The Human Cost of War

And How to Assess the Damage

Alicia Casilio, dressed as an Iraqi civilian, stands silently at an anti-Iraq war protest in Boston, Massachusetts, January 11, 2007. Brian Snyder / Reuters

The wars that the United States has waged in the Middle East have generally led to yet more interventions. There was the support for the mujahideen in Afghanistan in the 1990s and the hot pursuit of Osama bin Laden in 2001. Then came the Iraq wars in 1991 and 2003 and, now, support for the forces seeking to bring down Syrian President Bashar al-Assad. Among the many reasons for the record of poor outcomes is the United States’ failure to account for the human costs of war.

Washington and the broader policy world are often quick to analyze the failures and occasional successes of U.S. armed conflicts. But rarely do they look at how war affects local populations—from the scale of destruction and the severity of injuries to the reasons why millions of the displaced never return to their old towns or homes. Nor do policymakers consider how many were killed directly by war’s violence or indirectly through privation, disease, and other causes.

As retired U.S. Army General Tommy Franks once remarked, “We don’t do body counts.” (Although the military does sometimes count casualties that result from U.S. action, just not from the war as a whole.) But this sentiment has given an impression that the U.S. military callously disregarded civilian life in Afghanistan and, later, in Iraq. And, indeed, there was a chronic absence of sympathy for the fate of civilians in Iraq. Thus, as General David Petraeus acknowledged in his rewrite of The U.S. Army Field Manual in 2006, population protection had to become a priority. “During any period of instability, people’s primary interest is physical security for themselves and their families,” the manual stated. “When [U.S.] forces fail to provide security or threaten the security of civilians, the population is likely to seek security guarantees from insurgents, militias, or other armed groups. This situation can feed support for an insurgency.”

Afghans bury some of the victims of an airstrike in a mass

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