The Lancet estimate of 650,000 Iraqis Dying a Fraudulent Claim?

The statistics made headlines all over the world when they were published in The Lancet in October last year. More than 650,000 Iraqis – one in 40 of the population – had died as a result of the American-led invasion in 2003. The vast majority of these “excess” deaths (deaths over and above what would have been expected in the absence of the occupation) were violent. The victims, both civilians and combatants, had fallen prey to airstrikes, car bombs and gunfire.

Body counts in conflict zones are assumed to be ballpark – hospitals, record offices and mortuaries rarely operate smoothly in war – but this was ten times any other estimate. Iraq Body Count, an antiwar web-based charity that monitors news sources, put the civilian death toll for the same period at just under 50,000, broadly similar to that estimated by the United Nations Development Agency.

The implication of the Lancet study, which involved Iraqi doctors knocking on doors and asking residents about recent deaths in the household, was that Iraqis were being killed on an horrific scale. The controversy has deepened rather than evaporated. Several academics have tried to find out how the Lancet study was conducted; none regards their queries as having been addressed satisfactorily. Researchers contacted by The Times talk of unreturned e-mails or phone calls, or of being sent information that raises fresh doubts. . . . .

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Lancet Survey on Post War Fatalities in Iraq Continues to be heavily Criticized

If the New York Times critiques you (even with caveats) from the right, you know that you are in trouble:
Three weeks ago, The Lancet, the British medical journal, released a research team's findings that 100,000 or more civilians had probably died as a result of the war in Iraq. The study, formulated and conducted by researchers at the Bloomberg School of Public Health at the Johns Hopkins University and the College of Medicine at Al Mustansiriya University in Baghdad, involved a complex process of sampling households across Iraq to compare the numbers and causes of deaths before and after the invasion in March 2003.

The 100,000 estimate immediately came under attack. Foreign Secretary Jack Straw of Britain questioned the methodology of the study and compared it with an Iraq Health Ministry figure that put civilian fatalities at less than 4,000. Other critics referred to the findings of the Iraq Body Count project, which has constructed a database of war-related civilian deaths from verified news media reports or official sources like hospitals and morgues.

That database recently placed civilian deaths somewhere between 14,429 and 16,579, the range arising largely from uncertainty about whether some victims were civilians or insurgents. But because of its stringent conditions for including deaths in the database, the project has quite explicitly said, ''Our own total is certain to be an underestimate.''

It has refrained from commenting on the 100,000 figure, except for noting that such a number ''is on the scale of the death toll from Hiroshima'' and, if accurate, has ''serious implications.'' Certainly, the Johns Hopkins study is rife with assumptions necessitated by the lack of basic census and mortality data in Iraq. The sampling also required numerous adjustments because of wartime dangers -- and courage in carrying out the interviews. Accordingly, the results are presented with a good many qualifications.

I haven't spent a lot of time going through the methodology used in this survey by Lancet, but it seems obvious to me that those surveyed could have lied to create a false impression. After all, some of those interviewed do have a strong political motive and there is the concern that they could greatly exaggerate the number of deaths to those conducting the survey. There is also the question of the comparability of the before and after war fatality rates. Andrew Bolt has a very extensive and interesting critique of the Lancet paper:

But what evidence we have tells us these pre-war death rates were actually much higher. Dated United Nations figures suggest the overall death rate was well over seven in every 1000 – or close to, if not higher than, the present rate of 7.9 in every 1000 that the Lancet survey suggests.

But even more persuasive are 2002 figures from UNICEF, which in a much bigger survey of 24,000 households found the infant mortality rate in Iraq before the war was actually a tragic 108 deaths per 1000 infants.

This is more than three times higher than the Lancet survey claims was the case – and double what even the survey claims is the infant mortality rate today. . . .

The researchers did not ask for proof of the children's deaths and admit they were reluctant to ask for proof of all the adults' deaths, either, "because this might have implied that they did not believe the respondents, perhaps triggering violence". Were the Iraqis likewise scared to tell the truth?

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