the severe undercount of serious injuries in Gaza.

Dr. Firoz Sidwa (47:23)

Yeah, the serious injuries in Gaza are also likely, very, very much undercounted. But also, you know, they're not even really categorized by the Ministry of Health is one of the other issues, because, again, I just don't think they have the capacity to do it. The huge numbers of amputated children that are just totally unheard of in the world. Gaza has more children with amputations per person than any place in the world. But I would bet even in absolute terms, Gaza has more child amputees than anywhere else in the world. You're talking about thousands and thousands of children that have a limb missing. You know, it just goes on and on from there.

Ralph Nader (47:56)

It goes on. Even these 15 people who make up the Hamas Ministry of Health are reported to be starving and so weak they may not be able to continue their work.

Dr. Firoz Sidwa (48:08)

Everyone in Gaza is starving right now. And this is another thing that Alex de Waal points out. The intensity of the starvation in Gaza, meaning how widely spread it is, is completely unheard of. There is no place other than, again, just going back to the analogy that people kept repeating it that I mentioned at the beginning, other than a concentration camp, it is very hard to starve an entire population all at the same time. That's a very difficult thing to do unless you have them in a cage, which is what Gaza is.

Ralph Nader (48:36)

And Trump can change this with one phone call to Netanyahu could have changed.

Dr. Firoz Sidwa (48:41)

Trump can change it, absolutely. But we have to remember that they're not going to unless we force them to. We can bemoan the moral depravity of Donald Trump and Joe Biden all we want. The fact of the matter is, if we Americans need to get politically organized and we need to create a country where we are actually in control of our own government, because the vast majority of Americans are staunchly opposed to this. And a few who aren't just don't know what's happening, no rational human being would ever be in favor of what's being done to Gaza.

Ralph Nader (49:10)

And for those who want to give their opinion to Donald Trump, there is a White House call center, which we will give you that you can call and register your opinion. So, you know, people in the White House see that there's a throbbing pulse of outrage here that is being conveyed directly to the White House, the belly of the beast along with Congress that is making this massive mass murder, genocide continue day after day. Well, thank you very much, Firoz Sidwa. We've been talking with Dr. Faroz Sidva who's been over to Gaza as a volunteer in the semi destroyed Gaza hospital system. He's also developed a network of other American health workers and doctors back from Gaza. He's put letters to Joe Biden twice without any acknowledgment signed by dozens of these dedicated people. And he's continually pursuing the highest ideals of the medical profession. Thank you very much, Feroz.

Dr. Firoz Sidwa (50:11)

Thank you all.

Steve Scrovan (50:12)

We've been speaking with Dr. Faroz Sidwell. We will link to his work@ralphneiderradiohour.com up next, we welcome back weapons expert Theodore Postol to give us his estimate of of the Gaza death count. But before we do that, let's hear from our corporate crime reporter, Russell Mokhiber.

Russell Mokhiber (50:27)

From the National Press building in Washington, D.C. this year. Corporate crime reporter Morning Minute for Friday, August 15, 2025. I'm Russell Mulkheimer. Communities across the United States are rising up against the tech industry's plans to build massive data centers that consume voluminous local water supplies. The data centers are needed to feed an insatiable artificial intelligence machine. More than $60 billion in data center projects have been blocked or delayed by this growing wave of local bipartisan opposition. That's according to a report from Data Center Watch. What was once just infrastructure is now a national flashpoint and communities are pushing back, the group says. Just last week, the Tucson City Council voted unanimously to reject the building of Project Blue Blue, a massive data center tied to Amazon. Opposition to data center development cuts across political lines. For the corporate crime reporter, I'm Russell Mulciber.

Steve Scrovan (51:26)

Thank you, Russell. Welcome back to the Ralph Nader Radio Hour. I'm Steve Scrovan along with David Feldman, Hannah and Ralph. Now a weapons expert gives us his estimate of the Gaza death toll.

David Feldman (51:36)

David Theodore Postal is professor of science, technology and national Security Policy emeritus in the Program in Science, Technology and Society at MIT. In 2016, he received the Garwin Prize from the Federation of American Scientists for his work in assessing and critiquing the government's claims about missile defenses. Welcome back to the Ralph Nader Radio Hour Theater.

Theodore Postol (52:01)

Postal, Very nice to be here. Thank you for having me.

Ralph Nader (52:05)

Welcome indeed. Well, we're focusing on one major level of massive undercount of the Deaths and injuries in Gaza since day one. I got alerted to this, Ted, when I heard that the Assistant Secretary of State for Biden testified for Congress. She was asked about the casualties just a few weeks after October 7th, and she said our casualty estimates are higher than Hamas. Well, that opened a lot of eyes and it also closed her from every mentioning that again. But you are the expert on the destructive power of whatever munitions the Israeli genocide is using and we'd like to get your view on what range of estimates you think are plausible here.

