...Would it surprise you to learn that if the Johns Hopkins estimates of 400,000 to 800,000 deaths are correct -- and many experts in the survey field seem to suggest they probably are -- that the supposedly not-yet-civil-war in Iraq has already cost more lives, per capita, than our own Civil War (one in 40 of all Iraqis alive in 2003) ? And that these losses are comparable to what some European nations suffered in World War II ? You'd never know it from mainstream press coverage in the U.S. "Everybody knows the boat is leaking, everybody knows the captain lied," Leonard Cohen once sang. The question the new study raises: How many will go down with the ship, and will the press finally hold the captain fully accountable ?Iraqi Death Rate May Top Our Civil War -- But Will the Press Confirm It ?
At a glance and for a lay audience, the contrast in these figures suggests that science must have gone wrong. The reaction of an intelligent sceptic might be to dismiss both figures and ask for additional homework. Moreover, any attempt to reconcile these sharply opposing tallies would only add to the statistical confusion and shift the political debate from the legitimacy of a conflict to the legitimacy of its metrics.posted by y2karl at 10:12 PM on October 19, 2006
However, as the power of numbers rarely escapes political influence in the context of human conflict and suffering, it is necessary to elaborate a coherent statistical language that might help to answer the two essential questions raised by war: that of the jus ad bellum (whether entering into a war is justifiable), and the jus in bello (whether a war itself is conducted justly).
When thousands have already perished, it could be argued that it is in principle too late for the former (even though retrospective studies can still be done) and too technically challenging for the latter; and that as a result, to invoke numbers to support a case is morally irrelevant. Paul Farmer expresses it well in his 2005 Tanner lecture: "Where, in the midst of all of these numbers, is the human face of suffering."
...For the Johns Hopkins study, a civilian dies in Iraq every three minutes from a war that has long perverted the meaning of both the jus ad bellum and the jus in bello. That civilian would not have died if the coalition had not come. For Iraq Body Count, the same story is told almost twice per hour. How much of a difference does it make? That is the political question these two statistics convey to the world, even if statistics themselves cannot answer it.
IBC’s apologia talks about the Iraqi Living Conditions Study...Iraq Body Count’s Distortions
The ILCS is a perfectly good study, if you want to learn how many Iraqis own washing machines or what the Iraqi wage gap is (working women make twice as much as working men per hour; however, women are only 16% of the labor force). What it does not give is death rates after the war, except for infant and maternal mortality...
The ILCS doesn’t have any figure for the total death rate, so it’s really incomparable with the Lancet study. But even if it were, IBC’s claim that the ILCS must take precedence betrays ignorance of statistical testing. The meaning of 'the 95% confidence interval of the 650,000 figure is 400,000-900,000' is 'If the real figure is between 400,000 and 900,000, then the Lancet study’s methodology gives a 95% confidence interval that includes 650,000.'
In other words, the Lancet study may have a large error margin, but it also has high enough a figure that it doesn’t matter. From the above formulation, if some group releases a study that says 400,000 Iraqis died, then the Lancet’s figure is within its margin of error, so we can’t conclude the group is wrong. But if a group claims that 40,000 Iraqis died, then the Lancet’s figure is well outside its margin, so the Lancet contradicts it.
When we have two contradictory studies, we can’t ever assume that the one with the larger sample size is wrong. We can only assume that if we have some discrepancy that lies within the margin of error. If the discrepancy is this big, we need to investigate the methodologies and see who’s doing a mistake; it’s possible neither side is, but the probability of that is vanishingly small. In this case, we have a study of Iraqi death rates that uses a standard epidemiological methodology, versus a compilation of media reports that not only neglects deaths not reported to the authorities but also neglects deaths not mentioned in the media.
Gilbert Burnham , lead author of the controversial Johns Hopkins University study that finds vastly higher civilian casualty toll than other research, joined washingtonpost.com World Opinion Roundup columnist Jefferson Morley online... to discuss the study's conclusion that more than 600,000 Iraqis may have died since March of 2003.Transcript
Two experts told The Washington Post's David Brown last week that they found the article's methodology to be sound. The British science site, Nature.com (by subscription), also found merit in the study, saying the death toll "withstands scrutiny."Is Iraq's Civilian Death Toll 'Horrible' -- Or Worse?
"The numbers do add up," said Daniel Davies, a stockbroker and blogger for the Guardian. He argued that the sample of 1,849 households interviewed by Iraqi doctors working for the JHU research team was as large as that used by political pollsters.
