The Human cost of the Syrian Civil War

If the U.S. takes action in Syria, it should not be on the basis of an abstract principle based on an arbitrary red line tied to the use of chemical weapons. The real level of suffering is vastly higher than the number of dead from chemical weapons would indicate, and any effort to use force – to create some kind of viable end state – must take that into account.

The Limited But Uncertain Lethality of Chemical Weapons

There still is no clear picture of the level of casualties that came out of the Syrian use of chemical weapons on August 21st, and there are no estimates at all of the total impact of the use of chemical weapons during the civil war. Media sources are reporting something on the order of 1,400 dead, and avoid estimating the number of wounded or those who are recovering with any lasting side effects.

There is no agreement among intelligence or official estimates. The British Joint Intelligence committee issued an intelligence report referring to “at least 350 fatalities.” Secretary Kerry seems to have been sandbagged into using an absurdly over-precise number like 1,429 dead (of which an equally precise 426 were children). Put simply, there is no way in hell the U.S. intelligence community could credibly have made an estimate this exact.

It is unclear, however, that these figures really had an intelligence source. Some sources indicate they may have actually come from a Syrian source called the Local Coordination Committees (LCC) which, at the time, did not agree with other Syrian opposition sources like the Syrian Observatory for Human Rights (SOHR),  which some feel has a reputation for giving exaggerated estimates – neatly repeating the kinds of mistakes in the misleading data on Iraq given to Colin Powell a decade ago. President Obama was then forced to round off the number at “well over 1,000 people” without any explanation.

There is no estimate at all of those affected with short-term symptoms or who may have long term effects. The number is probably much larger than the number killed, but it is unlikely there will ever be an agreed-upon figure; the examination of the impact of Iraqi use of chemical weapons in the Kurdish town of Halabja never produced a credible estimate of the long-term effects of Saddam Hussein’s use of poison gas because the estimate became so politicized that it was impossible to distinguish the exaggerations from the facts. Many of the reported symptoms also create questions about the purity of any Sarin used in Syria, the lethality of its distribution in any given area and whether some other agent may have been present.

Moreover, if relatively pure nerve gas of any kind was used, most data on its effects indicate it tends to either kill quickly or produce only temporary effects. People who talk about the “horror” of chemical weapons go back to different weapons used in World War I that had more lingering effects, and do not seem to have any idea of the impact of artillery in producing the maimed and disabled or the suffering a major body wound with a bullet, shell fragment, grenade, mine, IED, or serious burn can produce. War is not surgery, it is butchery, and butchery that often leaves the victim alive.

Speaking for All the Dead

What is also clear is that chemical weapons scarcely represent a meaningful measure of the suffering in the Syrian civil war or the need to find some solution. If one only considers the possible number of total dead, in the fighting, there are no clear estimates of what has actually happened. The UN Human Rights Office (OHCHR) does, however, put out conservative estimates which it notes are, “Unfortunately…(the) most likely a minimum casualty figure. The true number of those killed is potentially much higher.”

The suffering was grim long before anyone tried to enforce red lines about chemical weapons. The UN issued a report on June 13, 2013 that estimated 60,000 dead as of November 30, 2012. The estimate rose to “at least 92,901 people…killed between March 2011 and April 2013.” This estimate could have been nearly three times higher. It was based on a report which stated:

“Analysis of the …death toll carried out on behalf of OHCHR by the non-profit organization, Human Rights Dana Analysis Group, which compiled datasets from the Syrian Centre for Statistics and Research, the Government of Syria (up to March 2012 only), the Syrian Network for Human Rights, March 15 Group, the Syrian Observatory for Human Rights, the Syrian Revolution General Council, the Syria Shuhada Website, and the Violations Documentation Centre.

…Information from the eight different sources resulted in a combined list of 263,055 reported killings, fully identified by the name of the victim, as well as the date and location of the death, OHCHR said. Any reported killing that did not include at least these three elements was excluded from the list…. Each reported killing was then compared to all the other reported killings in order to identify duplicates, resulting in 92,091 documented cases of individuals killed.

“The statistical analysts who produced the report noted that there is ‘a strong likelihood’ that a significant number of killings may not have been reported by all eight sources and that 37,988 reported killings containing insufficient information were excluded from the analysis.”

In presenting that estimate, a UN spokesperson stated that an estimated 80% of the dead were male, and that the war involved “the killings of at least 6,561 minors, including at least 1,729 children under ten years old…There are also well-documented cases of individual children being tortured and executed, and entire families, including babies, being massacred,” adding these figures demonstrated  “just how vicious this conflict has become.” The report goes on to add , “Civilians are bearing the brunt of widespread, violent and often indiscriminate attacks which are devastating whole swathes of major towns and cities, as well as outlying villages.”

