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Mortality estimates in Iraq

Dear all,

There has recently been some discussion of how to analyse various
mortality estimates in Iraq under sanctions.  I would like to explain
CASI's understanding of some of the various figures which were circulated
in Shankar Gopalakrishnan's and Edward G Qubain's recent postings to the

For a fuller discussion of U.N. agency figures on mortality and other
indicators of the humanitarian situation in Iraq, please see Colin Rowat's
July 2000 briefing "U.N. Agency reports on the humanitarian situation in
Iraq", which can be found on  Mil is right to
point out that there is no U.N. (or other independent) study that
establishes causality between sanctions and excess mortality in Iraq.

Shankar wrote about the claim that 1 million deaths are attributable to

> I think the figure actually comes from the Iraqi Ministry of Health
> whose latest report seems to have a revised estimate of around 1,500,000
> deaths (they were earlier saying 1,800,000).  The source references can be
> found either with people who recently went to Iraq (I know at least the
> IAC Sanctions Challenge delegates received info packets containing MOH
> statistics) and on the CASI web site - 

CASI has always maintained that Iraqi Ministry of Health figures are
unreliable.  The most extensive critique of IMoH figures that I know of
has been published by Amatzia Baram in the The Middle East Journal.[1]
Baram provides several compelling reasons why they should not be trusted.  
The key point, however, is that we have no means to validate these
figures, and that they therefore are of little use.  Using them seriously
damages our credibility.  Also: we do not need them, as there are several
independent estimates.

Shankar also writes:

> On the issue of the change in the FAO reported figure of child deaths -
> in their report on this issue, CASI outlines why they think the figure is
> in between the 1995 and 1996 estimates and probably much closer to the
> higher one, which I think is also the position taken by some FAO
> investigators. The argument is given in the CASI report and I find it
> fairly convincing.

This refers to a discussion in CASI's February 1999 draft document
"Starving Iraq: one humanitarian disaster we can stop"
Please note that the '1995 and 1996 estimates' do not refer to official
FAO figures.  They come from researchers Sarah Zaidi and Mary C.
Smith-Fawzi, from the Centre for Economic and Social Rights, who
participated in the 1995 FAO survey.  In 1995, they published an article
in 'The Lancet' which stated that "since August, 1990, 567 000 children
[under the age of five] in Iraq have died as a consequence" of maintaining
the economic sanctions.[2] This estimate is not a good one and is now
widely held to be inaccurate.  The 1996 estimate came from research
carried out by Zaidi, using similar methodology, but reaching very
different conclusions.  These results were published by Sarah Zaidi
herself in the Lancet in 1997, concluding that both the 1995 and 1996
estimates suffered from methodological problems.[3]

These figures are now mainly of historical value, but were very important
at the time.  Above all, it was the 1995 estimate which led to the
exchange between Lesley Stahl and Madeleine Albright where Albright stated
that the death of half a million children was 'worth it'.[4]

Instead, the main source for discussion of mortality in Iraq should be
Unicef's 1999 survey.  It concluded that "if the substantial reduction in
child mortality throughout Iraq during the 1980s had continued through the
1990s, there would have been half a million fewer deaths of children
under-five in the country as a whole during the eight year period 1991 to
1998."[5] This is the only independent, comprehensive study carried out,
and supersedes previous estimates. By accident, not by statistical
accuracy, the 1995 estimate came close to the figure relevant to the
period 1991 to 1998.  Out of academic interest one can note that in
January the Iraqi Minister of Health had presented an under five child
mortality figure of 429,000, which is close to the Unicef estimate.[6]

Please be aware, however, that the Unicef report does not make any
conclusions about causality.  The survey did include recording 'cause of
death', but this part of the study has not been released.  The Unicef
estimate therefore does not support statements such as:'half a million
children have died because of sanctions'.  However, a recent FAO report
concluded that the continued high incident of malnutrition "supports UN
findings that infant and child mortality have more than doubled since the
end of the 1980s."[7]  Also, in the words of the 1999 humanitarian panel
report: "Even if not all suffering in Iraq can be imputed to external
factors, especially sanctions, the Iraqi people would not be undergoing
such deprivations in the absence of the prolonged measures imposed by the
Security Council and the effects of war."[8]

I hope this is of some help,

Per Klevnäs

Research Co-ordinator, Campaign Against Sanctions on Iraq                  fax 0870 063 5022

Girton College,           
Cambridge CB3                     t: +44 (0)79 905 01 905
England                           f: +44 (0)87 016 96 390

[1] Volume 54, Number 2, Spring 2000 "THE EFFECT OF IRAQI SANCTIONS:

[2] Zaidi, Sarah and Mary C. Smith-Fawzi. "Health of Baghdad's children",
The Lancet, 346, p.1485. December 2, 1995.

[3] Zaidi, Sarah. "Child mortality in Iraq", The Lancet, 350, p.1105.
October 11, 1997.

[4] Drew Hamre has a clip of this inteview on

[5] See press release on and the
report itself on

[6] Arabic News Service, January 18, 1999,

[7] ES:TCP/IRQ/8924, p. viii,

[8] Annex II of S/1999/356, 30 March 1999,, §45.

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