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

The Human Cost of War

And How to Assess the Damage

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 grave near Kunduz, September 4, 2009.

Afghans bury some of the victims of an airstrike in a mass grave near Kunduz, September 4, 2009.

But the broader problem—a lack of accounting for the costs of war—cannot be attributed entirely to the Pentagon alone. There has long been public and political indifference to the human tragedy in the wars in Korea, Vietnam, Afghanistan, and Iraq. And even when analysts sought to calculate the financial costs of war, these numbers were, more often than not, calculated according to the costs to the United States rather than to the locals living in the war zones. The Congressional Research Service, for example, estimated that as of 2014, the costs of the Iraq and Afghanistan wars totaled $1.6 trillion but made no mention of the costs to those countries.

The problem with this perspective, apart from a dangerous moral apathy, is that it leaves future decision-makers with little to no information about how large-scale military operations actually transpired on the ground and how the conduct of war might affect postwar politics and recovery. As the United States’ past few wars have shown, conflict can return more savagely than ever if the wounds of war aren’t addressed.

Already, it is all too easy for the United States to put aside the grisly outcomes of conflict and, instead, renew hopes for a quick victory.
Ahmad Masood / Reuters An Afghan National Army officer takes part in a training exercise at the Kabul Military Training Center in Afghanistan, October 7, 2015.

The first step toward a solution is to conduct an impact assessment after every armed conflict.

Impact assessments, which are well established in law and public policy, first appeared in the 1970s in the field of environmentalism. They are very extensive analyses undertaken before, say, a construction project, to predict its effect on the natural environment. Since then, the technique has been broadly adapted to other fields: assessing victim damage to determine a criminal sentencing or determining the level of transparency at public agencies or corporations. A variety of other uses have been proposed, such as racial impact statements to measure bias in the criminal justice system or social capital impact statements to assess the effect, for example, of a housing project on social cohesion in a community.

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Reuters An Afghan boy cries during a funeral of members of his family in Logar province, March 27, 2013.

A conflict impact assessment would address these issues by drawing useful data from many of the more comprehensive military analyses. But it would also place the analyses in a broader context: the ways in which war has altered society, politics, livelihoods, intercommunal relationships, resources, infrastructure, and so on.

Among the many elements of an assessment would be a series of postwar surveys that would gauge the affected population’s perceptions of what happened during the war and why—for example, how a conflict impacted livelihoods, as well as access to health care, safe housing, and clean water and sanitation. In addition to data on mortality and injuries, this look at postwar  quality of life would provide a valuable measure of local sentiments, especially if the national government may not have been able to do so or want to share such information publicly. 

The surveys should, of course, be supplemented by studying the empirical effects of war on infrastructure, society, and the economy as a whole: damaged water systems, decrease in school enrollment, rise in unemployment, number of functioning hospitals, number of marriages, fertility rate, and internal migration, to name a few. Political indicators should also be measured; for example, press freedom and the status of minorities, which are already reported by the U.S. State Department, should be integrated into the overall assessment.      

An agency such as the U.S. Government Accountability Office could take the lead in conducting these assessments. They would need assistance from on-the-ground nongovernmental organizations and academic experts, as well as to coordinate efforts with other federal agencies, foreign governments, and international organizations. The assessment, which would need to be vetted by a review board comprising independent experts, should be taken at the end stages of a war or, more likely, soon thereafter.

A U.S. soldier shields himself from the rotor wash of a Blackhawk helicopter after being dropped off for a mission with the Afghan police, Afghanistan, December 20, 2014.

A U.S. soldier shields himself from the rotor wash of a Blackhawk helicopter after being dropped off for a mission with the Afghan police, Afghanistan, December 20, 2014.

Iraq is a key example of how an impact assessment could have helped the United States better assess its strategy toward armed conflicts. Although there were a number of polls measuring Iraqi attitudes toward the United States during the 2003–2011 war, the military did not make good use of them. These surveys, along with the mortality surveys, could have red flagged the significance of destructive violence in the country and become the basis for important policy decisions—for example, to privilege civilian protection, which the Geneva Conventions, the international treaties outlining humanitarian norms during war, obligate an occupying power to do.

During the conflict, Iraqis consistently blamed the United States for the mayhem. During the worst violence, roughly 80 percent of Iraqis felt that way. Even after the war had subsided in August 2008, as an expansive survey conducted by ABC News and others revealed, Iraqis opposed the U.S. presence, and 70 percent denounced the United States’ role in their country as being “very bad.” Around 55 percent of Iraqis judged security to be worse than before the war, and a similar percentage endorsed attacks on U.S.-led coalition forces. More recently, in the spring of 2014, 73 percent of Iraqis saw the United States as a source of instability in Iraq.

These deep discontents relate, of course, to the devastating destruction that left the country “a smoking ruin,” to borrow a phrase from the historian Juan Cole. As the scholars Joseph Stiglitz and Linda Bilmes determined, the economic toll for Iraq runs into the trillions of dollars. It is this destruction that, in tandem with poor, sectarian-addled governance, led in part to the rise of the self-proclaimed Islamic State (also known as ISIS). A conflict impact assessment could have filled that information gap, providing data for a range of indicators such as the damage of a conflict on the local economy, the social fabric, and the local politics from neighborhood to national. Active surveillance, including a household survey, helps to document how ordinary life has been altered by war and how, when amplified by the millions, it affects an entire country and can lead to the discontents that fuel extremism.

Although policymakers might shy away from an impact assessment because it could elicit blame and criticism, that is not its purpose. It is to stir the nation and lawmakers to look hard at the human costs of war. Already, it is all too easy for the United States to put aside the grisly outcomes of conflict and, instead, renew hopes for a quick victory. But with the right information, Washington may finally begin approaching war as the pernicious and momentous thing that it is—and remember that its consequences, at home and abroad, do not end simply with a cease-fire.

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