The Lancet Report vs. Iraq Body Count

I made note of the report in The Lancet on recently-completed research in Iraq of how death rates have changed in the months .

The study’s authors estimated that 100,000 more Iraqis had died in than would have died had the death rates in Iraq remained the same as their pre-war levels. This increased death rate was almost entirely due to deaths from war violence, and those deaths were overwhelmingly the result of coalition “aerial weaponry.”

This 100,000 number raised eyebrows, since until now, the closest thing to rigorous civilian mortality figures had been from sources like Iraq Body Count, and the press had gotten used to writing paragraphs juxtaposing the Iraq Body Count figures (at this writing: 15,285 ± 1,066) with the boilerplate Pentagon assertion that they do everything possible to minimize civilian casualties. (The Pentagon does not release its own estimates of the civilian casualties its actions cause, and in fact frequently insists that it does not even generate such estimates. The Iraq Health Ministry was doing its own counts for a while, but was ordered to stop.)

The huge difference between the Iraq Body Count and Lancet numbers is not surprising. While both counts are an attempt to get some estimate of the war’s impact, they are actually counting very different things. In short:

  • Iraq Body Count counts all civilian deaths in Iraq that were caused by coalition military action and that were mentioned in at least two independently-generated reports in certain of the major English-language news media. (See their Methodology page for more detail.)
  • The Lancet report is a statistical extrapolation from a random sample of households in Iraq, where people in the household were interviewed to determine deaths in that household from all causes in .

Clearly, they’re counting very different things, and you would expect that the Iraq Body Count figures — which only count a death if two, independent, major, English-language media sources report on it and agree that the dead person was a civilian and was killed by coalition action (or perhaps, negligent inaction1) — would be lower by far than the actual fatality figures, and lower than the Lancet results too, unless you were confident that the over-all health situation had improved so much in Iraq since the invasion as to counteract the effects of warfare.

The Lancet’s report is generous with the details about how the study was conducted and the difficulties involved with doing such a study in occupied Iraq. For instance, part of the study involved picking a random starting point with GPS coordinates, and then finding the thirty interviewable households closest to that point. However, in one of those random starting points, this technique could not be used:

Falluja was the only cluster where GPS units could not be used to find the random starting point. These devices have military uses and their possession resulted in the imprisonment and death of many Iraqis during the previous regime. Since interviewers were stopped and searched repeatedly getting into Falluja, the use of a GPS unit could have resulted in the killing of interviewers. Stopping a car in Falluja at a random point at the date of the visit () and walking away from it was also likely to result in the killing of interviewers. For Falluja, the team assumed an approximate size of the town. They picked a distance down a main road and a number of blocks to the side based on random number selection. Interviewers walked the final 700 m estimating the distance. This presents the potential of subconscious or other forces influencing the selection of the starting point.

The Falluja data sample, as it turned out, was not only difficult to collect but difficult to analyze: two-thirds of the violent deaths recorded in the study happened there, making it an “extreme statistical outlier,” and also, atypically, “23 households of 52 visited (44%) were either temporarily or permanently abandoned. Neighbours interviewed described widespread death in most of the abandoned houses but could not give adequate details for inclusion in the survey.” (This highlights one deficiency of the study’s method — if everybody in a household is killed, or if enough are that the household no longer exists as such, this study’s method will not notice them. You can’t interview a pile of rubble.)

Because of this, for most of the conclusions in the Lancet study (including the “100,000” estimate), the data from the Falluja cluster were not included.

People better at statistics than myself have criticized the meaningfulness of numbers generated under such difficult conditions, and these criticisms have themselves been criticized by folks, who probably, unlike myself, passed their introductory stats class with a grade that helped their average.

That said, I won’t be entirely shy about drawing some conclusions from this study. What jumped out at me was that the increase in deaths noticed by the Lancet researchers was largely the result of violent deaths (one such before the invasion, seventy-three after, or twenty-one if you exclude Falluja), and that these violent deaths were overwhelmingly due to coalition airstrikes: two were attributed to anti-coalition forces, one to the old regime during the invasion, seven were criminal, two were unknown, the other 61 were caused by the coalition — three with small-arms fire2 and the remaining 58 “caused by helicopter gunships, rockets, or other forms of aerial weaponry.”

