Monday, 1 November 2004
British medical weekly The Lancet estimates more than half of 100,000 Iraqi civilians have died from violence.
Middle East Online
PARIS - Around 100,000 Iraqi civilians have died as a result of the March 2003 US-led invasion of Iraq, more than half of them from violence, according to an estimate to be published on Friday by the British medical weekly The Lancet.
The research, based on interviews among Iraqi households and an extrapolation of the data, was led by experts from the Johns Hopkins Bloomberg School of Public Health in Baltimore, in the US state of Maryland.
"Making conservative assumptions, we think that about 100,000 excess deaths or more have happened since the 2003 invasion of Iraq," the authors said.
"Violence accounted for most of the excess deaths and air strikes from coalition forces accounted for most violent deaths."
Their figure is based on data from 988 households from 33 randomly-selected neighbourhoods in Iraq.
Families were asked to give the number of deaths since January 2002, the date and cause and, if a violent death was involved, the circumstances.
The mortality rates for the 14.6 months before the invasion were then compared with those for the 17.8 months after it, and a nationwide estimate was then extrapolated.
The 988 households, comprising 7,868 residents, were visited between September 8 and 20 2004. Five of the households refused to be interviewed.
In the period before the invasion, the interviewed households had 275 births and 46 deaths, most of them caused by heart attack, stroke and chronic illness. Only one occurred from violence.
In the period afterwards, there were 366 births and 142 deaths, 73 of them - 51 percent - from violence. Heart attack, stroke, neonatal death and infectious disease were the other significant causes.
Twenty-one of the deaths occurred among children younger than a year old.
The sample used for the study is small by the standards of epidemiology, the discipline of using statistics to estimate the prevalence of mortality or sickness.
The authors themselves acknowledge that the sampling strategy "might not have captured the overall mortality experience in Iraq."
And, they say, it is possible that "many of the Iraqis" reported to have been killed by the US forces could have been combattants.
Of 61 killings attributed to the US forces by the interviewees, 28 involved men aged 15-60, 28 were children younger than 15, four were women and one was a man.
The study was led by Les Roberts of the school's Center for International Emergency Disaster Studies and included two specialists in community medicine at the Al-Mustansiriya University in Baghdad.
Fifty-two of the 73 reported deaths from violence occurred in a cluster around the Sunni bastion of Fallujah, where US forces have waged fierce battles with insurgents.
If Fallujah is stripped out of the calculations, the overall estimate for the civilian tally nationwide comes to just under 100,000, at 98,000.
If it is included, the death toll would rise around 200,000, although the researchers stress that there is "substantial... uncertainty" in making a projection of that kind.
"Our results need further verification and should lead to changes to reduce non-combatant deaths from air strikes," the authors add.
The study will be published online Friday by the London-based Lancet.
Its editor, Richard Horton, acknowledged in a commentary that "certain limitations were inevitable and need to be acknowledged right away," but said that despite these flaws, the data and the analysis had been approved in a fast-track peer assessment by other experts in the field.
In the circumstances of warfare, scientific data is rare and precious but analysis is invariably hedged with uncertainties, he said.
