If you live in America, chances are you know someone who's been sent to Iraq. Most of them aren't home yet, but hopefully the number who don't return will be small. Because every casualty is a life-altering event for the family and their community.

In the scale of tragedies, then, I'm stunned and shocked at this Lancet report that the civilan casulaties in Iraq probably number a hundred thousand. When an occupying army kills civilians - men, women, children - they create persistently motivated enemies. The single most lasting effect of this war will have been to create a radicalized generation intent on the downfall of the USA.

We estimate that 98000 more deaths than expected (8000-194000) happened after the invasion outside of Falluja and far more if the outlier Falluja cluster is included. The major causes of death before the invasion were myocardial infarction, cerebrovascular accidents, and other chronic disorders whereas after the invasion violence was the primary cause of death. Violent deaths were widespread, reported in 15 of 33 clusters, and were mainly attributed to coalition forces. Most individuals reportedly killed by coalition forces were women and children. The risk of death from violence in the period after the invasion was 58 times higher (95% CI 8·1-419) than in the period before the war.

Summary in the Johns Hopkins press notice. Interview between Spencer Ackerman and one of the report's authors. Reuters summary.