Lancet interview

by Chris Bertram on April 20, 2005

Socialist Worker has an interview with Les Roberts who led the team which conducted the Lancet survey which estimated 98,000 excess deaths in Iraq since the war began. (via Lenin .)



dsquared 04.20.05 at 2:48 am

Quite extraordinary. He refers to this article in the New England Journal of Medicine, which finds (Table 2) that in a survey of 894 US Army soldiers, 116 of them (out of 861 who responded to the survey question) regarded themselves as having been personally responsible for the death of a noncombatant. That’s 13.47% (I don’t know why the NEJM rounds it to 14% and suspect someone has made a transcription error).

I think that the most sensible way to extrapolate from this (which is not to say that this is a legitimate calculation; call it the least bad way to create a number) is to say that, given that it was an eight month tour of duty, we got 116 noncombatant deaths in about 215000 troop-days. There were 250,000 US and 45,000 British troops (plus other coalition forces) in the initial assault on Iraq and about 130k US and 20K coalition troops by December. I’m guessing that this gives us 3 months of 300k troops and 5 months of 150k troops. That would be roughly 50m troop-days in the eight months of the tour of duty of the troops surveyed.

50,000,000 x (116/215,000) = about 27,000 civilian deaths. Note that UK troops would have seen fewer noncombatant deaths per troop-day, but units like the 815 US Marines surveyed saw twice the rate of the regular Army units – also, I am not allowing for the fact that some soliders might have been responsible for multiple noncombatant deaths.

This is really quite consistent with the Lancet study; if you crudely scale it up from eight months to eighteen you get 60,000 deaths, which is significantly more than the Lancet team would have attributed to coalition troops. I think that the evidence is getting really rather strong that something has gone very badly wrong with this war.


lenin 04.20.05 at 3:40 am

Call me an old cynic, but I think what went wrong with it was Iraq. Other countries (namely Afghanistan) have accepted US occupation with just as brutal proclivities, probably in large part because there wasn’t a civil society to speak of and the only opposing forces were discredited. Not so in Iraq.

Thanks for the statistical breakdown, that looks very useful.


dsquared 04.20.05 at 3:59 am

If you use that back-of-envelope calculation, please don’t cite it to me in any context which makes it look like I regard it as a legitimate estimate; it’s a ballpark order-of-magnitude consistency reckoning and nothing else.


Harry 04.20.05 at 5:31 am

“As far as I’m concerned the exact number of dead is not so important.”

That is a pretty extraordinary statement for the Lancet researcher to come out with isn’t it?


Chris 04.20.05 at 5:46 am

That is a pretty extraordinary statement for the Lancet researcher to come out with isn’t it?

Not when the implicit contrast to “exact” is “approximate”. That’s a pretty extraordinary straw for you to grasp at Harry.


lenin 04.20.05 at 6:06 am

dsquared – Sorry, I’ve already hammered out my thesis using your calculations. So if I fail, it’s all your fault.

Harry – You parse your sentences very curiously.

Here is what Les Roberts said:

“Most of the people killed by the coalition were women and children, which implies the use of a lot of force, and perhaps too much.

“As far as I’m concerned the exact number of dead is not so important. It is many tens of thousands. Whether it’s 80,000 or 140,000 dead, it’s just not acceptable.”

If the meaning isn’t transparent, I’ll translate, just for fun: the exact number is less important than the fact that too much force is being used, tens of thousands are dead and most of those killed by coalition troops are women and children.


Harry 04.20.05 at 7:00 am

I think it is a very revealing interview on a number of levels.


lenin 04.20.05 at 7:16 am

How many levels exactly? I perceive about seven, but perhaps you’d round it down to four?

Come on, Harry, you can afford to be less circumspect than this. Tell us what’s on your mind. What ‘levels’ are you scanning? Astonish me with your perspicacity.


Chris 04.20.05 at 7:39 am

Actually, I think there’s one aspect of the interview that makes me slightly concerned. Thanks to Daniel’s recommendation, I’ve recently read Peter Griffiths’s _The Economist’s Tale_ . Daniel will be familiar with the passage on p.45 about the invention of data by enumerators and the need to take precautions against this. The fact that Roberts only shadowed his enumerators for the first 8 days and not for the following 15 does raise the possibility that they might have preferred to make up data rather than go through the hard (and dangerous) slog of making house visits.

