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October 13, 2006

More on the Lancet study of Iraqi deaths

The right wing meltdown over the Lancet study was predictable. These ideologues operate in a perpetual state of denial. Like their beloved president, they reflexively subordinate science to politcs and brook no dissent.

When the wingnuts saw a conclusion they didn't like and immediately denounced the scientists as hacks. The Gateway Pundit even put up a picture of the lead author and encouraged his readers to deluge the guy with angry email.

The wingnuts don't seem to understand that not all evidence is created equal. They cling to the Iraq Body Count estimate, even though they can't explain why the a database of media reports should carry more weight than a systematic study of the population of interest.

The Lancet study is quite simply the best evidence we have about the death toll attributable to the invasion. The Iraqi investigators conducted interviews at 1849 households that contained
12 801 individuals
. The scientists went all over Iraq, except two regions that were too dangerous visit.

The takehome message of this study is that vastly more people have died in Iraq than the government or the media have told us. Sure, the study has a wide margin of error. We can be pretty confident that between 400,000 and 800,000 excess deaths have occurred since the invasion. Even the lower bound is shocking.

The alternative estimates are based on news reports or official figures. It may come as a big surprise to some people, but not every death gets reported. Last year, the United States averaged about 44 murders a day, every day. Does each of those deaths make the news? Not even close.

Unlike their colleagues in Iraq, journalists can travel freely in the US without fear for their safety. They aren't embedded with anyone or confined to their hotel rooms. They don't have to preserve operational security or face censorship. Even so, only a fraction of the murders that take place on any given day even get written up in the local paper.

The official figures are compiled by people with a strong interest in downplaying the death toll. Furthermore, different ministries don't necessarily talk to each other. Some morgues are run by the government, others by militias. Of course, not all the bodies will make it to the morgue. Even if when they do, the morgues are usually off-limits to journalists.

The Lancet study is a foundation for further inquiry. No scientific study is definitive. However, the right wing is terrified of honest debate. They can't even engage with this study because they've got sticker shock.

See also: Mark Chu-Carrol of Good Math/Bad Math reviews the Lancet study and deems the study a pretty solid upper bound for Iraqi deaths so far.

The Questionable Authority takes a hard look at the numbers. Read on and learn, wingnuts.

 

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Comments

David, I don't think I'm missing the point. I agree with you that the amount of suffering and death in Iraq under sanctions was unacceptable.

However, given the methodology of this study I think it makes sense to compare pre-invasion to post-invasion. It's very difficult to quantify what the death rate would have been in the run-up to the invasion if we'd never imposed the sanctions. The researchers asked their subjects how many people in their households had actually died in the months before the invasion, and how many since. It wouldn't make sense to ask the subjects to guess how many deaths there would have been in the months before the war if it hadn't been for sanctions.

The impact of sanctions is an important moral and scientific question in its own right.

Lindsay I don't think you understand me. The point I made was not specifically intended to highlight the deaths under the embargo. What I am saying is you are grossly undercounting the true death toll of the occupation itself.

given the methodology of this study I think it makes sense to compare pre-invasion to post-invasion

Depends. If by "makes sense" you mean it was their only practically feasible solution, flawed as it was, then yes. They couldn't ask people how many deaths were occuring 16 or 17 years ago and expect any accuracy.

But the problem is you are not then measuring the death toll of the occupation. You are measuring how much worse the occupations death toll was than the embargos already genocidal rate.

This is presumably standard practise for this type of research. Normally it works because if you have some factor X that is inflating the death toll in the period prior to the study the likelihood is it will be continuously present during the period of the study.

But that is NOT the case here. The embargo ceased immidiately the occupation started. You swapped one for the other. Certainly Bush continued the policy of keeping Iraq's civilian infrastructure destroyed, but it was his plan not the old sanctions plan doing it.

So 650K is not a measure of the deaths from the occupation. Do you understand? You need to add an amount to account for the sanctions death toll -- and yes, that's hard to calculate with any certainty.

Alon,
Now is the time to tell the truth; if your ideology is out of sync with them, it's time to change your ideology.

And what are your credentials here? If someone had asked you 2 weeks ago what the Iraq death toll was would you have said 650,000? Because I would and did say 800,000 to 1 million.

It seems to me that you are the one playing catch up due to your prejudices here. This report came as no surprise at all to me (plus or minus 10% anyway)

I see what you mean. The embargo was causing X deaths every day before the invasion. Then we observed that the invasion/occupation was killing Y number of people every day.

Assume that ending the sanctions immediately stops sanction-related deaths. So, we expect X fewer people to die every day than we did under sanctions. So when we see Y deaths every day during the occupation, the gap between the observed and the expected is that much wider and therefore the excess death rate is that much bigger.