The UN spokesperson also described a “drastically deteriorating pattern of the conflict” confirmed in a report by the Commission of Inquiry on Syria. “Government forces are shelling and launching aerial attacks on urban areas day in and day out, and are also using strategic missiles and cluster and thermobaric bombs...” She also warned that, “Opposition forces have also shelled residential areas, albeit using less fire-power and there have been multiple bombings resulting in casualties in the heart of cities, especially Damascus.”

There is no current estimate of the dead. The 100,000 figure used in May media reports was originally estimated in March by a Syrian opposition NGO. It first became a UN estimate when it was reported by UN Secretary General Ban Ki-moon on July 25, 2013, at a time the UN estimate the minimum number of confirmed deaths was rising at 7,000 a month. ( 

The UN has issued regular estimates of the increase in dead. UN Secretary General Ban Ki-moon still gave the total at “more than 100,000 people” at a speech on August 31, 2013. ( This has led some press estimates to raise the figure to 120,000, but there is no way to determine the number of actual dead. The UN’s conservative approach avoids propaganda and exaggeration, but it also means that no effort is made to estimate the range of possible dead or explain uncertainty.

The Syrian Observatory for Human Rights (SOHR) estimated 110,371 dead as of August 31, 2013. As is the case with the U.S. State Department and many other such estimates, the SOHR produced figures down to the last digit – a level of precision that is clearly statistically impossible:

  • The Syrian Observatory for Human Rights has documented 110,371 casualties since the beginning of the uprisings in 18/3/2011, from the first casualty in Dera'a, up till 31/08/2013.
    -    Civilians: 40,146. Including 5,833 children and 3,905 women.
    -    Rebel fighters: 15,992.
    -    Defected soldiers and officers: 2,128.
    -    Regular soldiers and officers: 27,654.
    -    Unidentified casualties (documented by pictures and footages): 2,726.
    -    Rebel fighters (most of which are non-Syrian and others are unidentified): 3,730.
    -    Popular defence committees, National defence forces, Shabiha and pro-regime informers: 17,824.
    -    Fighters from the Lebanese Hezbollah: 171.
    -    The death toll does not include more than 9,000 detainees and missing persons inside regime prisons and detention centres. Nor does it include more than 3,500 regular soldiers and officers held captives by rebel fighters.
    -    We also estimate the real number of casualties from regular forces and rebel fighters to be twice the number documented, because both sides are discreet about the human losses caused by clashes.
  • Death toll for August 2013: 5,493 were killed in Syria.
    -    Civilians: 3,109. Including 124 of which were tortured to death in regime prisons, 365 children and 348 women.
    -    Rebel fighters: 1,140.
    -    Regular soldiers: 1,186.
    -    Non-Syrian and unidentified rebel fighters (most of which are non-Syrian): 700.
    -    Defected soldiers and officers: 42.
    -    National Defence forces and popular defence committees: 386.
    -    Unidentified casualties: 70

The Syrian Local Coordination Committee reported the same figures as the  SOHR, and quoted the SOHR estimate, but added data on chemical weapons losses and described the totals as follows, (

  • Violence in Syria has killed more than 110,000 people, mostly civilians, since the beginning of the uprising against the regime of President Bashar al-Assad in mid-March 2011, the Syrian Observatory of Human Rights (SOHR) reported Sunday.
  • The report comes days after alleged sarin gas attacks in a Damascus suburbs killed 1,429 people, including at least 426 children, according to a U.S. intelligence assessment that was based on multiple streams of intelligence.
  • The SOHR, which relies on a network of activists, doctors and lawyers on the ground, reported that the death toll for the 29-month old conflict stands at 110,371, according to AFP.
  • Out of this total, at least were 40,146 civilians, including nearly 4,000 women and more than 5,800 children, AFP reported.
  • According to the assessment of the SOHR, 21,850 rebel fighters had been killed.
  • The watchdog reported the deaths of at least 27,654 army soldiers, 17,824 pro-Assad shabiha militia and 171 members of the Lebanese Shiite group Hezbollah, which has sent fighters to battle alongside the Syrian army.
  • The group counted another 2,726 unidentified people killed in the fighting throughout the war-torn country up until August 31, according to AFP.
  • “With such a massive and frightening number of victims that have fallen because of the international community’s silence, the observatory renews its call for the United Nations Secretary
  • General Ban Ki-moon, as well as all people with a conscience, to work seriously to end the killing in Syria,” the observatory said in a statement.

Silent About the Wounded

It is important to note that the UN and other sources make no attempt to deal with the number of wounded, and all of the collection efforts tend to undercount casualties among civilians that were not engaged in the fighting. Historically, the number of significant wounded tend to be two to three times higher than the number killed, but either receive limited attention or are never counted.