Theodore Postol (52:49)

I don't want to overstate my expertise here. There are others who have expertise too. But you know, I do have some background and for example, we can take a very simple fact. In June of 2021, we had a 12 story apartment building in Florida, which of course was not in the combat zone, collapse. And 98 people were verified dead there and they couldn't even identify. They had to use DNA techniques to identify many of the people with people who were believed to have been lost. So that's a single 12 story building, hundred people in that building. And imagining that there are a thousand such buildings destroyed that way in Gaza, which certainly plausible, I mean big buildings like this, you can see the aerial photographs of the ground where you see all these buildings that are large, multi story buildings that are basically collapsed, just piles of debris. Now the people in those buildings, where were they when the buildings were collapsed? Well, they weren't on the streets because you take shelter in some way. I don't know what you do, you go into a stairwell, which is a prudent thing to do if the building is not going to collapse. But if the building is totally collapsed, the stairwell doesn't help you much. And just from that alone, that exercise, you could imagine 100,000 people dead or more just from looking at the debris. Where are these people? Where were they? Where could they have gone? And I honestly can't say that I know, but what I can say is that it's highly plausible, in fact probable. I would say that 200, 300 or 400,000 people are dead. Easily. Easily. There is no infrastructure, there are no shelters, there's no place for them to have gone when these attacks occurred. All you can, if you look at the photographs of these buildings under attack and then look at the before and after photographs, they're just rubble, easily. In a city of 2.3 million people, there were some cases you could see, you know, photographic evidence of big fires in areas of Gaza when multiple attacks occurred.

Ralph Nader (55:05)

And no water to put them out, no water and no fire trucks.

Theodore Postol (55:09)

Once you have a mass fire, if you're inside the fire zone, you're dead. We know that from lots of data we have. Once you have a mass fire, the fire generates its own fire winds. No place to hide. The combustion is enhanced by the fire winds that are generated by the buoyantly rising hot air. Nobody lives through that, you know, just simply, it's a death trap. So anywhere there were mass fires, you can assume that essentially everybody inside the fire zone perished. But the collapse of buildings, I mean, a big building has an enormous amount of weight per unit area on each floor. So if the floor above you comes down, even if there aren't floors above it and there are floors above it, you're almost certainly at a minimum trapped. And most likely you're crushed or dead. But if you were unfortunate enough, and I say unfortunate enough to be trapped in a cavity, you're dead anyway. You're just going to die from exposure. And there's no water, there's no air, there's, you know. So when you have a large building collapse, everyone is going to be dead unless they're out of the building. It's just that simple. And even when you have large buildings collapse and you have people coming in to search for people, you typically only find a few people who happen to have been lucky enough to be trapped in a cavity that's near a surface area of the rubble heap. If you're deep in the rubble deep, your chances of surviving are near zero.

Ralph Nader (56:42)

Thank you very much, Professor Ted Postal, for coming on and sharing your views on the vast death and injury undercount in Gaza.

Theodore Postol (56:50)

Well, thank you very much for having me. I'm sorry I can't do more than just talk.

Steve Scrovan (56:56)

I want to thank Our guest again, Dr. Farouz Sidwa and Ted Postle. For those of you listening on the radio, that's our show. The you podcast listeners, stay tuned for some bonus material and we got a lot of it. We call that the wrap up featuring Francesco de Santis with in case you haven't heard, a transcript of this program will appear on the Ralph Nader Radio Hour substack site soon after the episode is posted.

David Feldman (57:17)

Subscribe to us on our Ralph Nader Radio Hour YouTube channel and for Ralph's weekly column. It's free@nader.org for more from Russell Mokheimer.

Steve Scrovan (57:27)

It'S@Corporatecrimereporter.Com the American Museum of Tort Law has gone virtual. You can visit tortmuseum.org to explore the exhibits. Take a virtual tour and learn about iconic tort cases from history.

David Feldman (57:39)

To order your copy of the Capitol Hill Citizen Democracy Dies in Broad Daylight. It's@capitol hillcitizen.com and remember to continue the.

Steve Scrovan (57:49)

Conversation after each program. You can go to the comments section@ralphnaderradiohour.com and post a comment or question on this week's episode.

David Feldman (57:57)

The producers of the Ralph Nader Radio Hour are Jimmy Lee Wirt, Hannah Feldman and Matthew Marin. Our executive producer is Alan Minsky.

Steve Scrovan (58:05)

Our theme music, stand Up, Rise up, was written and performed by Kemp Harris. Our proofreader is Elizabeth Solomon.

David Feldman (58:10)

Join us next week on the Ralph Nader Radio Hour. Thank you, Ralph.

Ralph Nader (58:15)

Thank you, everybody. Hi, this is Willie Nelson.

Dr. Firoz Sidwa (58:21)

You're listening to Radical Free Speech Radio.

David Feldman (58:24)

KPFK in Los Angeles.

Dr. Firoz Sidwa (58:28)

This is John Crumshow with a special politics or Pedagogy education report. Glad to be back with Dr. Freddy Perez. He's an optometrist in Los Angeles. Welcome to Politics for Pedagogy.

John Crumshow (58:39)

Thank you, John. Glad to be here. My first two years of college, I wanted to be a high school teacher. Then that was interrupted after two years of undergraduate by the military service during Vietnam War. I just went ahead and joined the Marine Corps and I spent four years in the Marine. Then I came back and visit my family. I will go back to my high school and say hi to my old teachers there. And the more I went back, the more I realized I saw the degradation of the quality of the students, how they treated the teachers and that kind of thing. And the more I thought of the idea do I really want to become a teacher? So one day I have worn glasses since I was 7 years old. I asked my my optometrist in New York City how do I become an optometrist? And and he says, well, you know, you have to finish your undergraduate school, in your case will be two more years and then you apply to optometry school and that would be another four more years. And he and I, I said, well, that I, I'll would you give me a letter of recommendation once I'm able to apply for optometry school? He said, sure, I could do that, no problem. And I went ahead and started the process of getting my undergraduate two more years, which I got at Portland State University in Oregon. And then when time came to apply to optometry school, I did write Dr. Dick.