The problem with this argument is that the sanction-related deaths probably haven't stopped during the occupation. On paper, the sanctions are over, but in practice the much of deprivation hasn't been reversed.

Of course the occupation and the ensuing civil war are part of the reason why the reversal of sanctions isn't benefiting the average Iraqi as much as we would hope.

And what are your credentials here? If someone had asked you 2 weeks ago what the Iraq death toll was would you have said 650,000? Because I would and did say 800,000 to 1 million.

I'd have said 200,000. And I'd have been right, since I'm mostly concerned with people killed by the coalition directly. If you want, I can produce links to comments where I said that months ago.

So 650K is not a measure of the deaths from the occupation. Do you understand? You need to add an amount to account for the sanctions death toll -- and yes, that's hard to calculate with any certainty.

And yet previous studies place the figure at 600,000-700,000 for the entire sanctions. The Nation article said excess child mortality was 350,000.

David,

>Joerg, I don't think most of your quibbling over the numbers is worth >replying to, although I could. It's distastefull, especially if you >are American, to be seen to try and low-ball the size of your >country's genocide.

I am not American though.

Neither am I, and neither is Lindsay. The most crucial mistake any liberal can make is that the radical who's attacking him is really interested in the specifics. When your entire politics is based on in-group boundedness, you're not going to let any dissenter in just because on other issues he agrees with you or just because you were wrong about him once.

The problem with this argument is that the sanction-related deaths probably haven't stopped during the occupation. On paper, the sanctions are over, but in practice the much of deprivation hasn't been reversed.

Correct. But then what is the question you want answering? Is it "how many people have died due to the occupation ignoring the effects of stuff that is similar to the sanction effects", or is it, as it is presented usually, "how many people have died because of the occupation?"

I think what we are asking is the effect of the war. For whatever reasons Bush has refused to stock hospitals or fix sewage systems or mend electricity supplies. That is a war crime and I think it's a perfectly legitimate aspect of the casualties of any war.

Alon,
I'd have said 200,000. And I'd have been right, since I'm mostly concerned with people killed by the coalition directly.

You'd have been wrong. The results said a certain proportion (30-odd% ?) was due to the direct killing by the coalition. That was a lower bound. The largest proportion was "unknown cause of death".

Of course you'd also be morally wrong. There is no moral distinction between causing direct and indirect killing. That's just an excuse for genocide.

In that case, the entire Middle East is swimming in the blood of people who would've lived if the local elites had developed their talent pools instead of just keeping the people in poverty and keeping their oil wealth to themselves. This, incidentally, applies both to pro- and anti-American regimes: Saudi Arabia, Iran, Syria, Iraq, Bahrain, Kuwait.

I am not American though.

LOL. "Not that there's anything wrong with it....."

Fair enough.
==============================

Neither am I, and neither is Lindsay.

Well I don't recall her trying to low-ball the numbers as you did. I have pointed out specific issues with what you've said. Those issues remain valid or not regardless of your nationality.

I do think though, had you been American, this question would have additional aspects for you.

Alon are you actually contesting the moral law that you are responsible for the reasonably forseeable results of a crime you commit?

Do you think there's a moral difference between shooting someone in the head and causing their death by blowing up the hospital they needed to survive?

I guess I'm being more pissy than usual about this. It's true I'm normally pretty bad.

Alon I apologise; and you certainly deserve recognition if you've been saying the direct deaths due to the war are in the hundreds of thousands.

Sorry everyone. It's been rather frustrating being the only person I know standing up and saying that the death toll was over half a million in recent months (and years-- with somewhat lower amounts). There always seems to be a huge rush to dismiss the numbers and pretend it's a much smaller problem than it is. I just see the same thing happening again all over the place.

Can you imagine a death toll where they started out estimating a number over 10x too high instead of 10x too small?

Well yeah -- the WTC victims estimates started out at 50,000. Funny how the direction the exageration lies in seems to change with the perceived quality of the victims.

Anyway sorry about being so grumpy.

I understand... the reason I make a direct/indirect distinction here is that it's not as if this sectarian violence is something the US intended. No state ever likes it when other actors use violence. If things had gone according to plan, the US would've installed Chalabi right away, destroyed the last vestiges of Saddam's regime, and left in the summer of 2003. Books arguing against the Iraq war from the competence angle have made it clear just how delusional the neocons were. Obviously, delusions kill - Mao really did think the Great Leap Forward would've improved agricultural productivity - but in most cases, they're not comparable to the Jewish Holocaust (to wit, the one man-made starvation that gets called a holocaust, the Ukrainian one, was deliberate).

