Betreff: Lancet reports 60,000 violent deaths in Iraq
Von: EPIC Dispatch
Datum: Fri, 19 Nov 2004 14:44:43 -0600 (CST)



U.S. and Iraqi forces now control Fallujah, but Iraq's violent insurgency continues to mount attacks across the Sunni heartland, raising the question as to whether a military solution to the insurgency is even possible.


Here at EPIC, we believe the emphasis should not be on further military operations, but rather on efforts to change the environment in Iraq.  The U.S., international community, and Iraq's interim government must work together to reduce the number of violent deaths, better safeguard civilians, improve job opportunities, and increase political participation among all Iraqis. 


According to the Bush administration, the attack on Fallujah was intended to "break the back of the insurgency," thus securing Iraq's Sunni heartland in time for national elections in January.  However, it may have had the opposite effect.  In response to the Fallujah offensive, 47 political parties are now calling for a boycott of January elections.  Without their participation, this will pose a major problem for the legitimacy of an elected body to govern the Iraqi people. 


This week, EPIC also mourns the apparent death of Margaret Hassan, director of the world's largest humanitarian organization, CARE International.  For 30 years, she devoted herself entirely to her adopted country.   She remained in Iraq through the 8 year war with Iran, the 1991 Gulf War, and the following 13 years of sanctions. "Mama Margaret" worked to bring medicine, clean water, and build hospitals for the people of Iraq.


Despite everything, Iraqis remain resilient and need our support.  There are so many others like Margaret who are making a difference in the lives of their compatriots.


In recent months, teams of Iraqi field workers risked their lives in order to collect data for the Lancet Report which we feature in this Dispatch.


I had the opportunity to speak with EPIC advisor Richard Garfield of Columbia University and one of the engineers of the Lancet Report.  A lighthearted and incredibly knowledgeable man, Richard has extensive experience studying mortality changes among civilians in humanitarian crises around the world.  In this exclusive EPIC interview, Richard shares his knowledge about several aspects of the report and its findings.  I hope that you enjoy the incredible work he and his Iraqi colleagues have done as much as I have.


Read the exclusive EPIC interview:


Best wishes,

Erik and Michelle




Lancet reports 60,000 Violent Deaths in Iraq
EPIC Dispatch No. 202

November 19, 2004



The Lancet Report


A population-based field study published in The Lancet, one of Britain’s top medical journals, suggests the death toll in Iraq is far higher than previously reported. The survey estimates that Iraq has suffered 98,000 deaths -- in excess of Iraq's expected death rate based on pre-invasion mortality figures - in the 18 months since the U.S. invaded Iraq. An estimated 60,000 of those deaths are attributed to violence, mainly reported to be caused by US air attacks. The survey was conducted by longtime EPIC advisor Richard Garfield of Columbia University and researchers from John Hopkins University and Baghdad's Al-Mustansiriya University. As an organization that has tracked mortality rates in Iraq since 1998, EPIC believes the Lancet study is the most reliable estimate to date: "It is the only one drawn from a large representative sample covering the whole country. Interviewers were expertly trained and supervised. The questionnaire and methodology used has proven reliable in Darfur and the Congo." Furthermore, the report was reviewed and edited by some of the world’s most expert statisticians. Help publicize this report by sending copies to your members of congress and local newspapers. (The Lancet, Oct. 29, 2004).


Read the report:


Read the interview:



The Economist reports: "Nan Lair, a professor of biostatistics at the Harvard School of Public Health…says that she believes both the analysis and the data-gathering techniques used by Dr. Roberts [of Johns Hopkins University School of Public Health who was involved in the study] to be sound…Arthur Dempster, also a professor of statistics at Harvard…agrees that the methodology in both design and analysis is at the standard professional level.  However, he raises the concern that because violence can be very localized, a sample of 33 clusters really might be too small to be representative."


