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Living Under Drones

Much of the public debate about drone strikes in Pakistan has focused narrowly on whether strikes are ‘doing their job’—i.e., whether the majority of those killed are “militants.”[1] That framing, however, fails to take account of the people on the ground who live with the daily presence of lethal drones in their skies and with the constant threat of drone strikes in their communities. Numerous other reports have highlighted the disastrous impacts of Taliban and other armed actor operations in Pakistan.[2] Those impacts must also factor into the formulation of governance and military policy in Federally Administered Tribal Areas (FATA). This report, however, aims to draw attention to a critical gap in understanding, specifically about life under drones and the socio-economic impacts of drone strikes on civilians in North Waziristan. Available evidence suggests that these impacts are significant, and challenges the prevailing US government and media narrative that portrays drones as pinpoint precision weapons with limited collateral impact. It is crucial that broader civilian impacts and the voices of those affected be given due weight in US debates about drones.

The most direct impacts of strikes, in addition to injuries and killings, include property damage, and often severe economic hardship and emotional trauma for injured victims and surviving family members. Importantly, those interviewed for this report also described how the presence of drones and capacity of the US to strike anywhere at any time led to constant and severe fear, anxiety, and stress, especially when taken together with the inability of those on the ground to ensure their own safety. Further, those interviewed stated that the fear of strikes undermines people’s sense of safety to such an extent that it has at times affected their willingness to engage in a wide variety of activities, including social gatherings, educational and economic opportunities, funerals, and that fear has also undermined general community trust. In addition, the US practice of striking one area multiple times, and its record of killing first responders, makes both community members and humanitarian workers afraid to assist injured victims.

Voices from Below: Accounts of Three Drone Strikes

The most immediate consequence of drone strikes is, of course, death and injury to those targeted or near a strike. The missiles fired from drones kill or injure in several ways, including through incineration,[3] shrapnel,[4] and the release of powerful blast waves capable of crushing internal organs.[5] Those who do survive drone strikes often suffer disfiguring burns and shrapnel wounds, limb amputations, as well as vision and hearing loss.[6]

This section sets out firsthand narrative accounts of three specific drone strikes for which there is considerable evidence of significant civilian casualties.[7] The narratives draw upon interviews, as well as corroborating evidence from other independent investigations, media accounts, and submissions to the United Nations, and courts in the UK and Pakistan.

The narratives provide detailed and stark accounts of the consequences such strikes have on those hit, those near, and their families.

March 17, 2011

On the morning of March 17, 2011, the US deployed a drone to fire at least two missiles into a large gathering near a bus depot in the town of Datta Khel, North Waziristan. To this day, US officials publicly insist that all those killed were insurgents.[8] That position, however, is contradicted by a range of other sources, including the Pakistani military,[9] an independent investigation by the Associated Press,[10] interviews with attorneys, and the testimony of nine witnesses, survivors, and family members gathered for this report. This evidence suggests that at least 42 were killed, mostly civilians, [11] and another 14 injured.[12]

According to those we interviewed, on March 17, some 40 individuals gathered in Datta Khel town center. They included important community figures and local elders, all of whom were there to attend a jirga—the principal social institution for decision-making and dispute resolution in FATA. The jirga on March 17 was convened to settle a dispute over a nearby chromite mine.[13] All of the relevant stakeholders and local leaders were in attendance, including 35 government-appointed tribal leaders known as maliks, as well as government officials, and a number of khassadars (government employees administered at the local level by maliks who serve as a locally recruited auxiliary police force).[14] Four men from a local Taliban group were also reportedly present, as their involvement was necessary to resolve the dispute effectively.[15] Malik Daud Khan, a respected leader and decorated public servant, chaired the meeting.[16]

The jirga had been convened in Datta Khel’s Nomada bus depot,[17] an open space in the middle of town large enough to accommodate over 40 people as they sat in two large circles about 12 feet apart.[18] Though drones were hovering daily over North Waziristan, those at this meeting said they felt “secure and insulated” from the threat of drones, because in their assessment at the time, “drones target terrorists or those working against the government.”[19] This, in contrast, was a jirga, a government-sanctioned meeting, held to ensure “no problems occurred in [the] area and no-one would pose problems for the government.”[20] According to a Pakistani military commander in North Waziristan, Brigadier Abdullah Dogar, the maliks had even taken care to alert the local military post of the planned jirga ten days beforehand.[21]

At approximately 10:45 am, as the two groups were engaged in discussion, a missile fired from a US drone hovering above struck one of the circles of seated men.[22] Ahmed Jan, who was sitting in one of two circles of roughly 20 men each, told our researchers that he remembered hearing the hissing sound the missiles made just seconds before they slammed into the center of his group.[23] The force of the impact threw Jan’s body a significant distance, knocking him unconscious, and killing everyone else sitting in his circle.[24] Several additional missiles were fired, at least one of which hit the second circle.[25] In all, the missiles killed a total of at least 42 people.[26] One of the survivors from the other circle, Mohammad Nazir Khan, told us that many of the dead appeared to have been killed by flying pieces of shattered rocks.[27] Another witness, Idris Farid, recalled that “everything was devastated. There were pieces—body pieces—lying around. There was lots of flesh and blood.”[28]

Khalil Khan, the only son of Malik Hajji Babat, one of the khassadars present at the jirga, was in the Datta Khel bazaar when he heard about the strike.[29] “We were told in plain words that none of the elders that had attended survived. They were all destroyed, all finished.”[30] Khalil Khan immediately went to the Nomada depot to try to find his father.[31] When he arrived at the scene of the strike, he found injured victims and the bus depot in flames.[32] Unable to identify the body parts lying on the ground, all Khalil Khan could do was “collect pieces of flesh and put them in a coffin.”[33] Idris Farid, who survived the strike with a severe leg injury, explained how funerals for the victims of the March 17 strike were “odd and different than before.”[34] The community had to collect [the victims’] body pieces and bones and then bury them like that,” doing their best to “identify the pieces and the body parts” so that the relatives at the funeral would be satisfied they had “the right parts of the body and the right person.”[35]

The trauma of the strike was felt not only by those who witnessed its immediate aftermath, but also by the families left behind. Nearly all of those killed were the heads of large households, who used the government allowances they received through their positions as maliks and khassadars to support their households and fund small businesses. Malik Daud Khan, who led the jirga, was a government-appointed counselor for all of North Waziristan, serving as a political liaison between the Pakistani government and military and the other tribal leaders.[36] He oversaw jirgas throughout the region, and used his allowance, “which was respectable for a decent family,” to support six sons and the sons of his brothers.[37] Another malik, Ismail Khan, left behind a family of eight, of whom only two are males old enough to work.[38] The khassadar Hajji Babat also left behind another household of eight; his son now struggles to support them.[39] Because these men held government positions reserved for elders with “experience and years of wisdom,” their sons cannot take over their offices.[40] The sons have little hope of finding employment that would provide a standard of living afforded by the allowance of a malik or a khassadar.[41] Babat’s son, Khalil Khan, who spent over a decade working as a driver in the United Arab Emirates, told our research team that he often thinks of trying to go abroad again so that he can earn money to support himself.[42] “[But] if I go,” he worries, “what will happen to my family?”[43] The Pakistani government offered to compensate the families with three lakhs (300,000 rupees, or approximately US $3,200) for each man killed, but most did not take the compensation.[44] “[O]ur elders were worth much more than that. . . . [W]e had lost an entire community of elders.”[45]

Some men who survived are now unable to work or earn the living they could before the strike. Ahmed Jan, a malik who used to supplement his allowance by working as a driver, woke up in a hospital in Peshawar after the strike and learned he needed five to six lakhs (approximately US $5,300 to US $6,350) worth of surgery to implant a rod in his leg and to stop the bleeding from his nose and face.[46] Since then, he has lost most of his hearing and the use of one foot.[47] Unable to operate a car, he now depends on his sons, who are also drivers, to support his household.[48] Idris Farid, in addition to living with rods implanted in his leg, told us that the trauma of the strike has caused him to forget “the little bit of education that I [had] gotten when I was little,” and has left him terrified of loud noises “because I think it might be a drone.”[49]

The precise number of people who died in the March 17, 2011 strike has never been determined, though nearly all available sources—including the survivors with whom our researchers spoke—put it at close to 40 or higher.[50] An independent investigation by the Associated Press put the number at 42.[51] Pakistani intelligence officials initially reported that 12 or 13 of the dead were Taliban militants,[52] but the Associated Press investigation found that it was likely only four.[53] Of those four, only one, Sherabat Khan, has ever been identified by name.[54] TBIJ, in separate investigations, has so far obtained the names of 24 civilians killed who died in the strike.[55]

June 15, 2011

On June 15, 2011, the US launched between two and six missiles from a drone at a car travelling on the road between Miranshah and Sirkot in North Waziristan, killing five people. The News, a leading Pakistani newspaper, identified four of the victims in a story it ran two days later.[56] We were provided evidence of five victims in our interviews, as we detail below; TBIJ (in its own separate investigations) also identified five victims:[57] Shahzada (or ‘Sherzada’, no other name), Akram Shah, Atiq-ur-Rehman (nicknamed Tariq), Irshad Khan, and Umar (or Amar) Khan. According to initial press reports, anonymous Pakistani officials stated that all those killed in the strike were “militants”.[58] US officials did not comment, even after the dead men’s families and tribesmen made international news by blocking an important roadway in protest.[59] We interviewed five family and community members who testified that they knew those killed.[60] Together, the five interviewees provided information on each of the five victims, who they said were civilians.[61] Based on its own research, as well as media accounts, TBIJ, citing the names of each of the men above, has reported that at least five civilians were killed in the strike.[62]

According to those we interviewed, on June 15, Akram Shah drove with his cousin, Sherzada, into the city of Miranshah.[63] Akram, a father of three in his mid-thirties, was a former taxi driver who worked for the Pakistani Water and Power Development Authority as a driver.[64] Sherzada was a student in his late teens or early twenties.[65] Both he and Akram Shah lived in the small village of Spulga, some 15 kilometers outside of Miranshah, in a large extended-family compound headed by another cousin, a prominent malik.[66] Atiq-ur-Rehman, a young pharmacist, ran the Razmak Medical shop in the Miranshah bazaar.[67] Irshad Khan, a teenage student, worked in Atiq-ur-Rehman’s pharmacy.[68] Umar Khan ran a local auto parts store.[69] That evening, the five men—Akram Shah, Sherzada, Irshad Khan, Atiq-ur-Rehman, and Umar Khan—set out from Miranshah toward Spulga and the nearby village of Sirkot in Akram’s car.[70]

When the car was just two or three kilometers from Sirkot, it was struck by a missile.[71] According to some press accounts, the drone operators missed their first five missile firing attempts and chased Akram’s car down the road, finally destroying it with a sixth and final missile.[72] Other accounts state that Umar Khan escaped from the back seat after the car was hit, only to be killed by a missile seconds later as he tried to get away from the wreckage.[73] Nadeem Malik was at the mosque some two kilometers away when he heard “the noise of the bombardment,” and rushed to the site of the strike.[74] Several witnesses described the destruction of the car,[75] which Abdul Qayyum Khan likened to “a sandwich bent in half.”[76] Sayed Majid, whose cousin and two other relatives were killed in the strike, and Abdul Qayyum Khan, Atiq-ur-Rehman’s father, told our research team that the victims’ bodies were badly burned.[77] Khan spoke with local villagers who had seen the strike take place and who told him that they had collected the charred body parts from the wreckage.[78]

Khan was working five hours away in Peshawar on the evening the strike occurred.[79] A cousin called him shortly after it happened to say that he needed to return to the village as soon as possible, but would not tell him why.[80] Khan tried to find a ride back with a relative that night, aware that something was wrong, but with no idea that his son—a “peaceful guy” who was “very attached” to him—had been killed in a US drone strike.[81] It was not until Abdul Qayyum Khan arrived in Sirkot and from a distance saw his neighbors filing into his home that he realized the gravity of what might have happened.[82] “I thought I would have a heart attack,”[83] he recalls. “I started weeping. Lots of people there were weeping. . . . [Atiq-ur-Rehman’s wife] was weeping fiercely.”[84]

Ibrahim Shah, Akram’s Shah’s brother, was also working in Peshawar that evening when he received the news.[85] Trying to spare him the shock, his relatives called to say only that his brother had been injured in an accident, waiting until much later that night to call again and tell Ibrahim that his brother had in fact been killed in a drone strike.[86] Ibrahim took ten days off work to come back to the village, where he joined other villagers and family members of the deceased in a large protest a few hours before the funeral.[87] They lined up four of the victims’ coffins across the main Bannu-Miranshah road, and staged a procession and rally asserting that the deceased men were not terrorists.[88]

Just over a year after the strike, the families of those killed are still struggling to deal with the difficulty of losing loved ones. Atiq-ur-Rehman, a young man when he was killed, left behind a wife and four children, two boys and two girls, ranging in age from four months to four years.[89] According to Atiq-ur-Rehman’s father, a driver who now supports his dead son’s entire family, some of the children seem to understand that their father was killed, but they do not talk about it.[90] Akram, who was in his mid-30s at the time of the strike, also left behind a wife and three sons.[91] According to Akram’s brother, Akram’s wife became mentally unwell after his death, and now suffers from hypertension and headaches.[92] She and Akram’s sons are supported by a relative.[93] Abdul Qayyum Khan told our research team, “[w]e will ask…America just to quit their forces from Pakistan…but we will never curse them because it is of no use. We will ask nothing of them. In my point of view, this is a futile effort. My son will not come back. My son is dead.”[94]

January 23, 2009

Just three days after taking office, the Obama administration carried out its first drone strikes in Pakistan. The strikes, launched on January 23, 2009, targeted two houses, one in the village of Zeraki, North Waziristan, and one in Wana, South Waziristan.[95] Citing an unnamed Pakistani security official, The Washington Post reported the following day that the attacks struck “suspected terrorist hideouts” and killed “at least 10 insurgents, including five foreign nationals and possibly even ‘a high-value target.’”[96] Other initial media accounts also reported that those killed by the strikes were militants.[97] The Long War Journal, which does not provide separate data on individual strikes, wrote a post on its website about the two attacks on January 23, 2009.[98] On the Zeraki strike, it reported that ten people (without identification or classification) had been killed and that the target of the strike was “a compound run by a local named Khalil.”[99]