Moreover, many civilian wounded do not seek reportable medical treatment, and no systematic attempt ever seems to be made to made to assess the patterns in those who receive a wound that has some lasting or disabling effect. In other words, those who live and continue to suffer are never counted.

Guesstimating the Refugees and Displaced

There also is no way to really estimate what may be the most serious impact of the Syrian civil war: The massive numbers of Syrians who have no real home, income, and access to adequate food, education, and medical services. 

The UNHCR provides the following estimate of the refigure situation at the end of June 2013.

Unrest in the Syrian Arab Republic has been mounting since March 2011, leading to the displacement of tens of thousands of civilians. As of June 2012, more than 78,000 people are estimated to have fled to neighbouring Jordan, Lebanon, Turkey and Iraq, putting an increasing strain on the governments and host communities.

In response, the United Nations and its humanitarian partners issued an appeal in March 2012 for US$84 million to support Syrian refugees. The Syria Regional Response Plan outlines current and future needs for some 100,000 Syrian refugees over six months. Led by UNHCR, the plan is the result of a coordinated effort between seven UN agencies, 27 national and international NGOs and partners, and host governments. The Regional Response Plan will be revised at the end of June 2012.

In Jordan, some 21,400 Syrians had registered with UNHCR as of June 2012. This figure is expected to increase as UNHCR and partners expand their outreach efforts and level of assistance to Syrians. The Jordanian government and UNHCR believe there are tens of thousands of vulnerable Syrians in the country. Many refugees have arrived with limited means to cover basic needs, and those who could at first rely on savings or support from host families are now increasingly in need of assistance.

In Lebanon, many refugees are in a precarious situation, with little or no financial resources. UNHCR and partners are working with the government, local authorities and international and national partners to assist more than 27,500 Syrians. More than half of them, 17,000, have been registered in the north. UNHCR and partners are assisting 3,000 Syrian refugees in Tripoli and 7,500 in Bekaa, who are pending registration.

In Turkey, some 24,300 Syrians are registered with the government, which is hosting them in the provinces of Hatay, Gaziantep, Kilis and Sanliurfa. The government has assumed responsibility for assisting, sheltering and protecting the refugees in camps, with UNHCR providing technical support as well as thousands of tents and tens of thousands of blankets. In addition, UNHCR is registering and assisting refugees who were previously hosted in Syria, such as Iraqis now living in urban environments.

Iraq has recently seen a growing number of Syrians arriving. As of June, some 4,400 had been registered with a further 425 awaiting registration. UNHCR and partners have started assisting refugees, in close cooperation with the authorities. Meanwhile in Syria, the government continues to work with UNHCR and partners to assist some 110,000 refugees.

The UN raised that estimate sharply in a news release on September 3, 2013, having previously noted that over 1,000,000 children were refugees outside their country, ( )

The number of Syrians forced to seek shelter abroad since civil war began in March 2011 passed the 2 million mark on Tuesday with no sign of the outflow ending soon.

"The war is now well into its third year and Syria is haemorrhaging women, children and men who cross borders often with little more than the clothes on their backs," the UN refugee agency said in a statement released to mark the milestone.

"This trend is nothing less than alarming, representing a jump of almost 1.8 million people in 12 months," UNHCR said. One year ago today, the number of Syrians registered as refugees or awaiting registration stood at about 230,670 people.

UN High Commissioner for Refugees António Guterres said Syria had become "a disgraceful humanitarian calamity with suffering and displacement unparalleled in recent history." He added that "the only solace is the humanity shown by the neighboring countries in welcoming and saving the lives of so many refugees."

More than 97 per cent of Syria's refugees are hosted by countries in the immediate surrounding region, placing an overwhelming burden on their infrastructures, economies and societies. They urgently need massive international support to help deal with the crisis.

UNHCR Special Envoy Angelina Jolie, meanwhile, expressed her dismay at the level of death, damage and danger that has forced so many Syrians to run for their lives.
"The world risks being dangerously complacent about the Syrian humanitarian disaster. The tide of human suffering unleashed by the conflict has catastrophic implications. If the situation continues to deteriorate at this rate, the number of refugees will only grow, and some neighboring countries could be brought to the point of collapse," she said.

Jolie added that the world was "tragically disunited" on how to end the Syria conflict. "But there should be no disagreement over the need to alleviate human suffering, and no doubt of the world's responsibility to do more. We have to support the millions of innocent people ripped from their homes, and increase the ability of neighboring countries to cope with the influx."

…With an average of almost 5,000 Syrians fleeing into neighboring countries every day, the need to significantly increase humanitarian aid and development support to host communities has reached a critical stage.

