Pertes humaines pendant la guerre d'Irak

Les pertes humaines pendant la guerre d'Irak sont les victimes de cette guerre menée par une coalition conduite par les Etats-Unis en Irak entre 2003 et 2011. Le nombre des victimes est compris entre 151 000 et 1 million de morts, irakiens dans leur immense majorité. L'incertitude concernant le nombre de morts est liée aux méthodes utilisées pour le décompte ; elle affecte uniquement le nombre d'Irakiens morts ; celui des soldats américains tués, estimé à 4431, n'est pas sujet à débat.

L’estimation des décès causés par la guerre pose de nombreux défis^[1]^,^[2]. Les experts font la distinction entre d'une part les décomptes de cadavres, qui comptabilisent les décès officiellement signalés et, d'autre part, les enquêtes auprès des familles permettant de comparer le nombre de morts en excès après l'invasion de l'Irak au nombre de morts avant l'invasion^[3].

La méthode consistant à dénombrer les corps dans les hôpitaux, les morgues, ou à se fonder sur les décomptes dans des sources médiatiques, sous-estime en général le nombre de morts parce qu'une partie des décès n'est pas déclarée : des victimes meurent dans des zones dangereuses, peu couvertes par les journalistes, certaines sont enlevées, exécutées et enterrées clandestinement dans des fosses communes. Le décompte des cadavres a dénombré au moins 110 600 morts violentes en avril 2009 (selon Associated Press). Le projet Iraq Body Count documente selon cette méthode entre 186 901 et 210 296 civils victimes de mort violente.

L'autre méthode consistant à interroger les familles engendre un risque inférieur de sous-estimation, mais ce risque demeure, parce que de nombreuses familles ont fui le pays après y avoir perdu un des leurs, et se trouvent exclues de l'enquête. Les sondages auprès d'échantillons de population produisent des estimations du nombre de victimes de la guerre en Irak allant de 151 000 morts violentes en juin 2006 (selon le Iraq Family Health Survey) à 1 033 000 décès excédentaires en 2007 (selon l' enquête Opinion Research Business (ORB) de 2007). D'autres enquêtes couvrant différentes périodes temporelles évoquent un total de 461 000 décès en juin 2011 (dont plus de 60 % de mort violente) selon PLOS Medicine 2013 ; et un total de 655 000 décès en juin 2006 (dont plus de 90 % de mort violente), selon l'étude The Lancet de 2006.

Les résultats varient aussi selon que l'on considère uniquement les morts liées au combat, ou si l'on inclut les morts liées à l'effondrement du système de santé, de police et de justice. Ils varient de manière évidente selon la date à laquelle on arrête le décompte, et selon que l'on considère les civils uniquement, ou les civils et les combattants ensemble. Certaines études sont évaluées par les pairs, et considérées comme scientifiques (The Lancet, Plos Medecine), d'autres non (Iraq Body Count).

Le sujet est sensible, ayant des implications politiques. Toutes les estimations des victimes de la guerre en Irak sont contestées^[4]^,^[5].

Près de 60% des décès sont dus à une mort violente, selon Plos Medicine (étude de 2013). Parmi des morts violentes, 35% sont imputables à la coalition, 32% aux milices, selon la même étude. La plus grande part des Irakiens victimes de mort violente sont été tués par balles ; viennent ensuite les voitures piégées, les explosions et les bombardements aériens, selon plusieurs études qui, sur ce point, sont concordantes.

On entend par « guerre d'Irak » la séquence historique comprenant l'invasion de l'Irak en 2003, l'occupation du pays par les Etats-Unis et la coalition, l'insurrection irakienne et la guerre civile en Irak qui ont suivi.

↑ Wang, « Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015 », The Lancet, vol. 388, n^o 10053,‎ 8-14 october 2014, p. 1459–1544 (PMID 27733281, PMCID 5388903, DOI 10.1016/S0140-6736(16)31012-1) :
« Indeed, it has been challenging to accurately document the number of casualties from wars and deaths resulting from malnutrition, infections, or disruption in health services during wars. »
↑ Adhikari, « Critical care and the global burden of critical illness in adults », The Lancet, vol. 376, n^o 9749,‎ 16-22 october 2010, p. 1339–1346 (PMID 20934212, PMCID 7136988, DOI 10.1016/S0140-6736(10)60446-1) :
« However, during times of war, we should remember that evidence from systematic household cluster sampling suggests that most excess deaths, and, by extension, most demands for intensive care, do not arise from violence but from medical disorders resulting from the breakdown of public health infrastructure (eg, cholera), or from the discontinuation of treatment of chronic diseases caused by interruption of pharmaceutical supplies. »
↑ Tapp, « Iraq War mortality estimates: A systematic review », Conflict and Health, vol. 2, n^o 1,‎ 7 mars 2008, p. 1 (PMID 18328100, PMCID 2322964, DOI 10.1186/1752-1505-2-1) :
« Of the population-based studies, the Roberts and Burnham studies provided the most rigorous methodology as their primary outcome was mortality. Their methodology is similar to the consensus methods of the SMART initiative, a series of methodological recommendations for conducting research in humanitarian emergencies. [...] However, not surprisingly their studies have been roundly criticized given the political consequences of their findings and the inherent security and political problems of conducting this type of research. Some of these criticisms refer to the type of sampling, duration of interviews, the potential for reporting bias, the reliability of its pre-war estimates, and a lack of reproducibility. The study authors have acknowledged their study limitations and responded to these criticisms in detail elsewhere. They now also provide their data for reanalysis to qualified groups for further review, if requested. [...] The IBC was largely established as an activist response to US refusals to conduct mortality counts. This account, however, is problematic as it relies solely on news reports that would likely considerably underestimate the total mortality. »
↑ Hagopian, Flaxman, Takaro et Esa Al Shatari, « Mortality in Iraq Associated with the 2003–2011 War and Occupation: Findings from a National Cluster Sample Survey by the University Collaborative Iraq Mortality Study », PLOS Medicine, vol. 10, n^o 10,‎ 15 octobre 2013, e1001533 (PMID 24143140, PMCID 3797136, DOI 10.1371/journal.pmed.1001533)
↑ Levy et Sidel, « Documenting the Effects of Armed Conflict on Population Health », Annual Review of Public Health, vol. 37,‎ mars 2016, p. 205–218 (PMID 26989827, DOI 10.1146/annurev-publhealth-032315-021913, S2CID 32121791) :
« Although the Roberts and Burnham studies faced some criticism in the news media and elsewhere, part of which may have been politically motivated, these studies have been widely viewed among peers as the most rigorous investigations of Iraq War–related mortality among Iraqi civilians; we agree with this assessment and believe that the Hagopian study is also scientifically rigorous. Although the methodology and results in the four studies cited here have varied somewhat, it is clear that the Iraq War caused, directly and indirectly, a very large number of deaths among Iraqi civilians—which, in fact, may have been underestimated by these scientifically conservative studies. A paper by Tapp and colleagues and a recent report by three country affiliates of the International Physicians for the Prevention of Nuclear War have extensively reviewed these four epidemiological studies as well as other studies that attempted to assess the impact of the Iraq War on morbidity and mortality. »

