THE invasion of Iraq has cost the lives of 655,000 Iraqis, most of them killed as a direct result of violence, according to a disputed new study.

The figure — 13 times higher than the gloomiest of previous estimates —was compiled by random sampling of households across Iraq. It concluded that 601,000 people had died in the country’s unrelenting violence, and the rest from medical conditions and diseases whose treatment has been neglected as a result of the disruption caused by the conflict.

The study was carried out by American and Iraqi epidemiologists and was published in The Lancet, which issued a disputed estimate of the Iraq death toll at 100,000 after the US-British invasion of April 2003. But experts said that the soaring casualty rates among the native population matched those of other conflicts such as the Vietnam War. President Bush dismissed the figure yesterday as not credible. “The methodology is pretty well discredited,” he said.

Last December he put the estimated death toll at 30,000, although the US military has made a point of not keeping records of Iraqi casualties.

Iraq Body Count, a British-based organisation, has put the number at about 50,000 civilian deaths, although its estimates rely on previously published sources.

The Lancet report is not based on an actual body count but on a random sampling of 1,800 Iraqi households in 47 areas across the country.

Adel Mohsin, the Deputy Health Minister, said he doubted that the death toll from the violence was so high. “I think it’s a bit exaggerated. I’d say we are now averaging about 2,000 to 3,000, maximum, a month killed, which would be 36,000 a year.” His ministry announced yesterday that more than 2,660 civilians were killed in Baghdad alone in September, despite a significant US-Iraqi military operation to curb the violence.

Mr Mohsin did, however, agree that it was possible that as many as 50,000 people had died because of insufficient healthcare facilities. “Obviously if we compare the standard of treatment to countries like the UK, we have lost a lot of people.” That researchers from the respected Johns Hopkins University can place the estimated death toll at more than half a million reflects the shocking state of violence in Iraq and the near-total collapse of its medical infrastructure.

An Iraqi doctor from Baghdad’s main hospital told The Times yesterday that many routine operations had to be cancelled regularly to cope with the influx of people wounded in the city’s daily gun battles, bombings and shootings.

Even those that are operated on usually die afterwards because of the lack of post operative care, said the doctor, who asked not to be identified. The city has only two dozen intensive care beds still operating, and in many cases patients have to buy their own oxygen bottles on the black market, a luxury most cannot afford.

“If we send a wounded person to the general surgical ward after the operation no one will even take his blood pressure,” said the doctor, noting that such a lack of care amounted to a death sentence on severely wounded patients.

A senior health ministry official concurred with his grim diagnosis.

COUNTING THE DEAD

FIGURES COMPILED BY IRAQ BODY COUNT

Minimum 43,850 Maximum 48,693;

• In 2002 the US General Tommy Franks said: “We don’t do body counts.” At the outbreak of the Iraq War, in response, a group of British citizens set up Iraq Body Count, the project that now provides the most quoted fatality statistics. It monitors news stories to estimate deaths. Critics say that since many deaths go unreported, the figure is far too low

  STUDY FOR THE LANCET:

  Minimum 392,976 Maximum 942,636;

• In December 2005 George Bush said that an estimated 30,000 people had died by December 2005. It was in the range then being quoted by Iraq Body Count

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