Looking through the blogosphere I notice that all criticisms of the Lancet study “The Human Cost of the War in Iraq” (.pdf) are directed at the Lancet and not at the Iraqi physicians who carried out the survey and were overseen by epidemiologists at Johns Hopkins University’s Bloomberg School of Public Health, not that I am saying the physicians from Baghdad deserve criticism. No, they deserve our praise for conducting this survey in the most difficult of situations.

If you consider that the coalition has fired 200,000,000 rounds of ammunition while making Iraq safe for democracy, and if you abide by the fact that 31% of Iraqis have been killed by the coalition, while the majority are dying because of gun-fire, and then consider only 1 in 1000 rounds would have had to hit an Iraqi for John Hopkins study to be true, then to put yourself in that line of fire to carry out a survey like this is an act of supreme bravery. Especially if you are a physician trained to save lives, not take them.

The point I am making, is that those who continue to discredit The Lancet, one of the world’s top peer-reviewed medical journals, are probably people who have not read The Lancet report yet, for they would have noticed the paucity of criticism directed at the techniques used in the survey and the lack of intelligent criticism from Western politicians whose views boil down to “nothing to see here, move along now.”

“I cannot help but note that this “controversy” consists of ten parts people like you saying that there is a controversy, mixed with zero parts actual statisticians raising concerns about the utterly uncontroversial methods employed.” Daniel Davies

Why attack The Lancet when in fact, Lancet merely published the survey after it was peer-reviewed by four separate independent experts who urged publication? The reason is because the critics want to avoid dealing with the methodology, they’d trash The Lancet. Out of desperation. Period.

The study was completed in June/July and the authors submitted their paper to the Lancet where it was reviewed. The paper was considered a strong one and moved quickly into publication. The most important part of the paper is understanding the methodology used.

Professor Mike Tool, Centre for International Health, Melbourne,
another top expert has offered his opinion on the methodology employed in The Lancet study…

” The methodology used is consistent with survey methodology that has long been standard practice in estimating mortality in populations affected by war. For example, the Burnet Institute and International Rescue Committee (IRC) used the same methods to estimate mortality in the Democratic Republic of Congo. The findings of this study received widespread media attention and were accepted without reservation by the US and British governments. The Macfarlane Burnet Institute for Medical Research and Public Health’s Centre for International Health endorses this study.”

Richard Horton, editor of The Lancet praised the way the media has handled the paper. On the politicians that have attacked the survey, Horton expresses his sadness at how Bush immediately attempted to discredit the survey without having read the report; he says this shows Bush is an unthinking, superficial person.

What the researchers found was that around 654,000 people had died in the 40 months since the invasion began and of those, around 601,000 had died violent deaths, the greatest cause being gun fire. Clearly, those criticizing it have not taken the time to read the study, nor look at the methodology and are out of their depth, none more so than George Bush.

According to Richard Horton, it is not usual that the Lancet publishes any report with political significance and one that provokes an immediate response from George Bush. Horton discusses in the Lancet’s weekly podcast (linked here in .mp3 format) how the whole story moved immediately from being an issue of public health to one of politics.

“It is odd that the logic of epidemiology embraced by the press every day regarding new drugs or health risks somehow changes when the mechanism of death is their armed forces.” Les Roberts, co-author of the Lancet study

It should be noted that Tony Blair, Colin Powell, and the major media accepted and cite Les Roberts previous report on the Democratic Republic of Congo conflict which used the same methodology and which extrapolated that 1.7 million people had died as a result of the conflict without challenging its findings.

Hear Les Roberts talk about how easy it would be for concerned journalists to verify the results. All they would have to do is to to to four or five villages and ask the keeper of the graveyard how many people had been buried there since the invasion 2003.