Within a few days of the Zeraki strike, some sources in Pakistan published information that questioned the initial narrative. These sources cited the funeral for the victims, attended by “thousands of tribesmen,”[100] as well as information from official and other sources recognizing the death of three children and at least four civilians between the Zeraki and Wana strikes.[101] Two years later, Islamabad attorney Shahzad Akbar filed a suit on behalf of over a dozen Waziri residents who had been affected directly by drone strikes. One of the named plaintiffs in the suit was Faheem Qureshi, a fourteen-year boy who lost his left eye and suffered a fracture skull in the Zeraki blast. [102] The suit led to some additional reporting on the January 23 strikes, which emphasized that at least some of the victims were civilians.[103] In light of developments over the past three years, TBIJ now reports that in the Zeraki strike at least seven and as many as 11 civilians were killed, of a total of between seven and 15 total dead; the New America Foundation reported that five to six civilians were killed, in addition to four “militants.”[104] While ambiguity remains about some of those killed in the Zeraki strike, available evidence indicates that the attack killed numerous civilians, raising important questions about whether the US complied with basic principles of proportionality and proper precautions in attack. Our analysis focuses on the strike in Zeraki, Mir Ali, North Waziristan, though much of the initial coverage treated the two strikes together, since they both happened on the same day.[105]

We interviewed Faheem Quereshi, a 14-year old who survived the strike, his doctor, his cousin Ejaz Ahmad, who visited the strike site the following day, and the attorneys representing victims in the matter. We also reviewed physical and documentary evidence (including a complaint to the U.N.), media reports, and drone data aggregators. The narrative in this section is based on these sources. We have not been able to find an official US government statement about the strike,[106] nor were we able to locate any on-the-record statements about the strike by the Pakistani government, although media sources cited anonymous authorities.[107]

On the night of January 23, 2009, in the village of Zeraki in North Waziristan, relatives and neighbors gathered for tea and conversation in the hujra[108] of an elder named Mohammad Khalil. Media sources have described Khalil in different ways, ranging from a “tribal notable”[109] to someone “reported to be associated with Tehrik-i-Taliban Pakistan of Baitullah Mehsud.”[110] Some media sources suggest that Khalil may have invited Taliban or Al Qaeda fighters to his hujra,[111] a charge denied by both Faheem and Ejaz, who told our researchers that they believed that those in the house were innocent and not involved in terrorism.[112]

On the day of the strike, Khalil’s adult guests included his relatives Khushdil Khan, the owner of a hardware store in Mir Ali, and Mansoor-ur-Rehman, a former driver who had worked in the United Arab Emirates, as well as his neighbors Ubaid Ullah, Rafiq Ullah, and Safat Ullah.[113] Also in the hujra were Khalil’s nephews, twenty-one-year-old Azaz-el-Rehman Qureshi and sixteen-year-old Faheem Qureshi.[114] His female family members were present, as were children, but they were in a nearby space, separate from the men, as is common in Waziri culture.[115]

At about 5:00 that evening, they heard the hissing sound of a missile and instinctively bent their heads down.[116] The missile slammed into the center of the room, blowing off the ceiling and roof, and shattering all the windows.[117] The immense pressure from the impact cracked the walls of the attached house, as well as those of the neighboring houses.[118] Our research team reviewed photographs that Faheem showed us, which he said showed the destruction to the home. Faheem, who stated that he was approximately ten footsteps away from the center of the hujra, suffered a fractured skull and received shrapnel wounds and burns all over the left side of his body and face.[119] All others in the hujra—at least seven, but as many as 15 people—were killed.[120]

In the moments after the strike, Faheem said he “could not think.”[121] “I felt my brain stopped working and my heart was on fire,” stated Faheem.[122] “My entire body was burning like crazy.”[123] Faheem wanted to splash water on his face, but he could not find any.[124] After a few minutes of confusion, he stumbled out of the gate of his hujra, where neighbors found him.[125] They quickly gathered Faheem into a pickup truck and rushed him to a government hospital in Mir Ali, a ten-minute drive away, according to Faheem.[126] Medics there bandaged his wounds and transferred him to another hospital in Bannu, the closest major city outside FATA, where doctors operated to remove shrapnel from his abdomen and repair damage to his leg, arm, and eyes.[127] Following the surgery, Faheem was transferred to a private hospital in Peshawar, where he remained for at least 23 days.[128] In the end, Faheem lost his left eye, which has since been replaced by an artificial one; he also lost his hearing in one ear as a result of damage to his eardrum.[129] His vision in his right eye is still blurred, requiring ongoing treatment, and he now has only limited mobility.[130]

Faheem’s cousin Ejaz Ahmad, who lives just a few kilometers away, did not attend the gathering in the hujra that evening, and was instead at a friend’s home.[131] He discovered the next morning that his paternal uncle, Khush Dil Khan, in whose hardware store Ejaz worked, died in the strike.[132] “The bodies were completely destroyed,” Ejaz stated.[133] “All we could retrieve was the torso and upwards.”[134]

Those who dug through the rubble retrieved a small handful of items that the dead had on their persons at the time of the attack; Faheem still carries these around with him as reminders of the uncles and cousin he lost.[135] When the strike happened, Faheem’s cousin, Azaz-el-Rehman Qureshi, was preparing to move to the United Arab Emirates to work as a driver, and had just finished his final preparations, including obtaining a passport and having new clothes made.[136] Faheem showed our research team an identification card (in the name of Azaz-el-Rehman Qureshi, which we copied),[137] a pair of business cards for a Mir Ali fabric store, and a cargo service slip that Azaz was carrying in his pocket on the night of the strike, each with jagged tears that Faheem said he believed had been caused by missile shrapnel.[138] Faheem also showed us several items retrieved from the person of Mohammad Khalil, his uncle. These were an identification card in the name of Mohammad Khalil (which we copied[139]) and a shopping list covered in what appeared to be dried blood, listing everyday grocery items such as rice.[140] A third identification card, from his uncle Mansoor’s pocket, was also shredded; Faheem said he believed this was also due to shrapnel damage.[141]

The mental and emotional impact of the strike has been lasting. Faheem, a top student before the strike, told us he now feels uncomfortable and distracted when he studies: “[a]t the time the drone struck, I had to take exams, but…I couldn’t learn things, and it affected me emotionally.…I became very short-tempered and small things annoyed me. I got angry very quickly, small things agitated me.”[142]

He said that he had taken medicine at one point that had helped him to focus and resume his education. Recently, however, he has once again started having difficulties studying. He plans to return to the doctor to see if he can help.[143] Despite battling significant challenges and frustrations, he still dreams of becoming a scientist.[144]

Ejaz, whose uncle and cousins were killed in the strike, and who is currently studying for an arts degree in college, said that he too “continued to go to school after the strike, but [is] tense all the time.”[145] He hopes to become a teacher, but at this point plans to leave his studies after one year to move abroad to join his father.[146] Ejaz also told us that the female members of the household who escaped the strike without physical injury have nonetheless been affected by “mental tension and anxiety,”[147] and explained that both he and other members of the family have trouble sleeping at night.[148]

Faheem’s extended family has yet to recover from the economic damage caused by the strike. Mohammad Khalil left behind nine children, whom he had supported with his teacher’s pension; Mansoor-ur-Rehman left behind two sons and three daughters.[149] The strike caused substantial damage to the family’s house, reducing the hujra to a roofless shell and leaving large cracks in the adjacent structures.[150] Having lost their primary breadwinners and spent an enormous sum on Faheem’s medical care, the family cannot afford to rebuild.[151]

As the first of 292 drone strikes carried out under President Obama in Pakistan,[152] the January 23, 2009 strikes have received significant attention in the years that followed, including in books by two prominent American journalists. The narrative in those two books, however, focuses primarily on President Obama’s role in and reaction to the strike,[153] rather than on the accounts of victims such as Faheem Qureshi, or the impacts of the strike on family and community members.

Beyond Killing: Civilian Impacts of US Drone Strike Practices

The section below focuses on the impact that drones have on communities in North Waziristan beyond the immediately apparent death, injury, and destruction caused to those directly struck. The kinds of impacts described here are similar in numerous respects to those reported in conflict zones, or during periods of considerable violence, around the world. It is also essential to note, as described above,[154] that the Taliban presence in FATA has caused significant harm to civilians. However, because of the dearth of information in the US about the impacts of US drone strikes specifically, and because they tend to be framed as “precision” weapons, this section discusses their impacts on civilian populations in detail.

Impacts on Willingness to Rescue Victims and Provide Medical Assistance

There is now significant evidence that the US has repeatedly engaged in a practice sometimes referred to as “double tap,”[155] in which a targeted strike site is hit multiple times in relatively quick succession. Evidence also indicates that such secondary strikes have killed and maimed first responders coming to the rescue of those injured in the first strike. In a February 2012 joint investigative report, Chris Woods of The Bureau of Investigative Journalism (TBIJ) documented that:

[o]f the 18 attacks on attacks on rescuers and mourners reported at the time by credible media, twelve cases have been independently confirmed by our researchers. In each case civilians are reported killed, and where possible we have named them.[156]

Since those findings were released, several more strikes have repeated this pattern, including a strike on July 6, 2012 in which three “local people” and “tribesmen . . . carrying out rescue work” were reportedly killed and two more injured in follow-up strikes.[157]

Those interviewed for this report were acutely aware of reports of the practice of follow-up strikes, and explained that the secondary strikes have discouraged average civilians from coming to one another’s rescue, and even inhibited the provision of emergency medical assistance from humanitarian workers.

The lone survivor of the Obama administration’s first strike in North Waziristan, Faheem Qureshi, stated that “[u]sually, when a drone strikes and people die, nobody comes near the bodies for half an hour because they fear another missile will strike.”[158] He believes that he would likely not have survived if he had not managed to walk out of the smoking rubble of his hujra on his own, because his neighbors would have waited too long in coming to rescue him.[159] One interviewee told us that a strike at the home of his in-laws hit first responders: “Other people came to check what had happened; they were looking for the children in the beds and then a second drone strike hit those people.”[160] A father of four, who lost one of his legs in a drone strike, admitted that, “[w]e and other people are so scared of drone attacks now that when there is a drone strike, for two or three hours nobody goes close to [the location of the strike]. We don’t know who [the victims] are, whether they are young or old, because we try to be safe.”[161]

When individuals do try to recover bodies, they do so with knowledge that their efforts might get them killed or maimed. Noor Behram, a journalist who has reported extensively from the area, elaborated:

[W]hat America has tried to do is attack the rescue teams . . . . So now, what the tribals do, they don’t want many people going to the strike areas. Only three or four willing people who know that if they go, they are going to die, only they go in. . . . It has happened most of the times . . . [O]nce there has been a drone attack, people have gone in for rescue missions, and five or ten minutes after the drone attack, they attack the rescuers who are there.[162]

Another interviewee, Hayatullah Ayoub Khan, recounted a particularly harrowing incident that he said he experienced while driving between Dossali and Tal in North Waziristan.[163] He stated that a missile from a drone was fired at a car approximately three hundred meters in front of him, missing the car in front, but striking the road close enough to cause serious damage.[164] Hayatullah stopped, got out of his own car, and slowly approached the wreckage, debating whether he should help the injured and risk being the victim of a follow-up strike.[165] He stated that when he got close enough to see an arm moving inside the wrecked vehicle, someone inside yelled that he should leave immediately because another missile would likely strike.[166] He started to return to his car and a second missile hit the damaged car and killed whomever was still left inside.[167] He told us that nearby villagers waited another twenty minutes before removing the bodies, which he said included the body of a teacher from Hayatullah’s village.[168]

Crucially, the threat of the “double tap” reportedly deters not only the spontaneous humanitarian instinct of neighbors and bystanders in the immediate vicinity of strikes, but also professional humanitarian workers providing emergency medical relief to the wounded. According to a health professional familiar with North Waziristan, one humanitarian organization had a “policy to not go immediately [to a reported drone strike] because of follow up strikes. There is a six hour mandatory delay.”[169] According to the same source, therefore, it is “only the locals, the poor, [who] will pick up the bodies of loved ones.”[170]

The dissuasive effect that the “double tap” pattern of strikes has on first responders raises crucial moral and legal concerns. Not only does the practice put into question the extent to which secondary strikes comply with international humanitarian law’s basic rules of distinction, proportionality, and precautions, but it also potentially violates specific legal protections for medical and humanitarian personnel, and for the wounded.[171] As international law experts have noted, intentional strikes on first responders may constitute war crimes.[172]

Direct Property Damage and Economic Hardship Impacts

Many of the interviewees we spoke with experienced severe financial hardship as a result of strike damage to their homes, loss of a primary breadwinner, or medical costs incurred in caring for drone strike survivors.