Against this worry, though, I think we should set the following:

1. Roberts will, presumably, have established a relationship with his enumerators over the first 8 days such that he trusted them.

2. The fact that the results of this one survey are consistent with other studies (such as the NEJM) suggests that they are indeed credible.

I’m sure there’s more that Daniel and others can say on this issue.

Harry writes about aspects of the interview being “revealing”. But nothing in this whole debate has been so revealing as the total lack of interest taken by the coalition and their cheerleaders as to what the facts actually are. All their energy has gone into shouting “It just isn’t trooo!! ” at the Lancet people and none has gone into organising, calling for, supporting etc further surveys to confirm or disconfirm the Lancet findings.


Kevin Donoghue 04.20.05 at 7:54 am

Since the Lancet study suggested that heavy weaponry (rather than small-arms fire) was responsible for most deaths caused by coalition forces, it seems unwise to read very much into the number of soldiers who believe they killed civilians. (But I may be wrong in assuming that the soldiers concerned were not in tanks or helicopters.)


Barry 04.20.05 at 8:09 am

Or calling in air and artillery strikes. I remember reading somebody’s account of the initial invasion, and mentioning calling in many, many artillery strikes. If they took fire from a village (or thought that they did), they called in some artillery.


Chris Lightfoot 04.20.05 at 8:31 am

On the back-of-the-envelope number… I’d expect the number of personnel who feel “responsible” for any given noncombatant death to be rather larger than one. E.g. if you’re in a tank, and you come under fire and shoot up some bloke’s house and kill him, probably all of the crew of the tank will feel responsible. So we should probably scale it by some estimate of the granularity of military operations. Tanks have crews of three, infantry in squads of, what, a dozen? That would argue for quite a big reduction in the estimate.


dsquared 04.20.05 at 8:47 am

Actually this probably means quite a lot of double counting in the NEJM study; if you shell somewhere, then move in and find a dead child in the street, it’s likely that a whole platoon would suffer the trauma related to being responsible for the death.

Harry: It’s not at all an extraordinary statement for Les Roberts to come out with. He is aware of the precision of his estimate, and he is aware that even numbers quite low in his confidence interval are still extremely practically significant. He’s saying that the uncertainty around the point estimate doesn’t affect the truth of the statement that the data support the inference “tens of thousands of excess deaths have occurred”.

Chris: yes you’re right. There’s nothing that can really be done about this. For what it’s worth, Roberts has done work in Democratic Republic of Congo (albeit under somewhat less dangerous conditions) and results carried out by different teams cross-checked. I would personally be more worried by the possibility that the enumerators invented data points for political reasons than for personal safety, but there isn’t any evidence (in the absence of our doing body counts) to support this contention.


Brendan 04.20.05 at 8:57 am

There are a number of comments in the interview with i feel should be highlighted.

‘Americans are so hated that I couldn’t go around talking to people’.

This certainly backs up my own views, gleaned from watching the (few) documentaries by ‘unimbedded’ Western journalists in Iraq. The visceral hatred of ordinary Iraqis for Westerners (and the British and Americans in particular) is simply extraordinary, and doesn’t get captured by the numerous opinion polls. The fact is that Western journalists can’t walk the streets because they will get lynched, while the crowd stands and watches. Delude yourself of many things, but don’t delude yourself that they like us. They hate our f**king guts.

‘In a very prestigious journal called the New England Journal of Medicine there was an article published on 1 July 2004. Military doctors interviewed soldiers returning from Iraq.

They interviewed them because they were interested in post-traumatic stress disorder, so they asked the soldiers about stressful things that might have happened to them.

Among other things they found that 14 percent of the ground forces in the army had killed a non-combatant and 28 percent of returning Marines had killed a non-combatant.

If you work through the numbers you come up with a figure pretty darn close to our estimate in the Lancet.’

