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The report is divided into five chapters: Background and Context, Numbers, Living Under Drones, Legal Analysis, and Strategic Considerations. Immediately following is a brief account of the methodology of this study, including challenges faced by our research team. The report then turns to the five main chapters:

‘Background and Context,’ Chapter 1, provides brief background and context on: the nature of unmanned aerial vehicles; drones and targeted killings as a response to 9/11; Obama’s escalation of the drone program; the decision-making process behind drone strikes; the Pakistani government’s divided role; conflict, non-state groups, and military forces in northwest Pakistan; the Federally Administered Tribal Areas (FATA); and the limits on access to FATA.

‘Numbers,’ Chapter 2, assesses the debate on drone casualties, outlining the factors that produce conflicting and often unreliable reporting by government and media sources. Examining the methods and content of three well-known and widely cited drone data aggregators, this chapter explains what information can be gleaned from these sources, and challenges the oversimplified civilian/“militant” binary reproduced in many accounts.

‘Living under Drones,’ Chapter 3 sets forth the core findings of this report. The Chapter begins with firsthand narrative accounts of three specific drone strikes. For each of these strikes, there is significant evidence of civilian casualties. It further examines the broader impacts of drone surveillance and strikes in North Waziristan, including on the families of those killed, education and economic opportunities, emotional trauma, widespread fear, and the undermining of community institutions.

‘Legal Analysis,’ Chapter 4 provides an overview of the terms of debate on the legality of the US targeted killing program and drone campaign in Pakistan under both international and US domestic law. It describes the law related to key issues: whether US drone practices violate Pakistan’s sovereignty; when and which individuals may lawfully be targeted; and the extent to which the US has met, or failed to meet, its international legal obligations related to transparency and accountability.

‘Strategic Considerations,’ Chapter 5 examines the strategic implications of US drone strike policies in Pakistan. In particular, it considers available evidence about their effectiveness in hampering attacks by armed non-state actors, their impact on attitudes in Pakistan and the surrounding region toward the US, their geopolitical implications, and their effect on decision-making related to war and the use of force in the US.

The report includes several appendices. The first appendix provides additional narratives from victims and witnesses to drone strikes, as well as others directly affected by drones. The second appendix charts the timing and intensity of drone attacks between January 2010 and June 2012 in light of parallel political events and key moments in Pakistani-US relations. The third appendix compares statements of US officials on drone strikes with strike data reported by a leading strike data aggregator.


This report is based on over 130 detailed interviews with victims and witnesses of drone activity, their family members, current and former Pakistani government officials, representatives from five major Pakistani political parties, subject matter experts, lawyers, medical professionals, development and humanitarian workers, members of civil society, academics, and journalists. Our research team also engaged in extensive review of documentary sources, including: news reports; legal, historical, political, medical, and other relevant scholarship; civil society and analysts’ reports; court filings and other legal documents; government documents; and physical evidence.

Our research team conducted two separate investigations in Pakistan (including in Islamabad, Peshawar, Lahore, and Rawalpindi) in February-March 2012 and May 2012.[1] Investigations included interviews with 69 individuals (‘experiential victims’) who were witnesses to drone strikes or surveillance, victims of strikes, or family members of victims from North Waziristan.[2] These interviewees provided first-hand accounts of drone strikes, and provided testimony about a range of issues, including the missile strikes themselves, the strike sites, the victims’ bodies, or a family member or members killed or injured in the strike.[3] They also provided testimony about the impacts of drone surveillance and attacks on their daily lives, and their views of US policy.

Interviews were arranged through local contacts in Pakistan, including journalists, lawyers, tribal leaders, experts, and civil society members. The majority of the experiential victims interviewed were arranged with the assistance of the Foundation for Fundamental Rights, a legal nonprofit based in Islamabad that has become the most prominent legal advocate for drone victims in Pakistan. Those interviewees, who undertook an extremely unsafe, time-consuming, and difficult trip in order to be interviewed, were all male, as poor security conditions, together with cultural norms of purda (separation of men and women), restricted women’s ability to travel. One of the experiential victims interviewed is a female Waziri now residing outside Federally Administered Tribal Areas (FATA). Nine of the 69 experiential victims are clients of the Foundation for Fundamental Rights. None of the interviewees were provided compensation for participating in investigations for this report.[4]

The interviews were conducted by teams that included at least one Stanford or NYU researcher, as well as a translator. Some interviews also included a researcher from either Reprieve or the Foundation for Fundamental Rights. The interviews with individual Waziris were semi-structured, and lasted from approximately thirty minutes to two hours.

