News roundup: 

*Bill Ardolino of The Long War Journal takes his readers along on a night patrol with U.S. soldiers and members of a Baghdad neighborhood watch called Sons of Iraq:

Co-founded seven months ago by local leaders and members of the 82nd Airborne, the Al Sadria branch of the neighborhood watch is composed of about 250 members who are paid by and coordinate with American units. The branch is responsible for a series of predominantly Shia neighborhoods in central Baghdad that include part of the Shorja Market. Though leader Faris Abdul-Hassan refers to his group as “the first Shia Awakening” against criminals and terrorists, he refuses to hire anyone with sectarian allegiances.

“We want to put mental health professionals with our small-unit leaders,” Navy Surgeon General Vice Adm. Adam Robinson said. “We think if we can train them there. Tere’s a real synergy that can come. We can be there to help with treatment, training and surveillance.”

I stopped for a while and I saw many Iraqi Army cars riddled with bullets. I saw troops deployed everywhere I looked: on the roof of every high building, every road intersection, occupying government offices that before were occupied by political factions.

I was shocked when I saw traces of the fight, which was clear on the buildings close to the main streets.

As an Iraqi from the south who knows exactly what was going on, with the militias controlling everything in particular cities or ports, I did not expect that the Iraqi forces – which are majority Shia - would be able to confront the militia influence.

There was a new feeling. I had never seen before the Iraq Army, without hesitation, accusing the Mahdi Army of being involved in all the disorder there.

One of the soldiers told me: “The Mahdi Army are a group of criminals, they will destroy everything if we don’t stop them.”

In the past, I have never seen soldiers dare to say anything about them. I felt the reign of fear is broken, and that is it. Exactly the same feeling as when the Baathist regime fell.

*Military.com recently posted an article taking a look at the rise in per capita income within military communities:

The wars in Iraq and Afghanistan could be behind the jumps in income, according to experts. Combat pay and re-enlistment bonuses for professional soldiers, combined with the activation of National Guard and Reserve units, put more money in the bank accounts of personnel shipping out of Fort Bragg, said David G. Lenze of the U.S. Commerce Department's Bureau of Economic Analysis, which issued the income data.

The suit claims that many disabled combat veterans are in dire need of counseling and other services they are not currently receiving from the U.S. government. Erspamer [the plaintiff's counsel] estimates that 120 veterans who served in Iraq or Afghanistan commit suicide each week. The veterans' groups are not seeking monetary damages but want reform of a health care system in which they allege a huge backlog of cases prevents veterans from receiving timely care.

A majority of the VA's counselors, doctors, social workers and psychologists "don't have the tools and the information that they need to intervene effectively with suicidal vets," said Maris, a former president of the American Association of Suicidology who has been a consultant to the Army on suicide prevention.

He was particularly critical of the VA's top health care administrator, William Feeley, who said in a pretrial deposition April 9 that the agency has no systematic national plan for suicide prevention. Feeley also said he was unaware of any methods of tracking veterans at risk of suicide and that suicide rates "are not a metric we are measuring."

Among our recommendations is that effective treatments documented in the scientific literature — evidence-based care — are available for PTSD and major depression. Delivery of such care to all veterans with PTSD or major depression would pay for itself within two years, or even save money, by improving productivity and reducing medical and mortality costs. Such care may also be a cost-effective way to retain a ready and healthy military force for the future. However, to ensure that this care is delivered requires system-level changes across the Department of Defense, the Department of Veterans Affairs, and the U.S. health care system.

They gave various reasons for not getting help, including that they worried about the side effects of medication; believe family and friends could help them with the problem, or that they feared seeking care might damage their careers.

Rates of PTSD and major depression were highest among Army soldiers and Marines, and among service members who were no longer on active duty (people in the reserves and those who had been discharged or retired from the military). Women, Hispanics and enlisted personnel all were more likely to report symptoms of PTSD and major depressions.