The essence of science is replication. The fact that there is another study that implicitly backs up the Lancet study is very strong evidence for its accuracy (although obviously much more work remains to be done).

‘But I think that in my country, in particular among the leaders of my country, there is a grossly inadequate understanding of what a horrible thing war is, and all the misery and suffering that goes with it. My country went to war much too flippantly. Our data strongly supports that.

I went to Iraq hoping I’d find fewer deaths. It certainly never occurred to me that I’d find more deaths caused by coalition forces than by non-coalition forces. Listening to the press in my country that would have been an unbelievable thing.’



jet 04.20.05 at 9:46 am

A 95% confidence that the death toll from the invasion somewhere between 8000 and 194,000.

Were there really only 5 in 1000 deaths per year pre-war? The last UN data says that it was over 7 in 1000. Did things really improve that much from the last good UN numbers to the beginning of the war with the sanctions in place? Saddam was building palaces and blowing money AND lowering the death rate? What a guy.

And what about the Lancet studies claim that infant death rate, prewar, was 29 in 1000? The 2002 UNICEF study (with a much larger sample than the Lancet) says the death rate in 2002 was 108 in 1000.

If the Lancet study wasn’t off because of bad data (respondants lieing for political reasons), then ~2/11 people in Faluja died in the period covered. Riiight.

There is a reason CT keeps complaining that the Lancet study is legit, yet most in America disregards it. No one can respond to these arguements. When you can defend the prewar figure of 5/1000, the ignoring of the 2002 UNICEF figures for infant mortality, and the claim that there should be 50,000 dead Falujans in some mass grave some where, and that this shouldn’t be viewed with a gimlet eye over its release timing, then maybe you’ll change some minds.

Breathless in anticipation.


jet 04.20.05 at 9:52 am

The UN report on Global Warming comes out with a conclusion that Greenhouse gasses are the cause of warming and that major reductions are required. Then on a mid-report chapter conclusion, at the very bottom of a chart, Cosmic Radiation is cited as having the highest possible ranking in its effect on the warming model, yet the lowest possible ranking in the models ability to incorporate the theory. So with this huge unknown (that yes Cosmic radiation hugely effects our conclusions, yet we have no way to incorporate it), the UN still gives out an almost entirely unqualified conclusion.

Just like the Lancet study.

Does anyone else sense a pattern forming?


dsquared 04.20.05 at 10:02 am

The last UN data says that it was over 7 in 1000

Source for this? The numbers I have are 6.0 for 2003. Note that one would expect the crude mortality rate to fall in Iraq as the average age of the population has fallen substantially

The 2002 UNICEF study

Carried out in 1999 and extrapolated to 2002 without taking account of the change in acute and chronic child malnutrition. This is all old ground, Jet.

If the Lancet study wasn’t off because of bad data (respondants lieing for political reasons), then ~2/11 people in Faluja died in the period covered.

Obviously untrue; I am not sure what inference you are trying to draw (it would be a better idea to state what specific error you think has been made; there is a reason why medical journals usually reject papers whose Key Findings are “Riiiight”), but all the obvious candidates are invalid. Bad data does not imply people lying for political reasons, the validity of the Fallujah data does not depend on the validity of the other data and vice versa and your point estimate of 2/11 is wrong and appears nowhere in the paper.

the claim that there should be 50,000 dead Falujans in some mass grave some where

The facts of the matter appear to be that Fallujah was a town of 310,000 people of whom less than an hundred thousand can currently be accounted for. The idea that we can only say that something terrible has happened if we can find the mass graves is likely to form part of Saddam Hussein’s defence, and it is no more valid when you say it.

then maybe you’ll change some minds.

Perhaps, but obviously not yours. Since you visibly haven’t read the survey or any of the discussion, I would suggest that you’d probably better start breathing again if you’re waiting for me to spend a lot of time trying to break down your fact-resistance.


jet 04.20.05 at 10:32 am

The “Breathless in anticipation” was saracasm, as I did not expect a response at all.

