Evaluating war’s toll on a besieged nation is extraordinarily complex. Doing so without funding from an outside agency or organization makes such an evaluation even harder to pull off.
 
But four universities, including the University of Washington, pooled resources and conducted their own study, which drew worldwide attention in October with its estimate of nearly a half-million Iraqi war-related deaths from 2003 to 2011.
 
Further, more than one-third of those deaths were attributed to non-violent factors, such as the collapse of health and sanitation systems, reported the public health researchers from UW, Johns Hopkins, Simon Fraser University and Mustansiriya University in Baghdad.

Iraq-trio

Courtesy of Amy Hagopian

Professors Gilbert Burnham (Johns Hopkins), Amy Hagopian (UW) and Riyadh Lafta (Mustansiriya University) meet in Erbil, Iraq, in 2011 to plan the study on Iraq’s war mortality.

Gilbert Burnham, Amy Hagopian and Riyadh Lafta in Erbil, Iraq

Gilbert Burnham, Amy Hagopian and Riyadh Lafta in Erbil, Iraq

“Policymakers, governments, and the public need better data on the health effects of armed conflict,” said lead author Amy Hagopian, UW associate professor of global health. “Without this information, it’s impossible to assess the true human costs of war.”
 
Evidence suggests that the public believes deaths were far lower – 10,000 or fewer, she said.
 
For the study, published by the journal PLOS (Public Library of Science), Iraqi medical doctors surveyed members of 2,000 randomly selected households throughout the country. The doctors asked about births and deaths in the household during the span and whether any siblings had died. Households that identified a death as war-related were then asked how it occurred (gun, mortar, air strike) and who they thought the perpetrator was. As a check, the surveyors also asked to see death certificates at the end of their interview sessions.
 
Gathering these figures, the researchers extrapolated to reflect the entire nation’s population, then compared that figure with the number of deaths that would be expected in the absence of war (based on the two-year period before the war began).
 
They arrived at 405,000 dead – but that did not count Iraq’s vast refugee population, which had its own deaths to report. Calculating data from outside sources, the researchers estimated 56,000 additional deaths. These figures include both those who died from violent acts and those whose deaths occurred because society was falling apart around them.
 
The messages scientists want to convey, Hagopian said, is that war should be considered a public health problem and that more efforts should be made to prevent it. Further, the team wants the public to understand that at least one in three deaths outside of combat is caused by crumbling infrastructure, overburdened health systems and increased stress.
 
“Public health workers are against polio, we’re against tobacco smoke and we are against car crashes,” Hagopian said. “We should be against war, too. We used to think car accidents were just that. Now we know they can be prevented, and that car crashes are rarely ‘accidents.’ I want to do the same with war,” she said.
 
The study was reported by NBC, Los Angeles Times, BBC, The Atlantic, Washington Post, International Business Times, Cambodia Herald, Russian TV and more.
 
Related: How the Iraqi mortality study was conducted