Last November the Pentagon opened the Defense Center of Excellence for Psychological Health and Traumatic Brain Injury in an effort to bring together education, treatment, and research.  From the Department of Defense:

The center also will set standards and assess, survey and validate DoD programs, and decide, in part, how resources are directed... Center officials are reviewing hundreds of research project proposals that hope to claim a piece of the $300 million set aside by Congress last year for brain injury research. The office also will work with the military services to see which of the many programs funded with another $600 million from Congress are working and how to direct those funds to programs most beneficial to servicemembers and families.

Perhaps very recently they've started to evaluate hearing more closely, but when I returned from Iraq six months ago, we sat down for a simple hearing test like the one we did before we deployed. My roommate already was legally deaf in one ear and wasn't supposed to deploy, but he did anyway. He was on a patrol when an IED targeting dismounts went off right next to him, sending him sprawling to the ground with a concussion. He sat out for a few weeks to recover.

Back in the states, hearing in his bad ear was even worse than when he left. The only compensation, he was told, was free hearing aids for life.

The rest of us weren't lucky enough to receive that kind of slap in the face. Tests that showed degenerated hearing were looked at with suspicion and doubt, as if we had overstated our problems.

He then posts a video to illustrate the kind of noise troops are dealing with. The guns firing along with him are two M16's and a SAW (Squad Automatic Weapon).



More from the blogger:

I had a trick where I covered my ear with my right index finger when my rifle was resting on the ledge. This did little but was far better than the cumbersome foam earplugs we were given. It's too little, too late for those of us who were already given our hearing to the wars. I'm now in a customer service job where I answer the phone constantly, and I can't use my left ear with the receiver.

The Army's 10th Mountain Division located in Fort Drum, NY, has been the most deployed unit since the 9/11 attacks. A new report highlights an inadequate system in place at the Army base for treating soldiers with mental health issues. The report, published by the advocacy group Veterans for America, said soldiers can wait more than a month before seeing a proper health care worker.

Fort Drum is located near the Canadian border. Its remoteness and harsh winter weather doesn't exactly provide the most uplifting setting for soldiers recently back from combat tours in Iraq. Veterans for America notes this as the report begins, offering a glimpse into the setting where PTSD can begin to surface among veterans:

Generally speaking, winter conditions at Fort Drum are dreary, with snow piled high and spring still months away. More than a dozen Soldiers reported low morale, frequent DUI arrests, and rising AWOL, spousal abuse, and rates of attempted suicide.  Soldiers also reported that given the financial realities of the Army, some of their fellow Soldiers had to resort to taking second jobs such as delivering pizzas to supplement their family income.

The report illustrates an atmosphere where lack of trained mental health professionals, combined with a military culture of keeping things to one's self, can leave many veterans going untreated. As the systems stands now, soldiers can easily provide false information on questionnaires designed to seek out those who need counseling. The most common way a soldier can received treatment is through self-referral. Furthermore:

In meeting with Fort Drum Soldiers, VFA found a number of disconcerting examples of inadequate mental health care at Fort Drum. Some Soldiers reported that the leader of the mental health treatment clinic at Fort Drum asked Soldiers not to discuss their mental health problems with people outside the base. Attempts to keep matters “in house” foster an atmosphere of secrecy and shame that is not conducive to proper treatment for combat-related mental health injuries. 

The New York Times profiled Eli Wright, 26, an Army medic based at Fort Drum. He described common episodes of flashbacks and shot nerves as routine occurrences. 

Mr. Wright said he waited weeks at Fort Drum to see a mental health professional, who diagnosed post-traumatic stress disorder. He was prescribed medication and pointed toward group therapy, where, he said, “half the time the group is staring at the floor.” At times, he was taking two pills at once. “I couldn’t stay awake,” he said.

A few weeks ago NPR broadcast a lengthy report in which it detailed a number of the same issues outlined in today's report.  One soldier said he felt like he'd been tossed aside like a pair of worn-out boots. Last week Army Surgeon General Eric Schoomaker was interviewed by NPR about what was detailed in its initial story:

NPR: What do you say to these people who've had less help with their paperwork because of what you've described as a misunderstanding?
SCHOOMAKER: So far — you're giving me new information, I wasn't aware that anyone has not gotten the best advice. If anyone out there feels that they didn't get the best advice, they need to come forward and let us know about that.

