A study released today by the VA's National Center for Posttraumatic Stress Disorder found that 15 percent of the Iraq/Afghanistan vets seeking treatment at VA facilities report experiencing some kind of sexual trauma while serving in the military.  Additionally, these veterans are 1.5 times more likely require mental health care.  These numbers are derived from the nearly 40 percent of recent war veterans who've sought general medical care since being discharged from the military.  Screening all vets coming through VA medical facilities for sexual trauma is a standard practice.

Here are more statistics referenced in the report [via Reuters and USA Today]:|

• 76 percent of women who've had previous sexual trauma reported mental health problems, 51 percent of which include some form of PTSD.
• 47 percent of women without a history of sexual trauma reported mental health problems, 22 percent of which include some form of PTSD.
• Women with military-related sexual trauma experiences have a 59 percent higher risk of mental health problems.
• Men with military-related sexual trauma experiences have a 40 percent higher risk of mental health problems.
• One in seven female vets reported an instance of military sexual trauma.
• Just under one percent of male vets reported an instance of military sexual trauma.

The study covered 125,000 veterans seeking treatment from the VA between October 2001 and October 2007.  Active duty soldiers were not included because the VA is not involved with their care.  Additionally, the specific types of sexual trauma were not included, only the number of occurrences.

Reuters spoke to the new report's co-author Rachel Kimerling:

Kimerling said in a telephone interview the term "military sexual trauma" covers a range of events from coerced sex to outright rape or threatening and unwelcome sexual advances...

..."If you think about military service where you are living and working so closely with the same people, that even if it is not sexual assault ... it is possible that severe sexual harassment is just as traumatic," she said...

...Kimerling said that may mean many veterans are unaware they can be helped and she said she hoped more would come forward to seek treatment.

"There are dedicated health care services for military sexual trauma at every VA facility across the nation," she said.

Sexual trauma can lead to depression, anxiety, substance abuse and post-traumatic stress disorder, Kimerling said.

"We know there are effective, evidence-based treatments for them that are used in VA," she added.

Many women are afraid to report the assaults, says Anita Sanchez of the Miles Foundation, a non-profit that provides services to victims of military-related trauma. Fewer than a third of women who come to Miles for help after sexual assaults say they've told the military, she says.

"A typical scenario is it's either a supervisor or someone at her level, in the same military unit. If you come forward, you're tattle-telling on a comrade. Women have told me about the sneers, the sarcastic comments. They can find themselves ostracized," says Sanchez, and when other women see this, the lesson isn't lost on them.

The Humvees were taken Aug. 19 during Russia’s assault on the Georgian port of Poti, said Lt. Cmdr. Corey Barker, a spokesman for U.S. European Command. The vehicles were in Georgia awaiting commercial transport back to the U.S. following Operation Immediate Response, a multinational training exercise in July involving Georgian and U.S. forces. [Marine Corps Times]

Chris Biener, 21, Bohemia, Long Island:

New York: So you leave for Army Reserves boot camp next Monday. What'll you do until then?
CB: Hang out with some friends.
New York: What have you been doing up to now?
CB: I went to Stonybrook University and played football there for the first semester, then I went to Suffolk Community College, then I started working and going to school, back and forth, then I decided to do this.

New York: Why didn't you stay in college?
CB: I kept switching my major, which kept putting me back. So I worked at a swimming-pool store.
New York: Why are you joining the military?
CB: I almost did it straight out of high school, but my parents wanted me to go to college. I always wanted to join growing up.
New York: Why?
CB: I've always played sports, but there's no team after high school. So this is a big team to join.
New York: What's your big dream?
CB: I'm going to be an LPN, a nurse. So when I get out [of the military], I know I'll get a good job. And if I stay in, there'll always be people who need help.
New York: We're in two wars right now. You may go and be seriously physically or mentally damaged or die. Does that affect your decision?
CB: I used to think about it, but then I realized I'll be trained enough to probably get away from that situation, so if it happens, it happens.
New York: How would you characterize the situation [in Iraq] right now?
CB: We should be there, but the people don't want us there. It's kind of up in the air.
New York: Should we reinstitute the draft?
CB: No, I think the turnout's positive enough with volunteer people. With a draft you have an Army with people who don't want to be there. If it's volunteer, you'll get 100 percent out of all of them.
New York: Would you pick Iraq or Afghanistan to be deployed to?
CB: Iraq. There seems to be more going on. It'd be more fun. As a nurse, there'd be more jobs for me to do.
[Daily Intel]

Handman began basic training Aug. 29 at Fort Benning in Columbus. He soon wrote a letter to his parents in which he said, “I have just never been so discriminated against/humiliated about my religion.” He told them he feared for his safety.

