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Over 60,000 Palestinians have been killed in the 21-month Israel-Hamas war, Gaza’s Health Ministry said Tuesday.

The ministry, part of the Hamas-run government, said the death toll has climbed to to 60,034, with another 145,870 people wounded since Hamas’ Oct. 7, 2023, attack.

It did not say how many were civilians or militants, but has said women and children make up around half the dead.

The ministry is staffed by medical professionals. The United Nations and other independent experts view its figures as the most reliable count of casualties.

Israel’s offensive has destroyed vast areas of Gaza, displaced around 90% of the population and caused to a catastrophic humanitarian crisis, with experts warning of famine.

Hamas-led militants killed some 1,200 people, mostly civilians, in the attack that sparked the war, and abducted another 251. They are still holding 50 captives, around 20 believed to be alive, after most of the rest were released in ceasefires or other deals.

The war took a major turn in early March when Israel imposed a complete 2 ½ month blockade, barring the entry of all food, medicine, fuel and other goods. Weeks later, Israel ended a ceasefire with a surprise bombardment and began seizing large areas of Gaza, measures it said were aimed at pressuring Hamas to release more hostages.

At least 8,867 Palestinians have been killed since then.