Skip to content

When you choose to publish with PLOS, your research makes an impact. Make your work accessible to all, without restrictions, and accelerate scientific discovery with options like preprints and published peer review that make your work more Open.

PLOS BLOGS Speaking of Medicine and Health

Quantifying the Dirty Nature of War

PLOS Medicine Senior Editor, Amy Ross, discusses the potential impact of the “Dirty War Index”, a tool developed by Madelyn Hsiao-Rei Hicks and Michael Spagat, to minimize civilian harm in areas of armed conflict.

Image Credit: valeyoshino, Flickr

While international humanitarian treaties, such as the Geneva Conventions, have sought to limit the barbarity of war over the past century and violence and deaths due to armed conflict have diminished dramatically in the last few generations, political violence within or between countries is still rife in many parts of the world. Media reports on civilian injuries and deaths in areas of armed conflict emerge on what seems to be a daily basis and, with often biased reporting of such events, it can be difficult to identify who is responsible for the worst of these harms. As data on these civilian deaths have become more readily available, a field of research has developed that attempts to quantify the impact of different war tactics on civilian deaths with the ultimate goal to minimize civilian harm.

In December 2008, PLOS Medicine published a Policy Forum by Madelyn Hsiao-Rei Hicks and Michael Spagat proposing a new tool, called the Dirty War Index (DWI), that was developed to systematically identify “rates of particularly undesirable or prohibited, i.e., “dirty,” war outcomes inflicted on populations during armed conflict”.

It uses a fairly basic calculation:

DWI = Number of “dirty,” i.e., undesirable or prohibited cases / Total number of cases × 100

where high DWI values can indicate indiscriminate warfare, especially dangerous weapons, or targeting of civilians.  As one of several examples in the paper, the researchers apply a “child casualty DWI” (Number of child casualties/ Total number of casualties) to weapons-casualty data from Chechnya between 1994 and 2005, to calculate the following ratios for different explosive devices: antitank landmines (34/223, DWI = 15), antipersonnel landmines (223/1,004, DWI = 22), booby traps (65/214, DWI = 30), and other unexploded ordnance (255/892, DWI = 29). They conclude that unexploded ordnance and booby traps are more dangerous to children than landmines in this setting.

The paper has a respectable number of citations and views since publication, however, the impact of the DWI outside of the academic literature may not be immediately obvious. As an example, several months after publication of the DWI, the authors worked with Lieutenant Colonel Ewan Cameron from the British Army to adapt the tool for use by NATO. Rebranded as the Civilian Battle Damage Assessment Ratio (CBDAR) to better fit with military culture, the adapted tool could be integrated into the pre-existing military Battle Damage Assessment (BDA) system, with the goal to provide quantitative evidence to support tactical and strategic decisions that might minimize the risk of harming civilians. The CBDAR was used in the Regional Command-South (RC-S), one of the six Regional Commands under NATO/ISAF in Afghanistan, to monitor and analyze civilian casualties. In a report from the Center for Civilians in Conflict, Lieutenant Colonel Cameron explains the impact of this tool on NATO procedures in Southern Afghanistan: “The analysis affected tactical guidance specifically with RC-S, including influencing the use of warning shots, caltrops, and light and sound at checkpoints and on vehicle and foot patrols”.

In a research article published in PLOS Medicine in 2011, Madelyn Hsiao-Rei Hicks and colleagues applied a “Woman and Child DWI” to mortality data from Iraq (between March 2003 and March 2008) by measuring the proportion of women and children among civilian deaths of known demographic status from the Iraq Body Count database. They found that the most indiscriminate effects on women and children were from unknown perpetrators using mortar fire (DWI = 79), nonsuicide vehicle bombs (DWI = 54), and from Coalition air attacks (DWI = 69). These findings were cited in the Geneva Declaration 2011 Burden of Armed Violence Coalition report, which calls upon states to achieve measurable reductions in the global burden of armed violence by 2015. Furthermore, the findings reached Members of the US Congress as part of a Congressional Research Service Report on December 6th 2011 titled “Iraq Casualties: U.S. Military Forces and Iraqi Civilians, Police, and Security Forces” that provided Congress with information on the impact of specific weapons and warfare methods on the civilian population.

While the reliability of the DWI is tied to the reliability of the data sources available, which tend to be poor from areas of armed conflicts (read more about limitations of its uses here and here), it’s a flexible tool that has shown to be acceptable to multiple types of audiences concerned with war and civilian protection.  As summed up nicely by the lead author of the paper, Madelyn Hsiao-Rei Hicks: “The DWI approach that connects public health, civilian protection, and international humanitarian law seems able to enter discussions and the ongoing, active formulation of norms, standards and practice in warfare.”

You can read the full article here:

Hicks MH-R, Spagat M (2008) The Dirty War Index: A Public Health and Human Rights Tool for Examining and Monitoring Armed Conflict Outcomes. PLoS Medicine 2008


This is post 4 of 8 in PLOS Medicine’s 10th Anniversary blog series on the most interesting and influential articles of the last ten years. You can find links to all the posts in the series as they are published here.




Leave a Reply

Your email address will not be published. Required fields are marked *

Add your ORCID here. (e.g. 0000-0002-7299-680X)

Back to top