Abstracts | Documenting Mortality in Conflicts

Welcome and Opening by Debarati Guha-Sapir
Director, Centre for Research on the Epidemiology of Disasters (CRED)
Brussels, Belgium

Session 1: What are the Objectives of Estimating Mortality in Conflicts?
Advocacy, Judiciary and Programmatic Perspectives

Pierre Salignon

Project Director, Health and Nutrition Tracking Service (HNTS)
Geneva, Switzerland

Advocacy Perspectives on the Use of Mortality Data
Abstract to be received.

Helge Brunborg
Senior Researcher, Division for Social and Demographic Research, Statistics Norway
Oslo, Norway

Judiciary Perspectives on the Use of Mortality Data
The needs for demographic and statistical expertise at the International Criminal Court will be discussed. There is often a need to know the numbers of victims in war crimes trials, especially in connection with genocide charges: How many people were killed? How many were deported? What is the age and sex composition of the victims? How thorough was the ethnic cleansing? What was the population size and ethnic composition before and after the armed conflict? Such concerns are the major rationale for the need for expertise in demography and population statistics at international criminal courts.

Les Roberts
Associate Professor, Mailman School of Public Health, Columbia University
New York, NY, USA

Programmatic Perspectives on the Use of Mortality Data
The use of mortality data by NGOs and humanitarian agencies in conflict and post-conflict settings will be discussed.

Session 2: Working With Communities: Approaches to Collecting Data in the Field

Olivier Degomme

Research Fellow, Centre for Research on the Epidemiology of Disasters (CRED)
Brussels, Belgium

Data Collection Using Retrospective Mortality Surveys
The presentation will focus on retrospective mortality surveys as source of mortality data in situations where the prospective collection of mortality data is not possible. Topics that will be discussed include the selection of a representative sample, choice of an adequate recall period, calculation of mortality rates. The basis for the presented survey methodology will be the methodology developed by the SMART initiative.

2. Robinson, C: Technical Paper on Mortality (prepared for Global Nutrition Cluster Meeting on SMART, 7-9 April, 2008). Rome: SMART; 2008.

Jens Nielsen
Statistician, Bandim Health Project, Statens Serum Institut
Copenhagan, Denmark

Prospective Surveillance and the Bandim Health Project
The Bandim Health Project (BHP) followed the population in four district of Bissau, capital of Guinea-Bissau, before the civil war 1998-99 and continued to follow the population during and after the war. Everyone fled at periods of active fighting. Most returned shortly after a cease fire had been established. Hence, a population staying at the epicentre of the war was followed through the war period. Furthermore, BHP actively took part in humanitarian aid interventions and collected data to document the impact of these.

Jan Pfundheller
Investigator, Atrocities Documentation Team, Darfur, Sudan
Brewster, WA, USA

Use of Witness Accounts in Darfur, Sudan
The presentation will address the development of the specific survey tool used and the method of data collection used by the Atrocities Determination Team for Darfur in 2004. The tool was uniquely developed and implemented in an effort to determine specific information requested by the US Department of State. The analysis of the data was enhanced by on-the-ground coding of data by investigators in the field. Specifics that formed the basis for the genocide determination will be presented.

Tal Simmons
Reader, School of Forensic and Investigative Sciences, University of Central Lancashire
Preston, UK

Forensic Anthropology and Mortality Estimates
The use of forensic anthropology in immediate post-conflict settings has proved important, for both international tribunals and truth commissions, in the documentation of violations of international humanitarian law. Forensic anthropology strives to reconstruct (1) individual identity, through reconstructing victims’ biological characteristics (age, sex, ante-mortem medical conditions, etc.) and cultural affiliation; (2) time since death; and (3) manner (and cause) of death through an analysis of peri-mortem injuries. These aims can thus provide valuable demographic information concerning the targeted population and contribute to subsequent legal investigations. For example, forensic anthropology has contributed to the identification of repeated patterns of peri-mortem trauma indicative of torture of victims prior to death, demographics of victims indicating the selection of a particular segment of the population for summary execution, and the targeting of civilian populations in ethnic cleansing. Examples from the conflicts in the Balkans and Sri Lanka will be used to illustrate some of these principals.

Session 3: Using Complementary Methods: Triangulation, Meta Analyses and Cross-Disciplinary Approaches

Part 1

Olivier Degomme
Research Fellow, Centre for Research on the Epidemiology of Disasters (CRED)
Brussels, Belgium

Identifying Trends From Small-Scale Mortality Surveys
Small-scale mortality surveys are an important source of mortality data and are much more frequently conducted than nation-wide mortality surveys covering long periods of time. These small-scale surveys can be extremely useful in estimating trends in conflict related mortality. In contrast to large scale surveys, they have a considerable value as they give a more detailed picture of the mortality level at a specific point in time and in space. This session will discuss the advantages and limitations of trend analysis based on small-scale surveys and will illustrate this with some examples.

