'Intelligent discontent is the mainspring of civilization.' -- Eugene V. Debs

Wednesday, October 11, 2006

655,000 Dead Iraqis? 

Nothing is more vexing than the subject of Iraqi deaths as a result of the invasion, a subject examined here on three occasions: November 10, 2005, January 9, 2006 and February 9, 2006.

Readers of these earlier posts may recall two prominent interrelated themes: first, the extent to which the October 2004 Lancet study was credible, a study that concluded that between 8,000 and 194,000 people had died as a result of the invasion and occupation, with the most probable number being approximately 98,000, and, secondarily, the extent to which the work of Iraq Body Count, which relies exclusively upon media reports, had either wittingly or unwittingly begun to serve the propaganda purposes of the occupation by understating the number of Iraqi deaths.

Yesterday, the Lancet released the results of a new study which again brings these troubling subjects to the forefront:

A team of American and Iraqi epidemiologists estimates that 655,000 more people have died in Iraq since coalition forces arrived in March 2003 than would have died if the invasion had not occurred.

The estimate, produced by interviewing residents during a random sampling of households throughout the country, is far higher than ones produced by other groups, including Iraq's government.

It is more than 20 times the estimate of 30,000 civilian deaths that President Bush gave in a speech in December. It is more than 10 times the estimate of roughly 50,000 civilian deaths made by the British-based Iraq Body Count research group.

Of these deaths, approximately 601,000 resulted from violence, and, for once, the mainstream media addressed the question of the Lancet's methodology with sincerity, or, at least, the Washington Post did:

The survey was done by Iraqi physicians and overseen by epidemiologists at Johns Hopkins University's Bloomberg School of Public Health. The findings are being published online today by the British medical journal the Lancet.

The same group in 2004 published an estimate of roughly 100,000 deaths in the first 18 months after the invasion. That figure was much higher than expected, and was controversial. The new study estimates that about 500,000 more Iraqis, both civilian and military, have died since then -- a finding likely to be equally controversial.

Both this and the earlier study are the only ones to estimate mortality in Iraq using scientific methods. The technique, called "cluster sampling," is used to estimate mortality in famines and after natural disasters.

While acknowledging that the estimate is large, the researchers believe it is sound for numerous reasons. The recent survey got the same estimate for immediate post-invasion deaths as the early survey, which gives the researchers confidence in the methods. The great majority of deaths were also substantiated by death certificates.

"We're very confident with the results," said Gilbert Burnham, a Johns Hopkins physician and epidemiologist.

A Defense Department spokesman did not comment directly on the estimate.

"The Department of Defense always regrets the loss of any innocent life in Iraq or anywhere else," said Lt. Col. Mark Ballesteros. "The coalition takes enormous precautions to prevent civilian deaths and injuries."

He added that "it would be difficult for the U.S. to precisely determine the number of civilian deaths in Iraq as a result of insurgent activity. The Iraqi Ministry of Health would be in a better position, with all of its records, to provide more accurate information on deaths in Iraq."

Ronald Waldman, an epidemiologist at Columbia University who worked at the Centers for Disease Control and Prevention for many years, called the survey method "tried and true," and added that "this is the best estimate of mortality we have."

This viewed was echoed by Sarah Leah Whitson, an official of Human Rights Watch in New York, who said, "We have no reason to question the findings or the accuracy" of the survey.

"I expect that people will be surprised by these figures," she said. "I think it is very important that, rather than questioning them, people realize there is very, very little reliable data coming out of Iraq."

Meanwhile, the New York Times, apparently intent on demonstrating that the ghost of Judith Miller still resides there, took a different tack:

Gilbert Burnham, the principle author of the study, said the figures showed an increase of deaths over time that was similar to that of another civilian casualty project, Iraq Body Count, which collates deaths reported in the news media, and even to that of the military. But even Iraq Body Count puts the maximum number of deaths at just short of 49,000.

As far as skepticism about the death count, he said that counts made by journalists and others focused disproportionately on Baghdad, and that death rates were higher elsewhere.

“We found deaths all over the country,” he said. Baghdad was an area of medium violence in the country, he said. The provinces of Diyala and Salahuddin, north of Baghdad, and Anbar to the west, all had higher death rates than the capital.

Statistics experts in the United States who were able to review the study said the methods used by the interviewers looked legitimate.

Robert Blendon, director of the Harvard Program on Public Opinion and Health and Social Policy, said interviewing urban dwellers chosen at random was “the best of what you can expect in a war zone.”

But he said the number of deaths in the families interviewed — 547 in the post-invasion period versus 82 in a similar period before the invasion — was too few to extrapolate up to more than 600,000 deaths across the country.

Donald Berry, chairman of biostatistics at M. D. Anderson Cancer Center in Houston, was even more troubled by the study, which he said had “a tone of accuracy that’s just inappropriate.”

A couple of things jump off the page here, the tried and true technique of the Times to reinforce the acceptable government narrative by undercutting the general conclusion (Statistics experts in the United States who were able to review the study said the methods used by the interviewers looked legitimate) by highlighting the most vociferous critics with personal quotes (Robert Blendon and Donald Berry), and, more disturbingly, the uses and abuses of the Iraq Body Count estimates.

