More than 40,000 Palestinians have been killed in Israel’s military campaign in the Gaza Strip, the local Health Ministry said Thursday — a bleak indicator of the war’s toll even as a full count remained out of reach amid a near-total collapse of the enclave’s health-care system.

The official figure of 40,005 killed since October does not distinguish between civilians and combatants. But the Gaza Health Ministry, which has operated for years under the Hamas-led government, says the majority of the dead are women and children. At least 92,401 have also been injured over more than 10 months of war.

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