Iraq: Ultimately more lives will be saved?


An article published in the Lancet on 29 October 2004 estimated the extra Iraqi deaths from all causes since the invasion of Iraq at around 100,000.  Amnesty International estimated that “scores” of people were killed by Saddam Hussein’s regime in each of the two years before the invasion (that is, in 2001 and 2002).  If one accepts these figures as reasonable, it would have taken Saddam Hussein’s regime hundreds of years to match the carnage produced by Bush and Blair in less than 2 years.  Had Saddam Hussein been left in place perhaps 200 people would have been killed by his regime in the interim, compared with maybe 100,000 extra deaths as a result of his overthrow.



The removal of Saddam Hussein is a good thing for Iraq.  In the absence of “weapons of mass destruction”, that’s the only excuse the Prime Minister has left for the invasion of Iraq.


Lurking behind this assertion is the unspoken assumption that although the military action has cost human life, ultimately more lives will be saved, because a murderous tyrant has been overthrown.  He will no longer be in a position to murder innocent Iraqis.


This was the message the Prime Minister gave the House of Commons on the eve of the invasion (19 March 2003):


“Of course, I understand that, if there is conflict, there will be civilian casualties. That, I am afraid, is in the nature of any conflict, but we will do our best to minimise them. However, I point out to my hon. Friend that civilian casualties in Iraq are occurring every day as a result of the rule of Saddam Hussein. He will be responsible for many, many more deaths even in one year than we will be in any conflict.”


The message is clear: left alone, Saddam Hussein would kill more innocent Iraqis in a year than will be killed in the upcoming conflict.  Ultimately, more lives will be saved by taking military action to overthrow him.


So, on 19 March 2003, how many innocent Iraqis would one expect Saddam Hussein to kill in the next twelve months, if he was left alone?  Presumably, the Prime Minister had a figure in his head when he spoke.  Scores would seem to be a reasonable estimate: Amnesty International estimated that “scores of people, including possible prisoners of conscience, were executed” in 2002, a similar number in 2001 and “hundreds” in 2000, and nobody can accuse Amnesty International of being soft on Saddam Hussein.


An article published in the Lancet on 29 October estimated the extra Iraqi deaths from all causes since the invasion at around 100,000.  If one accepts this figure, it would have taken Saddam Hussein’s regime hundreds of years to match the carnage produced by Bush and Blair in less than 2 years.  Had Saddam Hussein been left in place perhaps 200 people would have been killed by his regime in the interim, compared with maybe 100,000 extra deaths as a result of his overthrow.


In the light of that, it takes a strange sort of logic to describe the removal of Saddam Hussein as a good thing for the Iraqi people.


US/UK not responsible

Of course, the Government doesn’t accept that there have been 100,000 extra Iraqi deaths because of the invasion.  It has no idea how many extra deaths there have been, because the occupying powers have made no effort to count them.  In the infamous words of US General Tommy Franks, “we don’t do body counts”.  If the bodies are Iraqi, he should have added for completeness.


(The deaths of US, UK and other foreign soldiers are meticulously recorded - as of 30 November, 1396 had been killed, 1258 US, 74 UK and 72 others - see, for example,  The death rate in the month of November was the worst ever, with 141 killed, slightly more than in April when the last assault on Falluja took place.)


But, whatever the number of extra Iraqi deaths as a result of the invasion, the Government accepts responsibility for very few of them.  On 17 November, Jack Straw made a formal response to the Lancet study in a written ministerial statement.  It began by reviewing what it calls the “security context”, saying:


“In the period of major combat activities in Iraq between the coalition and Iraqi forces loyal to Saddam Hussein, there were inevitably civilian casualties caused by military action by both sides.”


So, the US/UK may have killed a few civilians in March/April 2003.  But:


“Casualties – civilian and military – which have occurred since major combat activities ended on 1 May 2003 have done so directly as a result of those determined to undermine the political process.”


So, all deaths after Bush landed on the deck of the USS Abraham Lincoln and declared “mission accomplished” are the responsibility of those who continue to resist occupation.  The fact that none of this would have happened if the US/UK had not invaded is, of course, an irrelevant detail.


