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Civilian deaths from weapons used in the Syrian conflict

BMJ 2015; 351 doi: (Published 29 September 2015) Cite this as: BMJ 2015;351:h4736
Weapons of war
View an interactive graphic showing the impact of different weapon types on civilian men, women, and children in Syria.

Rapid Response:

Authors' response to Martin Gustafsson [Re: Civilian deaths from weapons used in the Syrian conflict]

Dear Martin,

Thank you for your comment.

We think that it is important to differentiate between data description and more advanced epidemiological analysis. Both are complementary but they have different purposes and thus answer different questions.

We did not hide the data from men. We discussed the importance of civilian men among the author group several times. We were also conscious that international humanitarian law (IHL) requires that combatants should minimize harm to non-combatants and this also motivated us to look at the deaths of women and children, and although we were careful not to specifically allege any breach of IHL we were conscious that data on the ratio of deaths of probable non-combatants to probably combatants might suggest non-compliance.

Even if the aim of the paper was to investigate death likelihoods in children and women by weapons used in the Syrian conflict ("The ongoing Syrian conflict is one of the largest humanitarian crises of the 21st century so far. Debarati Guha-Sapir and colleagues analyse the impact of weapons on civilian deaths, with a focus on women and children"), we clearly stated the death share in men early in the paper:

"Although the majority of deaths were of men, nearly 25% of Syrian civilians killed were women and children (see tables B1 and B2 in appendix on".

In addition, tables B1 and B2, which describe deaths in men, women, and children by the weapons used are available in the appendix.

We also wrote early in our paper conclusions:

"On the other hand, civilian men constituted the largest share of the civilian death toll, mostly being killed by shells, shootings, and executions".


"Our findings show the ongoing, severe impact of war on the deaths of children, women, and men in the civilian population related to the continued disregard of these resolutions"

Moreover, compared to women and children, death likelihoods for men were higher for shootings and executions as stated in one of our "key messages":

"Women were the second most likely to die due to explosive weapons. Men were mostly killed by shootings and executions"

On a final note, we only used throughout the article odds ratios and not, as you mentioned in your response, relative risks. They require different data, are calculated differently, and have also a different interpretation.

Jose M Rodriguez-Llanes and Louis Lillywhite, on behalf of all the authors.

Competing interests: No competing interests

26 October 2015
Jose M Rodriguez-Llanes
Louis Lillywhite (retired lieutenant general and senior consulting fellow at Chatham House Centre for Global Health Security, London, UK)
Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université catholique de Louvain
Brussels, Belgium