Speaking as a medical doctor, I
wish to set the record straight. The Lancet study is superb
science. The study followed a strict, widely accepted methodology to
arrive at its sobering conclusion. The study is being attacked not on
scientific grounds, but for ideological reasons.
People may not realize that The Lancet is the world’s most
prestigious medical journal. Prior to publication, the Iraq study was
subjected to a thorough peer-review by specialists in the field of
Three of the
study's authors, Gil Burnham, Shannon Doocy, and Les Roberts, are
The fourth author, Riyadh Lafta, is on the faculty of Al Mustansiriya
University in Baghdad. Under dangerous conditions, researchers
conducted a cross-sectional cluster sample survey involving a total of
1849 Iraqi households. The survey documented a four-fold increase in
the crude mortality rate from the pre-invasion to the post-invasion
periods and, in addition, characterized the causes of death.
The investigators followed the same methodology in Iraq that has had
been used in estimating death and disease in other conflicts such as
the Congo -- where the Bush administration uncritically accepted their
results. The public health tool they employed -- cluster surveys --
has been demonstrated time and again to be the best method of
estimating rates of death in areas where vital statistics are not
scrupulously maintained. Such bureaucratic vigilance is not the case
in present day Iraq.
In a war-ravaged country, an estimate of war-related deaths based on
the method of counting bodies will radically underestimate the number
of people who have died. In Iraq today, there have been numerous
reports of mass graves and of bodies dumped in fields, beside roads,
or in the Tigris River.
deaths are, by and large, not reported to authorities, as some of
these deaths may be linked to police forces.
must also consider the Muslim practice of burial where internment is
swift -- often on the same day. Therefore, relying on media reports of
the number killed, morgue logs, or Iraq Ministry or U.S. military
counts will not provide an accurate estimate of the death toll. We
must also not discount the possibility of bias by government
officials; the U.S. and Iraq have much to gain by minimizing civilian
Since the media has been unable to find a scientist critical of the
study, they've turned to policy wonks with literally no expertise in
the health sciences . Danielle Pletka of the American Enterprise
Foundation derides the study, but her advanced degree is in
international studies. Nor does Anthony Cordesman of the Center for
Strategic and International Studies nor Michael E. O'Hanlon of
Brookings have a health background.
his Oct. 11 press conference President Bush asserted "No, I don't call
it a credible report." He said he asked the generals and the generals
told him it was wrong. When asked to give a precise number of Iraqi
war-related deaths the President demurred, saying " I do know that a
lot of innocent people have died."
Despite the scientific rigor of the Hopkins study, there is a danger
that the unsubstantiated criticism by administration will color the
public's perceptions. In this age, where fact shares equal time with
conjecture, critics have attempted to discredit the Hopkins study
without specifically addressing the science whatsoever.
the administration believes the Hopkins study to be flawed, the
federal government should fund its own study of Iraqi mortality, and
submit the methodology and results to a medical journal subject to
independent peer review. After all the Hopkins study was funded in
large part by a $50,000 grant from MIT; surely the federal government
could afford such a study.
I belong to the Nobel Peace Prize-winning organization,
for Social Responsibility.
We care about the “
Medical Consequences of the War in Iraq.”
In fact, that's the title of our
to be held at UCLA this Saturday, Oct. 21. The conference is
co-sponsored by the UCLA School of Public Health and UCLA Extension.
Dr. David Rush, past president of the Society of Epidemiologic
Research, will discuss the Lancet Iraq study. You can register
registration number S3972U.
As physicians, we realize the horrible human cost and needless
suffering the American invasion has brought on the people of Iraq. The
war has also terribly harmed our own American soldiers, 2,765 of whom
have been killed and 20,000 of whom have suffered disabling injuries.
At his recent press conference, President Bush brushed aside a
question to quantify the human toll of the Iraq War with the comment
that “a lot of innocent people” have died. 655,000 is not a guess. It
is the best estimate that we have to date of the human tragedy in