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October 28, 2004

Iraqi Civilian Deaths Increase Dramatically After Invasion

Updated 2006 Iraq mortality study

Civilian deaths have risen dramatically in Iraq since the country was invaded in March 2003, according to a survey conducted by researchers from the Johns Hopkins Bloomberg School of Public Health, Columbia University School of Nursing and Al-Mustansiriya University in Baghdad. The researchers found that the majority of deaths were attributed to violence, which were primarily the result of military actions by Coalition forces. Most of those killed by Coalition forces were women and children. However, the researchers stressed that they found no evidence of improper conduct by the Coalition soldiers.

The survey is the first countrywide attempt to calculate the number of civilian deaths in Iraq since the war began. The United States military does not keep records on civilian deaths and record keeping by the Iraq Ministry of Health is limited. The study is published in the October 29, 2004, online edition of The Lancet.

“Our findings need to be independently verified with a larger sample group. However, I think our survey demonstrates the importance of collecting civilian casualty information during a war and that it can be done,” said lead author Les Roberts, PhD, an associate with the Bloomberg School of Public Health’s Center for International Emergency, Disaster and Refugee Studies.

The researchers conducted their survey in September 2004. They randomly selected 33 neighborhoods of 30 homes from across Iraq and interviewed the residents about the number and ages of the people living in each home. Over 7,800 Iraqis were included. Residents were questioned about the number of births and deaths that occurred in the household since January 2002. Information was also collected about the causes and circumstances of each death. When possible, the deaths were verified with a death certificate or other documentation.

The researchers compared the mortality rate among civilians in Iraq during the 14.6 months prior to the March 2003 invasion with the 17.8 month period following the invasion. The sample group reported 46 deaths prior to the March 2003 and 142 deaths following the invasion. The results were calculated twice, both with and without information from the city of Falluja. The researchers felt the excessive violence from combat in Falluja could skew the overall mortality rates. Excluding information from Falluja, they estimate that 100,000 more Iraqis died than would have been expected had the invasion not occurred. Eighty-four percent of the violent deaths were reported to be caused by the actions of Coalition forces and 95 percent of those deaths were due to air strikes and artillery.

“There is a real necessity for accurate monitoring of civilian deaths during combat situations. Otherwise it is impossible to know the extent of the problems civilians may be facing or how to protect them,” explained study co-author Gilbert Burnham, MD, associate professor of International Health at the Bloomberg School of Public Health and director of the Center for International, Disaster and Refugee Studies.

“Mortality before and after the 2003 invasion of Iraq: cluster sample survey” was written by Les Roberts, Riyadh Lafta, Richard Garfield, Jamal Khudhairi and Gilbert Burnham. Roberts and Burham are with the Johns Hopkins Bloomberg School of Public Health. Lafta and Khudhairi are with the College of Medicine at Al-Mustansiriya University in Baghdad. Garfield is with the Columbia University School of Nursing.

The study was funded by the Center for International Emergency, Disaster and Refugee Studies at the Johns Hopkins Bloomberg School of Public Health and the Small Arms Survey in Geneva, Switzerland.

Public Affairs media contacts for the Johns Hopkins Bloomberg School of Public Health: Tim Parsons at 410-955-6878 or paffairs@jhsph.edu