(See part 1 and part 2.)

When I looked at the Lancet study, saw who had done it, how it had been done, and where it had been published, I quickly gained confidence in their number of 655,000 excess deaths since the invasion of Iraq..

The study was based on a survey done between May and July 2006 by a joint team of people at the Johns Hopkins School of Public Health and the School of Medicine of Al Mustansiria University in Baghdad using standard methods. These excerpts from their paper details how they collected the raw data and their analyses.

In this survey, sites were collected according to the population size and the geographic distribution in Iraq. The survey included 16 of the 18 governates in Iraq, with larger population areas having more sample sites. The sites were selected entirely at random, so all households had an equal chance of being included. The survey used a standard cluster survey method, which is a recommended method for measuring deaths in conflict situations. The survey team visited 50 randomly selected sites in Iraq, and at each site interviewed 40 households about deaths which had occurred from January 1, 2002, until the date of the interview in July 2006. We selected this time frame to compare results with our previous survey, which covered the period between January 2002 and September 2004. In all, information was collected from 1,849 households completing the survey, containing 12,801 persons. This sample size was selected to be able to statistically detect death rates with 95% probability of obtaining the correct result. When the preliminary results were reviewed, it was apparent three clusters were misattributed. These were dropped from the data for analysis, giving a final total of 47 clusters, which are the basis of this study. (my emphasis)

The designers of the study seemed to have gone to some lengths to make sure that they had a truly random sample.

A series of completely random choices were made. First the location of each of the 50 clusters was chosen according the geographic distribution of the population in Iraq. This is known as the first stage of sampling in which the governates (provinces) where the survey would be conducted were selected. This sampling process went on randomly to select the town (or section of the town), the neighborhood, and then the actual house where the survey would start. This was all done using random numbers. Once the start house was selected, an interview was conducted there and then in the next 39 nearest houses.

In order to determine trends in the death rate , they split the time up into three periods and the results they obtained were as follows:

For the purpose of analysis, the 40 months of survey data were divided into three equal periods—March 2003 to April 2004; May 2004 to May 2005, and June 2005 to June 2006.

Following the invasion the death rate rose each year.

• Pre-invasion: 5.5 deaths/1000/year
• March 2003-April 2004: 7.5 deaths/1000/year
• May 2004-May 2005: 10.9 deaths/1000/year
• June 2005-June 2006: 19.8 deaths/1000/year
• Overall post-invasion: 13.2 deaths/1000/year
. . .
The [pre-invasion] rate of 5.5 deaths/1000/year will be considered as the “baseline” crude death rate, making the assumption that without conflict this rate would have continued at this level up to the present time, or even dropped somewhat (most likely).

The post-invasion excess death rate was:

• March 2003-April 2004: 2.6 deaths/1000/year
• May 2004-May 2005: 5.6 deaths/1000/year
• June 2005-June 2006: 14.2 deaths/1000/year
• Overall post-invasion: 7.8 deaths/1000/year

As there were few violent deaths in the survey population prior to the invasion, all violent deaths can be considered “violent excess deaths.”

The post-invasion violent death rate was:

• March 2003-April 2004: 3.2 deaths/1000/year
• May 2004-May 2005: 6.6 deaths/1000/year
• June 2005-June 2006: 12.0 deaths/1000/year
• Overall post-invasion: 7.2 deaths/1000/year

Percentage of all (not just excess) deaths due to coalition forces:

• March 2003-April 2004: 14%
• May 2004-May 2005: 21%
• June 2005-June 2006: 16%
• Overall post-invasion: 7.2 deaths/1000/year

Deaths due to unknown forces:

• March 2003-April 2004: 3.2 deaths/1000/year
• May 2004-May 2005: 6.6 deaths/1000/year
• June 2005-June 2006: 12.0 deaths/1000/year
• Overall post-invasion: 7.2 deaths/1000/year

Conclusion

While the actual value may be somewhat higher or lower than this number, the precision of these results is adequate to conclude that loss of life in this conflict has been substantial. (my emphasis)

The authors compare with other major conflicts and rightly conclude that the final figure of over 600,000 excess deaths puts the Iraq war right up there with the others in the scale of violence.

As with other recent conflicts, the civilians of Iraq bear the consequence of warfare. In the Vietnam War, 3 million civilian died; in the Congo, armed conflict has been responsible for 3.8 million deaths; in East Timor, an estimated 200,000 out of a population of 800,000 died in conflict. Recent estimates are that 200,000 have died in Darfur over the past 31 months. Our data, which estimate that 654,965 or 2.5% of the Iraqi population has died in this, the largest major international conflict of the 21st century, should be of grave concern to everyone.

What should be of especial concern is that the number of people killed by the actions of the US and coalition forces is so high. Overall 31% or 186,300 of the violent deaths were attributed to their actions and 13% or 78,130 of the violent deaths were due to air strikes which are still going on at a high rate. For those people who still cling to the fond hope that modern armaments, “smart bombs”, and “surgical” strikes have minimized the deaths of civilians, these appalling numbers should make for sober reading. We cannot blithely dismiss this level of death as “collateral damage”, the unfortunate and accidental by-product of a well meaning invading force.

But don’t hold your breath that the media is going to give the Lancet study the attention it deserves. As Norman Solomon points out:

American news outlets tend to be rather cavalier about the suffering at the other end of the Pentagon’s missiles, bombs and bullets. And there’s a strong tendency to brand documented concerns as unfounded speculation – a media reflex that suits war-crazed presidents just fine.