Economic and Political Weekly December 9, 2006 5028

The Dead in Iraq and the

War of Numbers
Two different studies on mortality in Iraq after the 2003
US invasion by Iraq Body Count and Johns Hopkins School
of Public Health provide vastly different assessments.
VINAY LAL
A
mong the many wars taking place
in and around Iraq the American
war on (or of) terror, the war
between the occupation forces and Iraqi
insurgents and civilians, the war relent-
lessly being waged on innocent civilians
by a wide array of armed forces, the strife
between sunnis and shias, the war by media
groups to gain the attention of the world,
to enumerate only the most obvious forms
of an escalating conflict that shows little
sign of diminishment the war of numbers
is shaping up as an important part of the
conflict. The daily barrage of the dead is
such that a long-term perspective on ca-
sualties may appear to be something of a
luxury. Since the American invasion of
Iraq in March 2003, the independent
organisation Iraq Body Count (www.iraq
bodycount.org) has been maintaining
a tally of civilian deaths in Iraq that
have resulted from the 2003 military inter-
vention by the USA and its allies, and its
count includes civilians who have died at
the hands of US forces, other coalition
troops, Iraqi security forces, insurgents,
and all other paramilitary organisations.
As of October 27, 2006, the Iraq Body
Count gave a maximum total of civilian
deaths of 49,697.
Excess Deaths and Its
As s es s ment
However, a recent and apparently cre-
dible study undertaken by the highly
respected Johns Hopkins School of Public
Health, whose researchers worked in
collaboration with Iraqi medical doctors
affiliated to the School of Medicine at
Baghdads Al Mustansiriya University, has
estimated that through July 2006, there
have been 6,54,965 fatalities since the
invasion.
1
These are described as excess
deaths, or fatalities above the pre-
invasion death rate. How is it possible that
by a foreign imperialist power. Iraq, one
fears, is not far from being reduced to a
similar state of paupery.
Johns Hopkins Study
The Johns Hopkins study, expectedly,
has attracted some criticism, and the
American administration officials imme-
diately dismissed it as unreliable. Of
course, unreliable here signifies nothing
at all, unless it be the well known inca-
pacity of officials in the Bush administra-
tion, for whom the example has been set
by the commander-in-chief himself, to
admit that Iraq has been turned into an
inferno. The authors of the study, who are
medical practitioners, cannot be accused
of being politically motivated, though in
fact, doctors and other health professionals
have every reason to feel aggrieved. The
health system in Iraq has disintegrated, and
there are documented instances of doctors
and nurses being targeted by killers to
prevent them from healing the wounded
among the enemy. There were 34,000
physicians in Iraq before the invasion of
2003, and already by mid-2004 some 2,000
had been murdered while another 12,000
had emigrated. Even the most inexpensive
medicines and medical supplies, such as
rehydration tablets, disposable needles
and plastic masks, are in acutely short
supply. Some Iraqi health care specialists
have given it as their opinion that Iraqi
deaths could have been halved if adequate
medical facilities had been available to
care for the wounded. On the other hand,
the American fatality rate has never been
so low, and American soldiers who would
have died of their present wounds in any
previous war have been given a new lease
on life by the most advanced system of
emergency medicine brought to the battle-
field and to military hospitals.
Iraq Body Count
Since the founder of Iraq Body Count
and the authors of the Johns Hopkins study
have alike expressed confidence in their
results, it is instructive to understand why
they might have arrived at such different
conclusions. Iraq Body Count attempts to
verify every report of fatalities, but, in
what is doubtless a critical shortcoming,
it relies entirely on online media reports
from recognised sources and eyewitness
narratives for its information. If a fatal
incident has not been seen or witnessed,
two widely cited figures on Iraqi fatalities
could be so hugely discrepant? Which study
is more credible, or is it the case that, both
studies being flawed, the truth lies some-
where in the middle? It surely matters how
many Iraqis have been killed since the
invasion, and not only because one study
furnishes a number that is more than 10
times greater than the other number, and
the human thirst for truth cannot appar-
ently be satisfied by both numbers. It
matters because the larger number, if true
or at least a more reliable approximation
of the truth, would suggest that an addi-
tional 2.5 per cent of Iraqs population has
been wiped out in little over three years,
and such an astronomical loss of lives
cannot but have far-reaching demographic
consequences. The Johns Hopkins study
notes that 6,01,027 of the excess deaths
occurred due to violent causes, and that the
victims are largely male, aged 15-44 years.
