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Lancet: "100,000 civilians dead since Iraq invasion"

Richard Horton (reposted by David) | 29.10.2004 16:47 | Analysis | Anti-militarism | World

New research published in the respected London medical journal "The Lancet" indicates that the civilian death toll in Iraq is around 10 times higher than previously thought.

"The present conflict in Iraq signals a contrast of paradoxical proportions. The Iraqi people, their interim government, and their largely US and British occupiers are preparing for landmark elections early in the new year. Yet a ruthlessly violent insurgency is successfully destabilising these arrangements, murdering foreign civilians and Iraqi law enforcement officers in the most brutal ways imaginable, and exploiting the world’s media in doing so. Amid this deep national uncertainty, it is hard to judge what is happening among Iraqis themselves. This week The Lancet publishes the first scientific study of the effects of this war on Iraqi civilians.

In a unique US-Iraqi collaboration, Les Roberts and his colleagues report substantially more deaths in Iraq since the war began than during the period immediately before the conflict. Much of this increased mortality is a consequence of the prevailing climate of violence in the country, and many of the civilian casualties that are described were attributed to the actions of coalition forces. These findings—and the tentative countrywide mortality projections they support— have immediately translatable policy implications for those charged with managing the aftermath of invasion.

The research we publish today was completed under the most testing of circumstances—an ongoing war. And therefore certain limitations were inevitable and need to be acknowledged right away. The number of population clusters chosen for sampling is small; the confidence intervals around the point estimates of mortality are wide; the Falluja cluster has an especially high mortality and so is atypical of the rest of the sample; and there is clearly the potential for recall bias among those interviewed. This remarkable piece of work represents the efforts of a courageous team of scientists. To have included more clusters would have improved the precision of their findings, but at an enormous and unacceptable risk to the team of interviewers who gathered the primary data. Despite these unusual challenges, the central observation—namely, that civilian mortality since the war has risen due to the effects of aerial weaponry—is convincing. This result requires an urgent political and military response if the confidence of ordinary Iraqis in the mostly American-British occupation is to be restored.

Roberts and his colleagues submitted their work to us at the beginning of October. Their paper has been extensively peer-reviewed, revised, edited, and fast-tracked to publication because of its importance to the evolving security situation in Iraq. But these findings also raise questions for those far removed from Iraq—in the governments of the countries responsible for launching a pre-emptive war. In planning this war, the coalition forces — especially those of the US and UK — must have considered the likely effects of their actions for civilians. And these consequences presumably influenced deployments of armed forces, provision of supplies, and investments in building a safe and secure physical and human infrastructure in the post-war setting.

With the admitted benefit of hindsight and from a purely public health perspective, it is clear that whatever planning did take place was grievously in error. The invasion of Iraq, the displacement of a cruel dictator, and the attempt to impose a liberal democracy by force have, by themselves, been insufficient to bring peace and security to the civilian population. Democratic imperialism has led to more deaths not fewer. This political and military failure continues to cause scores of casualties among non-combatants. It is a
failure that deserves to be a serious subject for research.

But this report is more than a piece of academic investigation.
A vital principle of public health is harm reduction. But harm cannot be diminished by individual members of society alone. The lives of Iraqis are currently being shaped by the policies of the occupying forces and the militant insurgents. For the occupiers, winning the peace now demands a thorough reappraisal of strategy and tactics to prevent further unnecessary human casualties. For the sake of a country in crisis and for a people under daily threat of violence, the evidence that we publish today must change heads as well as pierce hearts."

Richard Horton
The Lancet, London NW1 7BY, UK
The war in Iraq: civilian casualties, political responsibilities
Published online
October 29, 2004
 http://image.thelancet.com/extras/04cmt384web.pdf

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Commentary in The Australian:
Iraq civilian toll 'more than 100,000'
Correspondents in Baghdad
October 30, 2004

MORE than 100,000 Iraqi civilians have died since the US-led invasion of Iraq in March last year, according to a new scientific study.

The toll far exceeds all previous estimates, and the survey's publication yesterday - just days before the US presidential election - was bound to cause controversy by reinforcing the impression that events in Iraq were out of control.

The research, done in Iraq this September by a team of US and Iraqi scientists, was published on the online edition of The Lancet.

It suggests that the majority of civilian deaths have been due to military activity, with those caused by violence rising sharply in recent months.

The coalition forces keep records of casualties among their own troops, but neither the US nor Britain has attempted to count how many civilians have been killed.


British Foreign Secretary Jack Straw has previously estimated 10,000 civilian deaths.

A group of British academics called Iraq Bodycount, which compiles figures from witness accounts and media reports, recently put the number at between 14,160 and 16,289. Britain's Defence Ministry was yesterday sceptical about the new study's findings. "No figures that are produced are reliable at this stage," a spokesman said.