In view of the pressure the refugee exodus is placing on surrounding countries, including the worsening economic impact, ministers from Iraq, Jordan, Lebanon and Turkey will meet with UNHCR in Geneva on Wednesday in a bid to accelerate international support.

The 2 million figure represents Syrians who have registered as refugees or who are pending registration. As of the end August this comprised 110,000 in Egypt, 168,000 in Iraq, 515,000 in Jordan, 716,000 in Lebanon and 460,000 in Turkey.
Some 52 per cent of this population are children aged 17 years or below. UNHCR announced only days ago that the number of Syrian child refugees had exceeded 1 million.

A further 4.25 million people are displaced inside Syria, according to data from the UN's Office for the Coordination of Humanitarian Affairs (OCHA). Taken together, these numbers – amounting to more than 6 million people – mean that more Syrians are now forcibly displaced than people from any other country.
UNHCR is active in Syria and is leading the humanitarian response to the refugee crisis in each of the surrounding countries. Humanitarian agencies are worryingly under-supported, with receipt of only 47 per cent of funds required to meet basic refugee needs.

The Human Context

The problem with refugees and the internally displaced goes far beyond the immediate impact of being driven out of home any way of earning a living. As Iraq showed all too clearly, it can violently segregate a nation along ethnic and sectarian lines, and leave a lasting legacy of hatred and insecurity – sometimes along lines within meters of each other in populated areas. The overall educational system can be crippled, the strain of medical services affects every form of treatment, food production and distribution are disrupted, all savings are expended in immediate consumption, and no investment development occurs. The impact can go on for well over a decade.

Syria also presents special problems in terms of lasting effects. There is no accurate census for Syria but the CIA is probably broadly correct in estimating that its total population is around 22.5 million. ( It is also a uniquely young nation. Over a third (33.9% according to the CIA) is 14 years of age or younger. This means displacement affects children to an disproportionate degree.

It is also a highly polarized state with deep sectarian and ethnic divisions. The CIA estimates that Sunni Muslims make up 74%; other Muslims (including Alawite, Druze) make up 16%; Christian (various denominations) make up 10%; and there are tiny Jewish communities in Damascus, Al Qamishli, and Aleppo. The Agency World Factbook estimates that Arabs make up 90.3%, Kurds, Armenians, while others round out the remaining 9.7%. For decades, the Alawites have ruled over a vastly larger Sunni majority, and ethnic minorities like the Kurds have faced serious discrimination.
Assad and his father also crippled Syria economic development for decades, by sharply underinvesting in key areas like health and education (Syria ranked 178th in the world in national effort as a percent of GDP, and 73rd in the world in terms of education.). Even before the civil war, some 12% of Syrians lived below an extremely low poverty line, and there was serious unemployment and underemployment –  particularly for youth – although no credible numbers exist. Syria’s overall ranking in the world economy had been dropping for decades, and its per capita income only ranked 159th in the world – a dismal figure for a nation that had once been one of the best educated and most advanced states in the Middle East.

No one knows how much worse things are after almost three years of disruption and civil war, but the very fact that the UN now estimates that at least 9% of the population already consists of refugees outside the country, and another 19% has been displaced inside it – a total of 27% of the entire population – is a clear indication that it will be years before even the current level of economic and social damage can be dealt with.

Suffering and the Need for Negotiation and Reconciliation

There is one final message in these numbers. A divided Syria will mean division into insecure enclaves with no clear economic structure or support infrastructure and delay any healing and progress by years, if not indefinitely. An Assad victory can only occur through constant enduring repression, consume most state assets in security spending, and isolate Syria’s economy in many ways. A Sunni Islamist extremist victory would mean trying to push the country back to some idealized version of the Caliphate and 6th Century where no Alawite, Christian, Druze or other minority could be safe.

The U.S. and every country outside Syria needs to think about both the total butcher bill in current human suffering and the need for a solution that does not make things worse. An Assad victory would be a nightmare, but so would the wrong kind of rebel victory that either gave extremists power or took broad revenge against the Alawite and Assad’s other supporters.

There will need to be a negotiated peace, incentives to make that happen and last, and enduring humanitarian and other aid to help the nation recover. Putting a stop to the civil war will not be an “end state”, it will only be a beginning.

Anthony H. Cordesman holds the Arleigh A. Burke Chair in Strategy at the Center for Strategic and International Studies (CSIS) in Washington, D.C.

Commentary is produced by the Center for Strategic and International Studies (CSIS), a private, tax-exempt institution focusing on international public policy issues. Its research is nonpartisan and nonproprietary. CSIS does not take specific policy positions. Accordingly, all views, positions, and conclusions expressed in this publication should be understood to be solely those of the author(s).

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Anthony H. Cordesman

Anthony H. Cordesman

Former Emeritus Chair in Strategy