Iraqi Health Ministry casualty survey

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In January 2008 the Iraqi health minister, Dr Salih al-Hasnawi, reported the results of the "Iraq Family Health Survey" of 9,345 households across Iraq which was carried out in 2006 and 2007. It estimated 151,000 violence-related Iraqi deaths (95% uncertainty range, 104,000 to 223,000) from March 2003 through June 2006.^[1]^[2]^[3] Employees of the Iraqi Health Ministry carried out the survey for the World Health Organization.^[4] The results were published in the New England Journal of Medicine.^[5]

1 Criticisms
2 Excess deaths
3 Earlier Iraqi Health Minister estimate in November 2006
4 See also
5 References

[edit] Criticisms

Critical comments on this study appeared in the editorial section of the New England Journal of Medicine issue that contained the study.^[6] While commending the efforts undertaken by the Iraqi Health Ministry team, the authors also note "substantial limitations" of the final estimate. According to them:

"The sampling frame was based on a 2004 count, but the population has been changing rapidly and dramatically because of sectarian violence, the flight of refugees, and overall population migration. Another source of bias in household surveys is underreporting due to the dissolution of some households after a death, so that no one remains to tell the former inhabitants' story. Mortality estimates that are derived from surveying deaths of siblings were also calculated, but this method may also be subject to such underreporting. ..."

Other criticisms leveled at the Iraq Health Ministry estimate relate to the fear of giving information about violence-related deaths to government interviewers who represented "one side of the conflict" and the reliance on Iraq Body Count's data in dangerous areas (Anbar and Nineveh provinces and parts of Baghdad).^[7]

In a January 11, 2008 article Les Roberts is quoted:

"They roughly found a steady rate of violence from 2003 to 2006. Baghdad morgue data, Najaf burial data, Pentagon attack data, and our data all show a dramatic increase over 2005 and 2006."^[8]

John Tirman stated in a January 21, 2008 AlterNet article:

"Interviewers identified themselves as employees of the Ministry of Health, then under the control of Shiite cleric Moktada al Sadr. Those interviewed, therefore, would be wary of saying a brother or son or husband had been killed by violence, fearing retribution. And, indeed, there are nonviolent categories in the survey that suggest just such equivocation: 'Unintentional injuries' would equal about 40 percent of the death-by-violence toll, for example. Road accidents were ten times their pre-war totals-if someone is run off a highway by a U.S. convoy, is that a 'nonviolent' death?"^[9]

[edit] Excess deaths

Les Roberts, co-author of the Lancet study, said Friday, January 10, 2008:

"The NEJM article found a doubling of mortality after the invasion, we found a 2.4-fold increase. Thus, we roughly agree on the number of excess deaths. The big difference is that we found almost all the increase from violence, they found one-third of the increase from violence. ..."

"They roughly found a steady rate of violence from 2003 - 2006. Baghdad morgue data, Najaf burial data, and our data all show a dramatic increase over 2005 and 2006. ..."

"It is likely that people would be unwilling to admit violent deaths to the study workers who were government employees. ..."

"Finally, their data suggests one-sixth of deaths over the occupation through June 2006 were from violence. Our data suggests a majority of deaths were from violence. The morgue and graveyard data I have seen is more in keeping with our results." ^[10]^[11]

John Tirman (February 14, 2008) in Editor and Publisher wrote:

Yet another, a much larger house-to-house survey was conducted by the Iraq Ministry of Health (MoH). This also found a sizable mortality figure—400,000 “excess deaths” (the number above the pre-war death rate), but estimated 151,000 killed by violence. The period covered was the same as the survey published in The Lancet, but was not released until January 2008.

The ORB results were almost totally ignored in the American press, and the MoH numbers, which did get one-day play, were covered incompletely. Virtually no newspaper report dug into the data tables of the Iraqi MoH report, published in the New England Journal of Medicine, for that total excess mortality figure, or to ask why the MoH report showed a flat rate for killing throughout the war when every other account shows sharp increases through 2005 and 2006. The logical explanation for this discrepancy is that people responding to interviewers from the government, and a ministry controlled by Moktada al Sadr, would not want to admit that their loved one died by violence. There were, instead, very large numbers of dead by road accidents and “unintentional injuries.” The American press completely missed this.^[12]

[edit] Earlier Iraqi Health Minister estimate in November 2006

In early November 2006 Iraq's Health Minister Ali al-Shemari said that he estimated between 100,000 and 150,000 people had been killed since the March 2003 U.S.-led invasion.^[13]^[14]^[15]^[16] The Taipei Times reported on his methodology: "Al-Shemari said on Thursday [Nov. 9, 2006] that he based his figure on an estimate of 100 bodies per day brought to morgues and hospitals -- though such a calculation would come out closer to 130,000 in total."^[13]

The Washington Post reported: "As al-Shemari issued the startling new estimate, the head of the Baghdad central morgue said Thursday he was receiving as many as 60 violent death victims each day at his facility alone. Dr. Abdul-Razzaq al-Obaidi said those deaths did not include victims of violence whose bodies were taken to the city's many hospital morgues or those who were removed from attack scenes by relatives and quickly buried according to Muslim custom."^[16]

From a November 9, 2006 International Herald Tribune article^[14]:

"Each day we lost 100 persons, that means per month 3,000, per year it's 36,000, plus or minus 10 percent," al-Shemari said. "So by three years, 120,000, half year 20,000, that means 140,000, plus or minus 10 percent," he said, explaining how he came to the figures. "This includes all Iraqis killed — police, ordinary people, children," he said, adding that people who were kidnapped and later found dead were also included in his estimate. He said the figures were compiled by counting bodies brought to "forensic institutes" or hospitals.

From the November 11, 2006 Taipei Times article^[13]:

An official with the ministry also confirmed the figure yesterday [Nov. 10, 2006], but later said that the estimated deaths ranged between 100,000 and 150,000. "The minister was misquoted. He said between 100,000-150,000 people were killed in three-and-a-half years," the official said.