[DEBATE] : Lancet: 655,000 Iraqi war dead

[MFleshman at aol.com]

Study Claims Iraq's 'Excess' Death Toll Has Reached  655,000
By David Brown
Washington Post Staff Writer
Wednesday,  October 11, 2006; A12
A team of American and Iraqi epidemiologists estimates that 655,000 more  
people have died in _Iraq_ 
(http://www.washingtonpost.com/wp-srv/world/countries/iraq.html?nav=el)  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. 
The surveyors said they found a steady increase in mortality since the  
invasion, with a steeper rise in the last year that appears to reflect a  worsening 
of violence as reported by the U.S. military, the news media and  civilian 
groups. In the year ending in June, the team calculated Iraq's  mortality rate 
to be roughly four times what it was the year before the war. 
Of the total 655,000 estimated "excess deaths," 601,000 resulted from  
violence and the rest from disease and other causes, according to the study.  This 
is about 500 unexpected violent deaths per day throughout the country. 
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." 
The survey was conducted between May 20 and July 10 by eight Iraqi physicians 
 organized through Mustansiriya University in Baghdad. They visited 1,849  
randomly selected households that had an average of seven members each. One  
person in each household was asked about deaths in the 14 months before the  
invasion and in the period after. 
The interviewers asked for death certificates 87 percent of the time; when  
they did, more than 90 percent of households produced certificates. 
According to the survey results, Iraq's mortality rate in the year before the 
 invasion was 5.5 deaths per 1,000 people; in the post-invasion period it was 
 13.3 deaths per 1,000 people per year. The difference between these rates 
was  used to calculate "excess deaths." 
Of the 629 deaths reported, 87 percent occurred after the invasion. A little  
more than 75 percent of the dead were men, with a greater male preponderance  
after the invasion. For violent post-invasion deaths, the male-to-female 
ratio  was 10-to-1, with most victims between 15 and 44 years old. 
Gunshot wounds caused 56 percent of violent deaths, with car bombs and other  
explosions causing 14 percent, according to the survey results. Of the 
violent  deaths that occurred after the invasion, 31 percent were caused by 
coalition  forces or airstrikes, the respondents said. 
Burnham said that the estimate of Iraq's pre-invasion death rate -- 5.5  
deaths per 1,000 people -- found in both of the Hopkins surveys was roughly the  
same estimate used by the CIA and the U.S. Census Bureau. He said he believes  
that attests to the accuracy of his team's results. 
He thinks further evidence of the survey's robustness is that the steepness  
of the upward trend it found in excess deaths in the last two years is roughly 
 the same tendency found by other groups -- even though the actual numbers 
differ  greatly. 
An independent group of researchers and biostatisticians based in England  
produces the Iraq Body Count. It estimates that there have been 44,000 to 49,000 
 civilian deaths since the invasion. An Iraqi nongovernmental organization  
estimated 128,000 deaths between the invasion and July 2005. 
The survey cost about $50,000 and was paid for by Massachusetts Institute of  
Technology's Center for International Studies. 
Staff researcher Madonna Lebling contributed to this report. 
© 2006 The  Washington Post Company