In North Waziristan, extended families live together in compounds that often contain several smaller individual structures.[173] Many interviewees told us that often strikes not only obliterate the target house, usually made of mud,[174] but also cause significant damage to three or four surrounding houses.[175] Such destruction exacts a significant cost on communities, especially in a place like FATA where “underdevelopment and poverty are particularly stark,” and “savings, insurance, and social safety nets” are largely unavailable.[176]

A 45 year-old rural farmer who had to leave his village after a drone destroyed his house, told us how it affected his family:

A drone struck my home. . . . I [was at] work at that time, so there was nobody in my home and no one killed. . . . Nothing else was destroyed other than my house. I went back to see the home, but there was nothing to do—I just saw my home wrecked. . . . I was extremely sad, because normally a house costs around 10 lakh, or 1,000,000 rupees [US $10,593], and I don’t even have 5,000 rupees now [US $53]. I spent my whole life in that house . . . my father had lived there as well. There is a big difference between having your own home and living on rent or mortgage. . . . [I] belong to a poor family and my home has been destroyed . . . [and] I’m just hoping that I somehow recover financially.”[177]

He now lives in a small rented house in Miranshah with his five sons, the oldest of whom helps support the family by selling fruits and vegetables from a vending cart.[178]

Drone strikes that kill civilians also exact a substantial toll on livelihoods by incapacitating the primary income earners of families.[179] Because men are typically the primary income earners in their families, strikes often deprive victims’ families of “a key, and perhaps its only, source of income.”[180] Families struggle to compensate for the lost income, often forcing children or other younger relatives to forgo school and enter the workforce at a young age.[181] Eighteen-year-old Hisham Abrar, whose cousin was killed in a drone strike, explained that “a lot of men have been killed [who are] wage earners for the house, and now the kids and the families don’t have a source of income because of that.”[182] Others in his community do what they can to help, but “they are poor, and they usually just rely on labor services—daily wage earning. That’s only sufficient for themselves, so it’s hard to help others. But whenever they can, they do.”[183]

One man told us that several of his friends killed in the March 17, 2011 jirga strike[184] “left a family and children” to be cared for by family members who have to “work with their hands and feet” in hard labor to support them.[185] Another strike survivor explained that a friend killed in a strike:

left behind a mother, two sisters, and a young baby brother. And they now live on whatever the village gives them as charity. [The man’s younger brothers] tried to go out as laborers but they cannot do it. The other village men help them. And there are sometimes these neighbors that give them food, sometimes not, but they are basically living on charity.[186]

In addition to the loss of homes and primary wage earners, several of those interviewed were burdened with enormous medical bills following strikes incurred for surgeries, mental health care, and hospital stays. Without major emergency medical centers or adequate hospitals in North Waziristan, many victims were taken to Peshawar for medical treatment, a journey that can take anywhere from hours to several days due to rough terrain and poor security.[187] Once there, many ended up in private hospitals, running up bills of several lakhs each (each lakh equivalent to more than US$1000 each),[188] which is many times the average annual income in FATA.[189]

Medical bills of this magnitude can have a lasting effect on a victim’s family. Sameer Rahman’s nephew, for example, suffered significant injuries in a strike that took place during the holy month of Ramadan.[190] Family members took him to Peshawar for medical care, but struggled to raise the 280,000 rupees ($2,960) required for his treatment.[191] Forced to take out emergency loans, the family has amassed enormous debt and still owes about 100,000 rupees (approximately US $1,058).[192] The family of Dawood Ishaq, a father of four who lost consciousness for six days and underwent a leg amputation following a 2010 attack, had to “[take] loans from different people . . . in the village” to pay for his treatment. Dawood told us: “[m]y father had to labor hard and work in different positions to earn that money, and sometimes I’ve had to sell off stuff from home to make money. My kids have been sick . . . but we have to work very hard to earn money to pay for the expense.”[193] Now a double amputee, Dawood makes a living selling vegetables when he can in a market in Mir Ali.[194]

US authorities have not made any coordinated effort to provide compensation to strike victims in Pakistan, although compensation schemes to address civilian harm do exist in Afghanistan.[195] Pakistani authorities have offered limited compensation in some instances, but these offers, rejected by many Waziris on principle,[196] fail to address adequately the damage and loss of income the victims have sustained.[197]

Mental Health Impacts of Drone Strikes and the Presence of Drones

One of the few accounts of living under drones ever published in the US came from a former New York Times journalist who was kidnapped by the Taliban for months in FATA.[198] In his account, David Rohde described both the fear the drones inspired among his captors, as well as among ordinary civilians: “The drones were terrifying. From the ground, it is impossible to determine who or what they are tracking as they circle overhead. The buzz of a distant propeller is a constant reminder of imminent death.”[199] Describing the experience of living under drones as ‘hell on earth’, Rohde explained that even in the areas where strikes were less frequent, the people living there still feared for their lives.[200]

Community members, mental health professionals, and journalists interviewed for this report described how the constant presence of US drones overhead leads to substantial levels of fear and stress in the civilian communities below.[201] One man described the reaction to the sound of the drones as “a wave of terror” coming over the community. “Children, grown-up people, women, they are terrified. . . . They scream in terror.”[202] Interviewees described the experience of living under constant surveillance as harrowing. In the words of one interviewee: “God knows whether they’ll strike us again or not. But they’re always surveying us, they’re always over us, and you never know when they’re going to strike and attack.”[203] Another interviewee who lost both his legs in a drone attack said that “[e]veryone is scared all the time. When we’re sitting together to have a meeting, we’re scared there might be a strike. When you can hear the drone circling in the sky, you think it might strike you. We’re always scared. We always have this fear in our head.”[204]

A Pakistani psychiatrist, who has treated patients presenting symptoms he attributed to experience with or fear of drones, explained that pervasive worry about future trauma is emblematic of “anticipatory anxiety,”[205] common in conflict zones.[206] He explained that the Waziris he has treated who suffer from anticipatory anxiety are constantly worrying, “‘when is the next drone attack going to happen? When they hear drone sounds, they run around looking for shelter.”[207] Another mental health professional who works with drone victims concluded that his patients’ stress symptoms are largely attributable to their belief that “[t]hey could be attacked at any time.”[208]

Uncontrollability—a core element of anticipatory anxiety—emerged as one of the most common themes raised by interviewees. Haroon Quddoos, a taxi driver who survived a first strike on his car, only to be injured moments later by a second missile that hit him while he was running from the burning car, explained:

We are always thinking that it is either going to attack our homes or whatever we do. It’s going to strike us; it’s going to attack us . . . . No matter what we are doing, that fear is always inculcated in us. Because whether we are driving a car, or we are working on a farm, or we are sitting home playing . . . cards–no matter what we are doing we are always thinking the drone will strike us. So we are scared to do anything, no matter what.[209]

Interviewees indicated that their own powerlessness to minimize their exposure to strikes compounded their emotional and psychological stress. “We are scared. We are worried. The worst thing is that we cannot find a way to do anything about it. We feel helpless.”[210] Ahmed Jan summarized the impact: “Before the drone attacks, it was as if everyone was young. After the drone attacks, it is as if everyone is ill. Every person is afraid of the drones.”[211] One mother who spoke with us stated that, although she had herself never seen a strike, when she heard a drone fly overhead, she became terrified. “Because of the terror, we shut our eyes, hide under our scarves, put our hands over our ears.”[212] When asked why, she said, “Why would we not be scared?”[213]

A humanitarian worker who had worked in areas affected by drones stated that although far safer than others in Waziristan, even he felt constant fear:

Do you remember 9/11? Do you remember what it felt like right after? I was in New York on 9/11. I remember people crying in the streets. People were afraid about what might happen next. People didn’t know if there would be another attack. There was tension in the air. This is what it is like. It is a continuous tension, a feeling of continuous uneasiness. We are scared. You wake up with a start to every noise.[214]

In addition to feeling fear, those who live under drones–and particularly interviewees who survived or witnessed strikes–described common symptoms of anticipatory anxiety and post-traumatic stress disorder. Interviewees described emotional breakdowns,[215] running indoors or hiding when drones appear above,[216] fainting,[217] nightmares and other intrusive thoughts,[218] hyper startled reactions to loud noises,[219] outbursts of anger or irritability,[220] and loss of appetite and other physical symptoms.[221] Interviewees also reported suffering from insomnia and other sleep disturbances,[222] which medical health professionals in Pakistan stated were prevalent.[223] A father of three said, “drones are always on my mind. It makes it difficult to sleep. They are like a mosquito. Even when you don’t see them, you can hear them, you know they are there.”[224] According to a strike survivor, “When the drone is moving, people cannot sleep properly or can’t rest properly. They are always scared of the drones.”[225] Saeed Yayha, a day laborer who was injured from flying shrapnel in the March 17, 2011 jirga attack and must now rely on charity to survive, said:

I can’t sleep at night because when the drones are there . . . I hear them making that sound, that noise. The drones are all over my brain, I can’t sleep. When I hear the drones making that drone sound, I just turn on the light and sit there looking at the light. Whenever the drones are hovering over us, it just makes me so scared.[226]

Akhunzada Chitan, a parliamentarian who occasionally travels to his family home in Waziristan reported that people there “often complain that they wake up in the middle of the night screaming because they are hallucinating about drones.”[227]

Interviewees also reported a loss of appetite as a result of the anxiety they feel when drones are overhead. Ajmal Bashir, an elderly man who has lost both relatives and friends to strikes, said that “every person—women, children, elders—they are all frightened and afraid of the drones . . . [W]hen [drones] are flying, they don’t like to eat anything . . . because they are too afraid of the drones.”[228] Another man explained that “We don’t eat properly on those days [when strikes occur] because we know an innocent Muslim was killed. We are all unhappy and afraid.”[229]

Several Pakistani medical and mental health professionals told us that they have seen a number of physical manifestations of stress in their Waziri patients.[230] Ateeq Razzaq and Sulayman Afraz, both psychiatrists, attributed the phenomenon in part to Pashtun cultural norms that discourage the expression of emotional or psychological distress.[231] “People are proud,” Razzaq explained to us, “and it is difficult for them to express their emotions. They have to show that they are strong people.”[232] Reluctant to admit that they are mentally or emotionally distressed, the patients instead “express their emotional ill health through their body symptoms,” resulting in what Afraz called “hysterical reactions,” or “physical symptoms without a real [organic] basis, such as aches, and pains, vomiting, etcetera.”[233] The mental health professionals with whom we spoke told us that when they treat a Waziri patient complaining of generic physical symptoms, such as body pain or “headaches, backaches, respiratory distress, and indigestion,” they attempt to determine whether the patient has been through a traumatic experience. It is through this questioning that they have uncovered that some of their patients had experienced drones, or lost a relative in a drone strike.[234]

Mental health professionals we spoke with in Pakistan also said that they had seen numerous cases of Post-Traumatic Stress Disorder (PTSD)[235] among their patients from Waziristan related to exposure to drone strikes and the constant presence of drones.[236] For example, one psychiatrist described a female patient of his who:

was having shaking fits, she was screaming and crying . . . . I was guessing there might be some stress . . . then I [discovered] there was a drone attack and she had observed it. It happened just near her home. She had witnessed a home being destroyed–it was just a nearby home, [her] neighbor’s.[237]

Interviewees also described the impacts on children.[238] One man said of his young niece and nephew that “[t]hey really hate the drones when they are flying. It makes the children very angry.”[239] Aftab Gul Ali, who looks after his grandson and three granddaughters, stated that children, even when far away from strikes, are “badly affected.”[240] Hisham Abrar, who had to collect his cousin’s body after he was killed in a drone strike, stated:

When [children] hear the drones, they get really scared, and they can hear them all the time so they’re always fearful that the drone is going to attack them. . . [B]ecause of the noise, we’re psychologically disturbed—women, men, and children. . . Twenty-four hours, [a] person is in stress and there is pain in his head.[241]

Noor Behram, a Waziri journalist who investigates and photographs drone strike sites, noted the fear in children: “if you bang a door, they’ll scream and drop like something bad is going to happen.”[242] A Pakistani mental health professional shared his worries about the long-term ramifications of such psychological trauma on children:

The biggest concern I have as a [mental health professional] is that when the children grow up, the kinds of images they will have with them, it is going to have a lot of consequences. You can imagine the impact it has on personality development. People who have experienced such things, they don’t trust people; they have anger, desire for revenge . . . So when you have these young boys and girls growing up with these impressions, it causes permanent scarring and damage.[243]

The small number of trained mental health professionals[244] and lack of health infrastructure in North Waziristan exacerbates the symptoms and illnesses described here.[245] Several interviewees provided a troubling glimpse of the methods some communities turn to in order to deal with mental illness in the absence of adequate alternatives. One man said that “some people have been tied in their houses because of their mental state.”[246] A Waziri from Datta Khel—which has been hit by drone strikes over three dozen times in the last three years alone[247]—said that a number of individuals “have lost their mental balance . . . are just locked in a room. Just like you lock people in prison, they are locked in a room.”[248] Some of those interviewed reported that, to deal with their symptoms, they were able to obtain anti-anxiety medications and anti-depressants.[249] One Waziri man who lost his son in a drone strike explained that people take tranquilizers to “save them from the terror of the drones.”[250] Umar Ashraf obtained a prescription for Lexotanil to treat “the mental issues I was facing,” and said that taking the medicine makes him feel better.[251] Saeed Yayha, however, said that the prescription the doctors gave him to deal with “the pressure in his head” does not work for him;[252] “[i]t just soothes me for half an hour but it does not last very long.”[253]

Impacts on Education Opportunities

Numerous interviewees reported that drone strikes have affected young Waziris’ access to education, which is especially troubling given the impact of threats and violence by armed non-state actors against schools,[254] and FATA’s already low literacy rates.[255] First, some of those injured in strikes reported reduced access to education and desire to learn because of the physical, emotional, and financial impacts of the strike. Second, some families have pulled their children out of school to take care of injured relatives or to compensate for the income lost after the death or injury of a relative. Third, some families reported taking their children out of school due to fear that they would be killed in a drone strike.