I give the Lancet study about as much respect as the UN/IPCC studies on Global Warming. Lots of valid research that has too many holes to draw valid conclusions. 180 dead civilians a day for 18 months from the Lancet study, based on questioning a highly anti-US population, with an outlier of ~2/11 of the population of Faluja dead (pop. 285,000 and ~50,000 dead), and we’re supposed to believe this? In a town the size of Faluja, 50K dead in 18 months would have overwhelmed the burial facilities and there would be mass graves, mass burnings or dead bodies everywhere.

Taking the word of a couple thousand respondants in a highly anti-US environment sounds about as scientific as ignoring the complete lack of knowledge of cosmic radiations effect on global warming while admitting it has to have a strong effect.


Morgan 04.20.05 at 10:48 am

dsquared’s calculations at top of page may be in error I think (and I’d be interested to hear from anyone in the know what the correct ratios are) because he takes the total troop numbers. My undertstanding was that for any one front line combat soldier there were anywhere bewteen 3 and 5 second line support troops who are effectively non-combatant (medics,transport, supplies, engineering etc ,etc). This would put the total number of combat troops in action at any time down by several orders. So say 300K troops becomes
75K to 50K??


Kevin Donoghue 04.20.05 at 10:58 am

Although it isn’t really at all funny, it always provokes a smile when I see the old familiar line from Lancet-bashers like Jet: the alleged impossibility of disposing of the bodies. In the case of the Fallujah sample, 30 housholds reported 53 deaths over an 18-month period. Even assuming that there was a body to be buried in every case (unlikely given the manner in which they died), that isn’t really such a lot of digging for people accustomed to manual labour.

No only are critics like Jet too lazy to read the study, they must be pretty hopeless with shovels as well.


mstanley 04.20.05 at 11:01 am

When I was a kid, there was a friend of mine whose preferred method of argumentation was sticking his fingers in his ears and chanting “no-no-no-no-no” at a high volume. The “arguments” advanced by Jet and others as reasons for ignoring the evidence of civilian casualties coming out of Iraq strike me as a very similar method. Less arguments than an attempt to put a screen in order to ignore reality.

The press and military eyewitness descriptions of going back into Fallujah describe corpses on every street and vast piles of rubble everywhere.


mstanley 04.20.05 at 11:08 am

Just to respond to a few other things in Jets “arguments”. It is inaccurate to say the study estimates a 95% confidence interval ranging from 8000 to 194000 for *the death toll from the invasion*. Instead, the estimate is from 8-194 thousand deaths *in excess of the number who were dying under the tyranny of Saddam Hussein*. In other words, this is a measure of how much more destructive of human life our invasion has been than Saddam Hussein, the great devil figure of the right. (And no I hold no brief for Hussein — the great gain of being freed from his tyranny must be placed against the losses of the invasion).

Almost all mortality estimates have errors, the most important thing is that when you *compare* estimates you take them from studies using similar methodologies. This makes the difference or comparison between estimates valid. The Lancet study uses a similar methodology to estimate deaths before and after the beginning of the war. In other words, they are deriving their estimate of pre-war mortality from the same interviews they derive post-war mortality from. Therefore even if their estimating methodology has some error in it, we can expect this error to be cancelled out in the comparison between pre and post war mortality. Comparing estimates from similar methodologies in this way is much more accepted scientific practice than cherry-picking estimates from totally different sources using different methodologies.

Not to mention the fact that Jet seems to have lied about the pre war UN mortality estimates anyway.

But since Jet and others are not actually interested in learning anything about the destructiveness of the U.S. invasion and occupation, responses are kind of pointless.


jet 04.20.05 at 12:42 pm

mstanley said “Not to mention the fact that Jet seems to have lied about the pre war UN mortality estimates anyway.”

The Lancet Iraq Survey said: “The crude mortality rate was 5·0 per 1000 people per year.”

So I said 7 when I meant 6.8. Now I’m a liar? Truly you have a dizzying intellect.
And so what if dsquared cherry picks some study saying the UN number was 6 in 100,000. The UN says it was 8.1 from 1985-1990. Then went to 6.8 in the 1991 survey. And dsquared just (with appropriate magical thinking) says “aging population” and the whole world is to be convinced that 5 is now the legitimate number?