Handman’s parents contacted U.S. Sen. Saxby Chambliss, R-Ga., who forwarded their concerns to the Army. Four days after commanders interviewed Handman about being harassed, he was beaten in a laundry room near his barracks and treated at the Army post’s hospital.

Manganaro said investigators don’t believe religious bigotry was the motive for Handman being attacked, though she could not explain why...The investigation of Handman’s allegations of harassment found that one drill sergeant had ordered Handman to remove his yarmulke, which he wore with his uniform, as he ate in a dining hall. Another had called him “Juden,” the German word for Jews. [AP]

A new campaign ad by the group VoteVets criticizes Sen. John McCain for skipping a crucial GI Bill vote.  In the ad the veteran remarks: "Vet to vet, Senator McCain.  When you put money from your rich friends ahead of vets like me how is that country first?"



A few weeks ago I posted a pro-McCain ad featuring a wounded Iraq veteran.  I'm reposting it here for you to compare how veterans from two different ways of thinking voice support for their respective candidates.




The widow of an Iraq veteran who committed suicide after returning from the war is suing the federal government for negligence.  The deceased veteran, Donald Woodward, 23, made three suicide attempts and was seeking treatment at a VA hospital.  His wife said VA doctors were slow to diagnose her husband's psychiatric condition and did not schedule follow-up visits.  Woodward, at the time, was in VA out-patient care for depression.

"I intend to make them make changes," said his mother, Lori Woodward. "I have too many friends whose kids are in Iraq. I have a nephew now in Iraq, in the same unit, and I can't have my family go through this again."

Alison Aikele, a VA spokeswoman in Washington, said the agency does not typically comment on pending litigation. [AP]

The report concludes that environmental considerations—including clean water, sanitation, hazardous-waste management—can be important for achieving overall U.S. objectives during reconstruction and post-conflict operations, including both short- and long-term stability. If not properly addressed in planning or operations, environmental considerations can increase the costs of an operation and make it more difficult for the Army to sustain the mission. Yet, environmental considerations are not well incorporated into Army planning or operations in any phase of an operation. To address these shortcomings, the Army should take additional steps to ensure that environmental considerations (from strategic to tactical) are appropriately incorporated into planning, operations, training, and research.

• A contractor hired by the Defense Department dumped waste oil in a landfill in Iraq and then sold the barrels.

• U.S. soldiers in Afghanistan buried several drums containing unidentified liquids, which later turned out to be hazardous, posing a risk of soil and groundwater contamination.

• In Iraq, an airfield sits over an old airfield with leaking fuel tanks. “Major health issues arise whenever it is necessary to dig.”

• Commanders in Iraq have set up hazardous-waste disposal areas close to camp perimeters, creating a force-protection issue since they were potential targets for hand grenades and IEDs.

• High-grade diesel fuel was spilled in a lake in Iraq that was used for drinking water at a base. The lake is no longer used as a source of drinking water.

• U.S. forces in Iraq improperly dumped insecticides, batteries, oil products and other hazardous material. Soldiers joked that fuel spills were “replenishing the oil wells.”

• Troops in Iraq fell ill after rolling leaking drums of industrial-strength pesticides out of a building.

“It’s a pretty significant problem,” he said. “I think most soldiers are more concerned about the mission … and may not be as concerned about the environment. But it’s not just [a] … tree-hugger thing.”

Force-protection risks can also be increased by environmental issues, as illustrated in a case from Iraq. Because of the hostile environment there, commanders set up their own hazardous-waste accumulation points inside their base camps. These field-expedient satellite accumulation points were located too close to camp perimeters, creating potential targets for hand grenades and improvised explosive devices (IEDs).

Environmental issues can affect the military mission in yet another way. Poor U.S. environmental practices in host nations in the region that support U.S. forces can cause diplomatic problems that affect operations. In OIF, a contractor in a host nation dumped waste anti-freeze from a U.S. base camp and sold the drums. This incident caused a major diplomatic problem that is still being negotiated. Although it has not reached the level where it is affecting operations in this case, host nations have restricted U.S. activities in several non-contingency operations in other parts of the world because of environmental concerns. For example, restrictions were imposed on Army training in Germany, and an Army training range was closed in Okinawa.

