Counting the dead in Iraq
BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7491.550 (Published 10 March 2005) Cite this as: BMJ 2005;330:550All rapid responses
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The editorial board of “Epidemiologia e Prevenzione” (the journal of the Italian Association of Epidemiology) strongly supports the call for an independent inquiry into war-related casualties in the Iraqi population (BMJ, March 11 2005). Because of its support of the US policy, our government has deployed troops (3000 Italian soldiers) in Iraq over the last two years,. Thus, Italians are expecting to be given a proper assessment of the effects of the war on the Iraqi population. This demand of our public opinion is particularly cogent after the loss of one of our top security agents who has been shot dead in the streets of Iraq by US soldiers. As editors of an epidemiological journal, we intend to convey a reliable information to our readers. Epidemiologic knowledge can help prevent future deaths.
Benedetto Terracini MD (Scientific Editor of “Epidemiologia e Prevenzione”) benedetto.terracini@fastwebnet.it
Franco Berrino, Annibale Biggeri, Luigi Bisanti, Luca Carra, Franco Carnevale, Cesare Cislaghi, Maria Luisa Clementi, Nerina Dirindin, Francesco Forastiere, Giuseppe Gorini, Enzo Merler, Franco Merletti, Eugenio Paci, Salvatore Panico. Stefania Salmaso, Nereo Segnan
Competing interests: None declared
Competing interests: No competing interests
The public health and military experts who signed letters (1,2) to the UK and US government demanding a comprehensive inquiry into Iraqi war- related casualties have performed an important public service, as has the BMJ.
McPherson (3) says that “(T)he policy being assessed - the allied invasion of Iraq—was justified largely on grounds of democratic supremacy. Voters in the countries that initiated the war, and others—not least in Iraq itself—are denied a reliable evaluation of a key indicator of the success of that policy.” This justification for pre-emptive war was only advanced as it was shown that there was no evidence whatsoever for the previous one, weapons of mass destruction.
Failure to identify civilian casualties (who are the majority in any modern war) may constitute a war crime (2). Whatever the legal situation, the medical perspective is clear. If we don’t know the extent of the harm done in our name, we can’t know that the war was justified.
It is not surprising that governments on both sides of the Atlantic attempt to ignore or underestimate the deaths and injuries of Iraqis, and indeed of their own servicemen and -women. This process of denial can take extreme forms. (“We don’t do body counts” is to Abu Ghraib as “Arbeit Macht Frei” was to Auschwitz.)But official attempts at denial are failing. A substantial majority of adults polled by MORI supported the British Government ordering an independent commission to inquire into the total number of Iraqi casualties since the 2003 military action (4).
When denial can not be sustained, a favoured remedy is to establish "independent" inquiries whose findings can be influenced, delayed, or suppressed. Given the history and reasonable public perceptions, it will be necessary for the government to demonstrate unequivocally the openness and honesty of any such inquiry. The public health experts are well equipped to establish whether reasonable rules of evidence are being observed.
What they may be less able to do without wider support is to withstand another tactic of governments defending the indefensible - misrepresenting, threatening or traducing sources of unwelcome evidence. Those who willed, planned and justify this war have gone to extraordinary lengths to obscure the consequences of their actions, including attacks on the competence, character, and motives of those who demand an accounting (5).
The Lancet survey required seven Iraqi team members willing to risk their lives. (6) At a lesser, but very real risk to themselves, US and UK paramedics have refused to participate in a war which they believe to be immoral. Their situations and those of army doctors are under-reported.
Solidarity with these colleagues and with the Iraqi, US and UK dead is important. It would be appropriate for the BMA to speedily debate and endorse calls for the inquiry, and for the BMJ to provide an online site to help add our voices to demands for it.
Frank Arnold
Reading
1) McPherson K et al al. Global public health experts say failure to count Iraqi casualties is irresponsible. http://bmj.bmjjournals.com/cgi/data/330/7491/557/DC1/1 accessed March 12,2005.
2) Air Marshal the Lord Garden KCB and 45 others to Mr. Tony Blair, December 8, 2004. http://www.countthecasualties.org.uk/docs/openletter.pdf. accessed March 12,2005.
3) McPherson K. Counting the dead in Iraq. BMJ 2005;330:550-551. http://bmj.bmjjournals.com/cgi/content/full/330/7491/550 accessed March 12,2005.
4) New poll finds majority support inquiry into Iraqi casualties, 2 Feb 2005 http://www.countthecasualties.org.uk/item28 accessed March 12,2005.
5)Katz L, Tempest M. Kelly naming would 'fuck Gilligan' - Campbell. Guardian. September 22, 2003 http://politics.guardian.co.uk/kelly/story/0,13747,1047530,00.html accessed March 12,2005.
6) Roberts L, Lafta R, Garfield R, Khudhairi J, Burnham G. Mortality before and after the 2003 invasion of Iraq: cluster sample survey. Lancet 2004;364: 1857-64.
Competing interests: FWA was invited to contribute to the death and mutilation of Vietnamese civilians during the US occupation (1961-74). Like many others of his generation including George Walker Bush, he declined.
Competing interests: No competing interests
The irresponsibility of failure to count Iraqi casualties
Competing interests: None declared
Competing interests: No competing interests