(It’s like the assistant bosun of The Herald of Free Enterprise, saying: “It was nothing to do with me; I just left the bow doors open”.  Except that, he had an excuse – he fell asleep, and 193 people drowned off Zeebrugge; Bush and Blair have caused much greater carnage in Iraq with their eyes wide open.)


Straw continued:


“Security Council Resolution 1546, adopted on 8 June 2004, noted the request of the Iraqi Interim Government that the Multi-National Force should remain to help the sovereign Government of Iraq to ensure security and reaffirmed its authorisation on that basis.  The Multi-National Force has been acting under that mandate, in support of the Iraqi security forces, to ensure the maintenance of security and stability in Iraq.  The mandate specifically authorises action against terrorists.”


Shamefully, that is true.  In passing 1546 on 8 June, the Security Council voted unanimously to authorise the occupying forces to use whatever force their US commander considered necessary to put down resistance to occupation.  This repeated the authorisation first given with the passing of resolution 1511 on 16 October last year.  So, every Iraqi killed by the occupation forces since then has been killed with the blessing of the UN.


If the US commander had considered it necessary to raze Falluja to the ground, and kill everybody in it, thanks to resolution 1546, he would have been acting in accordance with the UN Charter in doing so.


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Apart from the Lancet study, there are two other sources of information about Iraqi deaths since the invasion:

(1)     the ongoing count of civilian deaths prepared by the Iraq Body Count organisation, and

(2)     figures collected by the Iraqi Ministry of Health for the period 5 April 2004 to 5 October 2004.


I will now describe these, followed by the Lancet study.  In doing so, I have drawn on the following two documents by CASI (Cambridge Solidarity with Iraq, formerly Campaign Against Sanctions on Iraq) at

(1)     The Lancet Iraq mortality survey: the UK government’s response is inaccurate and misleading

(2) The Government’s Response to the Lancet Mortality Survey


Iraq Body Count

The Iraq Body Count (IBC) organisation continues to compile a count of civilian deaths derived from online media reports of incidents in which civilians are reported killed (see  As of 30 November, their estimate ranged from 14,563 to 16,742.  The range is a reflection of the fact that different sources often report differing number of civilian deaths for a particular incident.  An attempt is made to distinguish military from civilian deaths (and most of the difference between the maximum and minimum reported arises from this issue).


In a comment on the Lancet study on its website, IBC emphases that “our own total is certain to be an underestimate of the true position, because of gaps in reporting or recording”.  There is no attempt to make up for this inevitable underestimation by other means.  It only includes deaths directly reported by the media or tallied by official bodies (for instance, by hospitals, morgues and, in a few cases so far, NGOs), and subsequently reported in the media – and, if they are not reported, they are not recorded by IBC. 


Iraqi Ministry of Health

The Iraqi Ministry of Health recently published civilian casualty figures for the 6-month period from 5 April 2004 to 5 October 2004, which put the number of violent deaths at 3,853, and the number injured at 15,517.  These are based on returns from Iraqi hospitals.  Inevitably, the figure for deaths is an underestimate, since at best it only includes those who are brought to hospital dead, or who die in hospital.


On 25 September, Knight Ridder Newspapers published an article by Nancy Yousef entitled Iraqi civilian casualties mounting, which reported on a slightly earlier version of these figures.  It quoted Iraqi health and hospital officials agreeing that “the statistics captured only part of the death toll”.  It continued:


“… families often bury their dead without telling any government agencies or are treated at facilities that don't report to the government. … The numbers also exclude those whose bodies were too mutilated to be recovered at car bombings or other attacks, the Ministry said.”


This may account for the fact that the Ministry of Health figures for Fallujah in April, when the first assault on the city took place, are substantially less than in May after the assault was called off – 344 dead and 1415 wounded in April, compared with 749 dead and 1983 wounded in May (see The Government’s Response to the Lancet Mortality Survey).