[Wang_et_al_2016-1] Wang, « Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015 », The Lancet, vol. 388, n^o 10053,‎ 8-14 october 2014, p. 1459–1544 (PMID 27733281, PMCID 5388903, DOI 10.1016/S0140-6736(16)31012-1) :
« Indeed, it has been challenging to accurately document the number of casualties from wars and deaths resulting from malnutrition, infections, or disruption in health services during wars. »

[Adhikari_et_al_2010-2] Adhikari, « Critical care and the global burden of critical illness in adults », The Lancet, vol. 376, n^o 9749,‎ 16-22 october 2010, p. 1339–1346 (PMID 20934212, PMCID 7136988, DOI 10.1016/S0140-6736(10)60446-1) :
« However, during times of war, we should remember that evidence from systematic household cluster sampling suggests that most excess deaths, and, by extension, most demands for intensive care, do not arise from violence but from medical disorders resulting from the breakdown of public health infrastructure (eg, cholera), or from the discontinuation of treatment of chronic diseases caused by interruption of pharmaceutical supplies. »

[Tapp_et_al_2008-3] Tapp, « Iraq War mortality estimates: A systematic review », Conflict and Health, vol. 2, n^o 1,‎ 7 mars 2008, p. 1 (PMID 18328100, PMCID 2322964, DOI 10.1186/1752-1505-2-1) :
« Of the population-based studies, the Roberts and Burnham studies provided the most rigorous methodology as their primary outcome was mortality. Their methodology is similar to the consensus methods of the SMART initiative, a series of methodological recommendations for conducting research in humanitarian emergencies. [...] However, not surprisingly their studies have been roundly criticized given the political consequences of their findings and the inherent security and political problems of conducting this type of research. Some of these criticisms refer to the type of sampling, duration of interviews, the potential for reporting bias, the reliability of its pre-war estimates, and a lack of reproducibility. The study authors have acknowledged their study limitations and responded to these criticisms in detail elsewhere. They now also provide their data for reanalysis to qualified groups for further review, if requested. [...] The IBC was largely established as an activist response to US refusals to conduct mortality counts. This account, however, is problematic as it relies solely on news reports that would likely considerably underestimate the total mortality. »

[Hagopian-4] Hagopian, Flaxman, Takaro et Esa Al Shatari, « Mortality in Iraq Associated with the 2003–2011 War and Occupation: Findings from a National Cluster Sample Survey by the University Collaborative Iraq Mortality Study », PLOS Medicine, vol. 10, n^o 10,‎ 15 octobre 2013, e1001533 (PMID 24143140, PMCID 3797136, DOI 10.1371/journal.pmed.1001533)

[Levy_Sidel_2016-5] Levy et Sidel, « Documenting the Effects of Armed Conflict on Population Health », Annual Review of Public Health, vol. 37,‎ mars 2016, p. 205–218 (PMID 26989827, DOI 10.1146/annurev-publhealth-032315-021913, S2CID 32121791) :
« Although the Roberts and Burnham studies faced some criticism in the news media and elsewhere, part of which may have been politically motivated, these studies have been widely viewed among peers as the most rigorous investigations of Iraq War–related mortality among Iraqi civilians; we agree with this assessment and believe that the Hagopian study is also scientifically rigorous. Although the methodology and results in the four studies cited here have varied somewhat, it is clear that the Iraq War caused, directly and indirectly, a very large number of deaths among Iraqi civilians—which, in fact, may have been underestimated by these scientifically conservative studies. A paper by Tapp and colleagues and a recent report by three country affiliates of the International Physicians for the Prevention of Nuclear War have extensively reviewed these four epidemiological studies as well as other studies that attempted to assess the impact of the Iraq War on morbidity and mortality. »

[1]

[2]

[3]

[4]

[5]

Pertes humaines pendant la guerre d'Irak

From Wikipedia, the free encyclopedia · View on Wikipedia