Exchange of letters with Iraq Body Count on Johns Hopkins study estimating 650,000 Iraqi war dead
6 April 2007
The following letter was sent to the World Socialist Web Site by the British-based Iraq Body Count Project in response to the editorial posted by the WSWS on March 20, entitled “The human costs of four years of war: The US invasion has caused nearly three-quarter million Iraqi deaths.” The letter is followed by a reply by Bill Van Auken of the WSWS editorial board.
We found your editorial, “The human costs of four years of war,” of 20 March 2007, generally well constructed and inspiring. Your editorial shows very clearly how Bush and Blair, with a toxic mixture of hubris and misplaced religious certainty, have undermined human life and the complex institutional framework of Iraq and turned this country into a nightmare in such a short period of time. On the topic of Iraqi civilian casualties, however, your editorial badly misinterprets the figures used by various media. While criticising press reports, you continuously refer to the figure 60,000 casualties as “unattributed estimates of 60,000 dead,” and [write that] “the source of these estimates...is not explained.” On the other hand, you seem to accept 655,000 as a “meticulous epidemiological study” without really explaining why this is the case.
As you know, the source of an estimated 60,000 is the research undertaken by Iraq Body Count (minimum 59,326 and maximum 65,160 to date). IBC is an ongoing human security project which maintains and updates the world’s only independent and comprehensive public database of media-reported civilian deaths in Iraq that have resulted from the 2003 US-led military intervention. The count includes civilian deaths caused by coalition military action and by military or paramilitary responses to the coalition presence (e.g., insurgent and terrorist attacks). It also includes excess civilian deaths caused by criminal action resulting from the breakdown in law and order which followed the coalition invasion. Casualty figures are derived from a comprehensive survey of online media reports from recognized sources. Where these sources report differing figures, the range (a minimum and a maximum) are given. This method is also used to deal with any outstanding uncertainty about the civilian or non-combatant status of the dead. All results are independently reviewed and error-checked by at least three members of the Iraq Body Count project team before publication.
The figure 655,000, which you seem to have accepted without explaining why, is taken from the Lancet medical journal in October 2006. This, in our view, is quite problematic and there is considerable cause for scepticism regarding these estimates. Firstly, the data presented do not distinguish between civilian and combatant deaths. IBC’s work is confined to violent civilian deaths. Secondly, the Lancet researchers visited 47 neighbourhoods and conducted interviews in 40 adjoining households in each neighbourhood. Only about 1,800 households containing 12,000 Iraqis were surveyed. These households reported a total of 302 violent deaths, each of which has been multiplied by two thousand to provide an estimate of how many of Iraq’s estimated 26 million population would have died if this proportion of deaths were representative of the country as a whole.
The study’s central estimate of over 600,000 violent deaths seems exceptionally high. Even its lower bound 95 percent confidence interval of 426,000 violent deaths is shockingly high. It is very unlikely that incidents of this scale would be so consistently discounted by the various media in Iraq. Although IBC technically requires only two sources for every corroborated death in its database, we actually collect, archive and scrutinize every single report we can find about each incident before it is added to our database. For larger incidents, the number of reports can run into the dozens, including news published in English, in the original, and others, mostly the Iraqi press, published in translation. In IBC’s news archive for August 2006, the average-size attack leaving 5 civilians killed has a median number of 6 reports on it.
We would hope that, before accepting such extreme figures, serious consideration is given to the possibility that the population estimates derived from the Lancet study may be flawed. The most likely source of such a flaw is some bias in the sampling methodology such that violent deaths were vastly over-represented in the sample. The precise potential nature of such bias is not clear at this point. But to dismiss the possibility of such bias out of hand is surely both hasty and irresponsible.
The Lancet researchers documented only 300 violent deaths. Iraq has reached such a sorry state that IBC records 300 deaths every few days. Do the American people need to believe that 600,000 Iraqis have been killed before they say “enough is enough”? The number of certain civilian deaths that has been documented to a basic standard of corroboration by “passive surveillance methods” surely already provides all the necessary evidence to consider this invasion and occupation an utter catastrophe at all levels.