I prefer to compare the US with respect to indirect deaths to a police force that fails to curb crime, or to a tin-pot African country that's too corrupt and incompetent to stem the spread of AIDS. Obviously, the direct deaths are something else.

David-

Well obviously your stance was utterly immoral in as much as you decided you had the right to decide another nations fate. War is the ultimate crime, if you felt bad about the genocidal sanctions you could certainly have opposed them without endorsing aggression.

The thing is, I still don't think lifting sanctions was a plausible or viable option. I believe Saddam Hussein would have pursued weapons of mass destruction, preferably nuclear, following such an event, because it would have been the rational thing for him to do-- for the precise reasons that North Korea and Iran are pursuing them. I believe he would have launched bloody reprisals against Kurdistan once his army was restored and the no-fly zone lifted. I believe he would have acted as an enormous source of tension in the region, actively taking efforts to undermine US interests. It didn't help that I genuinely believed in the presence of WMD in Iraq at the time. I had argued that his continued reticence to relinquish WMD in the face of the threat of war was clear indication of intent to use them; clearly, this was not the case. The sanctions were bad; Saddam unfettered was likely to be worse.

My positions were not due to the desire to "decide another nation's fate," they were directed towards minimizing loss of life. I think that's defensible under a consequentialist ethos. I believe that my premises were deeply flawed, and that the results have been horrific. I am less convinced that my moral reasoning was incorrect.


However in fact Bush had declared in public that the sanctions regime would not end after the occupation. Therefore if you were listening you'd have known he promised to only increase the death rate. He has been true to his word.

I think that's probably taken out of context. What possible motivation would there have been for maintaining the sanctions regime following a successful Iraqi transition to democracy of the candy-and-flowers-greeted-as-liberators variety?

David -
You listened to people you knew to be liars and ignored the people whose life you would be snuffing out.

Don't be a pillock. I didn't listen to the Bush administration bullshit, I listened to the organizations reporting large numbers of innocent deaths due to the sanctions. My opinion on the war was based entirely on my understanding of the impact on the people you claim I ignored. The US was deeply involved in Iraq, an involvement that began long before I was able to vote. My concern was how to end that involvement (interference, really) without further fucking over the people of Iraq. Sanctions were not going to go away, not just because of the US, but also because of the interests of other nations. Saddam was a genuinely evil man, a man my country helped prop up. I am involved against my will, but I won't just walk away from that fact in pursuit of ideological purity.

There is no excuse and it isn't a question of your stupidity. It was an immoral choice regardless of the accuracy of the data you trusted. You don't get to kill people because you happen to think it's for a good cause.

Do I get to just turn my back on a problem my country helped create? That's the other option, isn't it? Kill through sanctions, kill through war, or walk away leaving the people of Iraq and their neighbors to get further fucked over by a monster my government helped create.

What politically viable options were actually on the table that didn't involve someone or other dying?

Togolosh, the politically viable option was lifting the sanctions. Iraq was never as close to a democratic revolution as Iran, but it still had the infrastructure for a color revolution. The politically viable option now is to cut and run simply because it's better than the alternative.

``Does each of those deaths make the news? Not even close.''

Um... I suspect that almost all do make the news, in some newspaper, or radio or TV report or other. The difference with Iraq should nevertheless be clear, the media that the Iraq Body Count folk are looking at haven't anything like the scope of coverage that the combined local newspaper reports, plus local radio news plus local TV news has in the US.

Paul, you may be right. I'm putting forth a testable hypothesis.

However, there are strikingly few individual murders reported each day on Google News. Assuming an average daily murder rate of 44/day, I figured that if I typed in "murder" or "shooting" or "killing", I'd get 20 or 30 unique accounts of murders each day between these search terms.

In fact, I didn't get close. I went back a over a week on each of those terms, and I was never able to find more than 12 unique murders mentioned on any 24-hour period (even during the aftermath of the tragic Amish shootings). Most days, there were a lot fewer unique murders mentioned for the first time. You get dozens of reports about the same high profile murder, day after day, but you don't see anything like 44 new murders covered daily.

Obviously, Google News isn't the complete repository of US reporting in print and it doesn't really touch on most other media.

Still, when I trained as an EMT, I got the impression that most violent deaths happen when there are no reporters around. Unless the killer, the victim, or the crime is especially remarkable, the incident probably won't attract the press.

And America is a free country where journalists can roam around at will and report on whatever they want. (At least in theory.) Compare that to Iraq where your average correspondent is embedded with the US military and subject to OPSEC constraints.

``Even so, only a fraction of the murders that take place on any given day even get written up in the local paper.''