"The question that this study was set up to answer was: as a result of the invasion, have things got better or worse in Iraq? And if they have got worse, have they got a little bit worse or a lot worse... The results speak for themselves," Davies wrote. "In the 18 months before the invasion, the sample reported 82 deaths, two of them from violence. In the 39 months since the invasion, the sample households had seen 547 deaths, 300 of them from violence."
"# Some 800,000 or more Iraqis suffered blast wounds and other serious conflict-related injuries in the past two years, but less than a tenth of them received any kind of hospital treatment;"They further state (We'll call this IBC7):
[it implies] bizarre and self-destructive behaviour on the part of all but a small minority of 800,000 injured, mostly non-combatant, Iraqis;They don't exactly say what implies IBC7, but we can assume that it is implied by IBC2. That is, because
"people suffering injuries usually make strenuous efforts to receive appropriate treatment, or if they are severely incapacitated, others see to it that they do so."We'll call this IBC2a, and it's actually a premise of their argument.
(IBC6) incompetence and/or fraud on a truly massive scale by Iraqi officials in hospitals and ministries, on a local, regional and national level, perfectly coordinated from the moment the occupation began;In fact, it's easy to imagine that IBC9: (the failure of the media) and IBC6 (massive failure of government) are true, invalidating the need for any of their other final "absurd" implications to be true.
(IBC7) bizarre and self-destructive behavior on the part of all but a small minority of 800,000 injured, mostly non-combatant, Iraqis;
(IBC8) the utter failure of local or external agencies to notice and respond to a decimation of the adult male population in key urban areas;
(IBC9) an abject failure of the media, Iraqi as well as international, to observe that Coalition-caused events of the scale they reported during the three-week invasion in 2003 have been occurring every month for over a year.
Of course, death/injury ratios vary according to the weapons being used. Bombs and air strikes leave more wounded than does gunfire, but even the latter may cause widespread injury when it is indiscriminate, as it often is in gun-battles or in "defensive" fire by US troops who come under attack. By far the lowest proportion of injured are produced in the execution of captives, whether by guns or other means.Assume? Assume based on what? It's entirely flawed logic, built on nothing but idiotic assumptions. None of their premises are supported or obvious. The whole thing is an exercise in intellectual wank.
We might therefore calculate a much more conservative estimate of wounded associated with the Lancet findings...We assume 3 wounded for every explosive- or air strike-caused death, but only 1 wounded for every 2 gunfire deaths, and no wounded from the "unknown" and "accident" categories.
The peer-reviewed study's named authors include three researchers from the Bloomberg School of Public Health at Johns Hopkins University -- one of them is Gilbert Burnham, co-director of the school's Center for Refugee and Disaster Response -- and a professor from Baghdad's al-Mustansiriya University. Funding for the project was provided by MIT. These are not shabby credentials.Counting The Iraqi Dead
...Even if you assume that the number of Iraqi civilians killed since the war began is at the very low end of the study's range, that's still a quantum leap from earlier estimates. We now have reputable evidence -- not proof, I'll allow, but science-based evidence from respected scholars, published in one of the world's most prestigious medical journals -- that the humanitarian tragedy in Iraq is much, much worse than anyone had suspected.
If the study's findings are flawed, then its critics should demonstrate how and why. But no one should dismiss these shocking numbers without fully examining them. No one should want to.
...When I was doing my own field research a few decades ago in another place devastated by violent death – Hiroshima – I found that the most valuable and chilling moment of all came on virtually the first day, when I climbed a hill overlooking the rebuilt city. It resides in a natural bowl formed by the hills, and I found it all too easy to imagine nearly everything spread out below me, including all the people, dead and gone.Will Media Finally Count the Dead in Iraq ?
Here is a list of 12 American cities with a populaton of just under or just over 600,000. Think of them disappearing -- and imagine the U.S. one-tenth its current size. Then you've got the possible toll in Iraq:
Austin
Baltimore
Denver
Boston
Seattle
Milwaukee
Memphis
Washington, D.C.
Ft. Worth
Portland
Las Vegas
Sarah Leah Whitson, an official of Human Rights Watch in New York, told the Post, "We have no reason to question the findings or the accuracy" of the survey.How to Make Hundreds of Thousands of Dead Iraqis Disappear
Frank Harrell Jr., chairman of the biostatistics department at Vanderbilt University, told the Associated Press the study incorporated "rigorous, well-justified analysis" of the data.