One father, after seeing the bodies of three dead children in the rubble of a strike, decided to pull his own children out of school.[256] “I stopped [them] from getting an education,” he admitted.[257] “I told them we will be finished one day, the same as other people who were going [to school] and were killed in the drone attacks.”[258] He stated that this is not uncommon: “I know a lot of people, girls and boys, whose families have stopped them from getting [an] education because of drone attacks.”[259] Another father stated that when his children go to school “they fear that they will all be killed, because they are congregating.”[260] Ismail Hussain, noting similar trends among the young, said that “the children are crying and they don’t go to school. They fear that their schools will be targeted by the drones.”[261]

Mohammad Kausar, a father of three, explained: “Strikes are always on our minds. That is why people don’t go out to schools, because they are afraid that they may be the next ones to be hit.”[262] A college student, whose brother was killed in a drone strike, told us that in some cases, staff and teachers also “don’t come because of these drone strikes. The principal and maybe a few nominal staff come just for presence, but, apart from that, nobody comes . . . other people are scared to come to our places to teach us.”[263]

These fears are not without a legitimate basis, as drones have reportedly struck schools in the past,[264] resulting in extensive damage to educational infrastructure, as well as the deaths of dozens of children.[265]

Children and teenagers who have stayed in school described how drones have affected their concentration and diminished their drive to study. Faheem Qureshi, the sole survivor of the first strike in North Waziristan carried out under President Obama, was one of the top four students in his class before the drone strike fractured his skull and nearly blinded him.[266] Now, struggling with attention, cognitive, and emotional difficulties, he described how his studies have been affected:

Our minds have been diverted from studying. We cannot learn things because we are always in fear of the drones hovering over us, and it really scares the small kids who go to school. . . . At the time the drone struck, I had to take exams, but I couldn’t take exams after that because it weakened my brain. I couldn’t learn things, and it affected me emotionally. My [mind] was so badly affected . . .[267]

Waleed Shiraz, who was disabled in a January 2008 attack that killed his father, described how the strike altered his goals and devastated his family. A political science major in college, Waleed “dreamt of either leading some school in Peshawar as a principal or becoming a lawyer or even a politician representing Pakistan.”[268] When the strike took place, he was home on his first holiday from the National University of Modern Languages in Islamabad, spending time with his family and studying for exams.[269] At the time, he planned to study languages. Since the strike, those plans have radically changed:

I can’t dream of going back to college. I am unemployed. No one will give me admission into college and who is going to finance it? We are unemployed and our financial situation is extremely poor. Out of the ten kanals of land we owned [1 ¼ acres], we have sold five [5/8 acres] and the remaining five sit idle because my two younger brothers are too young. They can’t go to school, because I can’t afford supporting them, buying their books, and paying their fees. They are home most of the day and they are very conscious of the fact that drones are hovering over them. [The presence of drones] intimidates them. . . . My education is wasted.[270]

Teenager Sadaullah Wazir, also stated that he has had to give up on his dreams after losing both legs in a drone strike.[271] “Before the drone strikes started, my life was very good. I used to go to school and I used to be quite busy with that, but after the drone strikes, I stopped going to school now. I was happy [then] because I thought I would become a doctor.”[272]

Shahbaz Kabir explained that “education was always a problem in Waziristan, but, after the drone attacks, it got even worse. A lot of the children—most of the children—had to stop going to school.”[273] Many with whom we spoke, such as Malik Najeeb Saaqib, lamented the deterioration in education and expressed concern about what it meant for the future:

We want our children to get [an] education, to take [our story] to the world and get exposure for what’s going on here. We lag behind because of our lack of education and lack of facilities in our area. . . .We want our girls and boys to get [a] proper education. [We want] someone to become a doctor, someone to become an air pilot, but just because of drone attack[s] we can’t take them to school, can’t allow them.[274]

Mohsin Haq, 14, explained that some of his classmates have given up on school because “[t]hey are mentally disturbed. They can’t focus. They’re just too worried about their family. They’re not sure about anything, so school doesn’t make sense to them.”[275] He also revealed his fears about the impacts on future generations, and his hopes for change:

[The children in my community] are very optimistic that someday, when these things do stop, they will continue with their life as they were before, start going to school again. They still dream about a bright future, about the aspiring people they want to be, the future administrators, the future principals of the schools, and teachers and future politicians. . . . Every family, everybody, they do want to think about their bright futures, their prosperous jobs, and their young kids. But they can’t think like that because of these drones, because of this uncertainty.[276]

Impacts on Burial Traditions and Willingness to Attend Funerals

Interviewees stated that the US drone campaign has undermined the cultural and religious practices in North Waziristan related to burial, and made family members afraid to attend funerals.

Religion plays an important role in community life in Muslim-majority North Waziristan,[277] and Islam, like other religious and non-religious traditions, accords significant respect for the dead. Many consider it the community’s duty to bury the deceased as soon as possible after death,[278] to wash and cover the deceased,[279] and to hold a communal funeral service,[280] an event that involves recitations of prayer for the deceased and often serves as a collective coping mechanism.[281] Proper burial ceremonies and grieving rituals are “essential to reduc[ing] or prevent[ing] psychological distress” during times of large-scale disaster, and thus erosion of ceremonies attendant to death is likely to have a significant impact on the way communities grieve and deal with the loss of strike victims.[282]

Because drone strikes have targeted funerals and spaces where families have gathered to offer condolences to the deceased,[283] they have inhibited the ability of families to hold dignified burials. Interviewees stated that they stayed away from funerals for fear of being targeted. According to Ibrahim Qasim of Manzar Khel, “[t]here used to be funeral processions, lots of people used to participate. . . . But now, [the US has] even targeted funerals, they have targeted mosques, they have targeted people sitting together, so people are scared of everything.”[284] Firoz Ali Khan provided a similar account, noting that “not many people go to funerals because funerals have been struck by drones. Many people are scared. They don’t go to funerals because of their fear.”[285] Dawood Ishaq, who lost both his legs in a strike, confirmed this, explaining that people are reluctant to go to the funerals of people who have been killed in drone strikes because they are afraid of being targeted. [286]

In addition, because the Hellfire missiles fired from drones often incinerate the victims’ bodies,[287] and leave them in pieces and unidentifiable, traditional burial processes are rendered impossible. As Firoz Ali Khan, a shopkeeper whose father-in-law’s home was struck, graphically described, “These missiles are very powerful. They destroy human beings . . .There is nobody left and small pieces left behind. Pieces. Whatever is left is just little pieces of bodies and cloth.”[288] A doctor who has treated drone victims described how “[s]kin is burned so that you can’t tell cattle from human.”[289] When another interviewee came upon the site of the strike that killed his father, “[t]he entire place looked as if it was burned completely, so much so that even [the victims’] own clothes had burnt. All the stones in the vicinity had become black.”[290] Ahmed Jan, who lost his foot in the March 17 jirga strike, discussed the challenges rescuers face in identifying bodies: “People were trying to find the body parts. We find the body parts of some people, but sometimes we do not find anything.”[291]

One father explained that key parts of his son’s burial process had to be skipped over as a result of the severe damage to his body. “[A]fter that attack, the villagers came and took the bodies to the hospital. We didn’t see the bodies. They were in coffins, boxes. The bodies were in pieces and burnt.”[292] Idris Farid, who was injured and lost several of his relatives in the March 17 jirga strike, described how, after that strike, relatives “had to collect their body pieces and bones and then bury them like that.”[293] The difficulty of identifying individual corpses also makes it difficult to separate individuals into different graves. Masood Afwan, who lost several relatives in the March 17 jirga strike, described how the dead from that strike were buried: “They held a funeral for everybody, in the same location, one by one. Their bodies were scattered into tiny pieces. They…couldn’t be identified.”[294]

Impacts on Economic, Social, and Cultural Activities

Those interviewed stated that the widespread fear of drones has led some people to shy away from social gatherings, and inhibited their willingness to carry out day-to-day activities and important community functions.[295]

One interviewee stated that, “after the drones, people can’t go and talk with or sit with anybody at any time. And so they [face great difficulty carrying] on their business and their families.”[296] One man who lost a cousin in the March 17, 2011 jirga strike, explained:

We do not come out of our villages because it’s very dangerous to go out anywhere. . . . In past we used to participate in activities like wedding gatherings [and] different kinds of jirgas, different kinds of funerals. . . . We used to go to different houses for condolences, and there were all kinds of activities in the past and we used to participate. But now it’s a risk to go to any place or participate in any activities.[297]

The fears the interviewees described were not limited to ceremonial gatherings or other large group activities. Many said that they were afraid even to congregate in groups or receive guests in their home. Umar Ashraf, who has noticed the changes in community dynamics over the past few years, observed that “[W]e do not like to sit like this, like friends [gesturing in front of him at the small circle of interviewer, interviewee, and translator], because we have fear, since [they] usually attack people when they sit in gatherings.”[298] Sameer Rahman, whose family’s house was hit in a strike, confessed that “there are barely any guests who come anymore, because everyone’s scared.”[299] He also stated that he does not allow his children to visit other people’s homes when they have guests over, because he believes having guests makes it more likely that the house will be attacked.[300]

Sadaullah Wazir, a teenager, told us that drones have “made life quite difficult [in that] more than two can’t sit together outside because they are scared they might be struck by drones. . . . We often discuss that too many people shouldn’t sit together outside because they are vulnerable then.” [301] Another teenager told us:

We all used to get together, all our friends in the village. We used to have fun. But now, that’s not the case anymore. Earlier, in the village, we used to sit late into the night, till one o’clock in the morning, but now everybody’s habits have changed. Everybody goes home directly in the evening.[302]

Some of the Waziris interviewed described specific impacts of drone strikes on commerce and certain economic activities, a key issue that requires further research. One college student from North Waziristan explain­ed that “Because of these drones,  people have stopped coming or going to the bazaars. . . . [I]t has affected trade to Afghanistan.”[303] The owner of a shop selling toys in a North Waziristan market stated that ever since the drone strikes began, “It’s very hard for us, we just barely get by [with what we make in the shop]. . . . People are afraid of dying. They are scared of drones.”[304] One man, who once owned a car that he used to transport goods to and from the rest of Pakistan, said that in the past he would agree to be hired for 200 rupees a day. [305] Now, however, because of drones and the risks associated with their presence, “nobody is even willing to work for 500 rupees.”[306] This suggests that drones may have resulted in increased transportation costs for anyone dependent on goods moving in or out of FATA.

Interviewees stated that day-to-day activities, such as buying groceries or traveling to work, were nerve-wracking. Safdar Dawar, President of the Tribal Union of Journalists, the main association of journalists in the areas affected by US drones, described in simple terms how people in North Waziristan make everyday decisions about how to spend their time under the shadow of drones:

If I am walking in the market, I have this fear that maybe the person walking next to me is going to be a target of the drone. If I’m shopping, I’m really careful and scared. If I’m standing on the road and there is a car parked next to me, I never know if that is going to be the target. Maybe they will target the car in front of me or behind me. Even in mosques, if we’re praying, we’re worried that maybe one person who is standing with us praying is wanted. So, wherever we are, we have this fear of drones.[307]

Fahad Mirza, who has had several relatives badly injured in strikes, made a similar point: “We can’t go to the markets. We can’t drive cars. When they’re hovering over us, we’re all scared. One thinks they’ll drop it on our house, and another thinks it’ll be on our house, so we run out of our houses.”[308]

One of the most troubling community-wide consequences of the fear of gathering is, in several interviewees’ views, the erosion of the jirga system, a community-based conflict resolution process that is fundamental to Pashtun society.[309] Khalil Khan, the son of a community leader killed in the March 17, 2011 jirga strike, explained that “everybody after the strike seems to have come to the conclusion that we cannot gather together in large numbers and we cannot hold a jirga to solve our problems.”[310] Noor Khan, whose father Malik Daud Khan presided over that jirga and was killed, confirmed this account:

Everybody is scared, especially the elders. . . [T]hey can’t get together and discuss problems . . . [I]f a problem occurs, they can’t resolve it, because they are all scared that, if we get together, we will be targeted again. . . . Everybody, all the mothers, all the wives, they have told their people not to congregate together in a jirga. . . . [T]hey are pleading to them not to, as they fear they will be targeted.[311]

The jirga is a vitally important part of Pashtun communal and political life, providing opportunities for community input, conflict resolution, and egalitarian decision-making.[312] Hampering its functions could have serious implications for the communal order, especially in an area already devastated by death and destruction.

Impacts on Community Trust

Interviewees stated that US drone strikes have contributed to an undermining of community trust, and exacerbated tensions. Many Waziris have come to believe that paid informants help the CIA identify potential targets, including by placing small tracking devices, often referred to as “chips,” or “sims,” in vehicles or houses.[313] Stories about the CIA’s use of these chips were widely reported in 2009,[314] but we have not been able to corroborate whether any form of tracking or signaling devices were or are in fact being used. Nonetheless, many of those whom we interviewed believe that the chips exist, and are afraid of being planted with a chip.[315] Najeeb Saaqib, for example, explained how he believes drones targets are chosen:

I think there are some other intelligence agencies, foreign intelligence agencies, also working there in the shape of our own people. They grow a large beard and take the same positions as our own people, working for those external agencies. They put a chip or something else in places, and then a drone strikes those places. That’s what we think.[316]

Hayatullah Ayoub Khan similarly explained that “drones [select] their targets with the help of chips which are dropped in homes or cars by informants.”[317] Many other residents of North Waziristan gave similar accounts.[318] Policy analyst Samina Ahmed of the International Crisis Group also noted this widespread belief, explaining that many have told her that the Americans have “got people who throw parchiz [a local word for chips] into a car, or at the side of a house, and then the drone comes and it attacks that target.”[319]

These beliefs have bred a great deal of mistrust within the community, as neighbors suspect neighbors of spying for US, Pakistani, or Taliban intelligence, and of using drone strikes to settle feuds. As one resident of a drone-affected community explained: “People have internal enemies and conflicts with each other. [T]o get revenge [on] another party, they put chips on that house,” which then signals to the drones that the house is a target.[320] As a result, interviewees stated that communities are in a constant state of alert, and suspicious of outsiders. Sayed Majid confessed that “we do not allow [people from other villages] in the area very freely as they may have a sim [chip]. . . . [W]e have to keep an eye on strangers especially and do not let them wander freely.”[321] Farah Kamal put it more directly: “[P]eople start to think that other tribes are throwing the chips. There is so much confusion and mistrust created within the tribal communities. Drone attacks have intensified existing mistrust.”[322]



[1] See Numbers, infra Chapter 2: Numbers.

[2] Id.

[3] See, e.g., Yancy Y Phillips & Joan T. Zajchuk, The Management of Primary Blast Injury, in Conventional Warfare: Ballistic, Blast and Burn Injuries 297 (1991) (“The thermal pulse from a detonation may burn exposed skin, or secondary fires may be started by the detonation and more serious burns may be suffered.”); AGM-114N Metal Augmented Charge (MAC) Thermobaric Hellfire, GlobalSecurity.org, http://www.globalsecurity.org/military/systems/munitions/agm-114n.htm (last visited Aug. 17, 2012) (“The new [AGM-114N Thermobaric Hellfire] warhead contains a fluorinated aluminum powder layered between the warhead casing and the PBXN-112 explosive fill. When the PBXN-112 detonates, the aluminum mixture is dispersed and rapidly burns. The resultant sustained high pressure is extremely effective against enemy personnel and structures.”); Explosions and Blast Injuries: A Primer for Clinicians, Center for Disease Control and Prevention, http://www.bt.cdc.gov/masscasualties/explosions.asp (last visited on Sept. 17, 2012) (outlining one of the types of blast injuries as “burns (flash, partial, and full thickness”)).

[4] See, e.g., Phillips & Zajchuk, supra note 278, at 296 (“[V]ictims of an open-air blast will usually also have penetrating or non-penetrating secondary blast injuries from fragments or objects that have been hurled through the air from the force of the blast.”); David Hambling, Why was Pakistan Drone Strike so Deadly?, Wired (June 24, 2009), http://www.wired.com/dangerroom/2009/06/why-was-pakistan-drone-strike-so-deadly/ (describing how drone-launched missiles have a thick steel casing surrounding an explosive core, such that “when the bomb detonates, the casing blows up like a balloon before bursting and spraying high-velocity steel fragments in all directions. It is these fragments, rather than blast, that do most of the damage”); Explosions and Blast Injuries, supra note 278 (identifying “penetrating ballistic (fragmentation) or blunt injuries” as a possible type of blast injury).

