October 16, 2006
I had anticipated that the team behind Iraq Body Count would react to the latest survey on Iraqi mortalities published in the Lancet by trying to minimise their import and undermine their reliability. I was not wrong. The reason is fairly simple: they're defending their turf. They have been engaged in this operation ever since Media Lens asked them what they thought of the fact that mainstream media outlets were using their figures as reliable maximum estimates of the dead, and why they didn't challenge this evident untruth even though they acknowledged on their site that it was indeed an untruth. Their place in the media spotlight is threatened, and such is the only occasion under which they have put up any kind of a fight, even going so far during the spat with Media Lens to compare their opponents to terrorists on BBC 2.
I appreciate the Socratic method involved in IBC's attempt to rebut the findings of Burnham et al: rather than address themselves to matters of data collection, statistical analysis and methodology, about which the research team are often attacked in ignorance, IBC tries to examine a number of implications that result if one accepts the study's findings. Describing these implications as extremely anomalous, they conclude that the findings cannot be accurate. This assessment and their offering of it rests on some assumptions that are unsound.
The first implication that they don't like is that on average, "a thousand Iraqis have been violently killed every single day in the first half of 2006, with less than a tenth of them being noticed by any public surveillance mechanisms." Let's assume that this is in fact a sensible implication to draw from the report: why is it inherently improbable? Because the IBC asserts that it is. They assert that these deaths might be accounted for by 150 of what they called "medium-sized" assaults per day, missed by the media. (Notice that a medium-sized assault here is about five, but that mean is arrived at from a limited sample, that is the sample of reported deaths). They assert that it is "unlikely that incidents of this scale would be so consistently missed by the various media in Iraq." Why? Because the IBC gathers information on reported attacks, and has noticed, moreover, that these attacks were in fact reported. So, if these attacks were reported, it is inherently unlikely that a large number of others were not. They further assert that since 42% of the total deaths estimated by the Lancet comprise car bombs, air strikes and other explosions and ordinance, these cannot have been 'secret'. This is, once more, question-begging, since whether they are 'secret' or not depends to a large extent on whether they were reported or not. Similarly, IBC goes on to say that their data shows that deadly car bombs kill seven or eight people on average. The Lancet figures correspond to approximately 20 deadly car bombings a day, most of them unreported. And yet, say the IBC, we have data that shows that other car bombings have been widely reported. Precisely the ones that we know about, the ones that have in fact been widely reported. The IBC once more stipulates the conclusion in the premisses, a technique which is, as I say, known as question-begging. The killer blow: "The Pentagon, which has every reason to highlight the lethality of car bombs to Iraqis, records, on average, two to three car-bombings per day throughout Iraq, including those hitting only its own forces or causing no casualties, for the period in question." The claim that the Pentagon wish to maximise the extent of violence in Iraq in the public imagination is interesting, but as it is offered without proof, it can be dismissed with proof. Unless there is an additional claim, one with proof this time, that the Pentagon actually goes out of its way to measure and report on such matters, then the claim is unworthy of serious attention.
The second implication is as follows: "Some 800,000 or more Iraqis suffered blast wounds and other serious conflict-related injuries in the past two years, but less than a tenth of them received any kind of hospital treatment." Again, let's assume that this is a sensible implication to draw from the report, except this time we must add one stipulation: they mean recorded hospital treatment. Why do they think this improbable? Well: "people suffering injuries usually make strenuous efforts to receive appropriate treatment, or if they are severely incapacitated, others see to it that they do so." This is indeed the case in most instances. We might add that people without much money usually make strenuous efforts to become more affluent. Their success is often determined by something other than their strenuous efforts. But let's suppose that such strenuous efforts are made: hospitals are not the only possibility for treatment in any society, and are not necessarily the best if they happen to be bombed out, have little access to water, be short on medicines and blood stocks, have few staff etc etc. Additionally, given the general disarticulation of society in Iraq at the moment, and the lack of extensive control by the occupiers over huge areas of Iraq, it would not be surprising if large numbers of hospitals in high population areas did not keep good records, especially in cases of short-term emergency treatment, and did not communicate well with the Ministry of Health. Even those hospitals that are under the control of the Ministry of Health are reported to be the scene of sectarian killings (of patients), in which case statistics issuing from them are certainly not to be taken at face value. What is more, Iraq's health care system has been marked by serious embezzlement and corruption under the occupation, so that even where there has been little armed combat, many hospitals are barely functioning. One would anticipate a level of underreporting of casualties, and certainly a high level of undertreatment of them within the official healthcare system, in such circumstances. The point is that since IBC relies upon what it thinks are safe assumptions, we can easily add a number of other assumptions, which are grounded in empirical reports and data, that make the implication of under-reporting that they see as inherently implausible seem entirely predictable. The circularity from IBC continues when they remind us of monitoring systems already in place: it is implied that because those maintaining the system have an interest in keeping it in place, this must mean that it is in fact, well in place, and recording the situation quite well. Indeed, there was an interest in not allowing the invasion of Iraq to take place, and not allowing any hospital to be occupied, and not allowing sectarian parties to come to power, and not allowing the water infrastructure to be destroyed, and not allowing the medicines to run dry, and not allowing billions of dollars to be embezzled, and not allowing anyone to be killed or wounded. You can be certain that there was a powerful interest for many Iraqi social groups in preventing this, and they stood to lose a great deal from what happened, yet they seemed curiously reluctant to stop it: almost as if the question were to a large extent out of their hands.