Security, confidentiality, and privacy for those interviewed were key concerns. Our research team applied informed consent guidelines to all interviews, and interviewees chose if or how they wished to be identified in this report. We do not include the names and other identifying information of interviewed individuals in this report when so requested by the person concerned, or when the research team determined that doing so might place the individual at risk. Thus, many of the experiential victims have been given pseudonyms in this report. All of the medical and humanitarian professionals, and most of the journalists with whom we met, also expressed concerns for their safety, and requested anonymity.

In addition to our interviews with medical professionals in Pakistan, medical experts at Stanford reviewed this report’s sections concerning the psychological and physiological impacts of drones. These experts also met with our research team to discuss our findings and assist in our analysis of the classification of symptoms.

As part of our effort to speak with relevant stakeholders, our research team requested the input of the US government, and sought to share our findings in advance of this report’s release. Via letter sent July 18, 2012, we requested a meeting with the National Security Council (NSC), “the President’s principal arm for coordinating [national security and foreign] policies among various government agencies.”[5] At this writing, we had not received a response to our request.


The foremost challenge the research team faced was the pervasive lack of US government transparency about its targeted killing and drone policies and practices in Pakistan. This secrecy forced us to conduct challenging primary research into the effects of drones in Pakistan. Primary research in FATA is difficult for many reasons.

First, it is very difficult for foreigners physically to access FATA, partly due to the Pakistani government’s efforts to block access through heavily guarded checkpoints, and partly due to serious security risks.

Second, it is very difficult for residents of Waziristan to travel out of the region. Those we interviewed had to travel hundreds of kilometers by road to reach Islamabad or Peshawar, in journeys that could take anywhere from eight hours to several days, and which required passing through dozens of military and police checkpoint stops, as well as, in some cases, traveling through active fighting between armed non-state groups and Pakistani forces.

Third, mistrust, often justifiable, from many in FATA toward outsiders (particularly Westerners) inhibits ready access to individuals and communities.

Fourth, many residents of FATA fear retribution from all sides–Pakistani military, intelligence services, non-state armed groups–for speaking with outsiders about the issues raised in this report.

Fifth, practices of purda in FATA make it extremely difficult for women to travel, for outsiders to speak directly to Waziri females, or to obtain information about females through male family members. It is often considered inappropriate, for example, for men to provide the names of female victims of drone strikes. In addition, strict segregation can mean that neighbors or extended family members may not know how many women and children were killed or injured in a strike.[6] Because of these obstacles to speaking directly with women, most of the information the research team obtained about the impacts of drones on the daily lives of women came second-hand through husbands, sons, fathers, and in-laws, as well as by health care providers and members of civil society working in the area. Following interactions and the building of trust between our researchers and interviewees, a number of those interviewed expressed an interest in facilitating interviews with female witnesses and victims in future investigations.

Sixth, and as documented in the ‘Background and Context’ Chapter, FATA has very low literacy rates. This, in conjunction with the fact that much information about incidents in Waziristan is not recorded in written form, made it difficult for some interviewees to pinpoint the exact dates of certain strikes or to identify in terms that could be related to outsiders the precise geographical locations of small villages. The research team has made extensive efforts to check information provided by interviewees against that provided in other interviews, known general background information, other reports and investigations, media reports, and physical evidence wherever possible. Many of the interviewees provided victims’ identification cards and some shared photographs of victims and strike sites, or medical records documenting their injuries. We also reviewed pieces of missile shrapnel.

[1] Our researchers did not conduct in situ investigations in the drone-affected areas of FATA because of security risks at the time of our investigations, and because the Pakistani military prevents foreigners and non-FATA residents from accessing the region.

[2] A majority of the interviewees brought school-or government-issued photo identification cards to the interview indicating their residence in North Waziristan.

[3] We have defined “close family member” as a member of the interviewee’s household. In Waziri culture, households can include grandparents, parents, siblings, and children, as well as uncles, aunts, or cousins.

[4] The Foundation for Fundamental Rights and Reprieve organized and financed the transportation to Islamabad and Peshawar for the majority of experiential victims. The Stanford Clinic paid for the translation services and rental of the space used for interviewing in both Peshawar and Islamabad.

[5] White House, National Security Council, (last visited Sept. 12, 2012). We requested a meeting with US Deputy National Security Advisor Denis McDonough.

[6] Extended family households can be quite large; one interviewee, for instance, told us he lives in a large extended family compound of 50-60 relatives. Interview with Ibrahim Shah, in Islamabad, Pakistan (May 9, 2012).