In October 2006 researchers from Johns Hopkins University published a peer-reviewed article in The Lancet, one of Europe’s most important and respected medical journals, estimating that 650,000 Iraqis had been killed due to the U.S.-led invasion of their country, 601,000 violently.  The report was quickly marginalized in public debate in the United States.
The researchers’ methods were not to blame. They used the method accepted around the world to measure demographics such as birth and death rates in the wake of natural and man-made disasters: a cluster survey. No one found substantive flaws in the way they conducted their research. Instead, their findings were dismissed because they asked the politically charged question of how many Iraqis have died, and the answer they found was unacceptably high.
Since the Lancet estimate was based on a survey completed in July 2006 and no new demographic studies have been conducted since, Just Foreign Policy has created an update of the Lancet estimate to account for the violent deaths that have occurred since, in an effort to put the question of the overall death toll back on the table. We did this by extrapolating from the Lancet estimate using a trend line derived from a database of deaths reported in the Western media, maintained by Iraq Body Count.  Our best estimate, which we update regularly, is that over a million Iraqis have been killed violently as a result of the invasion and occupation. 
The treatment of the Lancet study and its findings has really been exceptional. In other war zones, results from cluster surveys have become the standard estimate of deaths. The cluster survey-based estimate that 200,000 have died in Darfur, for example, is consistently cited as established fact by both the U.S. media and the Bush administration.
There are no competing scientific studies of post-invasion deaths in Iraq. Neither the occupying forces nor the Iraqi government has commissioned an official, scientific study of Iraqi deaths, despite – or perhaps because of – the centrality of the death toll to assessing the decision by the United States to go to war. Aside from occasional unsubstantiated assertions from President Bush, the U.S. government does not even guess at Iraqi deaths. The standard estimates of Iraqi deaths quoted by the press and dominant policy makers come from two clearly inadequate sources: media reports and politicized assertions by the Iraqi government.
The media in any country only detect a fraction of all violent deaths. As Patrick Ball has shown, this is particularly true when there is an unusually high level of violence.  In Iraq, the media is limited to shrinking zones of safe passage. While press reports of violence in Iraq are important and often heroically obtained, they cannot provide an assessment of the actual scale of total deaths.
The Iraqi government used to release regular estimates of deaths in the country, but these were politically biased and unreliable. In early 2006, the Iraqi Minister of Health publicly estimated between 40,000 and 50,000 violent Iraqi civilian deaths since the invasion. In October 2006, the same week a study was published in the Lancet estimating 650,000 deaths, the Minister tripled his estimate, saying there had been 150,000. There is simply no centralized reporting mechanism that can count, one-by-one, all violent deaths in Iraq.
As of this writing, Iraq Body Count reports that between 69,000 and 76,000 Iraqi civilians have been killed. But, as Les Roberts, co-author of the Lancet study, points out, “There have to be at least 120,000 and probably 140,000 deaths per year from natural causes in a country with the population of Iraq.” If the Iraq Body Count figure captured all deaths (which the group does not claim), then the annual death rate for the past four years has increased less than 15 percent. Roberts remarks that this is not consistent with “numerous stories we hear about overflowing morgues, the need for new cemeteries and new body collection brigades.”  Estimates of violent deaths on the scale of the Iraq Body Count numbers are also hard to reconcile with estimates that 4 million Iraqis have fled their homes, since interviews with refugees indicate that the violent death of family members was often the event that precipitated flight.
The Iraq Study Group itself found that “there is significant underreporting of the violence in Iraq.” They cite a day in July 2006 when U.S. intelligence reported 93 attacks. “Yet a careful review of reports for that single day brought to light 1,100 acts of violence.”  The British daily Independent reports that the Iraqi government bans journalists from the scenes of bombings and has banned hospitals from providing information on casualties. 
On January 9, 2007, a reporter from Fox News was embedded with the U.S. Air Force. He reported that planes taking off from his location “dropped thousands of pounds of munitions. They bombed 25 targets deep inside Iraq.” Yet no reports of any deaths from those bombings reached the English-language press. 
