Toll Of War On Terror Taken On U.S. Military

September 1, 2011       Don McNamara      

When President George W. Bush declared the war on terror almost 10 years ago, there was little thought given to the possibility that the military service members taking part in that war would have to deal with their own terrors long after “Mission Accomplished.” In all likelihood, Iraq and Afghanistan combat veterans will be dealing with those wars during the next 10 years and beyond.

As the United States attempts to remove troops from Iraq and Afghanistan in a manner that appears orderly if not satisfying, nonprofits are working to help veterans who have been wounded emotionally as well as physically. Those nonprofits are providing services that the government can’t – or won’t, given spending cuts – to veterans who need the help. And they must provide those services knowing that donors are worn out, cash-strapped or mistrustful.

During the Iraq and Afghanistan conflicts – Operation Iraqi Freedom and Operation Enduring Freedom – service members could be sent (or “deployed”) to either place multiple times. In both places, they encountered car bombs, roadside bombs and improvised explosive devices (IEDs) instead of traditional military combat.

Ironically, medical advances and improved evacuation of the wounded helped save more lives than in previous wars. That means more veterans are coming home with traumatic brain injury (TBI), multiple amputations, spinal cord injuries or post-traumatic stress disorder (PTSD), possibly in combinations.

“One thing I think of first is really that the need of our veterans and veterans’ families and survivors hasn’t changed so much from one war to the next,” said Barry Jesinoski, acting executive director of the Washington, D.C., office of Disabled American Veterans (DAV). “What has really changed is, first, how we perceive those needs and, second, medical technology and techniques that are available now.”

The DAV does not limit its concern to any era or theater of operations, however.

“One of the things that does concern me is compartmentalization of treatment, for post-9/11 veterans and pre-9/11 veterans,” Jesinoski said. He cited the “caregiver legislation” passed by Congress last year that provides $1.7 billion to caregivers of an estimated 2,000 severely wounded Iraq-Afghanistan veterans for training, monthly stipends and healthcare.

Jesinoski lauded the support for post-9/11 veterans and their families but said it is the DAV’s position that such benefits should be available across the board.

Some of the most wide-ranging challenges facing returning veterans are related to PTSD. This is a severe anxiety disorder that can result from combat experience, among other things. Its huge array of symptoms can range from simple moodiness to deadly outbursts. The National Center for PTSD, whose website www.ptsd.org can be accessed through the website of the U.S. Department of Veterans Affairs (VA), estimates that from 11 to 20 percent of Iraq and Afghanistan veterans are experiencing some degree of PTSD.

According to the Office of Mental Health Services in the VA’s Central Office, in fiscal year 2010, some 408,167 veterans with primary or secondary diagnosis of PTSD received specialized mental health treatment at VA treatment centers. Of those, 78,227 (19 percent) were veterans of Operation Iraqi Freedom, Operation Enduring Freedom or Operation New Dawn (the name given to U.S. operations in Iraq after combat forces were withdrawn).

Between fiscal year 2002 and the first quarter of fiscal year 2011, a cumulative 177,149 veterans of the three campaigns received a provisional diagnosis of PTSD in VA medical centers and clinics.

One organization attempting to provide support is Welcome Back Veterans (WBV), co-founded by Fred Wilpon, principal owner of the New York Mets, and dedicated to helping returning veterans and their families deal with the stresses of resuming non-combat life. Wilpon got the idea after he and several Mets players visited Walter Reed Army Medical Center and talked to veterans returning from the wars. WBV is in a public/private partnership with the VA, the Department of Defense (DoD), Major League Baseball Charities, the McCormick Foundation, the Entertainment Industry Foundation and university hospitals around the country. The partnership started with Weill Cornell Medical College in New York, the University of Michigan and Stanford University, and quickly added Duke University, Emory University, UCLA and Massachusetts General Hospital.

Richard Auletta, a spokesman for Wilpon, said that redeployment three, four or even five times has had a serious effect on both veterans and their families and that there was no structure in place to help them Combat to Community: Facts and figures of Post-9/11 Veterans and Their Families (http://www.stp-sf.org/wp-content/uploads/2011/01/CtoC-Jan.2011-FINAL1.pdf), is a study published by Swords to Plowshares (Swords) a San Francisco-based nonprofit founded by veterans to help veterans return to civilian life. Authors estimate that 2 million individuals have seen military service in the Global War on Terror (GWOT) and of those, 810,000 have served multiple deployments. The study cites information obtained from the DoD’s Defense Manpower Training Center Contingency Tracking System Deployment File.