[5] See, e.g., Phillips, supra note 278, at 296 (“[T]he detonation of explosive munitions can create pressure waves that are powerful enough to injure the internal organs of casualties who are directly exposed to them. This injury—called primary blast injury (PBI)—may debilitate or kill the casualty by causing severe damage to the gas-containing organs of the body.”); AGM-114N Metal Augmented Charge, supra note 278 (describing the improved killing power of the “AGM-114 Hellfire missile [which] has a sustained pressure wave [that] propagates throughout a structure to extend the lethal effects of the warhead detonation.”); Explosions and Blast Injuries, supra note 278 (listing “blast lung,” and “abdominal hemorrhage and perforation” among injuries resulting from blasts).

[6] See supra notes 278- 280 and accompanying text; Norman Rich, Missile Injuries, 139 Am. J. of Surgery 414 (1980).

[7] In addition to the three strikes highlighted in this section, Appendix A provides brief narratives from strike survivors and individuals who have witnessed or lost relatives in drone strikes.

[8] Salman Masood & Pir Zubair Shah, CIA Drones Kill Civilians in Pakistan, N.Y. Times (Mar. 17, 2011), http://www.nytimes.com/2011/03/18/world/asia/18pakistan.html (“American officials on Thursday sharply disputed Pakistan’s account of the strikes and the civilian deaths, contending that all the people killed were insurgents.”); see also Sebastian Abbot, AP Impact: New Light on Drone War’s Death Toll, Guardian (Feb. 25, 2012), http://www.guardian.co.uk/world/feedarticle/10112674 (“US officials who were shown the AP’s findings [of civilian deaths in the ten deadliest attacks in North Waziristan between August 2010 and February 2012, including the March 17, 2011 incident] rejected the accounts of any civilian casualties, but declined to be quoted by name.”); Scott Shane, Contrasting Reports of Drone Strikes, N.Y. Times (Aug. 11, 2011), http://www.nytimes.com/2011/08/12/world/asia/12droneside.html (quoting an unnamed US official as stating: “There’s no question the Pakistani and US government have different views on the outcome of this strike. The fact is that a large group of heavily armed men, some of whom were clearly connected to Al Qaeda and all of whom acted in a manner consistent with A.Q.-linked militants, were killed.”). The US position appears to reflect the Obama administration’s controversial practice of classifying “all military-age males in a strike zone as combatants . . . unless there is explicit intelligence posthumously proving them innocent.” Jo Becker & Scott Shane, Secret ‘Kill List’ Proves a Test of Obama’s Principles and Will, N.Y. Times (May 29, 2012), http://www.nytimes.com/2012/05/29/world/obamas-leadership-in-war-on-al-qaeda.html?pagewanted=all.

[9] See Masood & Shah, supra note 283 (quoting Pakistani military chief, General Ashfaq Parvez Kayani, as saying immediately after the strike: “It is highly regrettable that a jirga of peaceful citizens, including elders of the area, was carelessly and callously targeted with complete disregard to human life.”).

[10] See Abbot, supra note 283.

[11] Obama 2011 Pakistan Strikes, The Bureau of Investigative Journalism, http://www.thebureauinvestigates.com/2011/08/10/obama-2011-strikes/(last visited Sep. 14, 2012); Abbot, supra note 283.

[12] See Obama 2011 Pakistan Strikes, supra note 286.

[13] Interview with Khalil Khan, Noor Khan, & Imran Khan, in Islamabad, Pakistan (Feb.26, 2012). Chromite is a valuable resource in the region, and a major source of employment. According to the FATA government website, 31,830 tons of chromite were produced in 2003-04, the latest date for which figures are available. Department of Minerals, Government of Pakistan Federally Administered Tribal Area Secretariat, http://fata.gov.pk/index.php?option=com_content&view=article&id=78&Itemid=81 (last visited Aug. 17, 2012).

[14] Interview with Khalil Khan, Noor Khan, & Imran Khan, in Islamabad, Pakistan (Feb.26, 2012).

[15] Sebastian Abbot, AP Impact: New Light on Drone War’s Death Toll, Associated Press (Feb. 26, 2012), http://news.yahoo.com/ap-impact-light-drone-wars-death-toll-150321926.html.

[16] More Petition High Court Against Drone Attacks, Dawn (May 9, 2012), http://dawn.com/2012/05/10/more-petition-high-court-against-drone-attacks/ (reporting on the petition of Noor Khan, son of Malik Daud Khan, in the Peshawar High Court against the Federation of Pakistan, Pakistan’s Ministry of Foreign Affairs, and Pakistan’s Ministry of Defence).

[17] Chris Woods & Christina Lamb, Obama Terror Drones: CIA Tactics in Pakistan Include Targeting Rescuers and Funerals, The Bureau of Investigative Journalism (Feb. 4, 2012), http://www.thebureauinvestigates.com/2012/02/04/obama-terror-drones-cia-tactics-in-pakistan-include-targeting-rescuers-and-funerals/.

[18] Interview with Mohammad Nazir Khan, in Islamabad, Pakistan (Feb. 26, 2012).

[19] Interview with Khalil Khan, Noor Khan, & Imran Khan, in Islamabad, Pakistan (Feb.26, 2012).

[20] Id.

[21] Chris Woods & Christina Lamb, Obama Terror Drones: CIA Tactics in Pakistan Include Targeting Rescuers and Funerals, The Bureau of Investigative Journalism (Feb. 4, 2012), http://www.thebureauinvestigates.com/2012/02/04/obama-terror-drones-cia-tactics-in-pakistan-include-targeting-rescuers-and-funerals/.

[22] Interview with Ahmed Jan, in Islamabad, Pakistan (Feb. 26, 2012); Interview with Mohammad Nazir Khan, in Islamabad, Pakistan (Feb. 26, 2012).

[23] Id.

[24] Id.

[25] Id.; see also Interview with Khalil Khan, Noor Khan, & Imran Khan, in Islamabad, Pakistan (Feb.26, 2012).

[26] See Obama 2011 Pakistan Strikes, supra note 286; Abbot, supra note 283.

[27] Interview with Mohammad Nazir Khan, in Islamabad, Pakistan (Feb. 26, 2012).

[28] Interview with Idris Farid (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[29] Interview with Khalil Khan, Noor Khan, & Imran Khan, in Islamabad, Pakistan (Feb.26, 2012).

[30] Id.

[31] Id.

[32] Id.

[33] Id.

[34] Interview with Idris Farid (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[35] Id.

[36] Interview with Khalil Khan, Noor Khan, & Imran Khan, in Islamabad, Pakistan (Feb.26, 2012).

[37] Id.

[38] Id.

[39] Id.

[40] Id.

[41] See id.

[42] Id.

[43] Id.

[44] Interview with Khalil Khan, Noor Khan, & Imran Khan, in Islamabad, Pakistan (Feb.26, 2012); see also Interview with Mohammad Nazir Khan, in Islamabad, Pakistan (Feb. 26, 2012).

[45] Interview with Khalil Khan, Noor Khan, & Imran Khan, in Islamabad, Pakistan (Feb.26, 2012).

[46] Interview with Ahmed Jan, in Islamabad, Pakistan (Feb. 26, 2012).

[47] Id.

[48] Id.

[49] Interview with Idris Farid (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[50] See, e.g., Interview with Idris Farid (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012). (estimating 37 dead); Interview with Ahmed Jan, in Islamabad, Pakistan (Feb. 26, 2012) (estimating at least 35 and fewer than 40 dead); US Drone Strike ‘Kills 40’ in Pakistani Tribal Region, BBC (Mar. 17, 2011), http://www.bbc.co.uk/news/world-south-asia-12769209; Tom Wright & Rehmat Mehsud, Pakistan Slams US Drone Strike, Wall St. J. (Mar. 18, 2011), available at http://online.wsj.com/article/SB10001424052748703818204576206873567985708.html.

[51] Abbot, supra note 290 (noting the names of all 42 and identifying 38 of them as civilians and tribal police). Unnamed US officials disputed this number, telling the Associated Press “the total of dead was roughly half what villagers reported” and citing as evidence “the number visible in the monitoring before and during the attack.” Id. However, all other available sources—including eyewitnesses, locals, and Pakistani intelligence—report numbers closer to the Associated Press figure. See, e.g., Dozens Die as US Drone Hits Pakistan Home, Al Jazeera (Mar. 17, 2011), http://www.aljazeera.com/news/asia/2011/03/20113178411386630.html; Kathy Gannon, Kimberly Dozier & Sebastian Abbot, AP Exclusive: Timing of US Drone Strike Questioned, Yahoo! News (Aug. 2, 2011), http://news.yahoo.com/ap-exclusive-timing-us-drone-strike-questioned-161145779.html; Katherine Tiedemann, Daily Brief: Pakistani Army Chief Condemns Deadly US Drone Strike, Foreign Pol’y (Mar. 18, 2011), http://afpak.foreignpolicy.com/posts/2011/03/18/daily_brief_pakistani_army_chief_condemns_deadly_us_drone_strike.

[52] Masood & Shah, supra note 283.

[53] Abbot, supra note 290.

[54] See, e.g., Out of the Blue: A Growing Controversy Over the Use of Unmanned Aerial Strikes, Economist (July 30, 2011), http://www.economist.com/node/21524916; Zia Khan, Waziristan Drone Attack: Taliban Faction Threatens Scrapping Peace Deal, Express Tribune (Mar. 21, 2011), http://tribune.com.pk/story/135711/waziristan-drone-attack-taliban-faction-threatens-scrapping-peace-deal/.

[55] Obama 2011 Pakistan Strikes, The Bureau of Investigative Journalism, supra note 286 (“The leader of the jirga, Malik Daud Khan, aged 45 was among those killed. . . . In July 2011 the Bureau’s field researchers additionally identified the following as slain civilians: Gul Akbar; Mohammad Sheen; Lewanai; Mir Zaman; Din Mohammad; Malik Tareen; Noor Ali; Zare Jan; Sadiq; Mustaqeem; Khangai; Gulnaware; Faenda Khan; and Dindar Khan, Umark Khan, Wali Khan, Sadar and Bakhtar, all five from the Khassadar police force. In sworn affidavits from multiple witnesses to the strike, filed in the London High Court in March 2012, five further civilians were identified by name: Ismail Khan, father of Imran Khan; khassadar Hajji Babat, father of Khalil Khan; Khnay Khan, father of Mir Daad Khan; and Gul Mohammed and his son Ismael.”).

[56] NWA Tribesmen Protest Drone Attack Casualties, News (June 17, 2011), http://www.thenews.com.pk/TodaysPrintDetail.aspx?ID=52979&Cat=7&dt=6/17/2011 (noting the occupations and the names of four of the victims: Akram Shah, Umar Khan, Shahzada, and Tariq (Atiq-ur-Rehman)).

[57] Obama 2011 Pakistan Strikes, supra note 286.

[58] See, e.g., 15 Killed in Two Suspected Drone Attacks, Cnn (June 15, 2011), http://edition.cnn.com/2011/WORLD/asiapcf/06/15/pakistan.drone.strike/index.html; Hasbanullah Khan, US Drone Kills Eight Militants in Pakistan, Agence France-Presse (June 15, 2011), http://www.google.com/hostednews/afp/article/ALeqM5gopljIE1s-r0P90OdcLQtEy9_6-A?docId=CNG.e930608f878ab4d4954c1738240ae4f3.321.

[59] See, e.g., NWA Tribesmen Protest Drone Attack Casualties , supra note 331 (noting that hundreds of tribesmen protested and “chanted slogans against the United States for killing innocent tribal people in the drone attacks.”); Tribesmen Protest Drone Attacks, Dawn (June 17, 2011), http://dawn.com/2011/06/17/tribesmen-protest-drone-attacks/ (noting, two days after the strike, that “enraged tribesmen blocked Bannu-Miramshah Road on Thursday [June 16] to protest killing of innocent people in US drone attacks in North Waziristan Agency”).

[60] Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012); Interview with Nadeem Malik (anonymized name), in Peshawar, Pakistan (May 9, 2012); Interview with Abdul Qayyum Khan, in Peshawar, Pakistan (May 9, 2012); Interview with Ibrahim Shah, in Peshawar, Pakistan (May 9, 2012); Interview with Azhar Aslam (anonymized name), in Peshawar, Pakistan (May 9, 2012).

[61] Id. Atiq-ur-Rehman (or Tariq) was known to all five interviewees; Sherzada was known by four of the interviewees; Akram was known by three of the interviewees; Umar (or Amar) and Irshad were each known by one interviewee.

[62] Obama 2011 Pakistan Strikes, supra note 286 (noting that its own researchers in Waziristan reported that “civilians belonging to the Zangbar family…were killed…include[ing] Shahzada,” citing links to seven media reports (two articles in Dawn and one each in The News, CNN, Boston.com, AFP, BBC News) as well as the UK Charity Reprieve and the South Asian Terrorism Portal (satp.org), and concluding based upon its review of all this information that 5-6 civilians were killed in the strike).

[63] Interview with Ibrahim Shah, in Peshawar, Pakistan (May 9, 2012).

[64] Id.; Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012); Interview with Nadeem Malik (anonymized name), in Peshawar, Pakistan (May 9, 2012); NWA Tribesmen Protest Drone Attack Casualties, supra note 331.

[65] Interview with Ibrahim Shah, in Peshawar, Pakistan (May 9, 2012); Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012).

[66] Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012).

[67] Interview with Abdul Qayyum Khan, in Peshawar, Pakistan (May 9, 2012); Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012); Reprieve, Complaint Against the United States of America for the Killing of Innocent Citizens of the Islamic Republic of Pakistan to the UN Human Rights Council 10 (Feb. 23, 2012), available at http://reprieve.org.uk/media/downloads/2012_02_22_PUB_drones_UN_HRC_complaint.pdf?utm_source=Press+mailing+list&utm_campaign=89f3db0a75-2012_02_23_drones_UN_complaint&utm_medium=email [hereinafter Complaint to UNHRC].

[68] Interview with Nadeem Malik (anonymized name), in Peshawar, Pakistan (May 9, 2012).

