Iraqi death toll doesn't add up
Sanctions imposed 12 years ago blamed for a million fatalities
Matt Welch
National Post
LOS ANGELES - The headline in this Sunday's Albany Times Union was a sobering slap in the face to those armchair strategists breezily debating a new invasion of Iraq:
"Sanctions killing Iraq civilians, UN says 1 million -- half children under 5 -- have died for want of food and safe water."
The article was from the Gannett News Service, a wire that feeds a chain of 94 newspapers across the United States.
Coming as it did during a week in which plans concerning Iraq dominated political discussion, the news could not have been more timely. Too bad it was wrong.
Because Saddam Hussein's government blocks any real independent inquiry, no one really knows how many civilians have died as a direct result of United Nations sanctions, which were originally imposed 12 years ago this past Tuesday in response to Iraq's invasion of Kuwait.
But it is possible to declare, with some precision, that the UN has never said sanctions have killed 500,000 Iraqi children under the age of five.
This may surprise readers of just about every newspaper in North America, who are long accustomed to letters to the editor and left-of-centre columnists claiming, in the words of the Hartford Courant's Susan Campbell on June 30, "According to UNICEF, a half-million children and toddlers have died since 1990 as a direct result of the sanctions."
That 500,000 number -- and its corollary, the 5,000 Iraqi children who are said to be dying from sanctions each month -- have proven to be remarkably resilient since first appearing on the scene in 1995. As Washington prepares for a war based on Baghdad's flouting of this very same sanctions regime (which was high on Osama Bin Laden's list of grievances aired after the Sept. 11 massacre), it's worth trying to figure out who is closer to the truth: critics, such as former UN Humanitarian Co-ordinator Denis Haliday, who characterize the policy as "genocide"; or supporters, such as The New Republic magazine, who argue that claims of the sanctions' terrible effects are false.
When people calculate child mortality among the under-fives in Iraq, the measuring unit is the gruesome euphemism of "excess deaths" -- the number of children who died "in excess" of what could be expected in "normal" times.
This immediately begs two questions that are seldom asked: What is "normal," and how can you assign specific responsibility for the excess deaths? (A list of candidates for the latter would include: sanctions, drought, hospital policy, breast-feeding education, destruction from the Iran-Iraq and Persian Gulf wars, Saddam's misgovernance, depressed oil prices, farm policy, overdependence on oil exports, differences in conditions between the autonomous north and the Saddam-controlled south, and so on.)
Saddam has not wasted any time on such interpretative nuance: Every death, "excess" or otherwise, is the embargo's fault. According to the Iraqi government, in the 10-year period from 1991-2001, UN policy has killed 670,000 children under five, and 1.6 million Iraqis overall (5,550 and 13,300 per month, respectively). Curiously, those numbers have grown over time (the alleged under-five death toll this June was 7,337), despite the introduction of the oil-for-food program, which has brought approximately US$20-billion of food and supplies into the country since 1997.
If the dictatorial Iraqi government itself can only come up with 670,000 under-five deaths in 10 years, how on earth did elite North American reporters get to a "half-million" as early as 1996? Through a comedy of error-filled science, activism and journalism.
In August, 1995, the UN Food and Agriculture Organization (FAO) gave officials from the Iraqi Ministry of Health a questionnaire on child mortality, and asked them to conduct a survey in the capital city of Baghdad. On the basis of this five-day, 693-household, Iraq-controlled study, the FAO announced in November that "child mortality had increased nearly fivefold" since the era before sanctions. As embargo critic Richard Garfield, a public health specialist at Columbia University, noted in his own 1999 survey of under-five deaths, "The 1995 study's conclusions were subsequently withdrawn by the authors.... [Yet] their estimate of more than 500,000 excess child deaths due to the embargo is still often repeated by sanctions critics."
In March, 1996, the World Health Organization (WHO) published its own report on the humanitarian crisis. It reprinted figures -- provided solely by the Iraqi Ministry of Health -- showing that a total of 186,000 children under the age of five died between 1990 and 1994 in the 15 Saddam-governed provinces. According to these government figures, the number of deaths jumped from 8,903 in 1990 to 52,905 in 1994.
Then, a New York-based advocacy outfit called the Center for Economic and Social Rights (CESR) took a look at the Iraqi government's highest numbers and promptly tripled them. In May, 1996, CESR concluded "these mortality rates translate into a figure of over half a million excess child deaths as a result of sanctions."
That report might well have ended up in the dustbin of bad partisan mathematics had a CESR "fact-finding" tour of Iraq not been filmed by Lesley Stahl of CBS's 60 Minutes. Instead, in a May 12, 1996, broadcast that would later, ironically, win several journalism awards, Stahl threw CESR's bogus numbers at Madeleine Albright, then the U.S. ambassador to the United Nations.
"We have heard that a half million children have died," Stahl said. "I mean, that's more children than died in Hiroshima. And -- and you know, is the price worth it?"
Albright replied: "I think this is a very hard choice, but the price -- we think the price is worth it."
It was the non-denial heard round the world. In the hands of sanctions opponents and U.S. foreign policy critics, it was portrayed as a confession of fact, even though neither Albright nor the U.S. government has ever admitted to such a ghastly number (nor had anybody aside from CESR and Stahl ever suggested such a thing as of May, 1996).
