Nearly 100 Palestinians have died in Israeli custody since the start of the Gaza war, according to a Monday report by a human rights group that attributes many of the deaths to systematic violence and denial of medical care in Israeli prisons and detention centers.

The picture that emerges from the report by Physicians for Human Rights-Israel is consistent with findings by The Associated Press, which interviewed more than a dozen people about prison abuses, medical neglect and deaths, analyzed available data, and reviewed reports of autopsies.

Of the 98 prisoner deaths PHRI documented since the Oct. 7, 2023, Hamas incursion that ignited the war, 27 occurred in 2023, 50 in 2024 and 21 this year, the most recent on Nov. 2. PHRI says the actual death toll over this timeframe is "likely significantly higher," noting that Israel has refused to provide information about hundreds of Palestinians detained during the war.

Fewer than 30 Palestinians died in Israeli custody in the 10 years preceding the war, PHRI says. But since the war, the prison population more than doubled to 11,000 as people were rounded up, mainly from Gaza and the West Bank. The number of prisoners dying grew at an even faster rate over that period, PHRI data shows.

PHRI documented deaths by interviewing former detainees and prison medical staff, examining reports prepared by doctors who observed autopsies at the behest of dead prisoners’ families, and confirming dozens of fatalities through freedom of information requests.

"The alarming rate at which people are killed in Israeli custody reveals a system that has lost all moral and professional restraint,” said Naji Abbas, a director at PHRI.

Last year, the head of Israel’s prison system, National Security Minister Itamar Ben-Gvir, boasted that he had degraded prison conditions to the legal minimum. Under pressure from rights groups, conditions improved slightly.

Israel’s Prison Service said it operates in accordance with the law. It declined to comment on the death count and directed any inquiries to Israel’s army.

The army said it is aware some detainees have died, including people with preexisting illnesses or combat-related injuries. It said allegations of abuse or inadequate conditions are assessed, and that those who violate the army’s code of conduct are punished and sometimes subject to criminal investigations.

A former guard at a military prison notorious for its harsh treatment of Palestinians told the AP detainees were routinely shackled with chains and kicked and hit with batons, and that the facility had been dubbed a "graveyard” because so many prisoners were dying there. He agreed to talk to AP to raise awareness of violence in Israeli prisons and spoke on condition of anonymity due to fear of reprisal.

Although hesitant at first, the former guard at the Sde Teiman military prison in southern Israel said he eventually participated in beatings of prisoners.

One morning, early in Israel’s war against Hamas, the guard arrived at work to see a motionless Palestinian lying on his side in the yard, yet no guards rushed to see what had happened to the man, who was dead.

"It was sort of business as usual with the dead guy,” said the guard, who didn’t know the cause of death.