Ziad Obermeyer
Resident, Harvard Medical School
Boston, MA, USA

Estimating Conflict Mortality With Population-based Survey Data
In the absence of consistent and complete data from vital registration systems, estimates of deaths from conflict rely on population surveys or censuses, systematic investigations, or eyewitness reports. The relative merits of these different methods, in terms of error (systematic and stochastic) and convenience, are increasingly well understood. Selected results from analyses of two sets of population-based surveys, the World Health Surveys and the Demographic and Health Surveys, will be presented and compared to estimates from other methods.

Romesh Silva
Field Consultant and Statistician, Human Rights Data Analysis Group, Benetech
Palo Alto, CA, USA

The Use of Multiple Systems Estimation to Estimate Deaths in Timor-Leste
Assessments of the magnitude and patterns of human rights violations have been done by many methods, most frequently using convenience samples of qualitative interviews, retrospective mortality surveys and multiple systems estimation. In recent work with the Commission on Reception, Truth and
Reconciliation in Timor-Leste, estimates of conflict-related mortality were derived using a combination of survey-based estimates and multiple systems estimation based on survey data combined with graveyard records and qualitative testimony data. This paper presents the data and methods used to estimate conflict-related mortality between 1975 and 1999 in Timor-Leste. A discussion of the comparative advantages and disadvantages of the respective data sources and methods is presented. This paper show the complimentary nature of survey-based estimates and multiple systems estimation when estimating different causes of conflict-related mortality in war zones, when cause is population-based and one is elusive.

Part 2

Hamit Dardagan
Principal Analyst, Iraq Body Count
http://www.iraqbodycount.org

Iraq Body Count: a Database Approach
This talk will discuss the data-gathering work IBC has done recently, the nature of our source material and the kind of information it carries, the wealth of detail within the data we've gathered, the uses this detail may be put to (which we will illustrate through two specific examples) and the potential this work points towards.

Guillermo Bedoya-Jimenez
Analyst, International Criminal Court
The Hague, Netherlands

Use of Cross-Disciplinary Approaches at the ICC
The following topics will be discussed: (1) case selection and prioritization criteria at the International Criminal Court (determining the gravity of the situations, gravity of crimes and level of responsibility, comparative analysis of situations), (2) providing judiciary or prosecution evidence for trials (mortality estimates, needs of the ICC, assessment of the mortality excess in relation to regular mortality rates, geographic and chronological analysis, description of the composition and profile of the deceased population, description of causes of mortality (whether the mortality rates were the result of direct violence, lack of appropriate humanitarian assistance, hardship or other causes), mortality in IDP camps.

Phil Clarke
Co-Founder, Bloodhound
Copenhagan, Denmark

Bloodhound: Use of Remote Sensing and Web Technologies
The presentation describes the innovative methodology used by Bloodhound to estimate violent mortality at village level in Darfur, using new remote sensing and web technologies that were able to bypass government access restrictions. The errors and uncertainties in this methodology are then appraised, together with thoughts on its application in other conflict settings.

Fredy A. Peccerelli
Director, Guatemalan Forensic Anthropology Foundation (FAFG)
Guatemala

The Work of the Guatemalan Forensic Anthropology Foundation
Abstract to be received.

Session 4: Pitfalls, Challenges and Limitations to Documenting Conflict Mortality

Part 1

Beth Osborne Daponte

Senior Research Scholar and Lecturer, Yale University
New Haven, CT, USA

Challenges to Statistical Estimation in Iraq
Challenges exist when making reliable and valid estimates of civilian mortality due to war. Beth Daponte will first discuss a framework used to examine war's impact on civilians and then will consider challenges common to each statistical approach taken to estimate civilian casualties. She examines results from the different approaches that have been used to estimate civilian casualties associated with the recent fighting in Iraq to date and compares the results of different approaches. She concludes by proposing that after fighting has ceased, other approaches to estimating Iraqi civilian mortality, such as post-war retrospective surveys and demographic analysis, should be employed.

Bethany Ann Lacina
PhD student, Stanford University and Research Assistant, PRIO
Oslo, Norway

Strengths and Limitations of Battle Death Data
The CSCW, PRIO Battle Deaths Dataset tracks deaths of civilians and soldiers in combat during state-based armed conflicts from 1945 to the present. It represents a compilation of the best available evidence, rather than the results of original research. I will comment on the strengths and limitations of the data set and on its uses in conflict research. Certain kinds of mortality data that are of great interest in conflict studies have generally not been studied using the sophisticated techniques of disciplines like epidemiology; I will discuss some the possibilities for addressing this gap.