Lily Hamourtziadou (IBC Assistant Researcher)
Bulent Gokay (IBC Research Consultant)* * *
Dear Ms. Hamourtziadou and Mr. Gokay,
Thank you for your letter. I must state frankly, however, that the World Socialist Web Site does not believe your criticisms of the Johns Hopkins study are valid from a scientific standpoint, and we further believe that, whatever your intentions, your approach provides a political boost to the authors and perpetrators of a war which you yourselves oppose.
In its editorial board statement of March 20, the WSWS stressed that the most important question posed by the four-year-old war in Iraq—and the one that is most obscured by the mass media—is “the staggering level of death and destruction...inflicted upon the Iraqi people.”
We noted the widespread use of the figure of 60,000 dead, pointing out that in all of the media cited the source of this figure was not given and the way that it was arrived at was unexplained. The editorial added: “Even if the unattributed estimates of 60,000 dead were true, it would represent a horrifying slaughter, representing 20 dead Iraqis for every US soldier killed. The reality, however, is that the ratio is at least 200 to 1.”
Representatives of your organization, Iraq Body Count (IBC), claim that the press reports are using figures taken from their research. This may well be the case, but it does not alter the fact that this source was not cited.
There is no doubt good reason both for why IBC’s total was reproduced in media reports on the fourth anniversary of the war, and for the failure to attribute this estimate.
First, there is good reason to believe that the total vastly underestimates the actual death toll resulting from the US-led war—which is why it is used by the media. However, the source of this estimate is problematic for the corporate media on two counts. The IBC has identified itself as opposed to the war. Second, any description of IBC’s methodology would raise questions as to whether the 60,000 figure reflects the real scope of the carnage unleashed by the US invasion in March 2003.
You go on to take issue with our use of the figures produced by the epidemiological study published last October by researches from the Johns Hopkins University Bloomberg School of Public Health and published in the British medical journal, The Lancet. This study arrived at an estimate of 654,965 as the most likely toll in terms of “excess mortality” since the US invasion of 2003.
The gist of your argument seems to be the following: the Johns Hopkins study produced an estimate that is “shockingly high,” and the research is suspect because it employed a method known as cluster surveys, gathering data from more than 12,000 Iraqis and then extrapolating it to the population as a whole to determine changes in the mortality rate since the US war began. Instead, you suggest, your own method is far more reliable.
You then write: “Do the American people need to believe that 600,000 Iraqis have been killed before they say ‘enough is enough’? The number of certain civilian deaths that has been documented to a basic standard of corroboration by ‘passive surveillance methods’ surely already provides all the necessary evidence to consider this invasion and occupation an utter catastrophe at all levels.”
Whether 60,000 or 655,000 Iraqis have died as a result of the US war and occupation is hardly a matter of indifference. While the killing of 60,000 would represent a historic war crime, the deaths of 655,000—fully 2.5 percent of the population—describes a crime that approaches genocidal proportions. Combined with the millions turned into refugees and the decimation of the country’s economy and every aspect of social and cultural life, this level of killing indicates a practice of sociocide, the systematic destruction of a people and their society.
The World Socialist Web Site contacted Gilbert Burnham, a professor of epidemiology and co-director of Johns Hopkins’ Center for Refugee and Disaster Response, who was one of the leaders of the Lancet study, for a response to your critique.
He wrote: “The basic problem is the body counters are not epidemiologists or demographers, and do not grasp the central principle that in very few situations can comprehensive national estimates be derived from reports of deaths, whether in the newspapers or even through reports from hospitals, and Iraq is not one of the countries where these estimates can be made (along with much or the world). Almost everything we know about mortality, disease prevalence, causes of deaths in probably 80 percent of the world’s population is derived from surveys—usually cluster surveys such as the one we carried out in Iraq. How many people died in Darfur? In Kosovo? In Congo? What is the death rate in Uganda, or Cambodia, or Angola? The answer almost without exception comes from cluster surveys.
“When there is such vigorous denial of a standard demographic and epidemiological tool as the cluster survey, one needs to look for other reasons why the results are not acceptable.”