According to Nancy Yousef’s article, Ministry of Health officials believe that most of the dead are non-combatants, since relatives would be inclined to bury dead combatants immediately rather than bring them to hospital.


Also, Yousef reports that “Iraqi officials said about two-thirds of the Iraqi deaths were caused by multinational forces and police” and “the remaining third died from insurgent attacks”:


“The ministry began separating attacks by multinational and police forces and insurgents on June 10. From that date until Sept. 10, 1,295 Iraqis were killed in clashes with multinational forces and police versus 516 killed in terrorist operations, the ministry said. The ministry defined terrorist operations as explosive devices in residential areas, car bombs or assassinations.”


Lancet study

The Lancet study is the work of Les Roberts, Riyadh Lafta, Richard Garfield, Jamal Khudhairi and Gilbert Burnham, academics from the John Hopkins University School of Public Health in Baltimore, from Columbia University in New York and from Al-Mustansiriya University in Baghdad.  It is entitled Mortality before and after the 2003 invasion of Iraq: cluster sample survey.


The Iraq Body Count attempts to count the number of civilians who have died violently since March 2003, but certainly understates the number, because not all such deaths are reported in the online media.  The Ministry of Health probably measures violent civilian deaths also (but not from March 2003) and also understates the number, because not all such dead are brought to hospital.


By contrast, the Lancet study aimed to estimate the total number of extra Iraqi deaths from all causes, as a result of the US/UK invasion in March 2003 (and therefore should come up with a much larger figure).  The estimate was done, not by counting individual deaths, but by a cluster sampling technique, where a number of “neighbourhoods” in Iraq were selected at random, and households in each “neighbourhood” were surveyed.  (This form of sampling is more prone to uncertainty than picking households at random, but this wasn’t possible because no reliable census data exists in Iraq).


During September 2004, data were collected from 33 clusters of 30 households about household composition, births and deaths since January 2002.  This enabled a comparison to be made between Iraqi mortality in the 14.6 months prior to the invasion and the 17.8 months afterwards.  By this means, the authors concluded that the most likely figure for extra deaths was 98,000 (and this was after excluding data from a cluster in Falluja, the inclusion of which would have given a much higher figure).  More than half the deaths reported as caused by the occupying forces were women and children.


As with any sampling technique, there is uncertainty associated with the result, which in this case is expressed as a “95% confidence interval” (8,000 to 194,000) within which it is 95% certain that the results lie.  Jack Straw tried to rubbish the result in his ministerial statement by implying that “any figure in the range is consistent with the data”, which is formally true; however, figures near the centre of the “confidence interval” around 98,000 are more likely to be accurate.  According to the authors, there is, for example, only a 10% chance that there has been less than about 45,000 deaths (see The Government’s Response to the Lancet Mortality Survey).


The study was reviewed in The Economist on 4 November, which found nothing seriously wrong with its methodology.


Note that this survey technique aims to count extra deaths from all causes.  Thus, it makes no distinction between combatants and non-combatants; however, since it is a household survey, in which deaths were only counted if the deceased was living in the house at the time of death, and for two months previously, few of the recorded deaths are likely to be regular Iraqi army deaths.  Note also that the survey aims to count extra non-violent deaths from causes attributable to the invasion and occupation, for example, an increase in infant mortality because of uncertain provision of water and electricity.


No reliable figures

The Government has been under pressure for some time about its refusal to provide an estimate of Iraqi deaths.  In the House of Lords on 7 September, for example, Lord (Norman) Lamont contrasted the Government’s apparently precise knowledge of the numbers killed by Saddam Hussein, with their self-confessed ignorance of the number of Iraqi deaths since March 2003.  He said:


“Re-reading the Government's dossier on Iraq’s alleged WMD, I was struck by the very precise estimate that the Government made of the number of people who were killed by Saddam Hussein through the use of mustard gas in the Iran/Iraq war – 20,000. The precision of that estimate, of course, stands in complete contrast to the Government's coyness and refusal in response to repeated questions to make any estimate of the number of Iraqis who have been killed in this war – a point made by the noble Baroness, Lady Williams of Crosby, and also by the noble Lord, Lord Judd.