“The VA does a great job, but it is overtaxed,” Auletta said. “It can take months to get an appointment at a VA hospital and months more to see a specialist. The people who served us so well deserve our support, and we want America to know that.”

Auletta said the WBV has raised more than $17 million to help veterans and their families receive treatment, a number confirmed on the organization’s website. Auletta called it “a drop in the bucket” of what is needed.

He also said that while Americans express support for veterans, often they are unaware of how many veterans there are or of what sacrifices they have made.

The idea of superficial support was also on the mind of Jennifer Stasch, communications director of Swords. She said her organization uses the treatment of returning Vietnam veterans as a model of how not to treat GWOT veterans.

“Many veterans do not acknowledge their service because they fear discrimination, and holding it in only increases instances of trouble, like violence and suicide,” Stasch said. “We’re seeing that over and over again.”

Stasch noted that with an all-volunteer Army, many service members come from disadvantaged backgrounds. Adding the veterans’ relatively young ages formed a bad brew that was made more toxic by multiple deployments.

“They’re a vulnerable population, and now there’s additional vulnerability,” Stasch said. If all of that is bad for veterans in general, Stasch said, it can be especially troublesome for women. Although officially American women cannot serve in combat, they found themselves in battlefield situations in Iraq and Afghanistan. “Combat to Community” estimates that more than 235,000 women served in Iraq and Afghanistan, again citing the DoD Defense Manpower Training Center. The DoD lists 110 women as having been killed there.

“One of the transitions all veterans face is combat to community, but women veterans also face the transition of combat to caregiver,” Stasch said. “Now you have to come home and face your children.

“Women are not going into VA care because they are mistrustful of the DoD system,” Stasch said. “They’re going back to their communities silently, blending in or being assimilated without their scars being treated.

“There are many increases in domestic violence, not just men of women but women of their children. There are studies showing children underperforming in school,” Stasch said. A report issued by Brown University’s Watson Institute for International Studies titled Costs of War estimates that by 2007, some 700,000 children had a parent in Iraq or Afghanistan and by 2008 more than 2 million American children had coped with a parent going to that zone. Of those, half a million might be clinically depressed.

“The issue of women veterans and the recognition and proper care of our women veterans is extremely important to us,” Jesinoski said. “The VA has made great strides over the last 10 years with dedicated women veterans health care clinics in VA medical centers, recognizing the special needs of our women veterans.”

Just as the Iraq and Afghanistan conflicts brought new problems on the battlefield and afterward to service members, so have nonprofits trying to help them been forced to make adjustments.

“We have to recognize, and at DAV we believe we have done a good job of recognizing, that today’s new veterans, either socially or through technology, interact differently from veterans of previous generations,” Jesinoski said. “They want to go online and learn as much as they can about filing for benefits, for example.

“They’re doing a lot online, and they get guidance from their peers and through social media. And that’s kind of a new world for us, but our communications staff has done a fantastic job about getting veterans online and active through social media.”

Jesinoski did not have numbers about Iraq-Afghanistan veterans receiving services because the DAV does not track them by their era, but he offered the following statistics.

In 2010, the DAV provided some assistance, which could include just a sit-down counseling session, to 200,000 veterans. Since 2001 the DAV has offered a national Transition Service Program that provides classroom-setting benefits briefings to service members about to be discharged. Jesinoski said, between 85,000 and 100,000 transitioning service members took part (not all of whom served in Iraq or Afghanistan) during 2010, and of that the DAV handled almost 27,000 claims for various forms of assistance.

Now that President Barack Obama has announced troop withdrawals from Afghanistan, combat veterans will be returning stateside, many of them to civilian life. Converting to a non-military, non-combat existence is more difficult than many people might think, and some combat veterans can’t do it.

“We’re seeing young veterans who had multiple deployments and then have to make the transition to civilian life,” Stasch said. “It’s tough. And for many it’s so tough that they find it easier to redeploy and re-enlist because that’s easier than making the transition to civilian life. But when troops are brought home for good, those people are not going to be able to redeploy. What’s going to happen to them then?”

The American public and members of Congress “and other positions of leadership very understandably want to put the war behind them,” Jesinoski said. “The discussion today is about the drawdown. That’s probably very good news. Whether one agrees with the plan or not, getting them home safely is the main goal.

“It’s our job to keep that in the forefront. History has told us that after people come home (from war), the more time that goes by the less support there is for groups like us and for veterans and the military in general, said Jesinoski. “We’ve got to keep working to take care of this next generation of veterans, not just today but throughout their lives.” NPT