TEL AVIV, Israel (AP) — The number of Palestinians dying in Israeli custody surged to nearly 100 people since the start of the war in Gaza, according to a report published Monday by a human rights group that says systematic violence and denial of medical care at prisons and detention centers contributed to many of the deaths it examined.

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. AP spoke with a former guard and a former nurse at one prison, an Israeli doctor who treated malnourished prisoners brought to his hospital, former detainees and their relatives, and lawyers representing them and rights groups.

The 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.

Of the 98 prisoner deaths PHRI documented since the Oct. 7, 2023, attack 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.

Read More: Palestinian deaths in Israeli custody have surged. A prison guard describes rampant abuse