100,000 Iraqi Deaths
By EMMA ROSS, AP Medical Writer
of deaths in Iraqi households estimates that as many as 100,000 more
people may have died throughout the country in the 18 months after the
U.S. invasion than would be expected based on the death rate before the
war. There is no official figure for the number of Iraqis killed since
the conflict began, but some non-governmental estimates range from
10,000 to 30,000. As of Wednesday, 1,081 U.S. servicemen had been
killed, according to the U.S. Defense Department. The scientists who
wrote the report concede that the data they based their projections on
were of "limited precision," because the quality of the information
depends on the accuracy of the household interviews used for the study.
The interviewers were Iraqi, most of them doctors.
and conducted by researchers at Johns Hopkins University, Columbia
University and the Al-Mustansiriya University in Baghdad, the study is
being published Thursday on the Web site of The Lancet medical journal.
The survey indicated violence accounted for most of the extra deaths
seen since the invasion, and air strikes from coalition forces caused
most of the violent deaths, the researchers wrote in the British-based
journal. "Most individuals reportedly killed by coalition forces were
women and children," they said. The report was released just days before
the U.S. presidential election, and the lead researcher said he wanted
it that way. The Lancet routinely publishes papers on the Web before
they appear in print, particularly if it considers the findings of
urgent public health interest.
reports then appear later in the print issue of the journal. The
journal's spokesmen said they were uncertain which print issue the Iraqi
report would appear in and said it was too late to make Friday's issue,
and possibly too late for the Nov. 5 edition. Les Roberts, the lead
researcher from Johns Hopkins, said the article's timing was up to him.
"I emailed it in on Sept. 30 under the condition that it came out before
the election," Roberts told The Asocciated Press. "My motive in doing
that was not to skew the election. My motive was that if this came out
during the campaign, both candidates would be forced to pledge to
protect civilian lives in Iraq (news - web sites).
"I was opposed to the war and I still think that the war was a bad idea,
but I think that our science has transcended our perspectives," Roberts
said. "As an American, I am really, really sorry to be reporting this."
Peto, an expert on study methods who was not involved with the research,
said the approach the scientists took is a reasonable one to investigate
the Iraq death toll. However, it's possible that they may have zoned in
on hotspots that might not be representative of the death toll across
Iraq, said Peto, a professor of medical statistics at Oxford University
in England. To conduct the survey, investigators visited 33
neighborhoods spread evenly across the country in September, randomly
selecting clusters of 30 households to sample. Of the 988 households
visited, 808, consisting of 7,868 people, agreed to participate in the
survey. At each one they asked how many people lived in the home and how
many births and deaths there had been since January 2002. The scientists
then compared death rates in the 15 months before the invasion with
those that occurred during the 18 months after the attack and adjusted
those numbers to account for the different time periods.
though the sample size appears small, this type of survey is considered
accurate and acceptable by scientists and was used to calculate war
deaths in Kosovo in the late 1990s. The investigators worked in teams of
three. Five of the six Iraqi interviewers were doctors and all six were
fluent in English and Arabic. In the households reporting deaths, the
person who died had to be living there at the time of the death and for
more than two months before to be counted. In an attempt at firmer
confirmation, the interviewers asked for death certificates in 78
households and were provided them 63 times. There were 46 deaths in the
surveyed households before the war. After the invasion, there were 142
deaths. That is an increase from 5 deaths per 1,000 people per year to
12.3 per 1,000 people per year — more than double.
more than a third of the post-invasion deaths were reported in one
cluster of households in the city Falluja, where fighting has been most
intense recently. Because the fighting was so severe there, the numbers
from that location may have exaggerated the overall picture. When the
researchers recalculated the effect of the war without the statistics
from Falluja, the deaths end up at 7.9 per 1,000 people per year — still
1.5 times higher than before the war. Even with Falluja factored out,
the survey "indicates that the death toll associated with the invasion
and occupation of Iraq is more likely than not about 100,000 people, and
may be much higher," the report said. The most common causes of death
before the invasion of Iraq were heart attacks, strokes and other
chronic diseases. However, after the invasion, violence was recorded as
the primary cause of death and was mainly attributed to coalition forces
— with about 95 percent of those deaths caused by bombs or fire from
helicopter gunships. Violent deaths — defined as those brought about by
the intentional act of others — were reported in 15 of the 33 clusters.
The chances of a violent death were 58 times higher after the invasion
than before it, the researchers said.
of the 73 violent deaths were not attributed to coalition forces. The
researchers said 28 children were killed by coalition forces in the
survey households. Infant mortality rose from 29 deaths per 1,000 live
births before the war to 57 deaths per 1,000 afterward. The researchers
estimated the nationwide death toll due to the conflict by multiplying
the difference between the two death rates by the estimated population
of Iraq — 24.4 million at the start of the war. The result was then
multiplied by 18 months, the average period between the invasion and the
survey interviews. "We estimate that there were 98,000 extra deaths
during the postwar period in the 97 percent of Iraq represented by all
the clusters except Falluja," the researchers said in the journal.
isn't about individual soldiers doing bad things. This appears to be a
problem with the approach to occupation in Iraq," Roberts said. The
researchers called for further confirmation by an independent body such
as the International Committee of the Red Cross, or the World Health
Organization (news - web sites). The study was
funded by the Center for International Emergency Disaster and Refugee
Studies at Johns Hopkins University and by the Small Arms Survey in
Geneva, Switzerland, a research project based at the Graduate Institute
of International Studies in Geneva.