Wednesday, October 11, 2006

The Agony in Iraq

The Washington Post today tells us:
A team of American and Iraqi epidemiologists estimates that 655,000 more people have died in Iraq since coalition forces arrived in March 2003 than would have died if the invasion had not occurred.
The editors put the story on page A12. On the front page we find "In Marine's Death, Clues to a Son's Life" and "FBI Agents Still Lacking Arabic Skills".

Comment: I don't know whether the lack of knowledge of Americans about what is happening in Iraq is due to lack of coverage in the big media or lack of interest. Of course, the two form a viscous cycle! JAD

How bad is the situation in Iraq?

The Lancet today published "Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey" by Gilbert Burnham, Riyadh Lafta, Shannon Doocy and Les Roberts. The authors write:
We estimate that almost 655 000 people—2·5% of the population in the study area—have died in Iraq. Although such death rates might be common in times of war, the combination of a long duration and tens of millions of people affected has made this the deadliest international conflict of the 21st century, and should be
of grave concern to everyone.
This estimate is based on a household survey that involved a couple of thousand households. It is a small sample, but the study was run by a team from Johns Hopkins University and published in a really good peer reviewed journal. It is credible.

According to WP, this mortality figure:
is more than 20 times the estimate of 30,000 civilian deaths that President Bush gave in a speech in December. It is more than 10 times the estimate of roughly 50,000 civilian deaths made by the British-based Iraq Body Count research group. (The Iraq Body Count estimate is actually beween 43850 and 48693 "civilians killed by military intervention in Iraq. JAD)
So why the difference? We can begin with a quotation from the summary published with the article:
Findings: Three misattributed clusters were excluded from the final analysis; data from 1849 households that contained 12 801 individuals in 47 clusters was gathered. 1474 births and 629 deaths were reported during the observation period. Pre-invasion mortality rates were 5·5 per 1000 people per year (95% CI 4·3–7·1), compared with 13·3 per 1000 people per year (10·9–16·1) in the 40 months post-invasion. We estimate that as of July, 2006, there have been 654 965 (392 979–942 636) excess Iraqi deaths as a consequence of the war, which corresponds to 2·5% of the population in the study area. Of post-invasion deaths, 601 027 (426 369–793 663) were due to violence, the most common cause being gunfire.

Interpretation: The number of people dying in Iraq has continued to escalate. The proportion of deaths ascribed to coalition forces has diminished in 2006, although the actual numbers have increased every year. Gunfire remains the most common cause of death, although deaths from car bombing have increased.
Iraq Body Count bases its count on media reports of civilian deaths from military action. It leaves out the deaths of Iraqi soldiers during the war. More importantly, while newspapers sometimes report someone as dead who is really alive, such reports are rare. On the other hand, with many deaths per day, we must assume that the media do not report them all. The Iraq Body Count is an underestimate.

The Lancet article, however, looks at the death rate since the war versus the death rate before the war. The excess death rate is attributed to the war. This approach catches the deaths that don't make the papers or TV. This rate would include not only the people killed in military action, but those dying in other forms of violence, and the people who die as a result of the current terrible conditions who would not have died in the better conditions found in peace time.

I wonder if this report misses kids who die because they haven't had enough to eat for a few years because of the dismal economic conditions, and who are often sick because of the dismal hygienic conditions and thus don't thrive, who don't get adequate medical conditions because of the weakened state of the health service delivery system, and who don't get the right medicines because of supply situation. It certainly does not capture the ill health and disability that have been caused by the conflict.

Migration

The International Organization for Migration reports:
It is estimated that there are more than 1.5 million internally Displaced Persons in Iraq today and perhaps 2-3 million Iraqis living abroad.
The U.S. Census Bureau estimates that the population of Iraq in 2001 was 23,332,000. Thus it would seem that 15 to 20 percent of the people of Iraq have been driven from their homes since the invasion.

How about the economy?

Juan Cole writes in his blog, Informed Comment:
So, with all due respect, these periodic Brookings charts on Iraq statistics (I assume this is the website for the statistics he refers to. JAD) in the NYT have been completely useless and largely misleading. The fact is that many of the statistics are phony. This latest one says that the unemployment rate in Iraq is 30 percent. I challenge that. I challenge Brookings to prove it. I say that in Kirkuk, Ninevah, Diyala, al-Anbar, Salahuddin, Babel and Baghdad provinces (nearly half the country), the whole concept of going to work is almost meaningless for many residents because of the horrible security conditions. And I doubt things are humming along in Basra or Maysan either. The recent reduction in the number of attacks on US troops is also a mirage, because the US military has just run fewer convoys off base and so been less exposed to roadside bombs. When they do run a convoy, it is as likely to be attacked as ever. Oil production in August briefly spiked, though it still was not at the level of 2.8 to 3 million barrels a day typical of pre-US Iraq (pace what the op-ed alleged on the basis of one month). But in September the production fell again to only 1.8 mn. barrels a day.

And they actually say that "the economy has shown some improvement." What?? Is there improved manufacturing productivity? Is Iraq producing more steel? Pharmaceuticals? Anything? Are retail sales up? No!. There is no improved ordinary economy. It is a mess, a hellhole. The only "improvement" in the Iraqi economy would be because of high petroleum prices. But because the oil industry is state owned and profits go straight to the government, this sector is disconnected from everyday livelihoods. There is no evidence that the oil income is getting out into the pockets of ordinary Iraqis. Moreover, there is every reason to believe that much of the petroleum income is being skimmed off by militias and tribes via smuggling, producing a collapse of security in Basra, Iraq's third-largest city. There is no mechanism for auditing where the oil money is going. Saying that increased petroleum prices are producing an improvement in the Iraqi economy is like saying that increased gambling receipts by the Sicilian Mafia are a sign of an improved economy.
Comment: This makes the U.S. losses on 9/11 pale by comparison. But then, Iraq had nothing to do with Al Aaeda nor 9/11, did it!

If the citizens of the United States fully comprehended the magnitude of the suffering inflicted on Iraq by the invasion and occupation, I wonder what the Congress would do and how the Executive Branch would respond? I know we would have some real changes in the next election!
JAD

2 comments:

John Daly said...

According to this article, President George W. Bush has dismissed the Lancet published study "as not credible".

Who do I believe, one of the two or three most respected medical journals in the world or the President of the United States? Sad to say, even tho the Pres has all the intelligence power of the U.S. government at his beck and call, I believe the Johns Hopkins researchers.

This seems to be another example of the Bush Administration's antagonism to scientific results that suggest its policies are wrong.

But of course, it could be that the President has read the report carefully, and has better understanding of epidemiology than the reviewers who approved the paper for the Lancet. Sure it is!

John Daly said...

Woops! This is the article:

"Study sees 655,000 Iraqi war deaths; Bush disputes" By Will Dunham, Yahoo News, October 11, 2006.