Congo Body Count Statistics Taken Out of Context

You've heard the numbers. Congo loses 2.3 million in civil war; later: 5.4 million deaths '98-09; worst war on record since the world war; chaos, madness, and other serious but difficult to grasp figures. Now researchers at the Human Security Report Project are rightfully seeking to correct the number to set the discussion back on track.

But now that they've spoken out, the media has simplified the point for mass consumption. It appears the death toll figure may lose it's meaning, and potentially slow down an already snail-like crisis response.

For a contextual glimpse at what's happening on the ground, check out this intimate photo essay from Congo's northeast by Les Neuhaus. Meanwhile, remember that the government of the Democratic Republic of Congo is the same that recently celebrated strapping a rat to a rocket and launching it across a field as a huge step forward for the country's space program. Imagine how much capacity this government has for collecting statistics across crowded towns and a vast, nearly impenetrable wilderness.

A few years ago, the International Rescue Committee and other aid agencies responding to several overlapping crises of public health, displacement, and war desperately needed numbers with which to plan projects. As I learned from Les Roberts, a public health expert and former IRC researcher, health researchers without much to go on from the Congolese government made a valiant attempt with a rapid survey to estimate just how many people were dying above the normal rate across the country. And the number, the "body count," I've since discovered, took on a life of its own, circulated through expat jungle pubs, took a left turn at the UN general assembly, and recently got shot down by this new set of researchers seeking to adjust the figure.

To be more specific, an effort to estimate how many people were dying above normal across a country like the DR Congo would typically require a huge, expensive census-like data collection process both before the crisis and at the time of measurement. Aid agencies could not do this, and should not have. The huge cost would have drawn funds away from medical response among other things.

Instead, the IRC used a rapid study method in which researchers randomly selected, for example (I don't have the exact numbers here), thirty locations, aka "clusters", across the area in question, then thirty households in each of those locations. Among many, many other things, the local data collectors would ask the family to estimate deaths over a period before the conflicts began equivalent to the amount of time since the conflicts began. (Incidentally, this is the same method Roberts and others used for the oft-debated 2005 Lancet Iraq mortality study, but that's a discussion for another post.)

The most critical and challenging aspect of this rapid survey method is how to adjust "random" selection in case the dice rolls on empty jungle, or selects more urban areas than are truly representative of the area. Perhaps the site selection landed on more "high death count" areas than are truly representative of the country?

As trained researchers, the team offered a wide range, reminding readers that their confidence in the number was low. Aid agencies and donor governments simply needed an estimate. (Thanks to Lindsay Stark, a child health specialist and friend at Columbia, for helping to clarify some of this for me.)

Of course, when public health researchers passed the number off to program officers to publicity writers to the media at-large to rights advocates and so on, the number became a hard and fast figure-of-thumb. Government and public obsession with body counts as indicators of course ensured that once the huge estimate was clarified, more funds would become available for health response.

Ironically, re-calculating the number or relying on a body count as the primary indicator is only a distraction from vital emergency action. After all, should we not devote our care and response to those who are still living, before the number gets big enough to wave a flag?

Photo credit: Steve Evans