Clearly, in relation to media reportage and official statements on Iraq, the reasons are political. The results are unacceptable because they expose the magnitude of the crime carried out by Washington and serve to deepen the revulsion of the people of the US and the entire world towards a war that the American ruling elite is determined to continue in order to establish its control over the region’s oil wealth.
The estimates of 1.7 million dead in the Congo, or 400,000 dead in Darfur—which are no less shocking than the Johns Hopkins estimates on Iraq—were arrived at through the same methods as those employed in the Hopkins research. Yet these are readily accepted by Washington, the United Nations and other world governments and routinely reported in the media. In Iraq, however, these scientific methods produce results that are, in the words of George W. Bush, “not credible.”
What of the methods employed by Iraq Body Count? As you yourselves indicate, IBC counts only those fatalities that are reported by at least two English-language media sources. It includes a “low” and a “high” estimate based on discrepancies between different press accounts.
IBC itself has noted on its web site, “It is likely that many if not most civilian casualties will go unreported by the media. That is the sad nature of war.”
Indeed, the paradoxical reality that has characterized every major conflict is that the intensification of violence is almost always accompanied by a sharp decline in the percentage of deaths that are actually recorded. In Iraq, this is due in no small measure to the inability of reporters, particularly those writing for the English-language media outlets that are the source of IBC’s data, to set foot in much of the country.
This point was made recently by the British Independent’sveteran Middle East correspondent, Patrick Cockburn: “The difficulty of reporting Iraq is that it is impossibly dangerous to know what is happening in most of the country outside central Baghdad. Bush and Blair hint that large parts of Iraq are at peace; untrue, but difficult to disprove without getting killed in the attempt.” The same argument is advanced in the latest issue of the American Journalism Review: “The relentless violence in Iraq has seriously compromised coverage of arguably the most important story in the world today. Certain facets of the conflict remain exasperatingly elusive or, at best, thinly reported. The media’s vital role as eyewitness has been severely limited.”
Under these conditions, press reports cannot possibly produce an accurate estimate of the total number of deaths in Iraq. Indeed, as Professor Burnham and other leading demographers have established, in wars generally, the number of fatalities counted through passive surveillance methods—reliance on figures reported by the government or the media—such as those used by IBC rarely amount to more than 20 percent of those later revealed through population studies.
You write that the Johns Hopkins study is “problematic” in part because it failed to “distinguish between civilian and combatant deaths,” as opposed to IBC data, which is restricted to violent civilian deaths.
It is difficult to discern what is problematic about this approach, either from a political or a methodological standpoint.
Politically, the deaths—both those of combatants and civilians, not to mention the thousands of young Iraqi conscript soldiers blown to pieces in the initial campaign of “shock and awe” bombardment—all represent the human catastrophe inflicted upon Iraq by the US war.
Methodologically, the Johns Hopkins study was designed to produce an estimate of the increase in mortality rates in the wake of the US invasion, quite a different matter than counting the number of violent deaths reported by the media.
You dismiss the work conducted in the study, writing: “...the Lancet researchers visited 47 neighbourhoods and conducted interviews in 40 adjoining households in each neighbourhood. Only about 1,800 households containing 12,000 Iraqis were surveyed.”
Only? It should be noted that major opinion polls are conducted regularly to determine the political views of entire populations in which the samples surveyed represent less than a 10th the size of the one used in the Iraq mortality study. This is the case in the US, where the population is more than 10 times as large as that of Iraq.
Such polls are conducted using random sampling methods, while the Johns Hopkins team employed the tool of cluster samples, which are routinely employed in areas beset by war or natural disaster.
More importantly, the size of the sample used was substantially higher than what is employed in most public health studies used to evaluate everything from vaccination rates to deaths in natural disasters. Estimates produced by these studies are regularly accepted as substantially accurate and serve as the basis for developing policy.
The study employed a substantially larger sample than was used in a similar and earlier survey conducted by Johns Hopkins whose results were also published in the Lancet, in October 2004, when 7,868 Iraqis were interviewed. Moreover, this time, every household was asked to produce death certificates to corroborate their accounts of lives lost since the 2003 invasion. In at least 80 percent of the deaths reported, the interviewers were able to corroborate the reports with death certificates.