Meanwhile, last Friday 19-year-old Pfc. Jack Sweet, a Fort Drum soldier, was killed by a roadside bomb in Iraq.
 

• An E-4 with more than three years of service now earns $1,949.10 per month; that would rise to $2,015.40 per month on Jan. 1 under the Pentagon plan.
• An E-7 with more than 10 years of service now earns $3,263.10 per month; a 3.4 percent raise would turn that into $3,374.10 per month.
• An O-3 with more than six years of service now earns $4,763.10 per month; that officer would earn $4,925.10 per month with a 3.4 percent pay increase.

A Hospital
Veterans in the Orlando, FL area are speaking out against what they perceive as the proposed budget's lack of funds for a local VA hospital.  As the Orlando Sentinel reports:

President Bush put $120 million in his proposed budget Monday for the long-awaited Orlando VA hospital, but area veterans said they were disappointed that more of the nearly $600 million needed will not come right away.  Michael Kussman, undersecretary of health at the Department of Veterans Affairs, said $120 million is all the agency needs this year to begin work on the facility...But area veterans are not so trusting after waiting years for a hospital. Orlando is the largest metropolitan area in the country without a VA hospital, forcing veterans to drive to Tampa or Gainesville for care.

"What a disappointment," said retired Air Force Col. Joseph Kittinger, a decorated veteran. "All of the politicians give lip service to the veterans, but that is all it is, lip service." He added, though, that the $120 million "is a start and better than nothing."

Long-term
The Iraq and Afghanistan Veterans of America took a long-term look at where it sees facets of the budget allocated for veterans ultimately ending up.

For veterans, the 2009 budget provides $47 billion in funding for veterans’ health care, benefits, and other services. This reflects a modest increase over 2008 levels. However, starting in 2010, the budget predicts sudden (and unrealistic) drops in costs for veterans’ care. The administration’s argument is that the deaths of earlier generations of veterans will reduce expenses, but this line of reasoning fails to account for the dramatic increase in the cost of caring for Iraq and Afghanistan veterans. This will push future budget expenditures up, not down. Like the budget as a whole, the long-term accounting in the VA budget is improbable.

•Increasing the size of the Army and Marine Corps: $20.5 billion, an increase of $8.7 billion or 73%, compared with 2008. This year, the Army would grow to 532,000 soldiers, and the Marine Corps would increase its ranks to 194,000. By 2012, the plan would be complete, with the Army topping out at 547,000 soldiers, while there would be 202,000 members of the Marine Corps.

•Aircraft and weapons: $45.6 billion, a $4.9 billion increase, that would include purchases of fighter planes such as the F-22A Raptor and F/A-18 Hornet and unmanned aircraft like the Predator and Reaper.

•Cyberspace security: The budget shows at least $65 million for research and development projects tied to computer security. Some elements of the effort are secret, and funding levels are not disclosed.

•Pay and health care: $149 billion to increase salaries and fund health care. Military salaries would increase by 3.4%.

Yesterday we learned from the Washington Post of the record-breaking number of Army suicides during 2007. This is the latest edition of veteran suicide news that's made national headlines--further evidence that this is one aspect of the homecoming experience that isn't getting any better despite all the attention.The latest figures as reported by the Post:

• In 2007, suicides among active-duty soldiers reached their highest point since the Army began keeping records in 1980.
• 121 soldiers committed suicide in 2007, a 20 percent increase over 2006.
• Attempted suicides or self-inflicted injuries rose sixfold since the Iraq war began: there were 350 cases in 2002 compared to 2,100 in 2007.
• Historically, suicide rates within the military decreases during wartime; the current trend is the opposite of that.
• In 2001 the suicide rate was 9.8 per 100,000 active-duty soldiers--in 2006 the rate jumped to 17.5 per 100,000.
• In 2007 twice as many soldiers committed suicide in the U.S. as they did in Iraq or Afghanistan.