An interesting new perspective on Stahl's reporting emerged earlier this year when a former 60 Minutes producer colleague of hers, Maurice Murad, wrote in the new book Into the Buzzsaw about trying to track down the sanctions-deaths story in late 1995. Murad, whose parents were born and raised in Baghdad, travelled to his ancestral home to see how sanctions were "killing my people."
Instead, after weeks of visiting various cities and literally begging the government and everyone he met to show him starving people, Murad concluded "there was no food crisis in Iraq." He prepared a "detailed rendering of what was wrong with all the other stories" about sanctions, and left it at that. "The last thing I wanted to do was get into a pissing match with broadcasts in my own news division. Even now I am loath to do it because most of the people involved are first-rate journalists who seldom get snookered. And anyway, they know who they are."
Albright's inhumane response actually helped motivate the nascent anti-sanctions campaign, which began gathering steam in 1997 and 1998. The new movement internalized the two main numbers -- the 500,000 under-five deaths from 60 Minutes and the 5,000-dead-children-a-month from the Iraqi government -- and regurgitated them in college dailies, liberal journals of opinion and on the letters pages of daily newspapers. Ironically, this happened just after Saddam finally agreed to the UN's six-year-old proposal to permit oil exports in exchange for humanitarian products and oil-equipment supplies.
But before anyone thought to recalculate the numbers, the United Nations Children's Fund (UNICEF) seemed to confirm them. In 1999, UNICEF released a pair of studies -- one on the autonomous north, the other on the Saddam-controlled south -- that concluded, after interviewing 40,000 households: "If the substantial reduction in the under-five mortality rate 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."
But the "substantial reduction" was historic; if the rate had merely held firm at 1989 levels, the number of "excess deaths" would have been 420,000. And there is a huge gap between UNICEF's "if" and the Gannett article's claim that the agency (along with the WHO) had attributed "1 million deaths, half of which are children younger than five," to "the ongoing collateral damage of the war and sanctions on Iraqi civilians."
In November of last year, after sanctions critics and journalists responded to Sept. 11 with misquotations in dozens of major publications, UNICEF felt compelled to send out a corrective press release. The surveys, UNICEF reiterated, were never intended to produce an "absolute figure" of deaths, and the half-million number was based on false assumptions: "In other words, if there hadn't been two wars, if sanctions hadn't been introduced and if investment in social services had been maintained -- there would have been 500,000 fewer deaths of children under five."
The UNICEF studies also produced fodder for the pro-sanctions crowd: namely, that child mortality actually decreased in the no-fly-zone north (from 80 per 1,000 in 1984-89 to 71 in 1994-98) while more than doubling in Saddam's south (from 56 per 1,000 to 131).
When the report was released, UNICEF executive director Carol Bellamy attributed this discrepancy to "the large amount of international aid pumped into northern Iraq at the end of the [Persian Gulf] war." Increased mortality in the south, UNICEF concluded, was due to several factors including a dramatic decrease in the breast-feeding of infants in favour of bottle-only feeding. "It's very important not to just say that everything rests on sanctions," Bellamy said in one interview. "It is also the result of wars and the reduction in investment in resources for primary health care."
From the standpoint of on-the-ground research, the UNICEF report is by far the best we have. For interpretation of the scores of other studies, I have been impressed with the aforementioned Richard Garfield, whose major work (available at
www.cam.ac.uk/societies/casi/info/garfield/dr-garfield.html) picked apart others' methodologies and freely admitted which of his data points were weakest.
Garfield's conclusion: Between August, 1991, and March, 1998, there were between 106,000 and 227,000 excess deaths of children under five. Recently, he has estimated the latter, less conservative number at 500,000 plus between 1990 and 2002.
The chief causes? "Contaminated water, lack of high-quality foods, inadequate breast-feeding, poor weaning practices and inadequate supplies in the curative health care system. This was the product of both a lack of some essential goods, and inadequate or inefficient use of existing essential goods."
And, of course, sanctions. "Even a small number of documentable excess deaths is an expression of a humanitarian disaster, and this number is not small," he concluded.
Garfield believes that during the last few years of oil-for-food, most of the blame for poor child mortality figures can be laid on the government of Iraq. And he also believes that if the country is bombed heavily, "it will be a terrible blow."
Which brings us back to the current debate, or lack thereof. After Sept. 11, when people (mostly from the political left) brought up Iraq, it was frequently to suggest that the sanctions-influenced humanitarian crisis may be contributing to the wellspring of anti-American sentiment in the Arab world. Last week, in two full days of hearings in the U.S. Senate, the subject of humanitarian effects barely came up.
The centre of the discussion has shifted from the concept of "smart sanctions" to the doctrine of "anticipatory self-defence." With the focus on plotting "regime change" and guessing about weapons programs, sorting through disputed mortality statistics is just not a priority.
The United States is in an expansive, pre-emptive mood. Awkward diplomatic arrangements -- such as the country's bizarre "friendship" with terrorist-producing Saudi Arabia -- feel vulnerable to restless public opinion and the alliance-shifting War on Terror. Punitive sanctions without weapons inspections will no longer do. As the embargo turns 12, only one bet seems safe: It won't see 13.