The work of conducting this broader survey involved no small threat to the lives of the eight Iraqi public health physicians who conducted the work. One of these physicians expressed the determination that lay behind this heroic work in response to a question from the Johns Hopkins magazine: “From the moral point of view, I have learned that when everybody is afraid to say the truth, then there should be somebody who volunteers to say it, on the belief that we are all going to die some day, either after doing nothing or after doing something. The main point is that people outside Iraq do not realize the real disaster we are suffering. Only the Iraqi people know that, simply because the foreigners are listening to the news while we are living the events on the ground.”
In the end, the new survey did largely confirm the work carried out two years earlier, but also recorded a horrifying rise in the mortality rate in 2005 and 2006, the period in which sectarian killings fomented by the collapse of Iraqi society and the divide-and-rule tactics of the US occupiers rose dramatically. Thus, while the Iraqi mortality rate stood at 5.5 per 1,000 before the invasion, the study showed that it rose steadily afterwards, first to 7.5, then to 10.9 and, between June 2005 and June 2006, to a staggering 19.8.
As for the estimate of total excess deaths caused by the invasion, the study provided a range of figures, stating that the survey had established with 95 percent certainty that the total increased mortality stood between 392,979 and 942,636, with 654,965 being the most likely figure, and with the likelihood declining as the estimate moved either higher or lower.
While the fairly wide range of figures—referred to by demographers as the “confidence interval”—reflected the limits of the statistical accuracy of such a study, even the lowest point on this scale, nearly 400,000, expresses the historical catastrophe inflicted upon Iraq by the US invasion.
The research was subjected to extensive peer review and found to represent a scientific and well-founded piece of work.
You urge us to consider the possibility that the study is “flawed” or that its methodology is “biased” in some way that “is not clear at this point.” Not to adopt this skeptical position, you warn us, would be “hasty and irresponsible.”
What we think would be irresponsible and indefensible would be for the World Socialist Web Site not to do everything in its power to make this important study known to the widest possible audience and to defend it against the political attacks, gross distortions and pervasive attempts to censor and obscure its findings carried out by both the Bush administration and the Blair government, as well as the mass media, particularly within the US.
We cannot help but add that we do see as genuinely irresponsible the efforts by IBC to undermine the credibility of this study and to speculate—with no foundation outside of the “gut” feeling that the numbers are too high—about its possible flaws and biases.
No doubt, the tallying of media-reported deaths in Iraq served a useful purpose under conditions in which the attitude of the American occupiers was summed up in the remark by Gen. Tommy Franks: “We don’t do body counts.”
Now, however, under conditions in which the governments responsible for this war and the mass media which helped them promote it are utilizing IBC’s figure of 60,000 deaths as a means of covering up the real magnitude of the disaster in Iraq, it seems self-evident that the principal responsibility confronting IBC would be to denounce and expose this misuse of its data, which, as the organization itself acknowledges, leave “most civilian casualties...unreported.”
You write: “The Lancet researchers documented only 300 violent deaths. Iraq has reached such a sorry state that IBC records 300 deaths every few days. Do the American people need to believe that 600,000 Iraqis have been killed before they say ‘enough is enough?’ ”
This argument borders on an appeal to irrationalism and backward prejudices against science that can serve no useful purpose in the struggle against war and the system that is responsible for it. That IBC records 300 deaths every few days based on press reports is hardly evidence that its numbers are more significant than the statistics gathered and scientifically analyzed by the Johns Hopkins researchers.
As for whether the American people “need to believe 600,000 people have been killed” in order to oppose the war, this is obviously not the case. A decisive majority of Americans now oppose the war, yet it is virtually certain that a random sample would disclose that a relatively small minority has even heard of the Johns Hopkins study, given that it was virtually blacked out by the mass media.
It is indeed important that the American people grasp the magnitude of the crime that has been carried out in Iraq in order to ensure that those responsible are held accountable.
Bill Van Auken