As I observed my February post, the IBC admission that it relies predominately upon Western media sources to confirm Iraqi deaths, more specifically reports published in English, is problematic, and potentially indicative of an ingrained cultural bias:

Given such an admission, it is hard to understand how anyone could consider the efforts of IBC credible, and it is even more extraordinary that American and British media commonly cite figures from it without acknowledging this embarrassing disclaimer, while ignoring the results of the study published by the Lancet. As an aside, am I the only person who finds the IBC explanation for relying solely upon reports "published in English" unpersuasive? After all, why is it necessary for "all team members" to be fluent in the language of a published report? Is this just a roundabout way of avoiding an acknowledgement that none of the participants of IBC can read and speak Arabic? Or is it also a means of ensuring that most reports will originate from sources reflexively sympathetic to the cultural perspective of the occupying forces?

Perhaps, I am being too sarcastic about an enterprise that started with such good intentions. Even so, we should not hesitate to wonder whether IBC has been transformed into an endeavor that puts a human face on the occupation, highlighting killings by the resistance and suicide bombers, while lacking the motivation to document killings by occupation forces. As Sam Ramadani said today in the Guardian:

Admittedly, reports on the ground are difficult and dangerous. But while western media are not averse to revealing deceptions around the WMD scare and pre-war lies, occupier-generated news still takes pride of place, and anti-occupation Iraqi voices of all sects - particularly Shia clergy such as Ayatollahs Hassani, Baghdadi and Khalisi - are ignored.

A few months before US soldiers boasted of using white phosphorus, the BBC's Paul Wood defended his reporting from Falluja in the November 2004 siege, telling Medialens: "I repeat the point made by my editors, over weeks of total access to the military operation, at all levels: we did not see banned weapons being used ... or even discussed. We cannot therefore report their use." Doctors and refugees fleeing US bombardment talked of "chemical attacks" and people "melting to death". But for the BBC, eyewitness testimony from Iraqis is way down the pecking order of objectivity.

It would clearly be wrong to portray victims' claims as uncontested facts, but there is a duty to publish and investigate them. Had, for example, Iraqi families' claims been highlighted shortly after the occupation began, the world would not have waited over a year to learn of torture at US-run jails. It was not until US soldiers gleefully circulated sickening pictures of tortured Iraqis that the media paid attention.

One must give the John Hopkins supervised research team credit. It, unlike the Occupation Authority, sought and utilized the expertise and experience of Iraqis, in this instance, Iraqi doctors. Even more impressive, it interviewed Iraqis themselves, instead of relying upon newspaper articles like the IBC. If anything, estimates of Iraqi civilian deaths, like those of the IBC, that rely predominately, if not exclusively, upon surveys of English language articles about events in Iraq, should be considered a floor, and thus, a general indicia of credibility of the challenging research performed by the John Hopkins supervised team to estimate the total number of Iraqi deaths, civilian, military and resistance.

In other words, it strongly suggests that hundreds of thousands of Iraqis have died, even if we reject the assertions of epidemiological statistical accuracy claimed by the John Hopkins team. Regrettably, neither the Post nor the Times drew such a common sense conclusion, as each predictably placed the IBC estimate in juxtaposition to the one published in the Lancet. Perhaps, IBC could step forward and object to such exploitation of its work, and demand a proper context in relation to the work of the John Hopkins team?

Doubtful. My impression of IBC has been that it acknowledges the limitations of its methodology on its website, while gaining notoriety for itself by allowing the mainstream media to use it for exactly the purpose encountered here, to discredit the work of others that place the war and occupation in a harsher, merciless light. After all, Dahr Jamail has reported that IBC actually criticized the earlier Lancet study. Imagine, a research group that estimates civilian deaths by reading the newspaper maligning the work of people who actually interviewed people in the field!

But we should resist the temptation to center the debate as a dispute between IBC and the John Hopkins team, pushing the Iraqis, yet again, to the margins. After all, 655,000 deaths, if one extrapolates from wikipedia, would constitute the death of roughly 2.5% of the populace (just over 26,000,000 in July 2005), with a potentially exponentially greater number of Iraqis wounded. If the number is reduced to 510,000, we are still confronting the deaths of 2% of the Iraqi population.

Significantly, the previous distinction between the earlier Lancet study and IBC estimates, that the John Hopkins team reached to record deaths from disease and lack of medical care connected to the war and occupation, while IBC relied solely upon estimating deaths from violence, has been obliterated, as the new Lancet study asserts, as already noted, that approximately 601,000 of the 655,000 deaths were violent. Unlike many, I have tried to avoid the debasement of the word genocide, but it is hard to find another term to properly describe such mortality from violence. For those of you inclined to dissassociate the US from the deaths of what has been described as sectarian violence, please consider my recent post on US involvement with Iraqi security forces implicated in death squad violence. While certainly traumatic for the families and communities involved, the deaths of 2,751 Americans are inconsequential by comparison.

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