[Mb-civic] British Medical Journal (Lancet): Civilian death toll in Iraq exceeds 100, 000

Fri Oct 29 21:57:16 PDT 2004

http://www.newscientist.com/news/news.jsp?id=ns99996596  

Civilian death toll in Iraq exceeds 100,000 

18:44 28 October 04 

NewScientist.com news service 

The invasion of Iraq in March 2003 by coalition forces has lead to the death 
of at least 100,000 civilians, reveals the first scientific study to examine the 
issue.

The majority of these deaths, which are in addition those normally expected 
from natural causes, illness and accidents, have been among women and 
children, finds the study, released early by The Lancet on Thursday.

The most common cause of death is as a direct result of violence, mostly 
caused by coalition air strikes, reveals the study of almost 1000 households 
scattered across Iraq. And the risk of violent death just after the invasion was 
58 times greater than before the war. The overall risk of death was 1.5 times 
more after the invasion than before.

The figure of 100,000 is based on "conservative assumptions", notes Les 
Roberts at Johns Hopkins Bloomberg School of Public Health, Baltimore, US, 
who led the study.

That estimate excludes Falluja, a hotspot for violence. If the data from this 
town is included, the study points to about 200,000 excess deaths since the 
outbreak of war.

Public health 

“These findings raise questions for those far removed from Iraq - in the 
governments of the countries responsible for launching a pre-emptive war,” 
writes Richard Horton, the editor of The Lancet in a commentary 
accompanying the paper. 

“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,” he 
writes. 

He argues that, from a public health perspective, 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,” he asserts.

He also praises the “courageous team of scientists” for their efforts, and 
notes the study’s limitations.

GPS sampling 

The team of US and Iraqi scientists recorded mortality during the 15 months 
before the invasion and the 18 months afterwards. They carried out the 
survey of 988 Iraqi households in 33 different areas across Iraq in September 
2004. 

Using a GPS (global positioning system) unit, the interviewers randomly 
selected towns within governates. They then visited the nearest 30 houses to 
the GPS point randomly selected.

Families living under one roof were asked about deaths in their household 
before and after the war. “Confirmation was sought to ensure that a large 
fraction of the reported deaths were not fabrications,” write the team. The 
interviewers did ask for death certificates, but only in two cases for each 
cluster of houses. This was because of concerns that implying the families 
were lying could trigger violence.

But the team believes that lying about deaths is unlikely and, if anything, “it is 
possible that deaths were not reported” because families might want to 
conceal them.

Horton acknowledges the potential for recall bias among those interviewed 
and also the relatively small sample size. “The research was completed 
under the most testing of circumstances - an ongoing war. And therefore 
certain limitations were inevitable and need to be acknowledged right away,” 
he says.

But he also calls for an “urgent political and military response”.

Journal reference: The Lancet (early online publication)

Shaoni Bhattacharya

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