Estimating the number of violent deaths in Iraq
16 January 2008 -- New research by WHO and the Iraqi government estimates that 151 000 Iraqis died from violence in the three years following the March 2003 invasion of their country.
Transcript of podcast
Veronica Riemer: You’re listening to the WHO podcast. This is episode 26. I'm Veronica Riemer.
In this episode: estimating the number of violent deaths in Iraq
New research by WHO and the Iraqi government estimates that 151 000 Iraqis died from violence in the three years following the March 2003 invasion of their country. That works out to be about 120 deaths a day. The estimate, published recently by the New England Journal of Medicine, is based on information gathered during a general health survey that was designed to provide the government with a basis for developing health policies and for planning health services. Dr Ties Boerma, WHO's director of Measurement and Health Information Systems, was involved in the study.
Dr Ties Boerma: The Ministry of Health in Iraq requested a survey on health that included reproductive health issues, mental health issues and also mortality. Normally, one would get mortality data from a death registration system, but it is not functioning well in Iraq. So, a survey included all these health issues.
Veronica Riemer: The survey involved more than 200 interviewers visiting nearly 10 000 homes across Iraq, sometimes under dangerous conditions. Dr Naeema Al Gasseer, the WHO Representative to Iraq, explains some of the challenges involved in conducting the survey.
Dr Naeema Al Gasseer: It has been very difficult. There have been roadblocks, curfews, suspicions among the populations about the interviewers; one interviewer was kidnapped. However, all these difficult conditions demonstrated the determination, the stamina, and the perseverance of the whole team wanting to do the studies and wanting to have the survey out. They wanted to have the survey out in the light.
Veronica Riemer: Perhaps most indicative of the danger the team faced in collecting the information is the fact that during the survey, one of the main investigators, a co-director of the Iraqi office of statistics, was shot dead on his way to work in Baghdad.
WHO is not the first to have estimated deaths in Iraq since the invasion. A study by another group, published in October 2006, estimated from a much smaller household survey that about 600 000 Iraqis died violent deaths during the same period. The WHO estimate is one quarter of that. However, it is three times higher than the death toll detected for the same time frame by a group that carefully screens media reports to count civilian deaths.
Dr Boerma pointed out that part of the reason why the estimates vary so widely is that it is very difficult to accurately estimate deaths in conflict situations, and scientists have to make calculations to compensate for that. Different calculation methods result in different estimates.
Dr Ties Boerma: The size of the survey is really important, particularly in situations of violence, because it tends to be very localized. So the chances of hitting households in areas where there has been a lot of violence can of course distort the overall estimate of the number. Therefore, it is very important that this survey involved 10 000 households spread all over the country. I think the Iraqis have done everything possible to ensure the quality of the survey.
It is also important that this survey wasn't just a mortality survey. There were other health issues. We also have data on who lives in the household, and those data all look very plausible.
It is the best possible picture we could obtain with a survey of this size under these circumstances. The true picture in exact numbers of deaths can only be revealed by a full and complete registration system, and that isn't present in Iraq right now. And it wasn't present since 2003. So, this is the best estimate that we can provide based on this survey.
Veronica Riemer: Speaking to reporters this week from Baghdad, Iraq's Health Minister Salih Al-Hasnawi commented on the validity of the estimate.
Salih Al-Hasnawi: This is a very sound survey, a household survey with accurate methodology. And, as you hear from the discussion, even the clusters that cannot be reached for security and other causes were replaced by a scientific manner by other clusters. So, I think it is a sound survey, and the sample is a good sample. So regarding me, as the Minister of Health, I believe in these numbers.
Veronica Riemer: If you would like to learn more about this story or to read the study, please visit www.who.int