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Estimating civilian deaths in Iraq – six surveys
By Nicolas J S Davies
Since I wrote Burying the Lancet Report . . . and the Children (Online Journal) in December, a number of people have asked me, “What about the other surveys that produced lower estimates of civilian deaths than the Lancet report?” The appearance of inconsistency between different surveys has led most news organizations to adopt the phrase “tens of thousands” when speaking of civilian deaths.
In this article, I hope to clarify the apparent inconsistencies between these different surveys. Six distinct groups have conducted and published surveys of civilian deaths in Iraq since the invasion. These surveys were conducted at different points in the conflict and with different methodologies, and it is important to understand exactly what each of them was attempting to count and when. Some were actual counts, which inevitably tend to underestimate deaths in war zones, while others used statistical methods to overcome this problem. Some counted only civilians killed by actual acts of war and some counted all violent deaths, while the Lancet report estimated total excess deaths from all causes resulting from the war.
Iraq Body Count Website
When President Bush recently spoke of 30,000 civilians killed in Iraq, his press secretary said that he was citing “published reports.” Directly or indirectly, what he was probably citing was Iraq Body Count. But I Iraq Body Count’s database is not intended as an estimate of total deaths. Its methodology is to record only war-related violent deaths that are reported by at least two approved international media sources. This generates a record of deaths that is accepted by the media that publish these reports in the first place. Its authors acknowledge that thousands of deaths go unreported in their database, but they say they cannot prevent politicians and the media misrepresenting their figures as an actual estimate of deaths. Iraq Body Count’s “minimum” number now stands at about 34,000.
The People’s Kifah Survey
Six months after the invasion, an Iraqi group called the People’s Kifah mobilized hundreds of academics and volunteers who “spoke and coordinated with grave-diggers across Iraq, obtained information from hospitals and spoke to thousands of witnesses who saw incidents in which Iraqi civilians were killed by U.S. fire.” Unfortunately they were forced to abandon the project when one of their researchers, Ramzi Musa Ahmad, was seized by Kurdish militiamen, reportedly handed over to U.S. forces, and never seen again. However, after only a month or two’s work, the People’s Kifah had already gathered evidence of at least 37,000 violent civilian deaths by October 2003.
The Iraq Living Conditions Survey
This survey was conducted by the Ministry of Planning and Development Cooperation of the Coalition Provisional Authority in April and May 2004 and was published in May 2005 by the U.N. Development Program. The “UNDP” imprimatur and the large sample size gave credence to its reassuringly low figure of about 24,000 “war deaths.” Tony Blair’s biographer John Rentoul told me that, in his opinion, this survey was definitive. However, its estimate of war-deaths was derived from a single question posed to families in the course of a 90-minute interview on living conditions, and the Norwegian designer of the survey has said that this number was certainly an underestimate. More than half of the deaths reported were in the southern region of Iraq, suggesting that it captured deaths in the initial invasion rather than in the violence that followed. In any case, after the invasion itself, the period covered by this survey was one of relative calm, and the two years of increasing violence that have followed are unaccounted for.
The Lancet Report
In September 2004, an international team of epidemiologists conducted a “cluster sample survey” of excess civilian deaths caused by the war in Iraq, comparing the pre-invasion and post-invasion periods. Their results were published in the British medical journal, the Lancet. They estimated that at least 100,000 Iraqi civilians had died in the previous 18 months as a result of the invasion and occupation of their country. This included additional deaths from heart attacks, strokes, infectious diseases and car accidents as well as from violence. However, they found that “violence accounted for most of the excess deaths and air strikes from coalition forces accounted for most violent deaths.”
The authors of the Lancet report made the conservative decision to exclude the much higher death rate they found in a cluster in Fallujah from their results, effectively leaving Anbar province out of the survey altogether. Including this data would have resulted in an estimate of 285,000 deaths. They, therefore, had a high degree of confidence in their conservative estimate of at least 100,000 total excess deaths from all causes, and in their statements attributing the majority of violent deaths to coalition air strikes. The Lancet report remains the most comprehensive study of mortality in post-invasion Iraq, but its authors' calls for additional studies to clarify its findings and for a reduction in air strikes have both been ignored.
Iraqi Health Ministry Reports
When Tony Blair was asked about the Lancet report in December 2004, he responded that, “Figures from the Iraqi Ministry of Health, which are a survey from the hospitals there, are in our view the most accurate survey there is.” In fact, the Iraqi Health Ministry reports, whose accuracy he praised, confirmed the Lancet report’s conclusion that aerial attacks by coalition forces were the leading cause of violent civilian deaths. Nancy Youssef of Knight Ridder wrote about one such report on September 25, 2004, under the headline “U.S. Attacks, Not Insurgents, Blamed for Most Iraqi Deaths.”
The Health Ministry began counting civilian deaths inflicted by coalition and resistance forces, as reported by hospitals, in June 2004. In the three months from June 10 to September 10, it counted 1,295 civilians killed by U.S. forces and their allies and 516 killed in “terrorist” operations. Health Ministry officials told Ms. Youssef that the “statistics captured only part of the death toll,” and emphasized that aerial bombardment was largely responsible for the higher numbers of deaths attributable to coalition forces.
BBC World Affairs Editor John Simpson reported on another Health Ministry report that covered the six months from July 1, 2004, to January 1, 2005. This report cited 2,041 civilians killed by U.S. and allied forces versus 1,233 by “insurgents.” Then something strange but sadly predictable happened. The Iraqi Health Minister’s office contacted the BBC and claimed that the figures had been misinterpreted; the BBC eventually issued a retraction; and details of deaths caused by coalition forces have been notably absent from subsequent Health Ministry reports.
Iraqiyun is an Iraqi humanitarian group headed by Dr. Hatim Al-Alwani and affiliated with the political party of Interim President Ghazi Al-Yawir. It released its report on July 12, 2005, making it the most recent survey to date. It counted 128,000 actual violent deaths, of whom 55 percent were women and children under the age of 12. The report specified that it included only confirmed deaths reported to relatives, omitting the large numbers of people who have simply disappeared without trace amid the violence and chaos.
Violence against civilians by Iraqi government and resistance forces has increased since most of these surveys were conducted. The U.S. air war has also intensified, especially during assaults on Fallujah and other towns in Anbar and Salahuddin provinces, and since the last few months of 2005. The U.S. Air Force acknowledged conducting about 290 air strikes in November and December 2005, compared with a total of 200 in the eight months between January and August.
More U.S. soldiers have died in Iraq during the period since the Lancet report was conducted in September 2004 than in the period it covered, and there is every reason to think that the same must be true of civilians. If, like the Lancet report, we are speaking of all civilian deaths that have resulted from the war, it is, therefore, now accurate to speak in terms of hundreds of thousands rather than tens of thousands. The results of the other five surveys, taken each in their own context and collectively, are entirely consistent with this conclusion.