The uncounted dead of Iraq

January 25, 2008

Nicole Colson cuts through the media hype surrounding the latest study of Iraqi deaths at the hands of the U.S. invasion.

THE MAINSTREAM media are trumpeting a new report in the New England Journal of Medicine (NEJM) that estimates the number of Iraqis who died from violence in the three years following the U.S. invasion as "only" 151,000.

This figure is less than a quarter of a previous Johns Hopkins University estimate of approximately 600,000 dead as the result of violence since the U.S. invasion of 2003.

Most major media outlets took the opportunity of the new survey, conducted by the Iraqi government and the World Health Organization (WHO), to heap scorn on the previous report by the Hopkins researchers that was published in the British medical journal The Lancet in 2006.

"New Estimate of Violent Deaths Among Iraqis Is Lower," read the headline in the Washington Post announcing the report. The New York Times reminded its readers that the Johns Hopkins study "has come under criticism for its methodology."

Actually, the Johns Hopkins study has come under all-out attack by the right wing since it was published in 2006. Conservatives claim that the study was funded by antiwar billionaire George Soros, even though his grant was made through the Massachusetts Institute of Technology and was unknown to the study's authors.

What else to read

The findings of the WHO report on the death toll in Iraq can be read at the New England Journal of Medicine Web site. The 2006 John Hopkins survey is also available for download. Hopkins study co-author Les Roberts wrote a response to the WHO study for the Institute for Public Accuracy.

Journalist Andrew Cockburn provides another examination in "How the New England Journal of Medicine Undercounted Iraqi Civilian Deaths" on the CounterPunch Web site. Tom Engelhardt's "CSI Iraq: The Corpse on the Gurney" debunks the contention of politicians and the media that the U.S. surge in Iraq has been a success.

For an excellent new book on Iraq, see independent journalist Dahr Jamail's Beyond the Green Zone: Dispatches from an Unembedded Journalist in Occupied Iraq, describing his time in Iraq reporting the other side of the story. Also newly published is In Praise of Barbarians, a collection of essays on U.S. imperialism and society by Mike Davis.

The crucial book on Iraq for antiwar activists is Iraq: The Logic of Withdrawal, now republished in an updated paperback edition from the American Empire Project with a foreword by Howard Zinn.

Another criticism was the fact that the report didn't include specific information such as names and addresses that would allow the identification of study participants--which, as co-author Les Roberts pointed out, researchers declined to do because it could have put those participants at risk of retaliation.

Though the Hopkins study authors have repeatedly answered these charges and defended their work, the WHO researchers not only conclude that the Hopkins study "considerably overestimated the number of violent deaths," but that it utilized improper methodology, and thus, implied that it played politics with the counting of the Iraqi dead.

In reality, the media--and the authors of the new WHO study--are the ones using the Iraqi death toll to advance a political agenda.

ACCORDING TO the WHO study, 128 Iraqis died each day on average in the first year following the invasion, then 115 a day in the second year, then 126 a day in the third year. Roughly nine out of 10 of those deaths were a consequence of U.S. military operations, insurgent attacks or sectarian warfare. In contrast, the study said, from January 2002 to March 2003 (before the war began), about a half-dozen violent deaths were reported daily.

The numbers of the WHO study would be horrifying enough if they were accurate. The report makes it clear that the number of Iraqi deaths caused by the invasion is far greater than the widely consulted Iraq Body Count Web site, which bases estimates of the toll from media coverage alone.

But as John Tirman, who helped publicize the 2006 Johns Hopkins report, commented on the AlterNet Web site, the WHO study doesn't begin to tell the whole story.

"[A] little digging would have revealed much more: the total deaths attributable to the war, nonviolent as well as violent, was about 400,000 for that period, now 19 months ago," he wrote. "If the same trends continued, that total today would be more than 600,000."

Tirman continued: "The deaths-by-violence in that [WHO] survey remained the same from year-to-year, however, which is not plausible--all observers agree that violent deaths were rising sharply in 2005 and 2006.

"The discrepancy is found in how the survey was conducted: Interviewers identified themselves as employees of the Ministry of Health, then under the control of Shiite cleric Moktada al-Sadr. Those interviewed, therefore, would be wary of saying a brother or son or husband had been killed by violence, fearing retribution.

"And, indeed, there are nonviolent categories in the survey that suggest just such equivocation: 'Unintentional injuries' would equal about 40 percent of the death-by-violence toll, for example. Road accidents were ten times their pre-war totals--if someone is run off a highway by a U.S. convoy, is that a 'non-violent' death?"

The authors of the WHO study say that, while the Johns Hopkins study relied on data from 1,849 households in 47 clusters, their study used data from 9,345 households in nearly 1,000 neighborhoods and villages. Thus, they claim, their study must be more accurate.

Statistically, however, such an increase in sample size doesn't necessarily mean more accuracy. In the case of the WHO study, the authors also admitted they ended up skipping a large section of the households originally chosen to by surveyed. "Of the 1,086 originally selected clusters," the study notes, "115 (10.6 percent) were not visited because of problems with security."

In other words, clusters of households in areas with higher levels of violence (and, therefore, a likely higher death toll), such as Anbar province and sections of Baghdad, were excluded. Instead, for these areas, the WHO researchers relied on estimates based on a formula derived from the Iraq Body Count site--which, since they are derived from media reports, are well-known to be conservative.

In addition, as journalist Andrew Cockburn noted, "This new study...explicitly sought to analyze only deaths by violence, imposing a measure of subjectivity on the findings from the outset. For example, does the child who dies because the local health clinic has been looted in the aftermath of the invasion count as a casualty of the war, or not?"

Les Roberts, one of the authors of the 2006 Johns Hopkins study, pointed out in a statement, "The [WHO researchers'] NEJM article found a doubling of mortality after the invasion, we found a 2.4-fold increase. Thus, we roughly agree on the number of excess deaths. The big difference is that we found almost all the increase from violence, they found one-third of the increase from violence.

"This new estimate is almost four times the 'widely accepted' [Iraq Body Count] number from June of 2006, our estimate was 12 times higher. Both studies suggest things are far worse than our leaders have reported."

As for playing "politics" with the numbers, the Post pointed out that "as the surge in violent deaths in 2006 from death squad activities and other killings became a major embarrassment, the Iraqi government moved to sharply curb access to the data."

NEVERTHELESS, THE conclusions of the new study should be taken seriously. Citing a "massive death toll in the wake of the 2003 invasion," the report concludes that violence "is a leading cause of death for Iraqi adults and was the main cause of death in men between the ages of 15 and 59 years during the first three years after the 2003 invasion.

"Although the estimated range is substantially lower than [the Johns Hopkins] estimate, it nonetheless points to a massive death toll, only one of the many health and human consequences of an ongoing humanitarian crisis."

As Tom Engelhardt commented on the TomDispatch Web site, "So another year has now passed in a country that we plunged into an unimaginable charnel-house state.

"Whether civilian dead between the invasion of 2003 and mid-2006 (before the worst year of civil war-level violence even hit) was in the range of 600,000 as a study in the British medical journal The Lancet reported or 150,000 as a recent World Health Organization study suggests, whether 2 million or 2.5 million Iraqis have fled the country, whether 1.1 million or more than 2 million have been displaced internally, whether electricity blackouts and water shortages have marginally increased or decreased, whether the country's health-care system is beyond resuscitation or could still be revived, whether Iraqi oil production has nearly crept back to the low point of the Saddam Hussein era or not, whether fields of opium poppies are, for the first time, spreading across the country's agricultural lands or still relatively localized, Iraq is a continuing disaster zone on a catastrophic scale hard to match in recent memory."

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