§ The Minister of State, Foreign and Commonwealth Office (Baroness Symons of Vernham Dean)This Statement provides a response to the article "Mortality before and after the 2003 invasion of Iraq: cluster sample survey" published in theLancet on 29 October concerning civilian casualties since the beginning of military action in Iraq in March 2003.
The Security Context
It is important to recall the background to the current violence in Iraq. In the period of major combat activities in Iraq between the coalition and Iraqi forces loyal to Saddam Hussein, there were inevitably civilian casualties caused by military action by both sides. Every effort was made, on the part of the coalition, to minimise the civilian casualties as required by international humanitarian law.
Casualties—civilian and military—which have occurred since major combat activities ended on 1 May 2003 have done so directly as a result of those determined to undermine the political process. Security Council Resolution 1546, adopted on 8 June 2004, noted the request of the Iraqi Interim Government that the multi-national force should 62WS remain to help the sovereign Government of Iraq to ensure security and reaffirmed its authorisation on that basis. The multi-national force has been acting under that mandate, in support of the Iraqi security forces, to ensure the maintenance of security and stability in Iraq. The mandate specifically authorises action against terrorists.
The Iraqi Government continue to face a violent insurgency. Every day brings grim evidence that the targets of this insurgency are not merely a supposed occupation force. They include members of Iraqi civil institutions and security forces, ordinary Iraqis and foreigners working to build a better future for Iraq. They include children killed when co-ordinated bombs were detonated near a water treatment plant in Baghdad, Iraqi army trainees and police butchered with premeditation and foreigners executed in front of the cameras. The scale of the threat has prompted international humanitarian agencies to close their operations in the country.
In those many parts of Iraq where there have been no terrorist incidents, there have been no casualties. If the terrorists and insurgents gave up their campaign, the violence in Iraq would cease.
However, while the insurgents continue in their attempts to destroy the political process leading to a constitutionally elected government, and to attack those rebuilding Iraq's infrastructure and public services, the multi-national force will support the efforts of the Iraqi Government and security forces to defeat them. That may include military action if there is no alternative.
The multi-national and Iraqi forces continue to act so as to minimise civilian casualties. This is despite the fact that the insurgents have shown no compunction in using mosques, schools and hospitals as defensive bases. The MNF is currently providing food and other supplies to civilians in the Fallujah area, and working closely with the Iraqi Ministry of Health to ensure medical supplies reach there.
The Iraqi Government and their international partners remain committed to defeating the terrorists and insurgents in Iraq. I pay tribute to all those who are working to build a safe and democratic country.
The Legal Context
The Lancet study suggests that there is an obligation deriving from Article 27 of the Fourth Geneva Convention for the multi-national force (MNF) itself to have a reckoning of the number of civilian casualties it has caused. There is nothing in Article 27, or elsewhere in the Fourth Geneva Convention, to support this suggestion.
The basic obligations under international humanitarian law as regards civilian casualties in an armed conflict are set out in Additional Protocol 1 to the Geneva Conventions, which also reflects customary international law. In particular, indiscriminate attacks are prohibited, and this includes any "attack which may be expected to cause incidental loss of civilian life, injury to civilians, damage to civilian objects, or a combination thereof, which would be excessive in relation to the concrete 63WS and direct military advantage anticipated". This obligation under international humanitarian law has been fully complied with by the United Kingdom in respect of all military operations in Iraq.
Casualty Estimates
In many cases it would be impossible to make a reliably accurate assessment either of the civilian casualties resulting from any particular attacks or of the overall civilian casualties of a conflict. This is particularly true in the conditions that exist in Iraq. However, since 5 April 2004 the Iraqi Ministry of Health has sought to collect casualty data. Explaining the procedure, the Iraqi Minister of Health stated on 29 October: "Every hospital reports daily the number of civilians (which may include insurgents) who have been killed or injured in terrorist incidents or as a result of military action. All casualties are likely to be taken to hospital in these circumstances except for some insurgents (who may fear arrest) and those with minor injuries. The figures show that between 5 April 2004 and 5 October 2004, 3,853 civilians were killed and 15,517 were injured. I am satisfied that this information is the most reliable available." We share this view. The Ministry's figures do not of course cover the whole of the period since military action was taken, but they do include the months of April and August, when casualty figures were particularly high.