Finally, military operations can be affected by the ability of the logistical systems to support them. If base camps and military equipment have large requirements for resources, the logistics system must supply them for military operations to continue. By taking steps such as developing local water sources and reusing engine oil to reduce logistical needs, the Army can reduce the logistical burdens of an operation, either by providing more logistics capacity for warfighting or by reducing the size of the logistical tail needed for an operation.

Among the report's recommendations for military leaders are to cultivate an "environmental ethic" throughout the Army; to better incorporate environmental considerations into strategic planning; and to train soldiers about environmental issues that could arise in the field before they deploy.

Former army sergeant Kristofer Goldsmith told the landmark hearing of "lawless murders, looting and the abuse of countless Iraqis."  He spoke of the psychologically fragile men and women who return from Iraq to find little help or treatment offered from official circles.  Goldsmith said he had "self-medicated" for several months to treat the wounds of the war...Another soldier told AFP he had to boost his medication to treat anxiety and social agoraphobia -- two of many lingering mental wounds he carries since his deployments in Iraq -- before testifying.  A group of veterans in the packed hearing room gazed blankly as their comrades' testimonies shattered the official version that the U.S. effort in Iraq is succeeding.  Almost to a man, the testifiers denounced serious flaws in the chain of command in Iraq.

The Post-9/11 Veterans Educational Assistance Act is designed to offer the brave men and women who have served honorably since September 11, 2001 a level of educational benefits on par with those provided to veterans of the World War II era.

Many people enlist to earn money for college, and almost everyone signs up for the education benefits -- which, in the case of the main GI Bill, requires a service member to pay about $1,200 into the plan-- but not everyone takes advantage of it. And that buy-in is not returned even if the benefits are unused.

About 70 percent use at least some part of it, said Keith Wilson, director of the education service, but the VA does not track how many earn degrees.

An independent study found that just over half use some part of the benefits, said Ray Kelley of AMVETS, a veterans support group, and only 8 percent use all. "Congress is realizing we're not giving them the benefits we say we're giving them," Kelley said. "They only have 36 months from the time they start using it to the time they finish." That means going to school full time, year-round.

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."

-In May 2007 the practice of stop-loss reached a three-year low of 8,540.

-"Since then, the number of soldiers forced to remain in the Army rose 43% to 12,235 in March."

-"Soldiers affected by stop loss now serve, on average, an extra 6.6 months...Key leaders at the small-unit level — sergeants through sergeants first class — make up 45% of those soldiers. Soldiers typically enlist for four-year stints."

-58,300 soldiers have been affected by the stop-loss since 2002.

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.

Two of the bill's sponsors, Sens. Patty Murray, D-Wash., and Lisa Murkowski, R-Alaska, said they'd attended town hall forums for veterans where men were outspoken about their health problems, but women waited until after the meetings to whisper some of their concerns, including sexual assault.

"Women don't have to whisper to me anymore," Murray said.

“As the Department of Veterans Affairs works to ensure that those who serve our Nation are not left behind, it is essential for them to recognize the physical, mental and reproductive health challenges that face women veterans may require a different menu of services, delivered in a different way than the VA has grown accustomed to."

Writing on TheHill.com earlier this month, Rep. Stephanie Herseth Sandlin (D-S.D.) offered up a helpful set of statistics on just how many women veterans are out there serving, or having recently served:

Approximately 70,000 women have served and separated from military service in Operation Enduring Freedom or Operation Iraqi Freedom (OEF/OIF). Among this group, in 2006 nearly 37.2 percent, or 25,960 sought and received healthcare from VA since separation from military service — up from 32.9 percent (15,903) in 2005. According to the Department of Veterans Affairs, the prevalence of potential Post Traumatic Stress Disorder (PTSD) among new OEF/OIF woman veterans treated at the VA from fiscal year 2002 to 2006 has grown dramatically from approximately one percent in 2002 to nearly 19 percent in 2006.

“There’s a lot of women who have residential needs who I think are less likely to come to the VA because it’s literally spending 24-7 with guys,” Miklos Losonczy, one of two VA psychiatrists behind the creation of the treatment center, told The Sunday Star-Ledger of Newark.

Losonczy worried that women veterans who need treatment might not be seeking it because “they think the VA is all men and wonder, ‘Why would I get my military sexual trauma treatment surrounded by men?”’