It bears repeating that the press conference lullaby about the coalition doing all it can to avoid civilian casualties is as much a lie as any of Stalin-era Pravda’s grain harvest reports. At least the editors of Pravda had the excuse that they’d be taken out and shot if they didn’t print the lies.

The coalition is inflicting effectively indiscriminate destruction on civilian areas with massive aerial firepower. And a new assault on Falluja is expected any day now.

In the early days of the invasion attempts to kill the Iraqi leadership through “precision” bombings, sometimes in civilian neighborhoods, went 0 for 50, meanwhile destroying whole blocks of homes and those inside. Did the coalition, in its eagerness to minimize civilian casualties, give up on this technique? Hardly. Instead, it seems to have taken Paul Tibbets’s advice regarding civilian casualties: “That’s their tough luck for being there.” Hardly a day goes by when the press doesn’t credulously report that the coalition has bombed a Zarqawi “safe house” — using the same sort of intelligence, the same techniques, and ultimately the same results (al-Zarqawi still seems to be on the loose, but those houses are dropping like dominoes3).

The coalition has chosen less-risky, more expensive, more cowardly, and more indiscriminately lethal forms of warfare to meet its objectives.4 That is what precision, guided bombs and helicopter gunships are for. If the worst that can happen if your target doesn’t turn out to be what you hoped it was is that innocent civilians get killed and maimed, well, what’s holding you back but decency and respect for humanity (and who’d be in uniform in Iraq if they were burdened by any of that)?

  1. Iraq Body Count now says that “In the current occupation phase this database includes all deaths which the Occupying Authority has a binding responsibility to prevent under the Geneva Conventions and Hague Regulations. This includes civilian deaths resulting from the breakdown in law and order, and deaths due to inadequate health care or sanitation.” But I doubt that many such deaths are considered newsworthy enough to meet their reporting requirements.
  2. “In one of the three cases, the 56-year-old man killed might have been a combatant. In a second case, a 72-year-old man was shot at a checkpoint. In the third, an armed guard was mistaken for a combatant and shot during a skirmish. In the latter two cases, American soldiers apologised to the families of the descendants for the killings, indicating a clear understanding of the adverse consequences of their use of force.” Evidence, perhaps, both that even in more direct, face-to-face combat, the U.S. is fairly careless about whom they’re shooting at; or, more charitably, that when they’re not bombing the battlefield from afar, virtual-reality style, they’re more sensitive to the consequences of their mistakes.
  3. Riverbend at Baghdad Burning makes al-Zarqawi out to be an Emmanuel Goldstein: “Everyone here knows Abu Mussab Al-Zarqawi isn’t in Falloojeh. He isn’t anywhere, as far as anyone can tell. He’s like the WMD: surrender your weapons or else we’ll attack. Now that the damage is done, it is discovered that there were no weapons. It will be the same with Zarqawi. We laugh here when we hear one of our new politicians discuss him. He’s even better than the WMD — he has legs. As soon as the debacle in Falloojeh is over, Zarqawi will just move conveniently to Iran, Syria, or even North Korea. ¶ …They’ve been bombing Falloojeh for several weeks now. They usually do the bombing during the night, and no one is there to cover the damage and all the deaths. It’s only later we hear about complete families being buried alive or shot to death by snipers on the street.”
  4. And here I find a better-worded echo on Crooked Timber: “The use of air strikes in civilian areas foreseeably results in increased civilian deaths. Going into a built-up area with troops to raid a (possibly booby-trapped) house used by insurgents exposes soldiers to greatly increased risk of death or serious injury; calling in an airstrike doesn’t. But we know from other theatres that such strikes often kill numbers of bystanders. The risk of the operation is transferred by deliberate and systematic policy from soldiers to bystanders. Such a policy runs contrary to traditional views about who should bear the risk of operations: we can’t insulate civilians completely but where there’s a choice soldiers both in virtue of the role they occupy and the fact (here) that they are volunteers should take on more exposure in order to protect civilians. It is hard to escape the thought that were co-nationals of the people dropping the bombs the ones in the bystander position, different methods would be used.”*

* (There’s something satisfyingly perverse about footnoting a footnote, don’t you think?) The folks at Kuro5hin have risen to the Crooked Timber challenge by modestly proposing that the insurgency-fighting techniques that have worked so well in Falluja be imported back to the United States to combat our own problems with crime and what-not.