Richard Garfield, a public health professor at Columbia University who works closely with a number of the authors of the report, told The Christian Science Monitor: "That's exactly wrong. There is no discrediting of this methodology. I don't think there's anyone who's been involved in mortality research who thinks there's a better way to do it in unsecured areas. I have never heard of any argument in this field that says there's a better way to do it."
The sampling "is solid. The methodology is as good as it gets," said John Zogby, whose polling agency, Zogby International, has done several surveys in Iraq since the war began. "It is what people in the statistics business do." Zogby said similar survey methods have been used to estimate casualty figures in other conflicts, such as Darfur and the Congo.
I recall seeing on The Daily Show that when Bush got done playing around with Suzanne Malveaux and her fashion statement that day, she asked him about the study. He replied that "their methodology has been pretty well discredited." This is a bald-faced lie, of course. But here's my question. Were there any follow-ups? Or was the purpose of the question merely to get the president on the record without holding him responsible for anything at all, even the unnecessary murder of hundreds of thousands of people? What the hell kind of society kills all these people and cannot be bothered to care? Cannot be bothered to count them and when someone does, risking their lives in the process, lies to discredit them -- and no one cares about that either?
Iraqi Prime Minister Nouri al-Maliki's office has instructed the country's health ministry to stop providing mortality figures to the United Nations, jeopardizing a key source of information on the number of civilian war dead in Iraq, according to a U.N. document.Iraq Aims to Limit Mortality Data
A confidential cable from the United Nations' top official in Baghdad, Ashraf Jehangir Qazi of Pakistan, said the Iraqi prime minister is seeking to exercise greater control over the release of the country's politically sensitive death toll. U.N. officials expressed concern that the move threatens to politicize the process of counting Iraq's dead and muddy international efforts to gain a clear snapshot of the scale of killing in Iraq.
Qazi warned in the cable that the development "may affect" the United Nations' ability to adequately record the number of civilians killed or wounded in the Iraq war as it endures a bloody new phase of sectarian violence. He said U.N. human rights workers would have "no guaranteed means to corroborate" figures provided by the government.
...Even the wildly fluctuating official death counts are a stark reminder that Iraqi, and by association U.S. officials, are attempting to minimize a problem getting worse by the day. Earlier this year, the figures released by the government following the Feb. 22 bombing of the Askariya shrine in Samarra, a Shia holy site, which has been cited as the spark that started the current round of killings, were suspiciously lower than numbers provided by morgue officials. But as for the overall picture, a September report published by the United Nations Assistance Mission for Iraq paints a grim picture: civilian deaths reached a record high for July and August with 6,600 civilians killed.Iraq's missing dead
Still, even these figures don't tell the whole story. For that, a visit to Medical City is in order. The Ministry of Health has instituted a strict policy for journalists, requiring them to seek permission before visiting the facility. Those allowed in get only a truly sanitized tour; more often than not reporters are barred from entering. But at the gate, guards who have worked at the facility tell a chilling tale. "Last year, I saw maybe 1,000 bodies a month coming into the morgue," says one man who, fearing for his life, requested his name not be published. "Now we're getting nearly 1,000 a week."
...While he describes the bodies, a dump truck pulls out of the facility. The guards open the gate, holding back a rush of people from all over central Iraq hoping to get in to look for loved ones. As the truck passes, the smell of decomposing flesh fills the air. "That's just the clothes from bodies pulled from the Tigris over the past few days," says the first guard.
...The more excitable fringes of the US blogosphere have come out with some interesting stuff. Let’s look at criticisms that don’t hold water first.UKPollingReport - Deaths in Iraq
Firstly, the turnout is unbelievably high. The report suggests that over 98% of people contacted agreed to be interviewed. For anyone involved in market research in this country the figure just sounds stupid. Phone polls here tend to get a response rate of something like 1 in 6. However, the truth is that - incredibly - response rates this high are the norm in Iraq. Earlier this year Johnny Heald of ORB gave a paper at the ESOMAR conference about his company’s experience of polling in Iraq - they’ve done over 150 polls since the invasion, and get response rates in the region of 95%. In November 2003 they did a poll that got a response rate of 100%. That isn’t rounding up. They contacted 1067 people, and 1067 agreed to be interviewed.
