The ongoing conflicts in Iraq, Afghanistan and Pakistan have taken a tremendous toll on the people of those countries – resulting in the deaths of between at least 158,000 to 202,000 civilians. The decade long war in Afghanistan has continued to take lives with each passing year. As of February 2013, between 17,000 and 19,000 civilians have died as a result of the violence. The total number killed in Pakistan may be as high or higher than the toll in Afghanistan, with NGO estimates ranging widely between 18,000 and 49,000 recorded deaths. In Iraq, over 70 percent of those who died of direct war violence have been civilians. Iraq Body Count conservatively estimates that at least 134,000 civilians have been killed in direct violence due to war between the invasion and early March 2013. If trends continue, another 4,000 or so Iraqis can be expected to die in 2013 from continued violence. In addition to the direct consequences of violence represented by these numbers, thousands more Iraqis, Afghans and Pakistanis are falling victim to the dangers of a battered infrastructure and poor health conditions arising from wars. In the case of Iraq, excess deaths indirectly resulting from the war add several times the 134,000 civilians killed directly by violence.
People have been killed in their homes at night and in markets and on roadways during the day. They have been killed by bombs, bullets and fire and by weapons whose acronyms have newly entered the lexicon -- improvised explosive devices (IED) and remotely piloted vehicles (RPVs or "drones"). Civilians die at checkpoints, as they are run off the road by military vehicles, when they step on a mine or a cluster bomb as they try to collect wood or tend to their fields, and when they are kidnapped and executed for purposes of revenge or intimidation. They have been killed by the US and they have been killed by its allies and they have been killed by insurgents and sectarians in the civil wars spawned or fanned by the invasions and what followed.
And death can happen some time — weeks or months — after a battle. In March 2002, Human Rights Watch documented the results when one US cluster bomb that had failed to explode on impact was detonated by five boys on their way to a picnic in Takh-te-Sefar, Afghanistan, "Ramin, 15, died immediately. . . . Soraj, 12, lost both legs. Ismaeel, 16, sustained a chest wound. Farhad, 18, injured his foot. Waheed, 5, received a chest wound and minor head injury."  The survivors would need immediate medical care, long-term care, and prostheses.
And the effects of war death and injury linger. When families lose members to death or injury, not only is the human suffering immense, but there is also often loss of the household’s only breadwinner. There are also financial burdens for medical care, care of a disabled or orphaned relative, and funeral expenses. 
When the nongovernmental organization Campaign for Innocent Victims in Conflict visited a neighborhood in 2008 affected by an airstrike in Herat, Afghanistan on October 22, 2001, it found that the neighborhood remained damaged from the strike. "The air-strike reportedly missed a military target and directly hit an area within the city, damaging or destroying the houses of forty-five families, killing twelve and injuring tens of others." CIVIC investigators interviewed survivors. "According to the father of one family, everyone he was close to was affected: 'One of the bombs landed in our yard. The other landed on my brother’s house, the other my neighbor here, the other my neighbor there.'" CIVIC also found that "Even those who were spared direct harm complained about a general deterioration of their quality of life, and that they had received no help to recover." 
Civilians also die when war damages infrastructure. These indirect war related deaths would not have occurred were it not for the damage to infrastructure, and environmental disruptions and dislocations produced by the war’s violence. Refugees from the violence, for example, often lose access to a stable food supply and/or to jobs and income, resulting in increased malnutrition and vulnerability to other disease. Loss of home or destruction of sewage treatment facilities can lead to lack of access to safe drinking water. Loss of access to health care is also common, leading to fatalities that would otherwise not have happened.
It is almost always difficult to record and count the dead and wounded in war. And there are often disputes about the identities of the dead. A variety of war zone observers have asked: Were these "innocent civilians" or "insurgents"? Were they killed by the US, by other pro-government forces, by anti-government forces, or by others? Given how the laws of war are written, many ask, were their deaths intended, the foreseeable consequence of using a particular weapon in a populated area, or an “acceptable accident”?
The challenge of counting the civilian dead in these war zones begin with these basic questions and then continues with contentious debates about the answers and the methods for recording and counting casualties.
The Costs of War project describes the specific challenges of estimating civilian death and wounding in Afghanistan, Iraq and Pakistan. The reports also discuss the ways civilians have been killed in each of these war zones and how the pattern of killing has changed over the course of the wars. The reports survey the various counts and estimates given by different sources, and then makes an estimate from them of the dead and wounded. (Page updated as of March 2013)
INFOGRAPHIC  “Rakan’s Story,” (2011), http://www.boston.com/news/local/massachusetts/gallery/080108_rakans_life/.
 Human Rights Watch, "Fatally Flawed: Cluster Bombs and Their Use by the United States in Afghanistan," (18 December 2002), G1407, http://www.unhcr.org/refworld/docid/3f4f594b7.html, p. 27.
 CIVIC, "Losing the People: The Costs and Consequences of Civilian Suffering in Afghanistan," (2009), Washington, DC, p. ii., www.civicworldwide.org/afghan_report.