As the US moves closer to war with Iraq, figuring out the likely human impact there - and how to prepare for it - is proving extremely difficult.
Estimating civilian and military casualties involves too many variables to be precise: New types of US weapons, the reliability of allied military intelligence, whether and how Iraq would resist an invasion bent on ousting Saddam Hussein, the condition of Iraq's civilian infrastructure, disinformation, and propaganda on both sides.
The US military is very wary of estimating enemy casualties - before or after the fact. It wants to avoid a scenario that echoes Vietnam - when many estimations of enemy losses turned out to be inflated.
"We don't do body counts," says Army General Tommy Franks, head of US forces in the Middle East and South Asia. Moreover, the Bush administration says Iraq has a clear record of making up casualty figures and scenarios - even putting its own people in harm's way.
Despite the uncertainties, United Nations planners estimate that up to half a million people "could require treatment as a result of direct or indirect injuries" resulting from war.
In a report entitled "Likely Humanitarian Scenarios," recently made public, UN contingency planners also warned that "the outbreak of diseases in epidemic if not pandemic proportions is very likely." According to a draft of the report, the nutritional status of some 3 million people "will be dire," 3.6 million people will need emergency shelter, and 900,000 Iraqis would flee to neighboring countries - with another 2 million likely to become internal refugees.
While Iraq has about the same population as Afghanistan (26 million), experts say its people may be more vulnerable to the hardships of war. Many more are concentrated in urban areas and therefore less used to surviving in a rough environment. They may have had access to modern water, sewer, and power facilities, but those systems already are in bad shape across much of the country. Some 500,000 tons of raw sewage flow into water sources daily, according to the aid group CARE International, and electricity is often off.
According to the UN World Food Program, at least 40 percent of Iraq's population (some sources put it as high as 60 percent) relies on government rations, a supply of such basics as flour, sugar, and rice. Since the Gulf War the number of children suffering chronic malnutrition has grown from 18.7 percent to 30 percent.
Having gone through two wars (the Iran-Iraq War, followed by the Gulf War), UN sanctions, and years of mistreatment under a dictatorial regime, "the Iraqi people now don't have the resources to withstand an additional crisis," says Margaret Hassan, CARE International's director for Iraq.
In anticipation of such needs, Oxfam International and other organizations are positioning staff and equipment in the region. UN agencies that focus on children, refugees, and others who need help are storing food, blankets, and other material in Iran and other neighboring countries.
Jeremy Hobbs, Oxfam's executive director, worries that, in the event of war, airstrikes will target Iraqi power stations.
"If that happened, the Iraqi water and sanitation system, which depends on electricity and which is already in a parlous state, would collapse, leaving millions of people vulnerable to diseases and epidemics," he says.
For its part, the Bush administration lays most of the blame for Iraqis' suffering at the feet of Saddam Hussein. "To craft tragedy, the regime places civilians close to military equipment, facilities, and troops, which are legitimate targets in an armed conflict," says the White House in a recent report titled "Apparatus of Lies: Saddam's Disinformation and Propaganda 1990-2003."
"To exploit suffering, Saddam blames starvation and medical crises - often of his own making - on the United Nations or the United States and its allies," the report charges.
After the Gulf War ended in 1991, estimates of Iraqi military casualties (deaths and injuries) rose as high as 100,000. But research by government agencies, private researchers, and the media eventually discredited such figures. For one thing, many Iraqi military units turned out to have been at much less than full strength before the war started. It's still a controversial subject, but most experts now say Iraqi casualties probably amounted to several thousand.
Since then, Iraqi reports of many civilian deaths tied to UN sanctions - especially those of small children - have become suspect as well.
Based on past experience, some observers are also suspicious of US assertions. Prior to the Gulf War, a Kuwait teenager testified to Congress that she witnessed Iraqi troops taking infants from incubators and leaving them to die.
It turned out that the girl - the daughter of the Kuwaiti ambassador to the US - had never worked at the hospital, and that a Washington public relations firm had arranged her testimony to build political support for US intervention.
In any case, the US - and whatever allies it can muster - are likely to be especially careful to avoid "collateral damage."
American officials do not want to repeat such mistakes as the bombing of an air-raid shelter in Baghdad that killed upwards of 300 people, the bombing of the Chinese embassy and a passenger train in Belgrade, and the attacks on a wedding party and Red Cross facilities in Afghanistan.