[69] Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012); see also NWA Tribesmen Protest Drone Attack Casualties, supra note 331.

[70] See Interview with Ibrahim Shah, in Peshawar, Pakistan (May 9, 2012); see also NWA Tribesmen Protest Drone Attack Casualties, supra note 331; Complaint to UNHRC, supra note 342, at 10.

[71] See Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012).

[72] Eight Killed in Waziristan Drone Attacks, Pak Tribune (June 16, 2011), http://paktribune.com/news/Eight-killed-in-Waziristan-drone-attacks-240425.html.

[73] Interview with Abdul Qayyum Khan, in Peshawar, Pakistan (May 9, 2012).

[74] Interview with Nadeem Malik (anonymized name), in Peshawar, Pakistan (May 9, 2012).

[75] Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012) (“[the car] was destroyed. Fully destroyed. It was burned.”); see also interview with Abdul Qayyum Khan, in Peshawar, Pakistan (May 9, 2012).

[76] Interview with Abdul Qayyum Khan, in Peshawar, Pakistan (May 9, 2012).

[77] See, e.g., id.; Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012); see also Eight Killed in Waziristan, supra note 347; NWA Tribesmen Protest Drone Attack Casualties, supra note 331.

[78] Interview with Abdul Qayyum Khan, in Peshawar, Pakistan (May 9, 2012).

[79] Id.

[80] Id.

[81] Id.

[82] Id.

[83] Id.

[84] Id.

[85] Interview with Ibrahim Shah, in Peshawar, Pakistan (May 9, 2012).

[86] Id.

[87] Id.

[88] Id.; Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012); see also NWA Tribesmen Protest Drone Attack Casualties, supra note 245; Tribesmen Protest Drone Attacks, supra note 245.

[89] Interview with Abdul Qayyum Khan, in Peshawar, Pakistan (May 9, 2012).

[90] See id.

[91] Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012).

[92] Interview with Ibrahim Shah, in Peshawar, Pakistan (May 9, 2012).

[93] See id.

[94] Interview with Abdul Qayyum Khan, in Peshawar, Pakistan (May 9, 2012).

[95] Obama 2009 Pakistan Strikes, The Bureau of Investigative Journalism, http://www.thebureauinvestigates.com/2011/08/10/obama-2009-strikes/ (last visited Aug. 22, 2012).

[96] R. Jeffrey Smith, Candace Rondeaux & Joby Warrick, 2 US Airstrikes Offer a Concrete Sign of Obama’s Pakistan Policy, Wash. Post (Jan. 24, 2009), http://www.washingtonpost.com/wp-dyn/content/article/2009/01/23/AR2009012304189.html. Pakistani media reported the strikes in similar terms. See US Drone Attacks Kill 14 in Waziristan: First Obama-Era Strikes in Tribal Areas, Dawn (Jan. 23, 2009), http://archives.dawn.com/archives/33530; Twenty Killed in US Drone Strikes in N, S Waziristan, Geo Pakistan (Jan. 23, 2009), http://www.geo.tv/1-23-2009/33388.htm (noting that the missile in North Waziristan targeted the house of “Khalil” and that foreigners were killed).

[97] See, e.g., Deadly Missiles Strike Pakistan, BBC News (Jan. 23, 2009), http://news.bbc.co.uk/2/hi/7847423.stm (citing officials as saying “[f]our Arab militants” were killed in the strike”); Ewen MacAskill, President Orders Air Strikes on Villages in Tribal Area, Guardian (Jan. 23, 2009), http://www.guardian.co.uk/world/2009/jan/24/pakistan-barack-obama-air-strike (while referencing reports that interviewed local interviewers, described the strikes as against “suspected militants.”); Juan Cole, Obama’s Vietnam?, Salon (Jan. 26, 2009), http://www.salon.com/2009/01/26/obama_85/ (claiming that the owner of the home “hosted a party of five alleged al-Qaida operatives in the guesthouse on his property,” and referencing Pakistani press accounts that claimed the strike killed “four Arab fighters and a Punjabi militant”). We were unable to find updated information in the Washington Post about these strikes.

[98] Bill Roggio, US Strikes al Qaeda in North and South Waziristan, Long War Journal (Jan. 23, 2009), available at http://www.longwarjournal.org/archives/2009/01/us_strikes_al_qaeda.php#ixzz1MJhxXvwL.

[99] Id.

[100] Mushtaq Yusufzai et. al., Thousands Attend Funeral of Drone Victims, News (Jan. 25, 2009), http://www.thenews.com.pk/TodaysPrintDetail.aspx?ID=19872&Cat=13&dt=1/25/2009 (noting that “thousands of tribesmen on Saturday attended the funeral prayers of the victims of Friday’s drone attacks in the North and South Waziristan Agencies,” and that “[they] were critical of the reporting of the international wire agencies….[and] claimed that all those killed in the attack were innocent and local villagers, who had nothing to do with militancy or Taliban”).

[101] Mushtaq Yusufzai, US Missile Strikes Kill 20 in Waziristan, The News (Jan. 24, 2009) (maintaining that militants were killed in the Zeraki strike, but asserting that Khalil Dawar, the owner of the house and others present were civilians, and that of the 20 killed in the Zeraki and Wana strikes “a majority [] were local tribesmen”) http://www.thenews.com.pk/TodaysPrintDetail.aspx?ID=19836&Cat=13&dt=1/24/2009; see also Death Toll From Frontier Drone Strikes Rises to 22, Dawn (undated article), http://archives.dawn.com/archives/124483 (referring to January 23, 2009 Zeraki drone strike as occurring on “Friday” and January 24, 2009 funeral as occurring on “Saturday” and noting that the two strikes killed “three children and at least four civilians”).

[102] Hasnain Kazim, Relatives of Pakistani Drone Victims to Sue CIA, Der Spiegel (Jan. 21, 2011), http://www.spiegel.de/international/world/striking-back-at-the-us-relatives-of-pakistani-drone-victims-to-sue-cia-a-740638.html (focusing on civilian victims, and noting “a lawsuit initiated by Karim Khan, a 43-year-old who lost his son and brother…[and joined by] [t]en other residents of Waziristan …[including] 14-year-old Fahim Qureshi, who on Jan. 23, 2009, lost his left eye, suffered a fractured skull and was hit by several shards in the stomach.”).

[103] Id.; see also Devi Boerema, Trying to Find the Truth Behind US Drone Strikes, Radio Netherlands Worldwide (Aug. 17, 2011), http://tswi.org/english/article/trying-find-truth-behind-us-drone-strikes (discussing civilian victims of drone strikes and noting that Shahzad Akbar “represents Fahim Qureshi and his family” in litigation in Pakistan).

[104] Obama 2009 Pakistan Strikes, supra note 370 (finding that seven to 15 were killed in the strike, including seven to 11 civilians); 2009: The Year of the Drone, New America Foundation, http://counterterrorism.newamerica.net/drones/2009 (identifying at least nine killed, including between five and six civilians).

[105] While we focus on the civilians harms in the Zeraki incident, evidence also suggests there have been civilian casualties in the second strike in Wana, South Waziristan, although that strike was beyond the scope of this report. See Campaign for Innocent Victims in Conflict, Civilians in Armed Conflict: Civilian Harm and Conflict in Northwest Pakistan 20-21 (2010); Obama 2009 Pakistan Strikes, supra note 370.

[106] The initial report by the Washington Post noted White House press secretary Robert Gibbs’ refusal to answer questions about the strikes. Smith, Rondeaux & Warrick, supra note 371 (“I’m not going to get into these matters.”).

[107] See, e.g., supra notes 371 and 372 and accompanying text.

[108] The hujra is the main meeting area in a Waziri home, usually where Waziri men entertain visitors. See Numbers, supra Chapter 2: Numbers.

[109] Cole, supra note 372; see also Complaint to UNHRC, supra note 342, at 5, 6 (describing Khalil, or Khaleel, as “a retired schoolteacher”).

[110] US Drone Attacks Kill 14 in Waziristan, supra note 371; see also Death Toll From Frontier Drone Strikes rises to 22, supra note 376 (depicting Khalil as a “tribesman and Taliban sympathizer”).

[111] Cole, supra note 372 (asserting that Khalil “hosted a party of five alleged al-Qaida operatives in the guest house on his property); Yusufzai, US Missile Strikes Kill 20 in Waziristan, supra note 376 (citing sources that asserted that “Khalil himself was not a militant, but had good relations with the Taliban and was considered a trustworthy tribal host of Taliban fighters in the area.”).

[112] See Interview with Ejaz Ahmad, in Islamabad, Pakistan (Mar. 2, 2012); Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012).

[113] Complaint to UNHRC, supra note 342, at 5-6; see also Interview with Ejaz Ahmad, in Islamabad, Pakistan (Mar. 2, 2012); Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012).

[114] Complaint to UNHRC, supra note 342, at 5-6.; see also Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012).

[115] See Interview with Ejaz Ahmad, in Islamabad, Pakistan (Mar. 2, 2012); see also supra Methodology (describing purda, the practice of separation of men and women).

[116] Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012).

[117] See id.

[118] Id.

[119] See id.; Complaint to UNHRC, supra note 342, at 5-6.

[120] Interview with Interview with Ejaz Ahmad, in Islamabad, Pakistan (Mar. 2, 2012); Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012); see Complaint to UNHRC, supra note 342, at 5-6.

[121] Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012).

[122] Id.

[123] Id.

[124] Id.

[125] See id.

[126] Id. Faheem noted that villagers ordinarily do not search the rubble of a strike for at least half an hour after impact, because they fear a second missile will strike the rescuers. Id.

[127] Id.; see Complaint to UNHRC, supra note 342, at 5-6.

[128] Id.

[129] Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012); see also Complaint to UNHRC, supra note 342, at 5-6.

[130] Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012).

[131] Interview with Ejaz Ahmad, in Islamabad, Pakistan (Mar. 2, 2012).

[132] Id.

[133] Id.

[134] Id.

[135] Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012).

[136] Id.

[137] Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012) (on file with Stanford research team).

[138] Id.

[139] Id.

[140] Id.

[141] Id.

[142] Id. These educational impacts on segments of Waziri society are further discussed later in this Chapter. See Beyond Killings: Civilian Impacts of US Drone Strike Practices, infra Chapter 3: Living Under Drones.

[143] Id.

[144] Id.

[145] Interview with Ejaz Ahmad, in Islamabad, Pakistan (Mar. 2, 2012).

[146] Id.

[147] Id.

[148] Id.

[149] Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012).

[150] Id.

[151] See id.

[152] Drone Strikes in Pakistan by Year (Graph), The Bureau of Investigative Journalism, http://www.thebureauinvestigates.com/wp-content/uploads/2012/07/Strikes-Per-Year-Dash6.jpg (last visited Aug. 22, 2012); Obama 2009 Pakistan Strikes, supra note 370.

[153] For example, in Obama’s Wars, Bob Woodward writes that Obama endorsed both the January 23, 2009 strikes even though they missed their intended high-value targets. Bob Woodward, Obama’s Wars 93 (2010) (“Neither strike killed the intended ‘HVT,’ or high value target, but at least five Al Qaeda militants died. . . . The president said good. He had fully endorsed the covert action program and made it clear he wanted more.”). Daniel Klaidman’s Kill or Capture (2012) paints a different picture of Obama’s reaction to news about the January 23, 2009 covert activities. According to Klaidman, Obama was informed that the Wana strike missed its target and killed civilians, including two children. Klaidman writes:

Obama was disturbed, and he grilled his counterterrorism adviser for answers. How could this have happened? What about the pinpoint accuracy of these weapons, which he had heard about all through the transition? . . . . [h]ere he was, in his first week as president, presiding over the accidental killing of innocent Muslims.

Daniel Klaidman, Kill or Capture: The War on Terror and the Soul of the Obama Presidency 40 (2012).

[154] See Numbers, infra Chapter 2: Numbers.

[155] Matthew Nasuti, Hellfire Missile Accuracy Problems Uncovered in Pentagon Data, Kabul Press (Nov. 27, 2011), http://kabulpress.org/my/spip.php?article89242 (speculating that the “double tap” strike pattern is actually less the result of strategy than it is a cover for the less-than-pinpoint-accurate technological capacity of the missiles used in most drone strikes and noting that “[d]ouble tap means that the military fires two Hellfire missiles at each target in order to ensure that at least one hits the target”); see also Derek Gregory, Lines of Descent, Open Democracy (Nov. 8, 2011), http://www.opendemocracy.net/derek-gregory/lines-of-descent (reporting the “Circular Error Probable” or “radius from the aiming point within which a [laser-fired Hellfire missile] will land 50 per cent of the time” at 9-24 feet, and that of a 500lb GPS-guided JDAM bomb at 30-39 feet).

[156] Chris Woods, Get the Data: Obama’s Terror Drones, The Bureau of Investigative Journalism (Feb. 4, 2012), http://www.thebureauinvestigates.com/2012/02/04/get-the-data-obamas-terror-drones/.

[157] Twenty Die in Double Drone Attack, Dawn (July 7, 2012), http://dawn.com/2012/07/07/twenty-die-in-double-drone-attack/; see also Chris Woods, CIA ‘Revives Attacks on Rescuers’ in Pakistan, The Bureau of Investigative Journalism (June 4, 2012), http://www.thebureauinvestigates.com/2012/06/04/cia-revives-attacks-on-rescuers-in-pakistan/.

[158] Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012).

[159] Id.

[160] Interview with Firoz Ali Khan (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[161] Interview with Dawood Ishaq (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012).

[162] Interview with Noor Behram, in Islamabad, Pakistan (Mar. 9, 2012).

[163] Interview with Hayatullah Ayoub Khan (anonymized name), in Islamabad, Pakistan (Mar. 2, 2012).

[164] Id.

[165] Id.

[166] Id.

[167] Id.

[168] Id.

[169] Interview with Shams Mohiuddin (anonymized name and location), in Pakistan (May 2012).

[170] Id.

[171] See Chapter 4: Legal Analysis; see generally Jean-Marie Henckaerts & Louise Doswald-Beck, International Committee of the Red Cross, Customary International Humanitarian Law: Vol. 1: Rules (2006), available at http://www.icrc.org/eng/assets/files/other/customary-international-humanitarian-law-i-icrc-eng.pdf (mandating the protection of medical and humanitarian personnel (Rules 25-32), the allowance and facilitation of unimpeded humanitarian relief for civilians in need, (Rule 55) and the provision of medical care for the wounded (Rules 110-11)).

