...I’m even more struck that here a year after our study came out, the first time the President has been asked about this was not by a reporter, but by someone from the public when he took a question.
-Les Roberts

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On the 1,000th day of the U.S. war on Iraq, we look at a subject that usually receives little attention -- the Iraqi civilian death toll since the war began. We speak with Dr. Les Roberts, the lead researcher of a study released last year on the number of deaths in Iraq, which put the toll at more than 100,000. [includes rush transcript] President Bush was asked about the Iraqi civilian death toll on Monday following his speech at the Philadelphia World Affairs Council.

Q: Since the inception of the Iraqi war, I'd like to know the approximate total of Iraqis who have been killed. And by Iraqis I include civilians, military, police, insurgents, translators.

THE PRESIDENT: How many Iraqi citizens have died in this war? I would say 30,000, more or less, have died as a result of the initial incursion and the ongoing violence against Iraqis. We've lost about 2,140 of our own troops in Iraq.

Source: The Lancet 2004; 364:1857-1864 (requires free registration)

DOI: 10.1016/S0140-6736(04)17441-2
Les Roberts, Riyadh Lafta, Richard Garfield, Jamal Khudhairi and Gilbert Burnham

Summary

Background

In March, 2003, military forces, mainly from the USA and the UK, invaded Iraq. We did a survey to compare mortality during the period of 14·6 months before the invasion with the 17·8 months after it.

Methods

A cluster sample survey was undertaken throughout Iraq during September, 2004. 33 clusters of 30 households each were interviewed about household composition, births, and deaths since January, 2002. In those households reporting deaths, the date, cause, and circumstances of violent deaths were recorded. We assessed the relative risk of death associated with the 2003 invasion and occupation by comparing mortality in the 17·8 months after the invasion with the 14·6-month period preceding it.

Findings

The risk of death was estimated to be 2·5-fold (95% CI 1·6–4·2) higher after the invasion when compared with the preinvasion period. Two-thirds of all violent deaths were reported in one cluster in the city of Falluja. If we exclude the Falluja data, the risk of death is 1·5-fold (1·1–2·3) higher after the invasion. We estimate that 98000 more deaths than expected (8000–194000) happened after the invasion outside of Falluja and far more if the outlier Falluja cluster is included. The major causes of death before the invasion were myocardial infarction, cerebrovascular accidents, and other chronic disorders whereas after the invasion violence was the primary cause of death. Violent deaths were widespread, reported in 15 of 33 clusters, and were mainly attributed to coalition forces. Most individuals reportedly killed by coalition forces were women and children. The risk of death from violence in the period after the invasion was 58 times higher (95% CI 8·1–419) than in the period before the war.

Interpretation

Making conservative assumptions, we think that about 100000 excess deaths, or more have happened since the 2003 invasion of Iraq. Violence accounted for most of the excess deaths and air strikes from coalition forces accounted for most violent deaths. We have shown that collection of public-health information is possible even during periods of extreme violence. Our results need further verification and should lead to changes to reduce non-combatant deaths from air strikes.

Published online October 29,2004

See Full Text Version of the Study on The Lancet Website (requires free registration)