The Post provides this sober passage about a young Army reservist currently hospitalized after her suicide attempt:

On Monday night, as President Bush delivered his State of the Union address and asked Congress to "improve the system of care for our wounded warriors and help them build lives of hope and promise and dignity," Whiteside was dozing off from the effects of her drug overdose.

Taking a look at the issue of veterans suicides it's somewhat alarming to read this USA Today article from 2003. The language, the sense of urgency, the utter surprise in statistical findings can make one wonder if five years from now we'll still be reading the same type of articles--waiting for things to get better. The lead paragraph from the article could easily be substituted for a story about the current findings:

Alarmed by the number of suicides among soldiers in Iraq, the Army has asked a team of doctors to determine whether the stress of combat and long deployments is contributing to the deaths.

One very simple idea that would have helped relieve the mental burden of our troops (short of finding a way out of Iraq), and help them get the care that they need, is to give them substantial time off between deployments. Spend two years in Iraq, spend two years at home. And, on the homefront, aggressively test, treat, and monitor troops for mental injuries...

...Even without dwell time, and a much deserved rest for our forces, we have got to be more diligent about mandatory and exhaustive screening of returning troops, and providing adequate care and monitoring.

Our Readers Who Comment for the most part commend The Post and reporter Dana Priest for continuing to report on what happens to mentally and physically wounded soldiers returning from Iraq. They express sympathy for the individual around whom this story is built, call for a change in political leadership, improved patient car...Some contend that such reporting aids the enemy and question the patriotism of the journalist and her news organization. And, as sometimes happens, commenters take the opportunity to issue boilerplate condemnations of the Iraq War, some of which are anti-Semitic.

OCTOBER 30 -- A study by the American Journal of Public Health reports findings that younger veterans are more prone to suicide. This is the opposite of suicide trends among the general public.

NOVEMBER 13 -- CBS News concludes a five-month investigation into the "hidden epidemic" of military suicides.

DECEMBER 12 -- The House Veterans Affairs Committee holds a hearing on how to stop veterans suicides.

Combat Stress is alarmed at the huge increase in veterans from the Falklands, Sierra Leone, Northern Ireland, Iraq and Afghanistan, who come knocking on their door for help. A few are still turning up suffering long-term effects from the second world war and Korea. The oldest applicant for help recently was aged 100.

The problems of veterans today are compounded by the widespread recognition through much of the army that the Iraq campaign is unpopular, nasty, unpredictable and brutal—and, in the views of a significant minority of soldiers and officers in private conversation, a pretty unnecessary conflict at that. In the first and second world wars, the plight of service personnel was shared by almost everyone in the land. More than 1 million soldiers served in Northern Ireland over 30 or so years, so that became part of the national experience.

But combat in Iraq and Afghanistan is not a national experience, and the services are worried that they appear in the minds of many now to be detached from most of British national life. Though more American soldiers have been involved—more than 3,000 killed and nearly 50,000 injured, physically or mentally—Iraq is not a shared experience nationally for Americans in the way that Vietnam was.

A well-trained fighting machine reduced to nothing more than an empty shell.  Combat stress is their calvary, the infantry to fight off their demons.  They were protecting you, now they need your help.

Master Sgt. Cindy Rathbun knew something was wrong three weeks after she arrived in Iraq in September 2006. Her blond hair began "coming out in clumps," she says.

As the last days of 2007 come upon us, I've compiled a timeline of veterans news throughout the year. What struck me is the vast number of veterans stories pouring out from all media outlets. Will this continue to be the case in 2008? Most likely it will be for the simple fact that the number of Iraq/Afghanistan vets is getting bigger. 

