Your correspondent suggests that science may be making the combat theater safer for soldiers.1 She neglects to mention that one may also "measure the effects of hell on earth" in the affected civilian population. A recent extraordinary epidemiologic study, undertaken at significant risk to the interviewers, suggested an approximate Iraqi death toll of 100,000 in the recent conflict, a figure far higher than that of press accounts.2 Studies of violence and mortality have been performed in Darfur, Sudan, demonstrating high mortality rates among civilians due to armed conflict.3 These scientific studies tell us as much about ourselves as does biomonitoring. Let "collateral damage" not be an afterthought.
Min-Han Tan, MD
