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How a study of Iraqis casualties was dismissed
The true toll of the U.S. war

November 11, 2005 | Page 5

ERIC RUDER looks at the horrific loss of life inflicted on Iraq by the U.S. war and occupation.

ALMOST EXACTLY a year before the 2,000th U.S. soldier was killed in Iraq, a study published in the British medical journal the Lancet estimated that 100,000 Iraqi civilians had already died--18 months into the occupation--as a direct or indirect consequence of the U.S. invasion.

The report's lead author, Les Roberts, hoped that the release of the study just a week before the 2004 U.S. presidential election would spotlight the horrific number of Iraqi civilians killed and force the candidates to deal with the issue.

It didn't turn out that way. Those in the antiwar movement trumpeted the Lancet report's findings, but two factors kept it from garnering more than a blip of mainstream news coverage.

First and foremost, Democratic presidential candidate John Kerry, as a supporter of the war in Iraq, had no interest in drawing attention to the study. "Democratic presidential candidate John Kerry voted in favor of the invasion of Iraq," Roberts said. "Most of the Democratic Party went along with this. That makes them at the least complacent in this fiasco."

Second, the Lancet study showed the number of Iraqi civilian deaths was so much higher than any other estimate that it was dismissed by the media. Also, because Roberts acknowledged to an Associated Press reporter that he opposed the war, the findings of the study carried the stigma of being "politicized"--even though other investigators who worked on the study hated Saddam Hussein with such ferocity that they had supported the U.S. invasion.

At the time, Iraq Body Count, the Web site that tracks Iraqi civilian deaths, was reporting a maximum of 17,000 civilians killed--a number that now has climbed to 30,163. This number--and the fact that the Lancet study carried a qualification about possible sampling error--was seized on by Slate.com writer Fred Kaplan to claim that the 100,000 figure couldn't be trusted. "This isn't an estimate," wrote Kaplan. "It's a dartboard."

But Scott Lipscomb, an associate professor at Northwestern University who works on the Iraq Body Count project, freely admitted that his Web site may significantly undercount the actual figure, because his group only counts deaths reported and confirmed in the media. "I am emotionally shocked, but I have no trouble believing that this many people have been killed," said Lipscomb. "We've always maintained that the actual count must be much higher."

Other researchers confirm that the Lancet study used sound research methods. "Les has used, and consistently uses, the best possible methodology," says Bradley Woodruff, a medical epidemiologist at the U.S. Centers for Disease Control and Prevention.

In fact, Roberts is no stranger to war-ravaged countries. He has compiled data in nine other war zones, including Bosnia, the Congo and Rwanda. His Congo research used methods similar to the Iraq study--and never faced the criticism that the Lancet report on Iraq drew. "Tony Blair and Colin Powell have quoted those results time and time again without any question as to the precision or validity," says Roberts.

The Lancet study team came up with its figures by carrying out a survey of Iraqi households picked at random. It used global positioning systems to choose 33 random points throughout the country. Once researchers arrived at these points, they interviewed the 30 nearest households.

The findings shocked even Roberts. He wasn't surprised so much by the 60 percent increase in the death rate--a large number, but in line with what Roberts found in other war-ravaged lands.

But Roberts expected the leading causes of increased deaths in Iraq--like in other war zones--would be from disease, the unclean drinking water, malnutrition and increased infant mortality because pregnant women find it difficult to get to hospitals during wartime. Instead, he and his team found that bombs and bullets caused most of the increased death.

In 32 of the 33 household clusters surveyed, 21 people died of violence after the occupation became--compared to just one violent death in the period before the war. Of the 21 who died from violence, two died in firefights where it wasn't clear who fired the shots, three were killed by violence attributed to the anti-occupation insurgents, seven were victims of criminal violence--and nine were killed by U.S. and coalition forces.

"I just didn't expect violence from the coalition to have dominated the causes of death in Iraq," Roberts said in a radio interview for National Public Radio's This American Life program. "No way reading the New York Times and listening to National Public Radio would I have believed that the coalition killed far, far, far more people than did the insurgents setting off car bombs.

"I should mention that only three of [the deaths from coalition forces] involved guys with guns. All the rest were helicopter gunships and bombs from planes. It's not about individual soldiers doing bad things. In fact, in two of those three cases when soldiers shot civilians with their guns, they actually went to the houses of the decedents and apologized to the families. So there's no evidence here of soldiers running amok. There's evidence here of a style of engagement that probably has relied very heavily on air power that has resulted in a lot of civilian deaths.