Secondly, people have been understandably confused by the mention of death certificates. Whenever possible interviewers asked if they could see the death certificate of people reported dead during the study. In 92% of cases those asked produced the certificate. This presents an apparant discrepancy - if over 80% of the deaths had been officially recorded, how come official Iraqi estimates of the dead were so low? The explanation given by the report - which seems perfectly reasonable - is that hospitals have continued to issue death certificates, but the system of collating the figures centrally has broken down to a large extent. In other words, a doctor in Iraq may still be giving out the paper certificates, but the figures are not necessarily passed on or registered with any higher authority.
Thirdly, some people have pondered whether Iraq’s mortality rate from before the invasion as determined by the study seems unfeasibly low at 5.5 per 1000. This compares to mortality figures of 10.1 for the European Union, a group of far more developed countries with better nutrition and health care. If Iraq’s pre-invasion mortality figure is artifically low, then it would wrongly inflate the number of excess deaths. However, the difference is actually because Iraq has a far younger population than the EU. Apart from countries in Southern Africa where AIDS is endemic, developed countries tend to have a higher mortality rate because they have more elderly people in proportion to young people, and an old person in a “safe” country is still more likely to die than a young fit person in an “unsafe” country...
How do we judge the health of a free society? How do we distinguish the appearance of democracy from the reality?MediaLens: Democracy and Debate - Killing Iraq
There are no hard and fast rules, no scientific methodologies. But as a rule of thumb it is safe to suggest that we can learn much from a society's willingness to address the humanitarian crimes for which it is responsible.
In a totalitarian society, we would expect such a discussion to be absent in any meaningful sense. But in a genuinely free society, we would expect a thorough, detailed and unrestrained debate. Although this second expectation is itself based on an important assumption: namely, that individual freedom implies moral concern, a sense of responsibility for the suffering of others. We assume that to be a free human being means, also, to be free from the bonds of selfishness and indifference.
October 11 and 12 were significant dates, then, for anyone seeking to establish something of the truth of our own society...
In sum, a free press in a free society would simply +have+ to investigate this study in depth, if only to resolve the confusion of a bemused and concerned public in response to an inherently credible report...
Where are the articles and programmes examining US-UK responsibility under international law, as occupying powers, for the catastrophe in Iraq ? Where the discussions of the abject failure of modern democracy to offer either the British or American people any semblance of meaningful choice on foreign policy ?
We have been monitoring and reporting media performance for five years, since July 2001. The current media response to a credible report that our government is responsible for the deaths of 655,000 Iraqis is the most shocking and outrageous example of media conformity to power we have yet seen.
The implications are clear - no crimes of state are too monstrous or extreme for mainstream journalism. There is no limit to their willingness to obscure the depredations of power. The corporate media, the liberal media very much included, is a grand lie - an apparent source of reason and hope that betrays the people it serves at every turn.
The study by Burnham and his colleagues provides the best estimate of mortality to date in Iraq that we have, or indeed are ever likely to have.The Iraq deaths study was valid and correct
We urge open and constructive debate, rather than ill-informed criticism of the methods or results of sound science. All of us should consider the implications of the dire and deteriorating health situation in Iraq.
Professor James A Angus, dean, faculty of medicine, dentistry and health sciences, University of Melbourne
Professor Bruce Armstrong AM, director of research, Sydney Cancer Centre; professor of public health and medical foundation fellow, University of Sydney
Dr Jim Black, head of epidemiology, Victorian Infectious Diseases Service
Professor Peter Brooks, executive dean, faculty of health sciences, University of Queensland
Professor Jonathan Carapetis, director, Menzies School of Health Research, Darwin
Dr Ben Coghlan, medical epidemiologist, Centre for International Health, Burnet Institute
Professor Mike Daube, professor of health policy, Curtin University
Associate Professor Peter Deutschmann, executive director, Australian International Health Institute, University of Melbourne
Associate Professor Trevor Duke, Centre for International Child Health, department of pediatrics, University of Melbourne
Professor Adele Green AC, deputy director, Queensland Institute of Medical Research
Associate Professor Heath Kelly, head, epidemiology unit, Victorian Infectious Diseases Reference Laboratory
Professor Stephen Leeder AO, co-director, Menzies Centre for Health Policy; professor of public health and community medicine, University of Sydney; chairman, Policy and Advocacy Group, Australasian Faculty of Public Health Medicine