The next implication is that "Over 7% of the entire adult male population of Iraq has already been killed in violence, with no less than 10% in the worst affected areas covering most of central Iraq." IBC doesn't like this because - well, in fact, they do not say. They simply tell us that this is what is implied. One assumes that they think this is inherently unlikely, but surely they were supposed to be testing that implication? Another version of this argument would be: "one implication of the report is that close to 655,000 people may well have died in Iraq. Furthermore, as if that wasn't bad enough, a further implication is that close to 600,000 of those have died violently. In Iraq! In one of the most violent societies in the world right now! Could you credit it?"
The next implication is that "Half a million death certificates were received by families which were never officially recorded as having been issued." In this, the IBC feels confident enough to chuckle. Either "500,000 documented violent deaths, for which certificates were issued, have somehow managed to completely disappear without a trace to Iraqi officials or the international media" or "there is a vast, elaborate, and very successful, cover up of this massive number of bodies and their associated paper trail being carried out in Iraq." So either the authors of the report believe in magic, or they believe in conspiracies. Indeed, the Lancet authors hint at conspiracy, but profoundly believe in magic, since they argue in supplementary notes that "Even with the death certificate system, only about one-third of deaths were captured by the government's surveillance system in the years before the current war, according to informed sources in Iraq." IBC adds "No one argues that Iraq's official figures are complete, including its officials. But could their coverage be so bad as to amount to no more than a small fraction of deaths, as suggested above?" This, indeed, is the very question which IBC is supposed to be trying to answer in the negative, without much success so far. Nevertheless, if the IBC accepts that the official figures are incomplete, then they have automatically subscribed to the crazy theory of 'disappearances' that they find so funny. They assert that the figures underlying the Lancet's claim are false, because a) there is no corroboration for the 5/1,000/year mortality rate in 2002 upon which the report's authors operate, and b) the claim that the Iraqi government recorded less than 40,000 deaths from all causes in 2002 is false, and that they have the official statistics as forwarded to them by the Los Angeles Times for 2002, which are closer to 80,000 (thereby reducing the level of under-reporting). At least this is an argument. About the first charge, it is worth noting that the figure, although based on one report, is corroborated in part by the ILCS, which records roughly the same infant mortality rate in 2002 as do Burnham et al. (If it matters, the CIA's estimate for total mortality in Iraq in 2002 was 6.02/1,000/year.) If IBC are now asserting that the true mortality rate could have in fact been lower, thereby acquitting the Iraqi government of undercounting substantially, then the implication of that is that the excess deaths were much higher than those recorded by the Lancet study. On the second point, we can assume for now that the IBC are correct, the Lancet authors are mistaken in their supplementary notes, and Hussein's government measured 70% of total deaths in 2002, not 30%. And then what is entailed? That because the previous Iraqi government measured Iraqi deaths less imperfectly than Burnham et al had supposed, it must not be possible for the occupation government to have measured them highly imperfectly, much less competently than the Hussein one. Yet, the crucial distinction, that one government operated in a situation of relative peace, and the other in war, seems to have escaped them. On this note, the evidentiary base that the Lancet authors adduce as corroborative support for the idea that one could expect a substantial gap between official reports of mortality based on mortuary reports and reliable statistically detected mortality is not restricted to this one example, contrary to what the IBC claims. The Lancet report notes in its conclusion that: "Other than Bosnia, we are unable to find any major historical instances where passive surveillance methods (such as morgue and media reports) identify more than 20% of the deaths which were found through population-based survey methods." This tends to be a problem in circumstances of war, especially in situations where the occupiers have specifically prohibited the counting of the dead.
The last implication the IBC doesn't like is: "The Coalition has killed far more Iraqis in the last year than in earlier years containing the initial massive "shock and awe" invasion and the major assaults on Falluja." This is apparently improbable because "All available evidence points to a significant and progressive reduction in Coalition military operations overall since the first year of the invasion." It transpires that the available evidence they avert to is simply that there were not widely reported assaults like 'shock and awe' and Falluja afterwards. Once again, if it wasn't reported in the largely Western press that IBC uses, then it doesn't count as "available evidence". Further, IBC cites the effects of reporting (what they "keenly recall") as evidence that the reporting can't be far wrong.
And this is it. The whole thing is an enormous and misleading exercise in circularity, a massive raise of the eyebrow, a titanic exercise in obfuscation. They cannot touch the study for methodology, they cannot find anything in it that is badly done: not a single cluster wrongly placed, not a single false extrapolation, not a particle of evidence of any fraudulence or fecklessness. They hazily refer to possible bias, but on the basis of nothing more solid than that this would explain away the uncomfortable implications that they draw. As Daniel Davies points out, the chances of the Lancet authors obtaining the sample they did, if the facts were much closer to what the IBC records, are so low that it would have to be fraud. The IBC cannot and do not make this accusation, because they are not prepared to test their flimsy insinuations and doubts in a court of law. For a proffered rebuttal entitled 'Reality Checks', the IBC's intervention is breathtakingly short on either rebuttal or reality.
Here is what an epidemiologist thinks.