"A Pentagon spokesperson said that they dropped about 50,000 bombs on Iraq. A very small fraction of them would need to miss their target or be based on bad information to explain 100,000 civilian deaths."

In fact, the picture would have been far worse if researchers had included results from their survey of Falluja--one of the places that their random site selection turned up as an investigation site.

In Falluja, the team recorded 53 total deaths, 52 of them violent deaths, since the invasion--and all but one of those 52 was killed by coalition forces. Of those killed by the coalition, 21 were children under 12 years of age. These figures were so high that Roberts and his team excluded them from the final estimate. If they had been included, the total deaths would have been far higher than 100,000.

In fact, the random selection of survey sites meant that only one other "hotspot" was surveyed--Sadr City, a neighborhood in Baghdad known for heavy fighting. But as the Lancet report notes, the cluster in Sadr City "by random chance was in an unscathed neighborhood with no reported deaths from the months of recent clashes." Other areas that were the site of heavy fighting, such as Ramadi, Najaf and Tal Afar, didn't need to be excluded because they weren't selected to begin with.

Of course, since the Lancet report was conducted, Iraq has become more violent and insecure. And the U.S. has initiated its most punishing assaults on Iraqi cities--such as the devastating second siege of Falluja and a string of offensives in Ramadi, Tal Afar and elsewhere--after the 2004 election.

Today, the number of Iraqi civilians killed since the U.S. invasion is anyone's guess. But those guesses would have to begin at 100,000 and climb--perhaps sharply--from there.

How much less do Iraqi lives count to Bush?

THE PENTAGON brags that two-thirds of the bombs used in Iraq since the invasion were "smart bombs." This compares to the 8 percent of bombs that were "smart" during the 1991 Gulf War--and 0 percent during the Second World War.

George W. Bush claimed on October 9, 2003, that the U.S. war on Iraq was "one of the most humane military campaigns in history."

But consider this: If a foreign invader killed the same proportion of American civilians as the U.S. military had killed in Iraq, this would amount to roughly 1.1 million dead innocent men, women and children. That's the equivalent of September 11 happening 385 times. Or more than 1,000 Hurricane Katrinas.

But set aside this comparison, and consider the Lancet study in purely Iraqi terms.

"The troubling thing about these results is that they suggest that the U.S. may soon catch up with Saddam Hussein in the number of civilians killed," wrote Juan Cole, an Iraq expert, in his widely read Informed Comment blog. "How many deaths to blame on Saddam is controversial. He did, after all, start both the Iran-Iraq War and the Gulf War. But he also started suing for peace in the Iran-Iraq War after only a couple of years, and it was Khomeini who dragged the war out until 1988. But if we exclude deaths of soldiers, it is often alleged that Saddam killed 300,000 civilians. This allegation seems increasingly suspect. So far, only 5,000 or so persons have been found in mass graves. But if [the Lancet study researchers] are right, the U.S. has already killed a third as many Iraqi civilians in 18 months as Saddam killed in 24 years."

No wonder there's such fierce resistance to the U.S. occupation--and so many people throughout the Arab and Muslim world are boiling with anger at the U.S. government.

Other surveys confirm Lancet findings

OTHER SURVEYS have confirmed the scale of civilian deaths first reported in the Lancet study.

The New England Journal of Medicine, for example, interviewed troops returning from Iraq and asked each a series of questions about their experiences. A total of 14 percent of Army soldiers and 28 percent of Marines said that they were responsible for the death of a non-combatant. So at a minimum, 41,000 soldiers who have returned from Iraq believe that they caused the death of one or more civilians.

An Associated Press survey of morgues in Baghdad and three surrounding provinces--a small part of the country--found that 5,500 people died violently during the 12 months after Bush declared an end to major combat operations. This survey excluded areas such as Falluja and Najaf that had seen heavy fighting, and because most resistance fighters aren't brought to morgues, the number was mostly limited to non-combatants.

"By comparison, crime-ridden Bogotá, Colombia, reported 39 homicides per 100,000 people in 2002, while New York City had about 7.5 per 100,000 last year," reported the Associated Press. "Iraq's neighbor Jordan, a country with a population a little less than Baghdad's, recorded about 2.4 homicides per 100,000 in 2003."

And this only accounts for the suffering of Iraqis who meet directly with violence. There are also high rates of malnutrition and non-lethal disease. And Iraq, which once had one of the most advanced health care systems in the Middle East, has now been thrown back a century or more in terms of the medical care average Iraqis are offered.

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