Here are selected stories from throughout 2007:

FEBRUARY 18 -- The Washington Post exposes decrepit living conditions for wounded soldiers recovering in Building 18 at the Walter Reed Army Medical Center:

Behind the door of Army Spec. Jeremy Duncan's room, part of the wall is torn and hangs in the air, weighted down with black mold. When the wounded combat engineer stands in his shower and looks up, he can see the bathtub on the floor above through a rotted hole. The entire building, constructed between the world wars, often smells like greasy carry-out. Signs of neglect are everywhere: mouse droppings, belly-up cockroaches, stained carpets, cheap mattresses.

MARCH 8 -- A New York Times study finds vast inequities in how veterans receive disability checks based on location and type of service.

"There may be soldiers who have been disfigured for the past four years who may feel that they are so unhappy with their appearance they may wish to look at different alternatives.  Face transplant is the only option for full reconstruction."

I recently spoke by phone with a military friend who's currently a nursing student at the Walter Reed Army Medical Center. He talked about how being with the war's wounded every day affects him, both on a human level and as someone who may be deployed to Iraq in the future. Of the scandal which broke last February at the hospital, he assumes the media blew it out of proportion and hasn't seen any negative conditions at the facility. 

What's interesting about his words is how in some cases they could be applied to any civilian hospital worker in the country, and in others we see how his position as a soldier informs his experiences. As he is still on active duty in the Army, he's asked for anonymity. Excerpts:


On working as a stateside medic and nursing student:

Personally I’d say that you get to see another side of the war from being on the health care side. [The wounded soldiers] are treated with a lot of respect. They’re really cared for. On an emotional level sometimes the reality of it catches you. You try to be professional, but you’re still human. And sometimes it dawns on you the situation that person’s in is a very harsh one…There are situations that I’m very happy these people are alive and everything else, but sometimes you wonder if there are fates worse than death. 


On his thoughts during off-duty time:

I think off-duty I think about it more. I think about the possibility–you know, I wear the same uniform as they do. These guys are younger than us. They’re kids. It scares me because I know that I’m still gonna be in the Army until 2010, and I’m pretty sure I’m going back over [to Iraq]. And to be faced with that reality every day looking at the people you’re looking at, and knowing that this is a very indiscriminate war; knowing that you can be walking to the bathroom and just get hit by something in any kind of zone. It's guerrilla warfare. It’s ugly. Your chances are very good that you can be that guy. There’s a lot more people injured than are coming up dead. 


On conversations with patients:

They’re pretty honest about what happened, or what they remember–which they usually don’t. They’re usually like, “yeah, I was driving or doing this and then I woke up and I was in Germany.” They like to talk it out. They love to try to relate to you [as an Army soldier].


On how he comforts a patient's fears:

I think it’d be safe to say it’s kind of like, you know how us infantryman have that black humor. I think humor is one of the things I use. 


On controlling his own fears:

I think the biggest thing that affects me is my fears. I mean, honestly, I get nightmares and stuff. But I think that’s more my anxiety of what my future holds. Sometimes you just need to indulge in the work and do whatever it is to help that person. Sometimes you focus on that person, and that’s how you get by.


On the worst he’s seen in a stateside military hospital:

The burn ward–it was just gruesome, you know. Everything was rearranged and changed. They have pictures [of the soldiers beforehand]–you know, a family puts up pictures. It’s a common practice. You look at someone who’s burnt severely and it’s hard to ever imagine they’re a human. And then right next to that patient–that slab of meat, rearranged face, it’s almost monstrous–right next to that, only to make it more melancholy, is the picture of the young kid with his future ahead of him. Not to sound so cliché. But, you know that person has the future ahead of him. That look that says, ‘look at me I just joined the Army, I’ve got my new uniform, a young girlfriend.’ And they’re not kind of robbed, they’re a hundred percent robbed of that. I think that’s a dark reality right there. 


On the best he’s seen:

The best moment I’ve had was one of my first patients I had. I actually watched him for three weeks.  I took care of him. He was one of my harder cases, and I purposely took him for academic reasons. And I watched him go from being very immobile and sick–just looking like hell to now he’s talking.  That was powerful. You actually watch your accomplishment by giving care, you actually nourish something back to life.