Anyways, if you are all so for crosschecking the Lancet with other sources, why not cross check it with except that wouldn’t support the silly claim of 100,000. So instead stick to your ridiculous extrapolations of random interviews with soldiers.

In glaring disbelief,

(PS, I was always against the war, but bullshit stinks whether it is your bullshit or someone elses.)


Hannibal Lector 04.20.05 at 1:08 pm

Jet spewed out:
“Anyways, if you are all so for crosschecking the Lancet with other sources, why not cross check it with except that wouldn’t support the silly claim of 100,000. So instead stick to your ridiculous extrapolations of random interviews with soldiers.”

I did check that site, and it listed some 20,000 dead according to official reports.

Given the chaos of war and the guerilla fighting during this Occupation period, it’s no surprise at all that there would be deaths unreported. So, as the man said, it’s not really important whether the number of dead was 50,000 or 150,000. Either way, a lot of Iraqis are dead because we invaded their country, and failed to implement sufficient security and reconstruction in the aftermath.

The Ugly American bumbles into the third world once again, causing death, destruction, and savagery in his wake.


mstanley 04.20.05 at 1:21 pm

Jet, you’re quite right that I shouldn’t have said you were an outright or deliberate liar. Apologies. But your arguments do not make sense, and you seem totally uninterested in understanding why that is so. Your motivation appears to be minimizing the destruction the US invasion has created in Iraq and not determining the fact of the matter.

The Iraq body count does not purport and does not attempt to be a comprehensive measure of deaths in Iraq. It is a count only of deaths reported in the newspaper. It is utterly beside the point to cite it. The fact that you do so is further evidence of your bad faith. If you looked at the site yourself you would find the following quote from the authors:

“Our maximum therefore refers to reported deaths – which can only be a sample of true deaths unless one assumes that every civilian death has been reported. It is likely that many if not most civilian casualties will go unreported by the media.”

As for UN vs. other estimates (you should post a link to UN estimates if you have it, BTW…hard to even evaluate this without exact #s, dates, and descriptions of UN methodology)…my point about differing methodologies still stands and you did not reply to it. Any error in the lancet methodology would be equally true of the pre and post-conflict estimates. To discredit the study you need to find a reason why survey reports of pre-conflict deaths would be particularly low compared to post-conflict deaths. E.g. recall bias for events further in the past. The fact that the pre-conflict period was fairly recent leads me to doubt this is a really important factor, but I suppose it’s possible.

The Lancet study is one piece of evidence out of numerous ones (including lots of eyewiteness testimony) indicating massive civilian casualties and social breakdown in Iraq during and after the war. This is independent of ones views about the invasion.


jet 04.20.05 at 1:40 pm

“Your motivation appears to be minimizing the destruction the US invasion has created…” And you appear motivated to maximize the destruction. And why would I point out that Iraq body count site if I was intent on “minimizing the destruction”? 20,000 people is a shit load of dead brothers, sisters, and moms.

“To discredit the study you need to find a reason why survey reports of pre-conflict deaths would be particularly low compared to post-conflict deaths.”
The US invasion was hugely unpopular in Iraq. Why wouldn’t we assume some bias in under-reporting pre-war deaths and over-reporting post-war deaths? And given undeniable bias in other scientific yet politically motivated bodies, ie the IPCC, why wouldn’t I expect bias from a different scientific and unquestionably politically motivated body, the Lancet (timing of the report)?

As for “As for UN vs. other estimates…”, I’m completely unqualified to argue the various merits of which UN/NGO/Gov statistic is better than the other. But the Lancet’s “because the Iraqis said so” arguement colors me unconvinced.


lenin 04.20.05 at 1:43 pm

Re: Lancet v IBC. Iraq Body Count have made their position clear:

“We are not a news organization ourselves and like everyone else can only base our information on what has been reported so far. What we are attempting to provide is a credible compilation of civilian deaths that have been reported by recognized sources. Our maximum therefore refers to reported deaths – which can only be a sample of true deaths unless one assumes that every civilian death has been reported. It is likely that many if not most civilian casualties will go unreported by the media. That is the sad nature of war.”