The Brookings Institution reports that the United States military regularly conducts tens of thousands of patrols a week, often in hostile neighborhoods.  It is not known – because it is not reported – how often deadly force is used on these patrols, particularly when soldiers at close range cannot be sure who is a threat and who is not.
There are also indications that the stress of urban combat has led some U.S. soldiers to see all Iraqis as the enemy. The U.S. Army’s Mental Health Advisory Team recently found that only 47 percent of soldiers and 38 percent of Marines thought “all non-combatants should be treated with dignity and respect.” Just 40 percent of Marines and 55 percent of soldiers said they would report a member of their unit for “injuring or killing an innocent noncombatant.”  The Nation recently interviewed fifty Iraq combat veterans on the record, of whom “dozens … witnessed Iraqi civilians, including children, dying from American firepower.” The veterans said these killings usually went unreported and unpunished, one suggesting that it would be impossible to investigate every incident where an Iraqi civilian was killed or wounded because they are so frequent. 
We also know from experience in Latin America that large numbers of bodies can be “disappeared.” Much of the sectarian killing in Iraq is reportedly committed by Iraqi security forces or allied militias who would be capable of such cover-up.
Unfortunately, the debate over whether the U.S. military should end its occupation of Iraq remains largely uninformed by accurate estimates of Iraqi deaths, at least here in the United States. Worse, there seems to be a lack of interest in how many Iraqis have been killed even as many who oppose withdrawal warn of the deaths that would ensue if the troops left. As a result, the American public is completely uninformed as to how many Iraqis have been killed. An AP poll in February asked Americans how many Iraqis had died as a result of the war. The median response was just under 10,000. 
The best estimate indicates that more than a million Iraqis have been killed as a result of the invasion and occupation. It is reasonable to suppose that if politicians and news media in the United States were forced to confront this reality, pressure for the end of the war would increase dramatically, and cavalier discussions of new military actions in Iran and Pakistan would be less likely.
Patrick McElwee is a policy analyst and Robert Naiman is a senior policy analyst at Just Foreign Policy, www.justforeignpolicy.org. Their counter of Iraqi deaths can be found at http://www.justforeignpolicy.org/iraq/iraqdeaths.html.
 Burnham, Gilbert, Riyadh Lafta, Shannon Doocy, and Les Roberts, “Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey,” The Lancet, October 11, 2006, http://www.thelancet.com/webfiles/images/journals/lancet/s0140673606694919.pdf
 See the most current estimate and Web counter at: http://www.justforeignpolicy.org/iraq/iraqdeaths.html
 See, for example: Ball, Patrick, Paul Kobrak and Herbert F. Spirer, “State Violence in Guatemala, 1960-1996: A Quantitative Reflection,” Washington: American Association for the Advancement of Science, 1999, http://shr.aaas.org/guatemala/ciidh/qr/english/qrtitle.html
 Roberts, Les, “Iraq‘s death toll is far worse than our leaders admit,” The Independent, February 14, 2007, http://comment.independent.co.uk/commentators/article2268067.ece
 Baker, James and Lee Hamilton, co-chairs, “Iraq Study Group Report,” December 2006, p. 62, http://www.bakerinstitute.org/Pubs/iraqstudygroup_findings.pdf
 Cockburn, Patrick, “The surge: a special report,” The Independent, 7 August 2007, http://news.independent.co.uk/world/middle_east/article2841425.ece
 Turse, Nick, “Bombs over Baghdad: The Pentagon’s Secret Air War in Iraq,” TomDispatch, February 7, 2007, http://www.globalpolicy.org/security/issues/iraq/occupation/2007/0207bombsbaghdad.htm
 “Iraq Index,” The Brookings Institution, http://www.brookings.edu/fp/saban/iraq/indexarchive.htm
 “Mental Health Advisory Team IV, Operation Iraqi Freedom 05-07: Final Report,” Office of the Surgeon,Multinational Force-Iraq and Office of the Surgeon General, United States Army Medical Command, November 17, 2006, pp. 35, 37, http://www.armymedicine.army.mil/news/mhat/mhat_iv/mhat-iv.cfm
 “Americans Underestimate Iraqi Death Toll,” Associated Press, February 24, 2007, http://www.huffingtonpost.com/huff-wires/20070224/death-in-iraq-ap-poll/
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