[172] Jack Serle, UN Expert Labels CIA Tactic Exposed by Bureau ‘a War Crime’, The Bureau of Investigative Journalism (June 21, 2012) (noting UN Special Rapporteur for extrajudicial, summary or arbitrary executions as observing that “if civilian ‘rescuers’ are indeed being intentionally targeted, there is no doubt about the law: those strikes are a war crime”), http://www.thebureauinvestigates.com/2012/06/21/un-expert-labels-cia-tactic-exposed-by-bureau-a-war-crime/.

[173] Interview with Zafar Husam (anonymized name and location), in Pakistan (May 2012); Interview with Dawood Ishaq (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012).

[174] Interview with Dawood Ishaq (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012).

[175] See, e.g., Interview with Ghulam Faris (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012) (estimating that seven or eight houses around a house hit by a drone strike were affected); Interview with Sadaullah Wazir, in Islamabad, Pakistan (Feb. 26, 2012) (“When a drone strikes, it easily destroys a house.”).

[176] Campaign for Innocent Victims in Conflict, supra note 380.

[177] Interview with Adil Hashmi (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[178] Id.

[179] Campaign for Innocent Victims in Conflict, supra note 380, at 26-28.

[180] Id. at 26.

[181] Id; see Interview with Hisham Abrar (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[182] Interview with Hisham Abrar (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[183] Id.

[184] See March 17, 2011 Strike Narrative, supra Chapter 3: Living Under Drones.

[185] In Interview with Masood Afwan (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012). Other relatives of those killed in the March 17, 2011 strike told of similar difficulties supporting family members due to lost income from the strike victims. See March 17, 2011 Strike Narrative, supra Chapter 3: Living Under Drones.

[186] Interview with Haroon Quddoos (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012).

[187] See, e.g., Interview with Dawood Ishaq (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012); Interview with Fahad Mirza (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012); Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012); Interview with Sameer Rahman (anonymized name) and Mahmood Muhammad (anonymized name), in Islamabad, Pakistan (Feb. 29, 2012); Interview with Ahmed Jan, in Islamabad, Pakistan (Feb. 26, 2012); Interview with Waleed Shiraz (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[188] Interview with Dawood Ishaq (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012); Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012); Interview with Sameer Rahman (anonymized name) and Mahmood Muhammad (anonymized name), in Islamabad, Pakistan (Feb. 29, 2012).

[189] The per capita income in FATA stands at a meager US$250 per year. United States Government Accountability Office, Combating Terrorism: The United States Lacks Comprehensive Plan to Destroy the Terrorist Threat and Close the Safe Haven in Pakistan’s Federally Administered Tribal Areas (2008), reprinted in Combating Islamic Militancy and Terrorism in Pakistan’s Border Region 59, 64 (Nikolas J. Koppel ed., 2010).

[190] Interview with Sameer Rahman (anonymized name) and Mahmood Muhammad (anonymized name), in Islamabad, Pakistan (Feb. 29, 2012).

[191] Id.

[192] Id.

[193] Interview with Dawood Ishaq (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012).

[194] Id.

[195] Campaign for Innocent Victims in Conflict, supra note 451, at 63.

[196] See, e.g., Interview with Khalil Khan, Noor Khan, and Imran Khan, in Islamabad, Pakistan (Feb. 26, 2012) (“I mean, after the strike, we lost an entire community of elders, so we did not take these 3 lakh rupees and we didn’t take compensation because we thought we were more than that.”); Interview with Khairullah Jan, in Islamabad, Pakistan (Feb. 29, 2012) (“We think the Pakistani government has a hand, or at least a heart, in it. We are Pashtuns and we will not accept compensation for this.”); Interview with Abdul Qayyum Khan, in Peshawar, Pakistan (May 9, 2012) (“We don’t need any financial benefit. I don’t want to sell my son.”).

[197] Campaign for Innocent Victims in Conflict, supra note 451, at 51-57.

[199] Id.

[200] Id.

[201] See, e.g. Interview with Azhar Aslam (anonymized name), in Peshawar, Pakistan (May 9, 2012) (“We have lost our peace of mind. We are not at peace. All the time we are scared. There could be a drone attack at any time. All the time, we are just scared.”); Interview with Idris Farid (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012) (“There’s a sense of fear pervading around all the time.”); Interview with Iqbal Ali Mir (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012) (“We are all scared in our hearts because nobody knows who will be hit.”).

[202] Interview with Nasim Rahman (anonymized name), in Islamabad, Pakistan (May 9, 2012).

[203] Interview with Khalid Raheem (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[204] Interview with Dawood Ishaq (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012).

[205] Interview with Sulayman Afraz (anonymized name and location), in Pakistan (2012). Anticipatory anxiety refers to a “complex combination of a future-oriented cognitive state, negative affect, and automatic arousal,” involving a “sense of uncontrollability focused on possible future threat, danger, or other upcoming potentially negative effects.” Phyllis Chua et al., A Functional Anatomy of Anticipatory Anxiety, 9 Neuroimage 563, 563 (1998) (citing David Barlow et al., Fear, Panic, Anxiety, and Disorders of Emotion, 43 Nebraska Symposium on Motivation 251-328 (1996)).

[206] See generally Abdel Aziz Mousa Thabet, Yehia Abed, & Panos Vostanis, Emotional Problems in Palestinian Children Living In A War Zone: A Cross-Sectional Study, 359 Lancet 1801 (2002), available at http://www.sciencedirect.com/science/article/pii/S0140673602087093.

[207] Interview with Sulayman Afraz (anonymized name and location), in Pakistan (2012).

[208] Interview with Ateeq Razzaq (anonymized name and location), in Pakistan (2012).

[209] Interview with Haroon Quddoos (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012).

[210] Interview with Mohsin Haq (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[211] Interview with Ahmed Jan, in Islamabad, Pakistan (Feb. 26, 2012).

[212] Interview with Farah Kamal (anonymized name), in Peshawar, Pakistan (May 15, 2012).

[213] Id.

[214] Interview with Peter Brenner (anonymized name), in Pakistan (2012).

[215] A teenager from Machi Khel described seeing “a lot of people [who] have been mentally affected” by drone strikes, and noted that sometimes people “have breakdowns where they start crying all of a sudden and they are really scared.” Interview with Sadaullah Wazir, in Islamabad, Pakistan (Feb. 26, 2012).

[216] Interview with Firoz Ali Khan (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012) (“whenever my wife sees a drone she is very confused and scared and runs inside the house”); Interview with Misbah Naseri (anonymized name), in Islamabad, Pakistan (May 9, 2012) (“We hide in different places.”); Interview with Sahar Nazir in Peshawar, Pakistan (May 15, 2012) (recounting second-hand anecdote of a woman who ran around frantically inside her home looking for places to hide when she heard a drone overhead).

[217] Interview with Khalil Arshad (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012); Interview with Haidar Nauman (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012).

[218] Interview with Umar Ashraf (anonymized name), Islamabad, Pakistan (Mar. 9, 2012) (describing how he has to keep himself distracted with work, otherwise “the sound of the drone stays in my brain”); Interview with Syed Akhunzada Chitan, National Assembly Member, in Islamabad, Pakistan (May 14, 2012) (describing how people wake up in the night screaming, hallucinating about drones).

[219] Interview with Idris Farid (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012) (“Any loud noise, I get scared because I think it might be a drone.”); Interview with Fahad Mirza (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012) (describing frightened reactions to noise, explosions, and loud sounds).

[220] Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012) (“[After I was injured in the strike,] I became very short-tempered and small things annoyed me. I got angry very quickly, small things agitated me.”); Interview with Saeed Yayha (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012) (“[W]hen the [drones] are there, I can’t talk to people. I start fighting with everybody even when someone is talking to me very sweetly. I start fighting with them because of all the pressure in my head.”).

[221] Pakistani psychiatrists interviewed attributed the frequent patient presentation of physical symptoms (such as aches and pains and vomiting) to the common reluctance of patients to recognize or acknowledge their emotional distress. Interview with Sulayman Afraz (anonymized name and location), in Pakistan (2012); Interview with Ateeq Razzaq (anonymized name and location), in Pakistan (2012); Interview with Hatim Sheikh (anonymized name), in Peshawar, Pakistan (2012); Interview with Abbas Uddin (anonymized name and location), in Pakistan (2012). Psychiatrists may refer to physiological responses to deeper psychological problems as “conversion” or “somatization” disorders. See American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, § 300.11, 300.81 (4th ed. 2000).

[222] Interview with Haroon Quddoos (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012); Interview with Saeed Yayha (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012); Interview with Azhar Aslam (anonymized name), in Peshawar, Pakistan (May 9, 2012).

[223] Interviews with Medical Health Professionals who requested anonymity, in Lahore, Pakistan (2012).

[224] Interview with Mohammad Kausar (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[225] Interview with Ahmed Jan, in Islamabad, Pakistan (Feb. 26, 2012).

[226] Interview with Saeed Yayha (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012).

[227] Interview with Syed Akhunzada Chitan, National Assembly Member, in Islamabad, Pakistan (May 14, 2012).

[228] Interview with Ajmal Bashir (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[229] Interview with Arman Yousef (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[230] Interview with Sulayman Afraz (anonymized name and location), in Pakistan (2012); Interview with Ateeq Razzaq (anonymized name and location), in Pakistan (2012); Interview with Hatim Sheikh (anonymized name), in Peshawar, Pakistan (2012); Interview with Abbas Uddin (anonymized name and location), in Pakistan (2012).

[231] Interview with Sulayman Afraz (anonymized name and location), in Pakistan (2012); Interview with Ateeq Razzaq (anonymized name and location), in Pakistan (2012).

[232] Interview with Ateeq Razzaq (anonymized name and location), in Pakistan (2012).

[233] Id.; see Interview with Sulayman Afraz (anonymized name and location), in Pakistan (2012).

[234] Interview with Ateeq Razzaq (anonymized name and location), in Pakistan (2012); see also Interview with Sulayman Afraz (anonymized name and location), in Pakistan (2012); Interview with Hatim Sheikh (anonymized name), in Peshawar, Pakistan (2012).

[235] PTSD is an anxiety disorder experienced by some individuals who have been exposed to a traumatic event. In diagnosing PTSD, psychiatrists look for three main categories of symptoms not present before the traumatic event took place: “intrusive recollection,” which can include flashbacks and nightmares; “avoidance of stimuli associated with the trauma and numbing of general responsiveness”; and persistent symptoms of anxiety or “increased arousal,” which can include difficulty sleeping, irritability, or an exaggerated startle response. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, § 309.81 (4th ed. 2000); see also John H. Casada, et. al., Psychophysiologic Responsivity in Posttraumatic Stress Disorder: Generalized Hyperresponsiveness Versus Trauma Specificity, 44 Biological Psychiatry 1037 (1998).

[236] Interview with Sulayman Afraz (anonymized name and location), in Pakistan (2012). Afraz is a psychiatrist who has treated patients from Waziristan whom he has diagnosed with PTSD. Id. He described his patients as having “the classic PTSD symptoms: restlessness, inability to sleep, flashbacks, nightmares, [and] hyper startle reaction”). Id.; see also Interview with Ateeq Razzaq (anonymized name and location), in Pakistan (2012) (describing treating a number of cases of PTSD related to drones); Interview with Abbas Uddin (anonymized name and location), in Pakistan (2012).

[237] Interview with Abbas Uddin (anonymized name and location), in Pakistan (2012).

[238] One symptom frequently reported and requiring further research was of itchy eyes and skin, often in children. A number of interviewees linked these symptoms with the drone strikes. See Interview with Waleed Shiraz (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012) (attributing itchy skin to chemicals purportedly released in drone strikes); see also Interview with Aftab Gul Ali (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012); Interview with Noor Behram, in Islamabad, Pakistan (Mar. 9, 2012); Interview with Haidar Nauman (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012). Allergy-like symptoms can be a product of traumatic stress. See Atul Gawande, The Itch, New Yorker (June 30, 2008),

http://www.newyorker.com/reporting/2008/06/30/080630fa_fact_gawande#ixzz1yrmCxIAZ. Atul Gawande, a physician and author, is an Associate Professor at the Harvard School of Public Health and Associate Professor of Surgery at Harvard Medical School. He has written that “[s]evere stress and other emotional experiences can . . . give rise to a physical symptom like itching—whether from the body’s release of endorphins (natural opioids, which, like morphine, can cause itching), increased skin temperature, nervous scratching, or increased sweating.” Id.; see also Petra C. Arck, et. al, Neuroimmunology of Stress: Skin Takes Center Stage, 126 J. of Investigative Dermatology 1697, 1701 (2006) (“stress exerts severe skin inflammation”). In the case of North Waziristan, however, it is unclear without further research whether the itchy symptoms are related to stress, or whether they have a physical cause related or unrelated to strikes.

[239] Interview with Khalil Arshad (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012).

[240] Interview with Aftab Gul Ali (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[241] Interview with Hisham Abrar (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[242] Interview with Noor Behram, in Islamabad, Pakistan (Mar. 9, 2012).

[243] Interview with Sulayman Afraz (anonymized name and location), in Pakistan (2012); See, e.g., William Yule, et. al., The Long-Term Psychological Effects of a Disaster Experienced in Adolescence: 1: The Incidence and Course of PTSD, 41 J. Child Psychology & Psychiatry 503 (2003).

[244] One medical professional who works with Waziri drone victims said that he believed there were only a few psychiatrists in the entire province. Interview with Zafar Husam (anonymized name and location), in Pakistan (May 2012).

[245] The mental health professionals we spoke with all raised concerns over the limited access to health services in the region. According to an April 2008 report by the US Government Accountability Office (GAO), FATA has 41 hospitals for a population of 3.1 million, and a doctor to population ratio of 1 to 6,762. United States Government Accountability Office, Combating Terrorism: The United States Lacks Comprehensive Plan to Destroy the Terrorist Threat and Close the Safe Haven in Pakistan’s Federally Administered Tribal Areas 6 (2008), available at http://www.gao.gov/assets/280/274592.pdf.

[246] Interview with Dawood Ishaq (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012).