Many if not most. The true figure is therefore bound to be much higher than that offered by IBC.


Steve 04.20.05 at 3:58 pm

Absolutely vital correction to both the Lancet study author and some of these comments.

Several times it was mentioned that a study in the New England Journal of Medicine found that 14% of deployed soldiers felt that they had personally killed a noncombatant, and from this, extrapolated the total numbers of noncombatants killed in Iraq.

The article is online, folks. Do a simple websearch. And the data is quite a bit more mixed. The survey in the NEJM surveyed US combat infantry soldiers only-generally in the army’s elite ground units (the 82nd Airborne, 101st Airborne, and marine infantry). They found that only 31% of soldiers (of elite infantry units!) had even participated in a firefight. Infantry make up a fraction of the total number of soldiers in the US Army-there are currently about 37 combat brigades in the US Army, of which about twenty of them are in Iraq at any given time. A combat brigade has about 2000 soldiers in it, not all of which are combat soldiers (that includes mechanics, logistics folks, planning staffs, etc). Maybe 40,000 Brigade soldiers at any given time, of which perhaps 30,000 are combat soldiers (out of 140,000 total). I would be shocked if 14% of soldiers in country even fired their weapons, much less felt that they had killed a noncombatant. I have no idea what the actual extrapolated number of killed civilians would be, but to claim it is 27,000, or 60-140,000 is loony.



Daniel 04.20.05 at 4:41 pm

the army’s elite ground units (the 82nd Airborne, 101st Airborne, and marine infantry

The figure of 13% refers to an infantry brigade of the 3rd infantry. The figure for the marine unit surveyed was much higher.


Chris 04.20.05 at 4:46 pm

Steve, good call for noticing that the soldiers surveyed were in elite infantry units and are therefore atypical. You are mistaken, though, in your assertion that only 31 per cent were involved in firefights. What the study actually says is

“Only 31 percent of soldiers deployed to Afghanistan reported having engaged in a firefight, as compared with 71 to 86 percent of soldiers and Marines who had been deployed to Iraq.”


Donald Johnson 04.20.05 at 4:53 pm

On the subject of polls from which it is hard to conclude anything precise, I also remember one made of Baghdad residents which found that somewhere around 20 something percent knew someone who had died as a result of the invasion. Around twice that many, or 50 percent, knew someone who had died because of Saddam. Or I think it was died–I’m fairly sure they used the same term in both questions. You can’t really get a firm number out of that, though I remember playing with it on a sheet of paper, but it’s at least suggestive that the war has hurt a huge number of people.

I ought to google around and find the poll, but prefer to be lazy instead.


andrew cooke 04.20.05 at 5:02 pm

why didn’t they ask the obvious question:

“why did you, and your team, repeatedly imply that 100,000 deaths was a lower limit when, in fact, your study showed that the number could be anywhere from 8,000 to 194,000? doesn’t that make you end up looking unreliable and politically motivated? did you think short term headlines would be worth damaging the reputation of important work like this?”

even in the report, he’s still saying “It is many tens of thousands” and gives the range “80,000 – 140,000”. the lower limit is 8,000. how much simpler can the math be?

and, of course, the socialist worker report doesn’t give the 95% limits anywhere.

it’s a damn shame that people post here trying to defend such shoddy work. this guy fucked up. he seriously screwed the likelihood of anyone treating such work seriously. he makes the left look bad. he’s a liability that wasted his time, and risked lives, to do work that he probably already knew would be statistically meaningless. it’s not science, it’s propaganda.

BBC: Dr Les Roberts, who led the study, said: “Making conservative assumptions we think that about 100,000 excess deaths, or more, have happened since the 2003 invasion of Iraq.