Jens Nielsen
Statistician, Bandim Health Project, Statens Serum Institut
Copenhagan, Denmark

Statistical Challenges for the Bandim Health Project
Impact of conflicts is often expressed by mortality i.e. by change in mortality. However, the whole population is affected by a conflict; there are no control group unaffected by the conflict. The Bandim Health Project (BHP) had followed the population in four districts of Bissau, capital of Guinea-Bissau, before and during the civil war 1998-99. Hence, it was possible to predict mortality during the war as it would have been had the war not occurred; thereby, creating a reference adjusting for local conditions. An intervention may perform well internally, but it is also important to evaluate the external impact on e.g. the population. However, the impact of an intervention on mortality cannot be separated from the impact of the conflict. Hence, a change in mortality associated to an intervention may be biased. Using more design (triangulation) to evaluate an intervention will indicate an effect, if they converge.

Michael Spagat
Professor, Royal Holloway, University of London
London, UK

Confidence Intervals and Cluster Surveys
We use data from the very large Iraq Living Conditions Survey (ILCS) to simulate the results of conducting conflict mortality surveys of varying sizes, drawing a sharp distinction between violent (war-related) deaths and non-violent deaths. Violent deaths are highly punctuated across space, concentrating strongly in a relative handful of locations. Non-violent deaths spread out rather evenly across space. Consequently, in small samples of 30, 50 or even 100 clusters estimates of violent deaths are substantially less reliable than estimates of non-violent deaths. Early results suggest that standard methods for calculating confidence intervals in small cluster surveys overstate the precision of violent-death estimates based on these surveys.

Part 2

Sandro Colombo
Director of Health Systems, International Rescue Committee
Geneva, Switzerland

Mortality Surveys in Countries in Crisis: Are Best Practices Always Feasible? Case studies from Darfur and DRC
[Sandro Colombo and Rick Brennan (IRC); Ben Coghlan (Burnet Institute), Olivier Degomme and Debby Sapir (CRED)]

The presentation will address the challenges and constraints that confront field epidemiologists in the conduct of mortality surveys in countries affected by complex emergencies. The authors will review some of the best practices emerging in the area of mortality estimation in difficult settings and key constraints imposed by poor security, political factors, logistics etc. Drawing on two case studies (Darfur in 2005 and DRC in 2007), the authors will conclude that, while best practices in mortality surveys remain an aspirational goal, methods may need to be adjusted according to field conditions.

Fredy A. Peccerelli
Director, Guatemalan Forensic Anthropology Foundation (FAFG)
Guatemala

Security Issues for Field Investigations.

Abstract to be received.

Mark Phelan
Public Health Specialist, Bureau of Intelligence and Research, US Department of State
Washington, D.C., USA

Field Issues and Government Use of Mortality Estimates
The presentation will address the challenges and constraints that confront field epidemiologists and researchers in the conduct of mortality surveys and subsequent death estimates in countries affected by conflict. The presenter will discuss in the field limitations to mortality surveys in terms of access, security and political pressures. The challenges of using complementary methods of estimating mortality, particularly at the government level, will also be discussed.

Attachment	Size
Salignon et al 2000.pdf	47.56 KB
Le Pape & Salignon 2003.pdf	1.6 MB
Brunborg 2003.pdf	195.68 KB
Checchi & Roberts 2005.pdf	677.96 KB
Checchi & Roberts 2008.pdf	104.16 KB
IRC (Roberts) 2002-3.pdf	347.44 KB
Guha-Sapir, Degomme, Phelan 2005.pdf	847.25 KB
Guha-Sapir and Degomme 2007.pdf	232.9 KB
SMART_Methodology_08-07-2006.pdf	1.42 MB
Nielson et al 2006.pdf	173.83 KB
Sodemann et al 2004.pdf	70.56 KB
Pfunderheller_ADT questionnaire.pdf	448.61 KB
Obermeyer et al 2008.pdf	397.13 KB
Bloodhound 2006.pdf	566 KB
Osborne Daponte 2008.pdf	143.14 KB
Lacina & Gleditsch 2006.pdf	284.27 KB
Lacina, Gleditsch, Russett 2006.pdf	94.45 KB
Johnson et al 2007.pdf	698.92 KB
WHO Darfur mortality survey 2005.pdf	675.47 KB
IRC DRC mortality survey 2008.pdf	1.07 MB
SIAM-ASA-mongraph-series-draft-paper.pdf	703.98 KB
FAFG Amnesty 2008.pdf	244.59 KB
SMART Mortality Paper 05.23.08.doc	152.5 KB