A set of comparisons comes to mind:
over the six years that the second world
war lasted, the UK lost 0.94 per cent of
its population, even though London was
subjected to relentless bombing over the
course of months, and China and the US
lost 1.89 per cent and 0.32 per cent of their
population, respectively. (The US only
entered the war after the attack on Pearl
Harbour in December 1941.)
The Korean war suggests a more chilling
comparison: though the precise number of
civilian casualties is a matter of some
dispute, with estimates varying from 1.8
million to nearly four million fatalities, the
matter-of-fact assessment of general Curtis
LeMay, the architect of the fire-bombing
of Tokyo in March 1945, casts a rather
more ominous light on the catastrophe
facing Iraq: Over a period of three years
or so we killed off what 20 per cent
of the population. Those who describe
North Korea as a rogue state have not
probed whether the countrys present
dilapidated state might not have some
relationship to the brutalisation of its people
Letter from America
Economic and Political Weekly December 9, 2006 5029
the victim is unlikely to end up as a statistic
and is consigned to utter oblivion. Iraq
Body Counts researchers admit that their
tally does not account for all war-related
civilian deaths, but nonetheless they insist
that their mortality statistics still furnish
the most reliable data for Iraqi civilian
casualties. The Johns Hopkins study, in
contrast, is described by its initiators as
the only population-based assessment of
fatalities in Iraq during the war. Follow-
ing on the heels of an earlier study in 2004,
which was faulted for securing a sampling
base of only 1,000 families and having a
large margin of error, the 2006 survey was
more exhaustive and used a standard cluster
survey method ordinarily used to measure
mortality in conflict situations. The survey
members covered 16 of the 18 administra-
tive districts in Iraq, and selected at random
50 sites for their survey, and 40 households
at each site. Every household thus had an
equal chance of being included, and even-
tually data from 1,849 households was
included.
Cluster Survey Method
While the authors of the Johns Hopkins
study scarcely claim infallibility, their study
is accompanied by a robust defence of the
methods they deployed to study mortality
in Iraq. The cluster survey method relies
on random sampling, except that, in situ-
ations of extreme conflict where the listing
of all persons or households becomes nearly
impossible, it involves random selection
of clusters of people or households rather
than individual people. They acknowledge
that researchers encountered numerous
difficulties, having to overcome US mili-
tary checkpoints, and occasionally some
suspicion in the homes that they visited.
Each survey team consisted of two men
and two women, all Iraqis, medical doctors
and fluent in English and Arabic. Each
researcher was trained in the use of the
questionnaire. The pre-invasion and post-
invasion mortality rates were compared,
and in every household where the death
of a member was reported to the survey
team, the interviewees were asked to present
a copy of the death certificate of their
relative. In 92 per cent of such instances,
the study reports, a death certificate was
present. Nonetheless, sceptics might feel
entitled to entertain the usual doubts the
size and representativeness of the sample,
the quality of survey techniques, the rap-
port between the researcher and the inter-
viewee about such sampling studies. Nor
does the thoroughness of the study pre-
clude some obvious questions: for instance,
could some who have been counted among
the dead simply have left the country?
Were household members likely to invent
deaths, either out of bitterness or in the
hope that this would entitle them to some
compensation?
