Saturday, April 14, 2007

Lafta Visit

Via Tim Lambert, we have more details of Riyadh Lafta's upcoming visit to Canada. (Lafta was the key Iraqi doctor for both Lancet I and II.) I think that he organized and supervised all the survey work.

A highly regarded Iraqi epidemiologist who wants to tell Americans about an alarming rise in cancer levels among Iraqi children will come to Canada instead because he couldn't get a visa to the United States.

Does Lafta have a degree in epidemiology or statistics or public health? Just curious. Lack of a degree does not imply incompetence, but if the only two surveys he has conducted have been for these articles, I am not sure that I would describe him as an "epidemiologist."

Once in Canada, Dr. Lafta will present estimates that paint a damning portrait of the war's ravages on children: that birth defects are on the rise since the war began, and that the number of children dying from cancers such as leukemia has risen tenfold.

Huh? There is no doubt that car bombs are bad for children, but what possible war-related mechanism could there be for a 10-fold increase in leukemia? Also, the Iraqi government can't keep track of death rates but it has accurate statistics on childhood leukemia? That seems, uh, implausible.

Dr. Lafta was born in Baghdad in 1960, was trained as a physician at Baghdad University College and then worked for 14 years for the Ministry of Health under Saddam Hussein. He became the head of the communicable disease department and then the primary-care department of Diyala province in northern Iraq.

It would be nice to have more details on this time-line. Did Lafta's 14 years at MoH include his time at Diyala? Was Lafta at MoH until the invasion in 2003? One way to make the dates work would be for Rafta to finish his training in 1989 (at age 29) and then spend then next 14 years until 2003 at MoH. 29 would certainly be a standard age for finishing training in the US (but no doubt Iraqi training schedules are different).

In order to have a sense of how qualified Rafta was to organize these surveys, we need to have a better sense of his background. If he did a lot of such surveys during his 14 years at MoH (either nationwide or just in Diyala), then he would be an excellent choice. If did no prior surveys, then he still might have done a great job for the Lancet team, but we need more details. How did the Lancet authors and Rafta meet each other?

Also, I guess that I am safe in assuming that Lafta is Sunni. Isn't it also the case that most/all higher ranking officials in the pre-war government (whether at MoH or elsewhere) were members of the Baath party? Now, obviously, just because one is a Sunni and/or a former member of the Baath party does not that one's professional work is suspect. But, in any survey situation, it is a concern if the interviewers are too "different" from the interviewees. (I have already discussed the issue of (the lack of?) Kurdish speakers among the interviewers.)

Consider the problem that Shia/Kurdish households might, not so much lie in order to deceive when confronted with Sunni interviewers as give those interviewers that answers that they seemed to "want." If the interviewers seemed to want to find some post-war deaths, then give them so post war deaths.

The analogous situation in the US in 1965 might be white interviewers asking black households in, say, Mississippi about police brutality. A black interviewee might well decide that the better part of valor was giving the white interviewer the answer that the interviewee thinks the interviewer wants. Tell the nice white lady that there are no problems with police brutality (even though there are). In this scenario, there is no subterfuge or fraud on the part of the interviewer. She is honestly trying to find the correct answer, honestly writes down what the interviewee reports.

I do not think that this is a major concern but it would be nice to know if all the interviewers were Sunni. My guess is that they are. (How many Shia became English-fluent doctors in Saddam's Iraq?) Again, this does not mean that they are lying, but it does suggest that we should look for patterns in the responses that the y recorded.


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