“I find it very difficult to reconcile the willingness to estimate Saddam Hussein’s actions in killing people and our inability to estimate how many people we killed in a war in which we participated and in which we fired the ammunition and in which we know how much ammunition we fired.”


In reply, Baroness Symons protested the Government’s compassion for dead Iraqis, but added:


“… there are no reliable figures for Iraqi civilian casualties not because we do not care, but because so far it has proved impossible to collect them. I shall be frank and say that I regret that enormously. I believe that it is a shortcoming that needs urgently to be remedied.”


She did not explain how the Government apparently managed to count the deaths caused by Saddam Hussein, but is unable to estimate the number killed under US/UK occupation.  Could the reason be that Iraqis killed, or allegedly killed, by the previous regime are politically useful, but Iraqis killed under US/UK occupation are politically embarrassing?


Straw responds

In his first response to the Lancet survey on Today on 29 October, Jack Straw did quote figures for Iraqi civilian casualties, even though, according to Baroness Symons, no reliable figures exist.  He quoted the Iraq Body Count figures, presumably because, whatever about their reliability, they were a damn sight lower than those from the Lancet study.


However, by the time he made his considered statement on 17 November these figures were back in the unreliable category.  Then, he preferred the even lower Ministry of Health figures and he quoted an apparently reassuring statement (dated 29 October) from the Iraqi Minister of Health about their reliability:


“Every hospital reports daily the number of civilians (which may include insurgents) who have been killed or injured in terrorist incidents or as a result of military action.  All casualties are likely to be taken to hospital in these circumstances except for some insurgents (who may fear arrest) and those with minor injuries.  The figures show that between 5 April 2004 and 5 October 2004, 3,853 civilians were killed and 15,517 were injured.  I am satisfied that this information is the most reliable available.”


The assertion that “all casualties are likely to be taken to hospital” is very different from what the Ministry officials told Nancy Yousef (see above), in particular, that families often bury their dead without telling any government agencies or are treated at facilities that don't report to the government.


Commenting on the apparent discrepancy between the Ministry of Health figures and those from the Lancet study, Straw said that “hospitals in Iraq have no obvious reason to under-report the number of dead and injured”.  Probably not, but they do have to receive the dead and injured before they can report them.


Nevertheless, Jack Straw concludes:


“So while recognising the bravery and professionalism of those conducting the Lancet study, the Government does not accept its central conclusion, and continues to believe that the most reliable figures for casualties in Iraq are those provided by Iraqi hospitals to the Iraqi Ministry of Health.”


That is a nonsensical statement, since the latter are for 6 months only and, unlike the Lancet study, do not pretend to measure all the extra deaths caused by the invasion and occupation.


Convention obligations

Under the Geneva Convention on the Protection of Civilian Persons in Time of War, the occupying powers have a duty of care to civilians under their occupation.  Article 27 of it says:


“Protected persons … shall at all times be humanely treated, and shall be protected especially against all acts of violence or threats thereof and against insults and public curiosity.”


The Lancet article concludes:


The fact that more than half the deaths reportedly caused by the occupying forces were women and children is cause for concern. …


“It seems difficult to understand how a military force could monitor the extent to which civilians are protected against violence without systematically doing body counts or at least looking at the kinds of casualties they induce.


“This survey shows that with modest funds, 4 weeks, and seven Iraqi team members willing to risk their lives, a useful measure of civilian deaths could be obtained. There seems to be little excuse for occupying forces to not be able to provide more precise tallies. In view of the political importance of this conflict, these results should be confirmed by an independent body such as the ICRC, Epicentre, or WHO.


“In the interim, civility and enlightened self-interest demand a re-evaluation of the consequences of weaponry now used by coalition forces in populated areas.”



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A final word: all of the studies show that violent deaths of Iraqis have skyrocketed since the invasion began, that tens of thousands of Iraqis who were alive then are now dead, and there is no end of the carnage in sight.


And the vast majority of them would have been alive if Saddam Hussein had been left in power.



Labour & Trade Union Review

December 2004