[247] See Obama 2010 Pakistan Strikes, The Bureau of Investigative Journalism, http://www.thebureauinvestigates.com/2011/08/10/obama-2010-strikes/ (last visited Aug. 30, 2012); Obama 2011 Pakistan Strikes, The Bureau of Investigative Journalism, http://www.thebureauinvestigates.com/2011/08/10/obama-2011-strikes/ (last visited Aug. 30, 2012); Obama 2012 Pakistan Strikes, The Bureau of Investigative Journalism, http://www.thebureauinvestigates.com/2012/01/11/obama-2012-strikes/ (last visited Aug. 30, 2012).

[248] Interview with Ismail Hussain (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[249] Interview with Khalil Arshad (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012); Interview with Sadaullah Wazir, in Islamabad, Pakistan (Feb. 26, 2012); Interview with Nadeem Malik (anonymized name), in Peshawar, Pakistan (May 9, 2012); Interview with Abdul Qayyum Khan, in Peshawar, Pakistan (May 9, 2012); Interview with Haroon Quddoos (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012); Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012); Interview with Saeed Yayha (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012). Most did not know the names of the medicines they were taking, but Khalil Arshad showed us his prescription for Lexotanil, a benzodiazopine derivative, and Nadeem Malik showed us his package of escitalopram, an anti-depressant. See Interview with Khalil Arshad (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012); Interview with Nadeem Malik (anonymized name), in Peshawar, Pakistan (May 9, 2012).

[250] Interview with Abdul Qayyum Khan, in Peshawar, Pakistan (May 9, 2012). “Tranquilizer” was the word used by Abdul Qayyum’s interpreter; he likely was referring to anti-anxiety medications.

[251] Interview with Umar Ashraf (anonymized name), Islamabad, Pakistan (Mar. 9, 2012).

[252] Interview with Saeed Yayha (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012).

[253] Id.

[254] See e.g., Society for the Protection of the Rights of Children, The State of Pakistan’s Children 53-54 (2012) (“Schools in the conflict affected areas of FATA and Khyber Pakhtunhwa were subjected to persistent attacks by militant forces. Countless schools were blown up causing extensive damage to educational infrastructure. Furthermore, threats of violence prevented students and teachers from attending schools. As a result, thousands of educational institutions especially girls school became nonfunctional and dropout rates increased tenfold . . .”), available at http://www.sparcpk.org/SOPC/Education.pdf.

[255] FATA has an overall literacy rate of 17.42%. Socio Economic Indicators, Government of Pakistan Federally Administered Tribal Area, http://fata.gov.pk/index.php?option=com_content&view=article&id=55&Itemid=91 (last visited Aug. 21, 2012).

[256] Interview with Najeeb Saaqib (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[257] Id.

[258] Id.

[259] Id.; see also Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012) (affirming that families keep their children at home because of drones).

[260] Interview with Noor Shafeeq (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[261] Interview with Ismail Hussain (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[262] Interview with Mohammad Kausar (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[263] Interview with Khairullah Jan, in Islamabad, Pakistan (Feb. 29, 2012).

[264] The most well-known school strike was an October 6, 2006 strike on a religious school in Bajaur that killed over 80 people, including 69 children. See, e.g., Yousaf Ali, Most Bajaur Victims Were Under 20, News (Nov. 5, 2006), http://www.thenews.com.pk/TodaysPrintDetail.aspx?ID=4043&Cat=13&dt=11/5/2006; see also Salman Masood, Pakistan Says It Killed 80 Militants in Attack on Islamic School, N.Y. Times (Oct. 31, 2006), http://www.nytimes.com/2006/10/31/world/asia/31pakistan.html?_r=1 (reporting on a on a religious school in Bajaur, resulting in reportedly 81-82 killed, including 69 children). Possible child casualties also have been reported in a number of other strikes on schools, but have not been confirmed. See, e.g., Griff Witte, Blast Kills At Least 20 in Pakistan, Wash. Post (June 20, 2007), http://www.washingtonpost.com/wp-dyn/content/article/2007/06/19/AR2007061901898.html (“Local residents said . . . that at least two missiles fired from the drone had destroyed a religious school and several adjacent houses, according to Rahimullah Yousefzai, a Peshawar-based journalist. . . . there might have been as many as 50 people in the school at the time of the blast, including children.”); Suspected US Missile Strike Kills Eight in Pakistan, News Track India (Oct. 23, 2008), http://www.newstrackindia.com/newsdetails/30650 (“A local journalist and tribal elder, Malik Mumtaz, said on the telephone that all those killed and injured [in a strike on a religious school] were students aged between 12 and 18.”).

[265] See Chris Woods, Over 160 Children Reported Among Drone Deaths, The Bureau of Investigative Journalism (Aug. 11, 2011), http://www.thebureauinvestigates.com/2011/08/11/more-than-160-children-killed-in-us-strikes/ (“A CIA strike on a madrassa or religious school in 2006 killed up to 69 children . . .”); see also Ali, supra note 539.

[266] Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012); see also January 23, 2009 Strike Narrative, supra Chapter 3: Living Under Drones.

[267] Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012).

[268] Interview with Waleed Shiraz (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[269] Id.

[270] Id.

[271] Interview with Sadaullah Wazir, in Islamabad, Pakistan (Feb. 26, 2012).

[272] Id.

[273] Interview with Shahbaz Kabir (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[274] Interview with Najeeb Saaqib (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[275] Interview with Mohsin Haq (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[276] Id.

[277] Palwasha Kakar, Tribal Law of Pashtunwali and Women’s Legislative Authority 2-3 (Afghan Legal History Project, Harvard Law School, 2004), available at http://www.law.harvard.edu/programs/ilsp/research/kakar.pdf (“In the Pashtun’s mind, Pashtunwali has a religious identity in Islam . . .”).

[278] Id. (“Islamic burial rituals normally require . . . prompt burial.”).

[279] Id. (“Islamic burial rituals normally require four elements: washing the body, shrouding . . .”).

[280] Id. (“Islamic burial rituals normally require . . . funeral prayers . . .”); see also Aziz Sheikh, Death and Dying—A Muslim Perspective, 91 J. of Royal Society of Medicine 138, 138-40 (1998) (detailing Islamic rituals and practices with respect to dying and noting that “often the dead will be buried within 24 hours,” and “a funeral prayer is held in the local mosque, and family and community members follow the funeral.”).

[281] Rajaie Batniji, Mark Van Ommeren & Benedetto Saraceno, Mental and Social Health in Disasters: Relating Qualitative Social Science Research and the Sphere Standard, 62 Soc. Science & Medicine 1853, 1855 (2006).

[282] Batniji, Van Ommeren & Saraceno, supra note 556, at 1855. See also Sue Lautze & Angela Raven-Roberts, The Vulnerability Context: Is There Something Wrong With This Picture (Sept. 23, 2003) (unpublished manuscript presented at the FAO International Workshop on “Food Security in Complex Emergencies, Tivoli, 23-25 September, 2003) (on file with author) (“The healing process involves psychological as well as socio-cultural practices that enable closure, e.g., bodies need to be identified and buried . . .”).

[283] Drone Blitz on Pakistan Enters Third Straight Day, Guardian (June 4, 2012), http://www.guardian.co.uk/world/2012/jun/04/15-dead-drone-pakistan; see also Irfan Burki, 10 Killed in Two South Waziristan Drone Attacks, News (Jun. 4, 2012), http://www.thenews.com.pk/Todays-News-13-15090-10-killed-in-two-South-Waziristan-drone-attacks (reporting on a drone that struck people gathered for funeral prayers, resulting in the death of up to ten individuals); Chris Woods & Christina Lamb, Obama Terror Drones: CIA Tactics in Pakistan Include Targeting Rescuers and Funerals, The Bureau of Investigative Journalism (Feb. 4, 2012), http://www.thebureauinvestigates.com/2012/02/04/obama-terror-drones-cia-tactics-in-pakistan-include-targeting-rescuers-and-funerals/ (reporting that between January 2009 and February 2012, “[m]ore than 20 civilians have [] been attacked in deliberate strikes on funerals and mourners.”).

[284] Interview with Ibrahim Qasim (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012); see also Interview with Hisham Abrar (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012) (“A lot of people don’t go to funerals now because they’re scared of drone attacks.”).

[285] Interview with Firoz Ali Khan (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[286] Interview with Dawood Ishaq (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012).

[287] See supra note 278.

[288] Interview with Firoz Ali Khan (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[289] Interview with Zafar Husam (anonymized name and location), in Pakistan (May 2012).

[290] Interview with Saad Afridi (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[291] Interview with Ahmed Jan, in Islamabad, Pakistan (Feb. 26, 2012).

[292] Interview with Abdul Qayyum Khan, in Peshawar, Pakistan (May 9, 2012).

[293] Interview with Idris Farid (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[294] Interview with Masood Afwan (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[295] Importantly, virtually all the interviewees who described deterioration in community life traced it specifically to the start of the drone program. See, e.g., Interview with Khalil Arshad (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012) (“Before the drones, people were happy and liked to go anywhere. Now, because of drones, people are scared and upset.”); Interview with Ismail Hussain (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012) (“Before this we were all very happy. We lived a very good life. But after these drone attacks a lot of people are victims and have lost members of their family. A lot of them, they have mental illnesses.”); Interview with Shahbaz Kabir (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012) (“Before the drone attacks, our land was a prosperous land and people were living in a peaceful way. Now, they are all the time scared and worried about the attacks”); Interview with Abbas Kareem (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012) (“[Life] was very good. It was good. It was a life of no problems. No consequences, no fear in our hearts. We lived a very good time.”).

[296] Interview with Ajmal Bashir (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[297] Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012).

[298] Interview with Umar Ashraf (anonymized name), Islamabad, Pakistan (Mar. 9, 2012).

[299] Interview with Sameer Rahman (anonymized name) and Mahmood Muhammad (anonymized name), in Islamabad, Pakistan (Feb. 29, 2012).

[300] Id.

[301] Interview with Sadaullah Wazir, in Islamabad, Pakistan (Feb. 26, 2012).

[302] Interview with Faheem Qureshi, in Islamabad, Pakistan (Mar. 2, 2012).

[303] Interview with Khairullah Jan, in Islamabad, Pakistan (Feb. 29, 2012).

[304] Interview with Firoz Ali Khan (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[305] Id.

[306] Interview with Haroon Quddoos (anonymized name), in Islamabad, Pakistan (Mar. 8, 2012).

[307] Interview with Safdar Dawar, President, Tribal Union of Journalists, in Islamabad, Pakistan (Feb. 29, 2012).

[308] Interview with Fahad Mirza (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[309] See generally Rare Condemnation by PM, Army Chief: 40 Killed in Drone Attack, Dawn (Mar. 18, 2011), http://dawn.com/2011/03/18/rare-condemnation-by-pm-army-chief-40-killed-in-drone-attack/; Lutz Rzehak, Afghanistan Analysts Network, Doing Pashto (2011), available at http://aan-afghanistan.com/uploads/20110321LR-Pashtunwali-FINAL.pdf; Sherzaman Taizi, Jirga System in Tribal Life (2007), available at http://www.tribalanalysiscenter.com/PDF-TAC/Jirga%20System%20in%20Tribal%20Life.pdf; Hassan M. Yousufzai & Ali Gohar, Towards Understanding Pukhtoon Jirga (2005), available at http://peace.fresno.edu/docs/Pukhtoon_Jirga.pdf.

[310] Interview with Khalil Khan, Noor Khan, & Imran Khan, in Islamabad, Pakistan (Feb.26, 2012).

[311] Id.

[312] See generally Rzehak, supra note 584; Taizi, supra note 584; Yousufzai & Gohar, supra note 584.

[313] See Interview with Khalil Arshad (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012); Interview with Umar Ashraf (anonymized name), Islamabad, Pakistan (Mar. 9, 2012); Interview with Ismail Hussain (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012); Interview with Hayatullah Ayoub Khan (anonymized name), in Islamabad, Pakistan (Mar. 2, 2012); Interview with Sameer Rahman and Mahmood Muhammad (anonymized name), in Islamabad, Pakistan (Feb. 29, 2012); Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012); Interview with Khalid Raheem (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012); Interview with Najeeb Saaqib (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[314] See, e.g., Carol Grisanti & Mushtaq Yusufzai, Taliban-Style Justice for Alleged US Spies, NBC (Apr. 17, 2009), http://worldblog.nbcnews.com/_news/2009/04/17/4376383-taliban-style-justice-for-alleged-us-spies?lite; Noah Schachtman, Spy Chips Guiding CIA Drone Strikes, Locals Say, Wired (June 1, 2009), http://www.wired.com/dangerroom/2009/06/spy-chips-guiding-cia-drone-strikes-locals-say/; Declan Walsh, Mysterious ‘Chip’ is CIA’s Latest Weapon Against al Qaida Targets Hiding in Pakistan’s Tribal Belt, Guardian (May 31, 2009), http://www.guardian.co.uk/world/2009/may/31/cia-drones-tribesmen-taliban-pakistan.

[315] See supra note 588; see also Interview with Sameer Rahman (anonymized name) and Mahmood Muhammad (anonymized name), in Islamabad, Pakistan (Feb. 29, 2012) (“[i]f you hold a sim in your finger, I’m pretty sure the missile’s going to come and hit your finger.”).

[316] Interview with Najeeb Saaqib (anonymized name), in Islamabad, Pakistan (Feb. 26, 2012).

[317] Interview with Hayatullah Ayoub Khan (anonymized name), in Islamabad, Pakistan (Mar. 2, 2012).

[318] See, e.g., Interview with Khalil Arshad (anonymized name), in Islamabad, Pakistan (Mar. 9, 2012) (“The Pakistani government gives money to our people for those chips to place in the houses, then the Americans fire on those places.”); Interview with Noor Behram, in Islamabad, Pakistan (Mar. 9, 2012) (“Some people say it’s through GPS, some people say it’s through the chips.”); Interview with Sameer Rahman (anonymized name) and Mahmood Muhammad (anonymized name), in Islamabad, Pakistan (Feb. 29, 2012) (“The chip, the sim, is what we’re looking for . . .”).

[319] Interview with Samina Ahmed, International Crisis Group, in Islamabad, Pakistan (Feb. 28, 2012).

[320] Interview with Umar Ashraf (anonymized name), Islamabad, Pakistan (Mar. 9, 2012).

[321] Interview with Sayed Majid (anonymized name), in Peshawar, Pakistan (May 9, 2012).

[322] Interview with Farah Kamal (anonymized name), in Peshawar, Pakistan (May 15, 2012).