Alarming Statistics
The findings of the Johns Hopkins study
are, to say the least, stunning. Though the
whole number of 6,54,965 excess deaths,
of which 53,938 were due to non-violent
causes, is the most alarming statistic to
emerge from the study, some of the other
key findings confirm the perception that the
conflict in Iraq has sharply escalated over
the course of the last 18 months. The crude
mortality rates tell their own depressing
story. In the 12 months preceding the in-
vasion of March 2003, the death rate was
5.5 deaths per 1,000 per year; in the 12
months following the invasion, it had risen
to 7.5 deaths per 1,000. From May 2004-05,
it again rose to 10.9 deaths per 1,000, but
in the subsequent 12 months, ending in June
2006, it nearly doubled to 19.8 deaths per
1000, or almost quadruple of the baseline
crude death rate of 5.5 deaths per 1,000 in
the pre-invasion period. At the present rate,
over 900 people are dying from violence
daily, and over 50 per cent of the violent
deaths can be attributed to gunshots. These
figures, as the authors of the study realise,
might not seem congruent with the figures
appearing in the newspapers and online media
reports. But, as they point out, the passive
surveillance methods to measure mortality,
such as visits to morgues and reliance on
media reports, have not been shown to
identify more than 20 per cent of the deaths
in other major conflict situations such as
Kosovo, the Democratic Republic of Congo
and Darfur.
Whatever ones own political inclinations,
profound ethical questions arise from such
studies. In the midst of the disagreements, it
is easy to forget that the violent death of a
single person diminishes everyone.
Mohandas Gandhi understood this, not
merely as something of an abstract idea, but
as an ethical stance that forbids us from
being seduced by the calculus of numbers
and the attendant geopolitical considerations.
In February 1922, at the height of the non-
cooperation movement which had been the
most concerted opposition to British rule
since the rebellion of 1857-58 and by the
admission of some colonial officials had
succeeded in paralysing British admini-
stration in various places, Gandhi invoked
his authority to put the entire movement into
suspension. Some 20 odd Indian policemen
serving under the raj had been killed at
Chauri Chaura by angry crowds, ironically
many of them acting in the name of the
Mahatma, and Gandhi was persuaded that
the country was not adequately prepared to
offer non-violent resistance. To his many
critics, who chafed at Gandhis authorit-
arianism, suspected him of subservience to
the regime of law and order, and felt enraged
that he had squandered the opportunity to
bring the British to their knees, Gandhi
replied unswervingly: With what words
could he console the bereaved widows of
the policemen, and with what countenance
could he look them in the eye and justify
those deaths as necessary in the name of
some higher political good?
Yankee Individualism
The Iraq Body Counts web site is pre-
faced in bold with a remark by general
Tommy Franks, US central command: We
dont do body counts. More accurately, it
is the Iraqi bodies that are not counted, since
the bodies of dead American soldiers are,
by contrast, a matter of obsessive concern.
The death toll of American soldiers, listed
by name, rank, regiment or division, and
place of origin appears across the country
with numbing regularity in the New York
Times, numerous other newspapers and
web sites, and public memorials. Even in
death, the American retains his, so to speak,
rugged Yankee individualism. The Iraqis
appear today, as they have in countless
other narratives, en masse, heaped together,
always as part of a collectivity. One must
wonder whether it is dead Iraqis that are
now being fought over, or whether the
terrain of conflict, as far as mortality in
Iraq is a question, has shifted to the
question of what constitutes science.
That two studies, both grounded in what
appear to their researchers to be objective
measures and animated by the concern to
fulfil a moral obligation to the Iraqi people
and to posterity, have come to such vastly
different assessments of mortality in Iraq
suggest that we must revisit, to invoke the
phrase of the historian of science, Ted
Porter, our trust in numbers. Modern
science replaced the certitudes of one age
with another set of certitudes, but as the
present controversies over death and destruc-
tion in Iraq indubitably demonstrate, our
uncertainties are not likely to be resolved by
more accurate studies or more empirical
research. Not all narratives are equally com-
pelling, but it also appears that one of the
many insights to be gained from the disputes
over mortality in post-invasion Iraq is that
in the onus to lead an ethical and politically
aware life, science may not offer much
more assistance than did religion.
Email: vlal@history.ucla.edu
Note
1 Gilbert Burnham et al, The Human Cost of the
War in Iraq: A Mortality Study, 2002-2006
Baltimore, Baghdad and Cambridge, Mass, 2006.
EPW