Professor Alan Lopez, head, School of Population Health; professor of medical statistics and population health, University of Queensland
Professor John Mathews AM, professorial fellow, School of Population Health, University of Melbourne
Professor A. J. McMichael, director, National Centre for Epidemiology and Population Health, ANU
Dr Cathy Mead PSM, president, Public Health Association of Australia, Canberra
Professor Rob Moodie, chief executive, Victorian Health Promotion Foundation
Professor Kim Mulholland, infectious disease epidemiology unit, London School of Hygiene and Tropical Medicine, UK
Professor Terry Nolan, head, School of Population Health, Melbourne University
Associate Professor Tilman Ruff, Nossal Institute for Global Health, University of Melbourne; president, Medical Association for Prevention of War
Associate Professor Peter Sainsbury, school of public health, University of Sydney
Dr Tony Stewart, medical epidemiologist, Centre for International Health, Burnet Institute
Professor Richard Taylor, professor of international health; head, division of international and indigenous health, School of Population Health, University of Queensland; director, Australian Centre for International and Tropical Health and Nutrition
Associate Professor Mike Toole, head, Centre for International Health, Burnet Institute
Associate Professor Paul J. Torzillo AM, University of Sydney; senior respiratory physician, Royal Prince Alfred Hospital, Sydney; clinical director, respiratory and critical care services, Central Sydney Area Health Service
Dr Sue Wareham OAM, immediate past president, Medical Association for Prevention of War, Canberra
Professor Anthony Zwi, School of Public Health and Community Medicine, associate dean (international), faculty of medicine, NSW University
The President said something else striking, while taking up the banner for 30,000 dead Iraqis. He certainly meant it to be the highest compliment he could bestow. "I applaud the Iraqis for their courage in the face of violence," he commented at his press conference. "I am amazed that this is a society which so wants to be free that they're willing to -- that there's a level of violence that they tolerate."Playing the Numbers Game with Death in Iraq
In fact, there's no evidence whatsoever that Iraqis "tolerate" levels of violence that would horrify any society. For most Iraqis, life under such conditions is obviously hell on Earth. It's our President who "tolerates" such levels of violence in the pursuit of his policies, so perhaps he should simply applaud himself.
The fact is that the Lancet figures have largely been avoided because most Americans, including most reporters, can't entertain the possibility that our country might actually be responsible for a situation in which almost 400,000, or around 655,000, or possibly 900,000+ "excess" Iraqis have died. At the top end of that continuum, you would have to think of the recent wars and serial slaughters in the Congo or the Rwandan genocide. At 655,000, you're talking about slightly more than the dead of the American Civil War. With the bottom figure, you're already at well over one hundred times the dead of September 11, 2001, almost seven times the American dead of either the Korean or Vietnam Wars, and over three times the dead of atomized Hiroshima. And let's keep in mind that any of these figures are purely provisional, since George Bush has over two years to go in office and has sworn not to pull American forces out of Iraq before he departs, even if, according to the Washington Post's Bob Woodward, only his wife and dog still back him on the subject.
The Vietnam analogy, never far from American consciousness, has been back in the press recently, but here's an apt Vietnam quote that seldom seems to rise to memory any more. General William Westmoreland, Commander of U.S. Forces in Vietnam, offered the following explanation for similarly staggering Vietnamese body counts (an estimated 3 million Vietnamese died in that country's French and American wars): "The Oriental doesn't put the same high price on life as does a Westerner. Life is plentiful. Life is cheap in the Orient."
It's hard to avoid the thought that a similar attitude toward Iraqi lives and deaths is at work in our government and in the media. After all, the kinds of denatured discussions now taking place about Iraqi deaths would be inconceivable if American deaths were at stake. Just consider, for instance, that the recent discovery of scattered human remains ("some as large as arm or leg bones") overlooked at Ground Zero in New York City has raised a furor and demands that all construction at the site be halted while it is thoroughly searched. Try to put that sort of concern for the dead back into the Iraqi situation or into perfunctory, daily, inside-the-newspaper passages like:
"In addition, about 50 bodies were collected Sunday around Baghdad, the capital, a figure considered high weeks ago but now routine. An Interior Ministry official said many of the victims had apparently been shot at close range and bore signs of torture."How, then, do you even begin to grasp such losses in a war of "liberation" launched by your own country? How do you even begin to imagine such levels of suffering, death, and destruction, or the increasingly chaotic and degraded conditions in which so many Iraqis now live and for which we are certainly responsible?
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posted by homunculus at 9:36 PM on October 19, 2006