Iraqi death rate will probably beat our own Civil War death rate, which was damn grim

Iraqi Death Rate May Top Our Civil War -- But Will the Press Confirm It?
The press, after its initial coverage, has turned away from the shocking Johns Hopkins study which estimated 400,000 to 800,000 deaths in the Iraq war since 2003. One of the authors of the study has issued a challenge: Check out their findings in the field -- and then confirm or debunk it.
By Greg Mitchell

With mass killings occurring every day in Iraq, and Americans falling at one of the highest daily rates of the entire war, it’s no wonder that support for the conflict in the U.S. continues to slip. What the American press, public and political figures have yet to grasp or acknowledge, however, is the true human catastrophe in Iraq, a 21st century holocaust, if I may put it that way. This inconvenient truth -- suggested, if not proven, by the Johns Hopkins study released last week -- seems to be too horrible for many to face, considering the mild or negative reaction to the report in the days following the broad attention it did receive at first.

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.

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"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?

When I completed a column on the Johns Hopkins study last week, it was too early to gauge the reaction, beyond President Bush standing by his estimate of 30,000 civilian casualties. Since then, a few pundits have weighed in, pro and con, but America’s role in possibly triggering a Darfur-on-the-Euphrates is now sinking out of sight.

Do the study’s numbers seem that far out? Many experts on such work, in fact, seem to support the methods used by the surveyors, and their work was peer-reviewed up the wazoo. Les Roberts, one of the co-authors of the study, has even challenged newspapers to send reporters to far-flung Iraqi provinces to check on local mortuaries and confirm or contest the findings. The Washington Post and Los Angeles Times, and possibly others, have checked with one or more mortuaries in the past, but someone ought to now answer the wider challenge.

Roberts, appearing on the “Democracy Now” radio program, said, “it’s going to be very easy for a couple of reporters to go out and verify our findings, because what we’ve said is the death rate is four times higher. And a reporter will only have to go to four or five different villages, go visit the person who takes care of the graveyard and say, ‘Back in 2002, before the war, how many bodies typically came in here per week? And now, how many bodies come in here?’ And actually, most graveyard attendants keep records. And if the number is four times higher, on average, you’ll know we’re right. If the numbers are the same, you’ll know we’re wrong.

“It is going to be very easy for people to verify this and get all of this talk about whether it’s political out of the way, because the fundamental issue is -- a certain number of Iraqis have died, and if our leaders are saying it’s ten times lower than it really is, we are driving a wedge between us and the Middle East.”

Washington Post columnist Eugene Robinson commented a few days ago: “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.” No one should want to, but many seem to be doing just that.

The same John Hopkins group had asked for an independent study of its similar survey in 2004, which also came in with a death toll well above other estimates. It never happened.

The new study, published last week in the respected Briitish medical journal Lancet, drew on data obtained by eight Iraqi physicians during a survey of 1,849 Iraqi families -- 12,801 people -- in 47 neighborhoods of 18 regions across the country. The researchers based the selection of geographical areas on population size, not on the level of violence. How strict were their standards? They asked for death certificates to prove claims -- and got them in 92% of the cases. I'd suggest that everyone go to the Lancet site and decide for yourself on their protocol, rather than rely on newspaper articles or talk radio.

Ronald Waldman, an epidemiologist at Columbia University who worked at the Centers for Disease Control and Prevention for many years, told the Washington Post the survey method was “tried and true.” He said that “this is the best estimate of mortality we have.” 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. Other death counts have been based on media or government reports, not door-to-door surveys.

“I loved when President Bush said ‘their methodology has been pretty well discredited,’” 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.

Some critics have charged that the research was politically motivated or that its release was timed to come shortly before U.S. elections. Gilbert Burnham, lead author of the paper and a public health professor at Johns Hopkins, has called that charge “bunk.” He said his “goal was to get this out in July or August, just so people wouldn’t say this was tied somehow to elections” but that peer review and other administrative issues slowed up publication.

The sad truth is: People who don’t want to face this sort of death toll won’t ever want to face it.

Critics of the survey -- from the president all the way down to National Review Online -- have continually cited the much lower number numbers gathered from press accounts and mortuaries, which is known as “passive surveillance.” The Johns Hopkins study notes: “Aside from Bosnia, we can find no conflict situation where passive surveillance recorded more than 20% of the deaths measured by population-based methods. In several outbreaks, disease and death recorded by facility-based methods underestimated events by a factor of ten or more when compared with population-based estimates. Between 1960 and 1990, newspaper accounts of political deaths in Guatemala correctly reported over 50% of deaths in years of low violence but less than 5% in years of highest violence.”

Yet Richard Nadler, writing at National Review Online, complained that "the Hopkins researchers don’t record 655,000 extra casualties -- they extrapolate them." Nadler, I’d bet, rarely attacks the validity of U.S. opinion polls which base their findings on interviews with about 1,000 Americans – in a country of 300 million.

On “Democracy Now, ” Les Roberts explained that “this cluster survey approach is the standard way of measuring mortality in very poor countries where the government isn’t very functional or in times of war. And when UNICEF goes out and measures mortality in any developing country, this is what they do. When the U.S. government went at the end of the war in Kosovo or went at the end of the war in Afghanistan and the U.S. government measured the death rate, this is how they did it. And most ironically, the U.S. government has been spending millions of dollars per year, through something called the Smart Initiative, to train NGOs and UN workers to do cluster surveys to measure mortality in times of wars and disasters.”

Even so, press response to the new survey has been muted, at best. “You know, I think that -- this is just my opinion -- the U.S. press sort of follows public opinion,” Roberts said. “It doesn’t necessarily lead it, except in a few circumstances, like AIDS in Africa. And the public is ready to think, ‘Wow, things might be going badly in Iraq.’ And I don’t think the public was ready to say that two years ago. .. No one asked George Bush about how many civilians had died or about our study for 14 months after the study came out. And then, when he was asked, it was just by a member of the public in a forum in Philadelphia.

“And now, within about four hours of the study coming out, he was asked directly, he was forced to respond, there was a dialogue going on. So I think that the nation, as a whole, is more ready to honestly talk about Iraq, and that's led the press to be more able to honestly talk about Iraq.” But will anyone take up the challenge to confirm or deny the 600,000 dead?

Finally, it should be noted that Iraq Body Count, which has chronicled, on a daily basis, the civilian casaulties in that country since the start of the war in an ongoing, questions the Johns Hopkins count, but concludes: "Do the American people need to believe that 600,000 Iraqis have been killed before they can turn to their leaders and say 'enough is enough'? The number of certain civilian deaths that has been documented to a basic standard of corroboration by 'passive surveillance methods' surely already provides all the necessary evidence to deem this invasion and occupation an utter failure at all levels."