Read the article here:



The Fallujah Offensive


On Nov 8, a force of over 10,000 US and 2,000 Iraqi troops commenced an assault on Fallujah that lasted about a week full of air strikes, artillery, and infantry.  After days of intense fighting, Fallujah has been left in ruins and declared a military victory for the United States.  


Without good intelligence, the massive firepower unleashed against insurgents in Fallujah put the entire city at risk.  We believe 80,000 to 100,000 residents remained in the city during the offensive.  The horrendous conditions for those who chose not to flee has emerged and is now “clear that US military claims of ‘precision’ targeting of insurgent positions were false…[and] the fears of large numbers of civilian injured have raised fresh warnings that the suffering in Fallujah will be used to rally insurgents across northern Iraq” (The Guardian, 11/14/04). 


As the Lancet study has shown, violence is the leading cause of death in Iraq today.  According to Lancet, an estimated 60,000 Iraqis have died from violence over the past 18 months, mostly from U.S. air attacks.  Last week a UN report said that 20 doctors had died during a US air strike.  Meanwhile, Prime minister Iyad Allawi said “there have been no civilian casualties during the battle of Fallujah, contradicting accounts from residents inside the city” (The Independent/UK, 11/15/04).  Growing anger over these civilian casualties creates the basis for which more insurgents are recruited.


To add insult to injury, a US soldier was videotaped shooting a wounded, unarmed alleged insurgent in a mosque and has sparked outrage in the Arab world. 

Read more:



The Aftermath


While major fighting has ceased, the city has been left in ruins and suffering continues inside the city where the people have been without water, food, and electricity.  On Nov. 13, Iraq’s Red Crescent group “sent seven truckloads of food and medicine to the city, but US forces blocked the aid convoy at Fallujah’s main hospital and said it could not enter.  The convoy turned back Monday after three days of frustration” (Reuters, 11/15/04).


Fareed Zakaria warns that either Fallujah “will mark a decisive blow against the insurgency…and thus [allow] for elections in January.  Or it will not make much of a dent in the overall strength of the insurgency and Iraq will remain deeply unstable”.  In his Op-ed for Newsweek, Zakaria delves into possible adverse consequences of the Fallujah offensive including the boycotting of elections to insurgent uprisings in several other cities across Iraq.  He states that “the overall objective….is to win the battle of ideas and the politico-military struggle for power.  The center of gravity in counterinsurgency operations is the local population.  Winning and maintaining their support is crucial.  Gaining territory is less important than eliminating support for the insurgents”.  


Read the Op-ed at:


As many have feared, forty-seven Iraqi political parties, including many with a religious base, have announced that they will boycott the planned January elections. “The communiqué…said the January election does not speak for the Iraqi people as long as it is “imposed” by the US-backed interim government and rejected by a clear majority of political and religious powers. The participants warned that the current wave of massive US raids across Iraq threatened the territorial integrity of the country and would virtually prove as futile the outcome of the upcoming election”. 

Read about the boycott:


The assault on Fallujah has not only put innocent civilians at risk, it now threatens to be yet another large setback for Allawi's government and the U.S. mission in Iraq.  “Iraq’s elections look increasingly unlikely to take place on schedule.  The security situation in the rest of the country is getting worse…[Allawi] will be seen as an American puppet, unloved, ineffective and unable to stem the violence.  And then we will be in real trouble in Iraq” (Newsweek, 11/22/04).   


Read more at:




Faces of Iraq tours America's heartland


EPIC continues to connect Americans to the plight of the Iraqi people.  Thanks to our partnership with Oxfam America, the acclaimed FACES of IRAQ photo exhibit is currently on tour in the heartland of the United States.  The exhibit includes the works of Iraq War veteran Benjamin Busch, awarding winning photojournalist Jane McBee, and labor photographer David Bacon.  From a portrait of a mother awaiting news of her son in a hospital to Iraqi intellectuals selling their books in order to survive, the photographs tell the story of Iraq and its people.