The report was compiled by a team led by Les Roberts, a public health expert from the Johns Hopkins Bloomberg School of Public Health in Baltimore in the US.

They surveyed households in 33 regions of the country. They then compared civilian mortality rates before and after the invasion.

Independent statisticians who have analysed the data said yesterday that the scientists' methodology was strong, and the civilian death count could well be conservative.

They said the work effectively rubbished suggestions by US authorities that civilian bodycounts were impossible to conduct. In coming to a total of 100,000 civilian deaths, the team excluded Fallujah, where two-thirds of violent deaths recorded had occurred.

Experts said that including this area, where collecting data remains highly dangerous, would push the number of civilian deaths much higher.

Dr Roberts said yesterday that the death toll from bombing suggested a pressing need to alter air strike strategies.

"We can say with absolute confidence that both mortality and violent deaths have gone way up," he said. "Making conservative assumptions, we think that about 100,000 excess deaths or more have happened since the 2003 invasion of Iraq. Violence accounted for most of the excess deaths, and air strikes from coalition forces accounted for most violent deaths."

Overall, the risk of death was found to be 2.5 times greater after the invasion. The risk was 1.5 times higher if mortality around the hotspot of Falluja was excluded.

The survey's publication came as Japan's embassy in Baghdad said it was checking a report that the body of an Asian had been found in Iraq, as fears mounted over the fate of a Japanese hostage threatened with death. Japanese news agency Kyodo reported the body had been found in Tikrit, 180km north of Baghdad, but was unable to say whether it was kidnapped Japanese Shosei Koda, 24. Tokyo had rejected demands by the al-Qa'ida-linked insurgents holding Koda that Japan withdraw its 600 soldiers from Iraq by late Thursday, local time.

The Times, AFP

Richard Horton (reposted by David)
- Homepage: http://image.thelancet.com/extras/04cmt384web.pdf

Comments

Hide the following 4 comments

WHat if it had been Saddam?

30.10.2004 14:33

I wonder how many would have died if Saddam had not been removed? Is there any serious study about the number of people that died under Saddam Hussein, and the number of people that die now?

I'd like to compare...

petter


Some Sums.

30.10.2004 23:24

Peter:
This survey of 100,000 is a conservative estimate, and averages out to 166 deaths per day. For example, it does not include Iraqi soldiers who died in the initial invasion.

If Sadam were to have murdered at least 166 per day for the last 20 months, including Sundays, then that would come close to the coalition figure of 100,000 deaths.

But what was his record? I have seen estimates of the number that Sadam killed, over the lifetime of his rule, of 100,000 300,000 400,000 and a million which implies they have no idea. However, the death rate in all these cases a lot less than an average of 166 per day. If you take the lower estimate the coalition is about 25 times more murderous; takeing the upper about 2,5 times more murderous.

Even on this very crude analysis the coalition is shown to be more murderous than Sadam using the largest estimate for the murders by Sadams regime.

I don't think the numbers game should be played, although it already has been by pro-war commentators and politicians. For example, John Hari of the Independent reported figures of how many would have died if Sadam had been in power, and, on that basis alone, claimed that the war was morally correct. One would hope that now he would now be totally discredited, along with this "moral argument".

HH


Extremely Brutal

31.10.2004 06:35

I don't care the number dead Iraqis. I just following my supreme commander order. I care the new kind of freedom and democracy offered my fool president for Iraqis. I care only the money given by army.

Oil Warrior

Oil Warrior


Moral arguments for war

31.10.2004 09:54

You're right HH. I can remember all sorts of UK politicians, plus an assortment of Iraqi Kurds esp. from the PUK, looking frowny-faced and earnest while telling the interviewer "Civilian casualties are always very sad, but no matter how civilians are killed in the liberation, it can't possibly be more than Saddam Hussein will kill."

So even if we wipe out the entire civilian population of Iran, and replace them with oil contractors, Saddam would somehow have managed to kill EVEN MORE. Cause he's just that evil, y'see.

What made me even angrier than listening to these gangsters saying this shite with a straight face, was the fact the TV and radio interviewers never challenged them on it.

So yeah, Johan Hari has been proven wrong. Big fucking deal. He's really sorry now. Big fucking deal. Maybe these war-happy fuckers can go out and sweep up the Depleted Uranium shell dust from populated areas, and face the families with dead, burnt and cancer-ridden children, if they really want to make amends.

At the Labour party conference this month, they managed to get all the big unions to vote to support Blair on the war, by surprising them with "an Iraqi woman", who cried and shrieked at them from the podium, "PLEASE PLEASE! DON'T ABANDON US!"

What doesn't seem to have been mentioned on the agenda was that this woman was a plant from the same CIA-backed exiles who persuaded Bush and Blair to go to war in the first place:
 http://news.scotsman.com/latest.cfm?id=3574429

John