[DEBATE] : Iraq Body Count disputes Lancet death toll estimates

[MFleshman at aol.com]

October 17, 2006
Huge gaps in Iraq death estimates 
Analysis 
By Paul Reynolds  
World affairs correspondent, BBC News website  


The estimate that about 655,000 people have died in Iraq as a  result of the 
2003 invasion is such a large figure that it has led to two  differing 
interpretations.  
Those who had faith in an earlier report from 2004 - also published in the  
medical journal The Lancet - are now able to say that this larger survey proves 
 their point that Iraqi deaths have been far greater than publicly reported, 
and  have now reached what the report calls "a humanitarian emergency".  
Those who thought that the 2004 survey was exaggerated - it estimated 98,000  
additional deaths up until September 2004 - think this one is even more wide 
of  the mark.  
Les Roberts, one of the report's authors said: "It may not be extremely  
precise, but it gets us into the ball park."  
Professor Gilbert Burnham, another of the report's authors and an  
epidemiologist at the Johns Hopkins Bloomberg School of Public Health, said:  "We're 
very confident with the results."  
And other epidemiologists supported that view. Ronald Waldman of Columbia  
University told the Washington Post that the survey used a method that was  
"tried and true" and that "this is the best estimate of mortality we have."  
On the other hand, Michael O'Hanlon of the Brookings Institution, which  
tracks statistics in its Iraq Index, said: "I do not believe the new numbers. I  
think they're way off."  

     It may not be extremely precise, but it gets  us into the ball park 
Les Roberts 
report  author 
 
The Brooking Index, relying on the UN (which gets figures from the Iraqi  
health ministry) and the Iraq Body Count (IBC), estimates the civilian death  
toll at about 62,000.  
The IBC, which counts the number of reported civilian deaths, puts them  
between 43,850 and 48,693, though it adds that "our maximum refers to reported  
deaths - which can only be a sample of true deaths unless one assumes that every 
 civilian death has been reported. It is likely that many if not most 
civilian  casualties will go unreported by the media."  
The IBC reaction to the Lancet report is awaited. (Update Monday 16 October:  
The IBC response has now been published. See below after summary of Lancet  
report)  
US President George W Bush rejected the estimate.  

     I don't consider it a credible report 
President Bush  
 
"I don't consider it a credible report," he said.  
The US commander in Iraq, Gen George Casey, used a similar phrase.  
British Foreign Secretary Margaret Beckett was more careful, and did not  
reject the report outright. However, she questioned it.  
"The report gives a figure which is orders of magnitude different from any  
other source... nobody else has come up with figures on this scale... the 
report  has been criticised by the Iraqi government as unreasonable," she said.  
One should note here the political nature of this debate, as well as the  
statistical. Some critics say that the report's authors and the editor of the  
Lancet Richard Horton have a political agenda in opposing the war in Iraq, and  
that therefore this should be taken into consideration when discussing this  
work. In turn of course some of these critics tend to be politically committed  
themselves.  
Report methodology  
First, though, to the report itself. Its strength, its authors argue, is in  
its tried and trusted method.  
It took a sample and then extrapolated broad results from that sample. This  
is a technique used in other areas of conflict, in public opinion polling and 
in  marketing, for example, in assessing television audiences.  
In 2004, 33 clusters were chosen across the country with 30 households in  
each cluster. These households contained 7,868 people. This time, 47 clusters  
were chosen, with 12,801 people.  

The method was to question people about deaths in their household  first in 
the "pre-invasion" period and then in the "post-invasion" period  leading up to 
July 2006.  
The difference would constitute what the survey calls "excess deaths".  
The report says that there were 82 deaths pre-invasion and 547 post-invasion. 
  
It then multiplied these figures up in relation to the Iraqi population of  
27,139,584, and came up with an estimated 654,956 "excess" deaths, 2.5 % of the 
 population.  
Some statistical caveats are entered. The lowest estimate of deaths is put at 
 392,979 and the highest at 942,636. The lowest figure is still much bigger 
than  the other counts.  
Of the "excess" deaths, 601,027 were attributed to the violence (mainly from  
gunfire and mainly among men aged 15-59), the rest coming largely from 
increased  illness and disease.  
The report concludes: "Our estimate of excess deaths is far higher than those 
 reported in Iraq through passive surveillance methods. This discrepancy is 
not  unexpected. Data from passive surveillance are rarely complete, even in 
stable  circumstances, and are even less complete during conflict."  
IBC response  
The Iraqi Body Count response is as follows. Its says the Lancet report  
implies that:  
On average a thousand Iraqis have been violently killed every day in the  
first half of 2006, with "less than a tenth being noticed by any public  
surveillance mechanism."  
Of 800,000 wounded people in the past two years, "less than a tenth received  
any kind of hospital treatment."  
Over 7% of the male population has been killed; 10% in central region.  
Half a million death certificates were issued to families but not officially  
recorded.  
The Coalition has killed far more people in the last year than in the  
invasion and Falluja type-operations of earlier years.  
The IBC says that such assertions suggested incompetence/fraud on a massive  
scale by hospitals and ministries, self-destructive behaviour by the wounded, 
an  utter failure by agencies to notice decimation of the male population and 
an  abject media failure to observe the scale of events.  
The IBC concludes: "In the light of such extreme and improbable implications, 
 a rational alternative conclusion to be considered is that the authors have  
drawn conclusions from unrepresentative data. In addition, totals of the  
magnitude generated by this study are unnecessary to brand the invasion and  
occupation of Iraq a human and strategic tragedy."  
'Missing' dead  
One issue raised by critics generally is that, to speak crudely, the numbers  
of bodies being discovered do not match the Lancet figures.  
It is assumed that the 601,000 violent "excess" deaths between March 2003 and 
 July 2006 (about 40 months) should produce an average of about 500 violent  
deaths per day.  
This is not going to be so all the time, given the spikes of violence, but it 
 is a rough criterion.  
The latest figures from the Iraqi health ministry (reported by the Associated 
 Press news agency on 11 October) stated that 2,667 people were killed in 
Baghdad  during September, 400 more than in August.  
This gives an average of about 86 per day in the capital.  
Baghdad is not the whole country of course, but AP reported the United  
Nations as saying that in July and August, 6,599 people were killed across the  
country, of which 5,106 were in Baghdad.  
This suggests that Baghdad has by far the highest number of actual and  
percentage dead.  
So, if the current rate in Baghdad is about 86 and the countrywide figure  
should be about 500 according to the Lancet report, where are the "missing"  
dead?  
Author's reply  
Update: I put these points to author Les Roberts who replied: "There have to  
be ~300 deaths per day from natural cause even if Iraq was the healthiest 26  
million people in the world. Where are those bodies? When the MOH [ministry 
of  health] in Iraq is perhaps recording 10% of them, why should they be doing  
better with politically charged violent deaths. Yes, I think almost nothing 
is  getting reported outside of Baghdad where things are worse."  
And he suggested that a way existed of checking his results.  
"There has rarely been a scientific report so easily verified or discarded.  
If someone went to 4 or 6 places picked at random in Iraq, and went to the 
grave  yards for those villages, they could easily see if there are 3 or 4 times 
more  bodies being brought in per week compared to 2002. Or, if someone could 
go to a  couple villages or places, if we are correct, on average ~70 percent 
of the  deaths occurring will be from violence.  
"This would take 2 reporters one day to decide if we are basically correct or 
 in error!"  
The difficulty of course is that the international media is incapable of  
getting around safely to do something like that easily. The local media is a  
source but cannot be relied on by itself.  
We are left then with the estimate from this report and the various counts by 
 other groups.  
The figures are now even more divergent than they were.