The tour began in late September at Prince George's Community College in Maryland.  According to curator Tom Berault, about 10,000 students, faculty, and members of the community visited the exhibit.  FACES then went on to Toledo, Ohio, where it opened the same night as the second presidential debate.  Now the exhibit is in Columbia, Missouri as part of the University's International Education Week. 


At every stop, the images capture the imagination, reminding Americans of what the press often can't convey: ordinary Iraqis -- families like ours -- are trying to keep their children safe and rebuild their lives. 


To learn how you can bring this powerful exhibit to your town, visit our website or contact Marie Brown at




A Veterans Day gift for Returning Soldiers and Military Families


EPIC affiliate Veterans for Common Sense (VCS), a non-partisan veterans' organization focused on national security, veterans' care, and civil liberties, today released its "Resource Guide for Veterans of Operation Iraqi Freedom and Enduring Freedom." The guide provides a comprehensive directory of services and programs available to military families and returning veterans. According to VCS, the inadequate availability of readjustment benefits for returning Iraq War veterans remains a serious problem.


According to a recent study published in the New England Journal of Medicine, as many as one in seven returning soldiers from the first rotation of troops to Iraq in 2002-03 (OIF I) suffer from war-related trauma. Of these soldiers, only one in four veterans actually sought treatment for their conditions due to fear of a negative impact on their careers. Matthew J. Friedman, MD, PhD., director of the National Center for Post Traumatic Stress Disorder, notes in the same issue of NEJM that this estimate may be conservative, both because of the methodology of the study, as well as the delay sometimes seen before onset of PTSD symptoms after returning from combat.


The organization notes that reports of suicides, both among deployed veterans and those recently returned, are on the rise. "The cost of untreated post-traumatic stress disorder is high for the veteran, their families and for society as a whole," said VCS Director Charles Sheehan-Miles. 


Read the full guide:



Readers Write:


The following emails were sent in response to recent EPIC Dispatches on the Presidential debates, the changing status of women in Iraq, and the need for justice regarding Abu Ghraib.


"People in several Latin American countries have tried to follow a period of dictatorship with an intensive search into the truth of their history.  This seems like . . . something we must do when the current Iraq War is over… There can be no honest discussion as long as the election campaign is going on here and are soldiers are getting killed there.  No candidate who wants to win can fail to pay homage to our cherished American myths, regardless of how untrue they may be."  -- Brian Scanlon, Mount Pleasant, SC


"Thanks for keeping me informed. I am interested by your title about the changing status of women… it would indeed be sad if women were to move backwards in a country where they have enjoyed opportunities and leadership roles for many years since the end of the British occupation." 

-- Denis Halliday, Former UN Humanitarian Coordinator in Iraq, New York City, NY


"Last year, when what we saw in Europe was what the White House wanted in the Press, your site confirmed our view that a significant number of Americans felt the same way as the majority of Europeans. You gave us heart that there were movements outside the main parties prepared to campaign. . . .The people of Spain didn't push for withdrawal of their troops from Iraq because of the bomb in Madrid 3-11: they had campaigned hard not to be involved before the war, and 98% of Spaniards were against what they saw as an unnecessary, illegal and high risk intervention. The Spanish are well used to terrorism, and won't run away from it, as some have portrayed. The country has only been a democracy for 25 years, and since the 1940s has seen freedom fighters against fascism (terrorists against the fascists!!!) and then ETA using terrorism for a Basque homeland. Interestingly, the Spanish newspapers have far more gruesome pictures of what is really going on than appear in the UK press, and I guess than in the US press." -- Paul Tempany, Seville, Spain


"The last EPIC email was the best one I've seen in weeks.  Very good stuff on the [Presidential] debates, the Wall Street Journal reporter, etc.  I think one of the most important things Kerry said about Iraq was in the second debate, when he said that Iraqis need to understand that the US does not have a long term interest in staying in Iraq.  Kerry's policies aren't the best but I think him saying that was his clever way of admitting that the insurgency is not about defeating "terrorists," it's about sovereignty."

-Carl LeVan, PhD Candidate, UC San Diego































Please visit Education for Peace in Iraq Center at