The new study estimates the deaths from March 2003 to June 2006, and compares them with the deaths in the pre-invasion period January 2002 to March 2003 in 47 randomly selected sites across Iraq. That led to the figure of 655,000 -- on average more than 500 deaths a day more than in pre-invasion Iraq.
The survey covered 1,849 households and 12,801 household members. Each household was surveyed about births, deaths, in-migration and out-migration in May and June this year. Wherever there was a death, surveyors asked for a death certificate, which was produced in 92 percent of the cases.
The study found that of the 629 deaths reported, 547 (87 percent) were in the post-invasion period compared with 82 (13 percent) in the pre-invasion period. The pre-invasion mortality rate was 5.5 per 1,000 people per year, while post-invasion this rose to 13.3 per 1,000 people per year.
"This doubling of baseline mortality constitutes a humanitarian emergency," the report says.
The investigators said that "the excess mortality could mainly be attributed to an increase in the rate of violent deaths, which has risen every year post-invasion." Of the 655,000 excess deaths, around 601,000 would have been due to violent causes, the report says.
Most violent deaths were due to gunshots (56 percent), the survey found. Air strikes, car bombs, and other explosions each accounted for 13-14 percent of violent deaths.
Deaths attributable to the coalition forces accounted for 31 percent of post-invasion violent deaths, the report said. The study found that the proportion of deaths attributable to coalition forces diminished this year, the actual number of people killed by the coalition forces rose.
The deaths mean that 2.5 percent of the population of Iraq has died unnaturally under the occupation, the report says.
"Although such death rates might be common in times of war, the combination of a long duration and tens of millions of people affected has made this the deadliest international conflict of the 21st century, and should be of grave concern to everybody," the authors wrote in the report. The study was carried out by a team led by Gilbert Burnham of the John Hopkins Bloomberg School of Public Health in Baltimore in the United States.
The authors are demanding an international inquiry.
"We continue to believe that an independent international body to monitor compliance with the Geneva Conventions and other humanitarian standards in conflict is urgently needed," they said. "With reliable date, those voices that speak out for civilians trapped in conflict might be able to lessen the tragic human cost of future wars."
The Lancet report is certain to create a public stir, but is unlikely to alter U.S. policy, says James Denselow of the Royal Institute for International Affairs in London.
"It is unlikely to have policy implications," Denselow told IPS. "The U.S. has always rode roughshod over the issue of casualties. And with this report out today, (U.S. President George) Bush was saying today what he said a year ago, that without the U.S. there Iraq will become a pariah state, that it will risk more of 9/11, I don't see any drastic change to that."
In the public eye "the report does undermine the U.S. project in Iraq," Denselow said. "There have been other reports to say that Iraqis have been more tortured under U.S. occupation than under Saddam, and now we have a report suggesting a higher ratio of deaths under U.S. occupation."
Bush has so far managed to combine the war in Iraq and the war on terror quite well. "But people are now seeing that the Iraq war has created a harder problem that the war on terror was intended to address," he said.
The conduct of the invasion has been shown up to be "mismanaged and tragically irresponsible," Denselow said. "But that does not mean there will be a change in what the U.S. is doing."
Bush declared Wednesday that the findings of The Lancet were not credible. Denselow said the report had "an academically sound basis" even though it was carried out in a difficult environment.
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