IHT: “We were shocked at the magnitude but we’re quite sure that the estimate of 100,000 is a conservative estimate,” said Dr. Gilbert Burnham of the Johns Hopkins study team.


jet 04.20.05 at 6:55 pm

Here’s something interesting. Go to the IBC site and check out the info surrouding the deaths. Just from my run down of the thousand or so reports, it does appear that most of the deaths are being caused by the insurgents. You have to really enjoy the humanity of descriptions like “children picking up trash”-“roadside bomb” and “hospital”-“carbomb”. Certainly gives a momentary charge of bloodlust to see the terrorists handled in a more medieval style.


jet 04.20.05 at 7:17 pm

Via the IBC on Fallujah: ” More than 600 Iraqis have been killed in the city since the siege began, said the head of Fallujah’s hospital, Rafie al-Issawi. Most of the dead registered at hospitals and clinics were women, children and elderly, he said. He refused to give figures, saying that doing so would suggest the remaining dead – young, military-aged men – were all insurgents, which he said was not the case.”

So the guy with the best possible knowledge of the Iraqi death count says there were 600+ Iraqi’s killed during the siege (the siege ended soon after his statement). And we know that number included combatants. So if at the height of combat, 600+ Fallujans were killed according to both the chief of the hospital and the US military, what does that tell us about the Lancet’s 50,000 estimate? That’s right.


jet 04.21.05 at 12:47 am

Wooble-dee boodle-dee Iraq booble-dee bloo! Pooble-dee fooble-dee Lancet shooble-dee shoodle-dee shoo!


Kevin Donoghue 04.21.05 at 4:35 am

Andrew Cooke,

The reason Roberts says that the figure of 100,000 excess deaths is conservative is that it is conservative. It is the maximum likelihood estimate with the Fallujah sample excluded entirely. The Fallujah cluster was the only real hot-spot picked up in the sampling process. Although there was a cluster in Sadr City, no deaths from violence were reported there. Oddly though, we don’t hear the Lancet-bashers demanding to know how likely is that.


mstanley 04.21.05 at 8:28 am

Andrew Cooke:

It’s difficult science to do, but this is an honest scientific estimate. You really need to read up on what a confidence interval is. The center of the confidence interval is most likely to be true, the tails (such as 8000 or 194000) are least likely. The 95% CI is a very strict and conservative level to use. The 8-194000 range was achieved only after completely excluding the highest casualty level site (Fallujah) from the sample, then using the strictest scientific CI. The authors of the study are completely entitled to their opinion that the excess casualty level (note: *excess* casualties, not casualties) is around the hundred thousand level, since their own research showed that it is more likely than not that excess casualties exceed 100,000. Not a perfect estimate, but the best that could be done.


the study makes completely clear that losses due to insurgents are included in the casualty figures. The authors are very straightforward and honest about what they are doing. It is the responsibility of an occupying force to maintain order. The insurgency is a result of our botched invasion and occupation. (Which is not saying the insurgents are not morally culpable for their actions, that is totally different).

Also, the doctor you quote was in no way trying to make an estimate of total Fallujah casualties over the entire sequence of raids, bombardments, sieges of Fallujah (which extended over a year). You should read the article the quote comes from for fuller context. This quote was after the U.S. took steps to restrict access to hospitals because of bad publicity. We shelled Fallujah with artillery (not “smart bombs”), it’s ridiculous to think that there were only 600 casualties.


mstanley 04.21.05 at 8:34 am

Here is the full al-Issawi quote:

“More than 600 Iraqis have been killed in the fighting in Fallujah the past week, the head of the city’s hospital said on Sunday.

Statistics of bodies were gathered from four main clinics around the city taking in casualties and from Fallujah General Hospital, said the hospital’s director Rafie al-Issawi. They totalled more than 600 dead, he said.

“We have reports of an unknown number of dead being buried in people’s homes without coming to the clinics,” al-Issawi said.”

Note that they are dead over one week located in the cities clincs, when not all casualties came in to get medical care due to the danger of venturing into the street.


soru 04.21.05 at 8:54 am

The center of the confidence interval is most likely to be true

And the most likely score for a batsman in cricket is 0. I can’t believe anyone with a basic understanding of statistics would use that form of argument without intent to mislead, without hoping that the listener will hear something different from the strict mathematical meaning.



