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More than half a million Iraqis have been killed since invasion

BMJ 2006; 333 doi: (Published 19 October 2006) Cite this as: BMJ 2006;333:821
  1. Owen Dyer
  1. London

    More than half a million Iraqi people, about one in 40 of the country's population, have died from violent causes since the March 2003 invasion, a study in the Lancet says.

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    Iraqis pray next to the coffins of victims of US airstrike in Ramadi, Iraq, on Monday 17 October 2005


    The figures in the paper, which was published online ahead of print publication on 12 October, are based on a cross sectional survey involving 1849 households with 12 801 people in 47 clusters throughout Iraq (, doi: 10.1016/S0140-6736(06)69 491-9).

    The survey looked at the number of deaths between January 2002 and July 2006. In the sample 629 violent deaths were reported, 82 before the invasion and 547 since the invasion. The researchers found that mortality had risen sharply in every year since the invasion.

    The researchers, from Johns Hopkins Bloomberg School of Public Health, Baltimore, and Baghdad's al Mustansiriya University, estimate that Iraq has had 654 965 (95% confidence interval 392 979 to 942 636) excess deaths in the last three years as a consequence of the war. They estimate that 601 027 (426 369 to 793 663) Iraqis have died violently since the invasion.

    Most of the victims of violence were men aged 15 to 44 years. The most common cause of violent death was gunshot, although the number of car bomb fatalities has risen recently. The interviewers asked to see death certificates in 87% of cases, and these were produced by 90% of the respondents who were asked.

    Thirty one per cent of the deaths were attributed to coalition forces. Although the proportion of deaths caused by coalition forces has fallen in the past two years, the crude number has climbed.

    The violence has grown steadily over the three years, and the number of deaths has been particularly high in the past 12 months, says the study's lead author, Gilbert Burnham. The findings indicate that Iraqis may currently be being killed at a rate of about 1000 a day, he says.

    The survey is the second undertaken in Iraq by the team. Like the first, its results are well in excess of estimates that are based on passive surveillance. The first study, published in November 2004 (Lancet 2004;364: 1857-64), estimated that 100 000 excess deaths had occurred since the March 2003 invasion, although the confidence interval was very wide.


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