I'd like to see the evidence for this. Have you a sample from the NYT, NY Post, etc., versus the NYPD to report? I don't often read the local paper often (the Austin American Statesman) or watch the local TV news, but the few times I have, it would seem that local killings, and serious traffic accidents, are found somewheres or other therein.

Also, there is a saying, ``if it bleeds, it leads'' which I commend to your attention.

``If things had gone according to plan, the US would've installed Chalabi right away, destroyed the last vestiges of Saddam's regime, and left in the summer of 2003.''

I don't think so. They intended to, and have, built large military bases in Iraq---at least four, by the available reports. Just one of those four has a capacity of 20,000 troops. Putting those bases in the heart of the Persian gulf oil region, was, as far as I can tell, a primary, if unstated, war aim for the US invasion. I suspect that any withdrawal of US troops will not including those stationed at those bases, and that the Pentagon will fight to keep them out of any withdrawal plans.

Those bases have cost so far several billion dollars to build: do you think that they are just going to blow them up or turn them over to the Iraq military? They certainly know about the windfall that the failure to destroy the bases (e.g., Cam Ranh bay) in Vietnam was for the People's Army of Vietnam. I find it hard to imagine that the Pentagon would want that episode repeated.

I don't think so. They intended to, and have, built large military bases in Iraq---at least four, by the available reports. Just one of those four has a capacity of 20,000 troops. Putting those bases in the heart of the Persian gulf oil region, was, as far as I can tell, a primary, if unstated, war aim for the US invasion. I suspect that any withdrawal of US troops will not including those stationed at those bases, and that the Pentagon will fight to keep them out of any withdrawal plans.

Ironically, this had a lot to do with wanting to reduce our presence in Saudi Arabia, which as nominally holy-ground inflamed tensions in the region.

Not working out that well for is, so far, is it?

Alon - I think there are cases where simply lifting sanctions would probably lead to a people-power revolution (Cuba being the most obvious case). Simply lifting sanctions on Iraq is IMO a different case. Leaving aside the question of getting buy-in from Kuwait, Turkey, Israel, and other US allies, Saddam is a particularly nasty character. Lifting sanctions would drop the death rate in the short term, but Saddams long term ambitions have always been expansionist. You can argue he learned his lesson in 1991, but he still had an active WMD program as late as 1998. I see no reason to believe that he wouldn't restart that program as soon as sanctions were lifted. Once he's armed with chemical weapons and delivery systems capable of reaching US regional allies there is a very real potential for millions of dead.

Let me make one thing clear - I don't want the USA to be GloboCop. I do, however, believe that as a nation we have a responsibility to try to clean up messes we helped create, and Saddam was certainly one of those.

Lindsay, I loathe Bush, but as a statistician I comment that the Hopkins study is not credible.

The Bush crowd have obviously launched an ill-conceived war, but this study is meaningless.

1. The sample space is not number of households, but number of clusters. 50 (47) clusters are an insufficient sample.
2. Instances in which neighbouring clusters were substituted destroy the randomness & hence destroy the utility of the study.
3. Baseline death rate which they took ~5 is wildly at odds with UN stats giving ~8. This difference would remove almost all "excess deaths"!
4. Study results show only 1 conclusion reliably: Death certificates likely give > 70% of deaths. Thus the certs are a more reliable estimate than the extrapolation.
5. Discrepancy of factor of 10 between Iraq Body Count and Hopkins study also indicates problem, possibly with both. Factor of (say) 2 would be more creditable.
6. Reported deaths were 35/day earlier in the year, 100/day now. Hopkins study would have it well over 500/day for past several years. That's simply not credible.

The major error is the baseline. The number they wish to find (excess deaths) is lost in the uncertainty of the baseline.

My own feeling (without analysis) is that the true number would likely run about 50% greater than the Iraq Body Count.

Here is an article giving more detail about the problems in the Hopkins methodology:
http://www.slate.com/id/2108887/

Lindsay, I've noticed your point that the baseline is inflated by sanctions-related deaths.

But in that case it is unfair to presume there exists an ideal peacetime non-sanction death rate. For example, without sanctions, one might well have had (to guess at) deaths from:

1. Additional invasions (Kuwait again?)
2. Additional internal deaths? (More aggression against Kurds? Kurd rebellion? Put down?)
3. Renewed Iran-Iraq strife?
4. Eventual deaths arising from possibility of Saddam returning to earlier-abandoned WMD development? (Not necessarily use of WMD, but increased aggression due to confidence WMD research would have given him ...)
5. Deaths or strife from internal attempt to overthrow Saddam?
6. Iranian interference in Iraq as in Lebanon? (Far-fetched, but possible)

In other words, no situation would correspond to an ideal non-sanction peacetime death rate.

Thus the fair number to calculate would be current deaths in excess of alternatives and remains a wild guess.

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