Is Iraq's Civilian Death Toll 'Horrible' -- Or Worse?

Is Iraq's Civilian Death Toll 'Horrible' -- Or Worse?
A report published last week in the British medical journal Lancet which found that more than 600,000 civilians have been killed in Iraq elicited a prompt dismissal from President Bush.

"I don't consider it a credible report," he said. "Neither does General (George) Casey (top U.S. commander in Iraq) and neither do Iraqi officials."

The president isn't the only one who has taken issue with the controversial findings of the study, the work of three epidemiologists from Johns Hopkins University. Iraq Body Count, an antiwar Web site in London that monitors reports of civilian casualties, praised the authors for their research, but suggested the astronomical estimate is hard to swallow.

The study has attracted news coverage around the world, with antiwar commentators touting its findings as "superb science," and Bush allies Tony Blair and John Howard echoing White House dismissals.

The IBC, while critical of the study, took care to emphasize that it does not defend the conduct of the war.

"Totals of the magnitude generated by this study are unnecessary to brand the invasion and occupation of Iraq a human and strategic tragedy," said the IBC researchers.

Estimates at Odds

Gilbert Burnham, lead author of the study, explained the dramatic difference in mortality estimates among researchers as the result of different methodology.

"Our total estimate is much higher than other mortality estimates because we used a population-based, active method for collecting mortality information rather than passive methods that depend on counting bodies or tabulated media reports of violent deaths," he said in a news release about the study. "Though the numbers differ, the trend in increasing numbers of deaths closely follows that measured by the U.S. Defense Department and the Iraq Body Count group."

Researchers working with John Hopkins doctors visited 1,849 households between May and July 2006 and interviewed residents about family deaths among the 12,801 people living in those homes. When they asked for death certificates to verify fatalities, they say they obtained them 92 percent of the time.

The directors of IBC contend that the researchers' findings, if true, imply several realities that are difficult to explain. They say the study implies that:

1. On average, a thousand Iraqis have been violently killed every single day in the first half of 2006, with less than a tenth of them being noticed by any public surveillance mechanisms;

2. Some 800,000 or more Iraqis suffered blast wounds and other serious conflict-related injuries in the past two years, but less than a tenth of them received any kind of hospital treatment;

3. Over 7% of the entire adult male population of Iraq has already been killed in violence, with no less than 10% in the worst affected areas covering most of central Iraq;

4. Half a million death certificates were received by families which were never officially recorded as having been issued;

5. The Coalition has killed far more Iraqis in the last year than in earlier years containing the initial massive "Shock and Awe" invasion and the major assaults on Falluja.

In order for all this to be true, the IBC said, one would have to assume massive fraud or incompetence by Iraqi government and health officials and an "abject failutre" of the media, among other things. Without dismissing the report entirely, the IBC qualified its implications as "extreme and improbable."

Defending the Data

But the study has its defenders. Two experts told The Washington Post's David Brown last week that they found the article's methodology to be sound. The British science site, Nature.com (by subscription), also found merit in the study, saying the death toll "withstands scrutiny."

"The numbers do add up," said Daniel Davies, a stockbroker and blogger for the Guardian. He argued that the sample of 1,849 households interviewed by Iraqi doctors working for the JHU research team was as large as that used by political pollsters.

"The question that this study was set up to answer was: as a result of the invasion, have things got better or worse in Iraq? And if they have got worse, have they got a little bit worse or a lot worse... The results speak for themselves," Davies wrote. "In the 18 months before the invasion, the sample reported 82 deaths, two of them from violence. In the 39 months since the invasion, the sample households had seen 547 deaths, 300 of them from violence."

No one disputes that Iraq has grown much more deadly. The question is how much.

A 2004 study by the same authors of the Lancet article estimated 98,000 violent deaths in the first 18 months after the invasion, a figure four times higher than the findings of a much larger survey done at approximately the same time by Norweigan researchers working for the United Nations. That study, the Iraqi Living Conditions Survey, estimated 23,743 civilian deaths in the first 13 months of the conflict.

In a telephone interview, Jon Pedersen, research director for the 2004 study, said several factors probably account for researchers' different findings.

One key issue is how researchers extrapolate from the deaths identified in their field research to a death toll for the whole country. Pedersen noted that the Lancet study is based on a pre-invasion mortality rate of 5.5 deaths per thousand people. The U.N., he said, used the figure of 9 deaths per thousand. Extrapolating from the lower pre-invasion mortality rate would yield a greater increase in post-invasion deaths, he noted. If the higher pre-invasion mortality rate is more accurate, then the deaths attributable to the war would be lower.

Another difficulty, he said, is doing accurate research under dangerous conditions. Pedersen wondered how tightly the study's authors could oversee the interviews as they were conducted throughout Iraq.

The JHU study, he noted, asked Iraqis only about mortality. The U.N. study asked Iraqis about many aspects of their living conditions. Pedersen said his study probably underestimated deaths caused by the war because the interviews did not focus on the issue, while the Lancet article probably overstated them because no other subject was discussed.

Pedersen said he thinks the Lancet numbers are "high, and probably way too high. I would accept something in the vicinity of 100,000 but 600,000 is too much."

"Regardless of the numbers that are possible," he added, "we are seeing a situation that is pretty horrible."

Reaction Roundup

The survey "has at least helped put a face on the type of violence confounding Iraq. Of those surveyed, researchers found 56 per cent of those who died violently were killed by guns. Slightly more than 27 per cent were killed by explosions, including car bombs, and 13 per cent lost their lives because of American air strikes."

-- "Reality check: Iraq's death toll, the numbers debate," CBC, Canada

"Surprise, surprise. Bush and [Australian Prime Minister] Howard ridicule the Johns Hopkins figures though the coalition has tabled none of its own. Joining in Washington's efforts to obfuscate, the Iraqi Government bars the central morgue and health ministry from releasing any details of the mounting toll. The lies and disinformation that got us into the war continue and the Iraqis pay an intolerable price for the wish-fulfilment fantasies of armchair generals and neo-cons."

-- "Blind Eye to Political Genocide," Columnist Philip Adams, The Australian

"The invasion of Iraq has caused immense human loss and tragedy in the Arab country where violence and revenge killings are spiralling out of control with an average of 100 people being killed and 1000 fleeing their homes every day as stated by UN Humanitarian chief, Mr Jan Egeland. President Bush and his administration should realise that truth can't be suppressed and it shall prevail."

-- "Iraq Death Toll After Invasion," The New Nation, Bangladesh

"Faced with these bloody figures, the matter of urgency for those involved in the war is how to curb and halt bloodshed instead of defending and justifying what they are doing in Iraq, as clashes with bloodshed are no games."

-- "Faced with merciless, bloody figures," People's Daily, China
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