Donald Johnson 04.21.05 at 10:49 am

When you look at the Lancet paper, particularly the table showing the Fallujah casualties, what’s striking about them is that there were apparently several air raids in several separate months which taken all together, killed 52 people. So one neighborhood apparently got pounded several times. Either there is something very special or very unlucky about this neighborhood, or a lot of people died in Fallujah and we never heard much about it. We know there were months of bombing by the Americans. We know that when Israelis have tried using jets or helicopters to take out Hamas militants they usually kill a fairly large number of bystanders. I doubt the American record is better.


mstanley 04.21.05 at 11:33 am

“I can’t believe anyone with a basic understanding of statistics would use that form of argument without intent to mislead, without hoping that the listener will hear something different from the strict mathematical meaning.”

Yeah, sure you can’t believe it. It’s perfectly true though, sorry. The constant repetition of “8-194000” as though all figures were equally likely is completely misleading, far more so than anything I said. If the 95% CI is for a standard normal is 8000-194,000, then the 80% CI is presumably something like 45,000-145,000. (Lancet study is not that simple, but close enough). So we have quite a high probability of 40000+ casualties (even when excluding Fallujah completely!), and a very good justification for the statement in the interview that there were tens of thousands of excess casualties from the war. Right there you have gotten rid of almost half of your confidence interval, in the move from 95% to 80% probability. 80% is a damn good level of probability for anything coming out of the mess that is post-91 Iraq. IMO it is certainly a higher p-value than one should have assigned to any of the assurances from the pro-war people who got us into this mess.


bruno 04.22.05 at 1:26 am

Chris is on the ball again. Thank you, Chris.


soru 04.22.05 at 5:47 am

quite a high probability of 40000+ casualties

That’s probably true. ‘100,000 dead’, which you hear 10 times for every one you hear ‘8-194000’, is not.



mstanley 04.22.05 at 8:42 am

“—quite a high probability of 40000+ casualties—That’s probably true. ‘100,000 dead’, which you hear 10 times for every one you hear ‘8-194000’, is not.


There is a 50% chance that there were greater than 100,000 excess deaths. Even excluding the Falluja cluster from the estimate.


Andy B 04.24.05 at 9:27 pm

Let’s please stop comparing apples to oranges.

When comparing lancet study to Iraq Body Count you must distinguish between violent war related deaths – the only thing the IBC looks at – and all deaths including sanitation, nutrition, crime, ect.

Comparing Lancet to the study of NEJM study of soldiers interview – Reading NEJM article I see only that it states in table 2 “being responsible for the death of a non-combatant” and puts the figure at 14% for army troops in Iraq and 28% for Marines. We have no idea what the definition of “responsible” is. It could be that a whole platoon feels responsible for a single death. There is no way to extraploit this to the number of dead Iraqis.

Jet – the lancet study is not a study of the number of deaths in fallujah. By no means do the authors try to indicate that they have a sample capable of predicting the amount of deaths in fallujah. I’m sure they would agree with you that it the study provides no information for studing the death rate there.


Shirin 04.25.05 at 1:54 pm

I think what went wrong with it was Iraq.

Ah yes – it is SOOOO messy when the victim resists the rapist. If only they would just lie back and enjoy it, everything would go so much more smoothly for all.


Shirin 04.25.05 at 3:36 pm

The visceral hatred of ordinary Iraqis for Westerners (and the British and Americans in particular) is simply extraordinary

Being an “ordinary Iraqi” myself, I must take strong exception to this notion that Iraqis have some kind of “visceral hatered” for Westerners in general and British and Americans in particular. Iraqis are by nature an open, warm and welcoming people – to those who approach them with respect and friendly intentions. Many Americans, British and other westerners have discovered and reported on this both before and after the Bush/Blair invasion.

Ordinary Iraqis, like ordinary people everywhere else in the world, DO take extremely unkindly to having their cities bombed to rubble, their lives turned upside down, their country in chaos. They DO have a visceral hatred for brutal, heavily armed strangers who scream at them in a foreign language, terrorize their children, “disappear” and torture their loved ones, and run them off the road or worse yet blast them away if they don’t show sufficient deference in traffic. Is that surprising?

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