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Iraq: Health Experts Condemn Failure To Count Casualties

The bomb scene on 28 February in al-Hillah, where more than 130 died. An international group of public-health experts has appealed to the British and U.S. governments to launch a full and independent inquiry into Iraqi casualties related to the war. The group -- from the United Kingdom, United States, Australia, Canada, Spain, and Italy -- says the joint U.S.-U.K. failure to monitor deaths in Iraq is "wholly irresponsible" from a public-health perspective.

Prague, 17 March 2005 (RFE/RL) -- There are no precise figures available on the number of Iraqis killed since the U.S.-led invasion of Iraq began two years ago this month. Estimates vary between 10,000 and 100,000.

But a group of more than 20 international health experts say in the latest issue of the "British Medical Journal" that monitoring casualties is a humanitarian imperative. They say an accurate count can help to save lives now and in the future. They also say it will remove uncertainties.

Signatory Phil McPherson is a visiting professor of epidemiology at Oxford University. He said an inquiry will give a better understanding of the humanitarian implications of the war.
"Now, it's quite clear that a lot of people aren't admitted to hospital in the course of invasion and are buried or otherwise disposed of without any contact with hospitals. And these people will not be counted. And moreover, the data -- such as it is -- is missing for the first year, and even now it is quite difficult to get a hold of."

"At the moment, I think the perception is, broadly speaking, that the allied invasion of Iraq was an unmitigated success because an evil dictator was thrown out to be replaced by a democratic government which represented the will of the people," McPherson said. "Now all that might be true, but the costs of that invasion are very poorly understood."

U.S. officials say U.S. and Iraqi forces go to extraordinary lengths to avoid civilian casualties. But at the same time, officials say the United States does not count civilian casualties.

Pentagon spokeswoman Lieutenant Ellen Krenke said in a written response to an RFE/RL inquiry that responsibility for counting casualties lies with Iraq's government. Krenke said the Iraqi government is "in the process of standing up." She added that they will be "a fully functioning organization with bureaus to do this type of tracking."

The British government also does not monitor Iraqi casualty figures. Britain's policy is to rely on figures released by Iraq's Health Ministry. Those data suggest that in the six months to last October, nearly 3,853 civilians were killed and more than 15,500 were injured. The figures include casualties of both military and insurgent actions.

But Professor Mcpherson argues that official figures are underestimated.

"They are basically only counting people who were admitted to hospital at the time of the invasion and who were dead," Mcpherson said. "Now, it's quite clear that a lot of people aren't admitted to hospital in the course of invasion and are buried or otherwise disposed of without any contact with hospitals. And these people will not be counted. And moreover, the data -- such as it is -- is missing for the first year, and even now it is quite difficult to get a hold of."

The Pentagon spokeswoman told RFE/RL that the United States believes there is no accurate way of validating estimates of civilian casualties in Iraq.

John Sloboda is the co-founder and a researcher with "Iraq Body Count" (, an independent website that attempts to monitor civilian casualties in Iraq. Sloboda said a survey on such deaths and injuries in Iraq would be costly and time consuming -- but it is feasible.

"It has already been done in parts of Iraq -- in situations of extreme danger -- that teams of investigators have gone out to towns and villages and done a survey," Sloboda said. "For example, there was a survey undertaken by an American and Iraqi team which was published in 'The Lancet" last year. Now, their survey was a relatively small sample. But with the support of the Iraqi government and the international community and the coalition military forces, of course it would be possible."

The survey by U.S. and Iraqi researchers published last October in "The Lancet" concluded that up to 98,000 Iraqi civilians have died as a direct or indirect result of the U.S.-led invasion.

That figure has been dismissed by both U.S. and U.K. officials as unreliable.

"Iraq Body Count" puts the death toll since March 2003 at between 16,000 and 18,500. Deaths are recorded in "Iraqi Body Count's" database only if they are confirmed by two reputable online sources.

The international health experts who issued the recent call for an accounting say a larger survey should draw on multiple sources and include household surveys. They say understanding causes of death is a core public-health responsibility, nationally and internationally.

The appeal comes as UN Secretary-General Kofi Annan last week warned of the rise of violence in Iraq to pre-election levels.

Annan said in his latest report to the Security Council that the scale and sophistication of attacks in Iraq are on the rise, worrying signs as that country's new leaders prepare to take power.

Sloboda of "Iraq Body Count" says February was a particularly deadly month for Iraqi civilians.

In the worst single attack, on 28 February a massive car bomb killed more than 120 people in Al-Hillah, south of the capital Baghdad.

("The Lancet" study of Iraqi casualties is available at
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    Golnaz Esfandiari

    Golnaz Esfandiari is managing editor of RFE/RL's Radio Farda, which breaks through government censorship to deliver accurate news and provide a platform for informed discussion and debate to audiences in Iran. She has reported from Afghanistan and Haiti and is one of the authors of The Farda Briefing newsletter. Her work has been cited by The New Yorker, The New York Times, The Washington Post, and other major publications. Born and raised in Tehran, she is fluent in Persian, French, English, and Czech.

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