Other figures are proposed by NGOs. www.iraqbodycount.net, an NGO-based website, provides a running estimate of civilian casualties based on media and other reports. This has suggested that from March 2003 to the present there have been between 14,284 and 16,419 civilian deaths. This is an estimate relying on media reports, and which we do not regard as reliable. It includes civilian deaths at the hands of terrorists as well as of the coalition forces. It relies on media reporting to decide who is a civilian and who is not. It does help to show however that the Iraqi Ministry of Health figures are not the only ones to differ widely from the Lancet's estimate.
The Lancet
The article estimates that between 8,000 and 194,000 more people died following the invasion of Iraq than previous rates of mortality would have predicted, with the "most likely" figure being 98,000 extra deaths. 73 of the total of 142 deaths recorded by the survey in the period since the invasion are judged to have occurred through violence from the coalition forces or from terrorists. Other deaths recorded were the result, for example, of heart attacks or road accidents, not of coalition or terrorist action.
The Lancet's researchers acknowledge that they encountered no evidence of widespread wrongdoing on the part of individual multi-national force (MNF) soldiers on the ground.
The design of the Lancet study and its statistical methodology passed the process of peer review before publication and is similar to that followed in cases where the data are difficult to obtain. But that should not mask the fact that any methodology critically depends on the accuracy of the data subject to its analysis.
64WSAs the authors of the study themselves acknowledge, it was carried out under exceptionally difficult conditions which in particular restricted the size of the samples surveyed. As the Lancet article says, the estimate of deaths is based on an extrapolation from an increase from 46 deaths in 110,538 person-months before the conflict, to 142 deaths in 138,439 person-months after the conflict. Of those, 61 deaths were attributed to coalition forces, most of them in Fallujah, a sample which the authors admit is an "extreme statistical outlier".
The figures derived from the survey's data on Fallujah would have resulted in an estimated 200,000 excess deaths within Fallujah alone over the past 18 months. This would amount to almost two-thirds of the total population of the town—which is just not credible. The authors of the study understandably discounted the data. In general they have noted that the data on which they based their projections was of "limited precision". This limited precision is reflected in the very large range which they use for their estimate of excess mortality (8,000–194,000). Although the levels of probability vary across its range, any figure within this range is consistent with the data.
We doubt the survey's attribution of 61 violent deaths to action by coalition forces. Only two deaths are attributed in the survey to "anti-coalition forces". This is an astonishingly small proportion of those said to have died from violence, given the large numbers of Iraqis we know have died in individual incidents at the hands of terrorists. Since 58 of the 61 deaths attributed to coalition forces were said to have been caused by "helicopter gunships, rockets or other forms of aerial weaponry", it cannot have been possible for the families in every case to have known for certain who was responsible. It is also possible that they would have been afraid to have blamed the deaths of their relatives on the insurgents. The authors also acknowledge that "many of the Iraqis reportedly killed by US forces could have been combatants". The greatest increase in deaths which they report was among 15 to 59 year-old men, while for instance among the elderly in the survey there was effectively no increase in the death rate at all.
Other questions about the Lancet study relate to the significant differences between its estimate and other evidence, notably the figures on casualties produced by the Iraqi Ministry of Health and quoted above.
If the Lancet survey is accurate we could have expected Iraqi Ministry of Health figures, compiled by hospitals, to show many more times the number of people killed and wounded over that period than they in fact do. Hospitals in Iraq have no obvious reason to under-report the number of dead and injured. The Lancet article does not explain this discrepancy.
So while recognising the bravery and professionalism of those conducting the Lancet study, the Government do not accept its central conclusion, and continue to believe that the most reliable figures for casualties in Iraq are those provided by Iraqi hospitals to the Iraqi Ministry of Health.