For a detailed description on Military Sexual Trauma (MST), check out this info from the VA.

"When the five-brigade surge went in...that took all the stroke out of the shock absorbers for the United States Army."

"There has been little, if any, change of the stress or tempo for our forces," [said Gen. Robert Magnus, assistant commandant of the Marine Corps], calling the current pace of operations "unsustainable."

Magnus suggested that if more Marines are freed from Iraq they could also go to Afghanistan. Marines "will move to the sound of the guns in Afghanistan," he said. But he said it would be difficult to keep the force split between the two countries because the Marine Corps has limited resources to command a divided force and supply it logistically.

The Marine Corps is "basically in two boats at the same time," he said.

...from that first impact, among many on the roof, the mood was scarcely one of cool detachment, or at least not as cautioned as it might have been by the longer-term implications of what we were seeing. Part of it, no doubt, was the air show — the sheer, astonishing, overwhelming demonstration of power, more like an act of God than man, unleashing in those watching from the roof something approaching awe.

These officers see a military apparatus severely strained by the grinding demands of war. Sixty percent say the U.S. military is weaker today than it was five years ago. Asked why, more than half cite the wars in Iraq and Afghanistan, and the pace of troop deployments those conflicts require. More than half the officers say the military is weaker than it was either 10 or 15 years ago. But asked whether “the demands of the war in Iraq have broken the U.S. military,” 56 percent of the officers say they disagree. That is not to say, however, that they are without concern. Nearly 90 percent say that they believe the demands of the war in Iraq have “stretched the U.S. military dangerously thin.”

• Presidency: 5.5 (16 percent had no confidence at all)
• CIA: 4.7
• State Department: 4.1
• Veterans Administration: 4.5
• Department of Defense: 5.6
• U.S. Congress: 2.7

Above all, though, the officers are clear that the chances for victory do not rest on the shoulders of the military alone. Nearly three quarters of the officers say the United States must improve its intelligence capabilities—the highest percentage of any of the choices offered. Active-duty officers and those who have retired within the past year give a much higher priority to nonmilitary tools, including more robust diplomacy, developing a force of deployable civilian experts, and increasing foreign-aid programs.

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.
 

The fifth anniversary of the start of our war in Iraq is a little more than a month away. There will be retrospectives looking back to those early days of shock and awe, in addition to news analysis and the nation's self-reflection. Even a month out from the anniversary, conversations about the upcoming day seem to revolve around the same theme: "can you believe it's already been five years?"  It is a sobering thought.  And even if you believe in the war, or are staunchly at odds with its premise, five years is a unit of time to view not so much in length, but in the various phases that occurred.

The summer of 2003, as I saw it, was a honeymoon period. The optimism for Iraq's future still ran high (at least in some circles), and at the same time I could see questionable expressions on the faces of Iraq's citizens as we patrolled past them. No one knew how it would all play out. Personally the fragile tensions that held together a shaky peace ended on November 12, when a suicide bomber destroyed the building in An Nasiriyah that at one time was my platoon's headquarters.

Homecoming was also different. There were no VA scandals, or talk of PTSD, or advocacy groups comprised of Iraq veterans. We simply came home and quickly immersed ourselves back into civilian life. To watch how that has changed is to examine the evolution of the war in Iraq and on the home front. To ask a veteran about his or her experiences in Iraq yields not an overall glimpse into the war, but an occasion to see just one phase of it. This is what needs to be remembered as the anniversary coverage begins. I remember seeing soldiers entering Iraq July 2003 and feeling bad for them. They'd missed the defining war of our generation. They would spend a few months in post-invasion mopping up, and go home on the tail end of the operation. Of course, the irony in this cannot be overstated.

We have enough perspective over five years to eschew generic "looks back" for a more nuanced analysis of how our country has fared over this time. It must be broken into phases: the invasion, the time surrounding 2004's battle for Fallujah, the grinding years of 2005 and 2006, the Abu Ghraib and Haditha investigations, and the controversial surge plan that's brought us to this point. At home the fascination with the invasion's pyrotechnics has given way to simply reading of the daily casualty figures ticking away over the news wires. There's also the trends in media coverage to consider, the heightened focus of home front veterans issues, and how artistic mediums have sought to portray the war and inform us.

Looking back on the fifth anniversary means not so much seeing what happened, but understanding how we got to where we are today, and how driven we are to look at Iraq not simply as a war, but as a series of distinct eras.

• 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%.