Wednesday, August 14, 2013

There is a very small portion of our country carrying a large burden for us.


Wounded Warriors



  Laurie Ott, Executive Director
CSRA Wounded Warrior Care Project
Augusta, Georgia
Media reports about the war in Iraq and Afghanistan have been punctuated with news of suicides among both active-duty personnel and veterans.  CBS News stated that based on death records from 45 states (requests for records were denied by 5 states) 120 military personnel committed suicide each   and every week in the year 2005.  Today’s home front suicide tally is running at least double the number of troop suicides in the war zones as thousands of men and women return with disabling injuries and mental health disorders that put them at higher risk.  According to the Biostatistics Department of the University of Georgia, veterans aged 20-24 who see combat in Iraq and Afghanistan are four times more likely to commit suicide than non-vets.  And the most recent twist in these alarming statistics is the number of veterans who are now committing cop-assisted suicide.
One young serviceman was so haunted by guilt over surviving an explosion that killed two close friends that after his return home, he took his own life.  Describing the incident on a homemade video, Sgt. Jacob Blaylock said it sent shockwaves through his soul (New York Times).  Behind the pain of Jackie Blaylock and other returning veterans is a complex and interlocking set of issues and challenges that were set in motion on September 11, 2001.
Roughly 1.7 million troops have been deployed in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) in Afghanistan since 2001.  And a disproportionate number of those service members come from the southeastern United States.  According to the Augusta Chronicle, 70 percent of troops returning from OEF/OIF come from the southeast.  There are 14 military installations in Georgia and according to the Department of Defense, as of FY 2008 there were 96,636 active duty and Reserve personnel in the state.  Next year, 34,000 veterans are slated to return to Georgia from the Army National Guard 48th Infantry Brigade.
More survivors with serious wounds - - Since 9/11, for every American who has died in battle, dozens more have survived thanks in large part to cutting edge military medical care.  Like no other war before, survivors of the War on Terror have serious injuries.  Service men and women are returning with wounds that, in earlier conflicts, would have been fatal.  According to the Dole-Shalala Report, in the Vietnam era five out of every eight seriously injured service members survived.  Today, seven out of eight survive. 

Invisible wounds - - At the same time, not all injuries from combat are visible.  Combat stress, or post-traumatic stress disorder (PTSD), has become the most common disability facing today's combat service members.  According to the RAND Report Invisible Wounds, 18.5 percent of troops returning from Iraq and Afghanistan are suffering either from PTSD or depression and an additional 19.5 percent report experiencing a traumatic brain injury during deployment. 
PTSD is an anxiety disorder that can occur after a traumatic event involving the threat of injury or death.  But there is a difference between the PTSD of a car wreck survivor and that of a soldier who is threatened with injury or death day after day, week after week, for months at a time.  Characterized by intrusive thoughts, painful memories, recurring nightmares, sleep loss, and hyper-vigilance combat PTSD is exacerbated by the battle mindset.  During combat, a soldier’s responsibility is to survive and to do their best to keep their buddies alive.  This can compound the normal sense of survivor guilt; most believe that they have failed their comrades who were killed or seriously injured. 
Pain isolates because it cannot be shared by anyone who has not had the same traumatic experience.  So there is more than a grain of truth in a combat veteran’s belief that family members or therapists will not understand because they haven’t “been there.” At the same time, research indicates that talking about a trauma is one key to unlocking its grip. 
Unfortunately, returning warriors, especially men, can be reluctant to open up.  For anyone steeped in a culture that demands discipline and celebrates stoicism, their first reaction is often to “suck it up.”  But as more servicemembers self-medicate with drugs and alcohol, the Army and other branches of the service have responded by launching behavioral health programs and actively seeking to encourage participation.  “The Army is really putting a lot of intensive effort into treating substance abuse as well as the underlying psychological problems associated with PTSD because you can’t treat one without the other,” says Colonel Philip Horton, Medical Director, Residential Treatment Facility, Fort Gordon, Georgia.
While the military is working hard to encourage servicemembers to seek behavioral healthcare when they need it, such a cultural sea change takes time.  A New England Journal of Medicine Study found that more than 60 percent of OIF/OEF veterans showing symptoms of PTSD were unlikely to seek care for fear of stigmatization or loss of career advancement opportunities (Friedman, 2004). 

Another cultural change has come in the wake of OEF/OIF where women, as never before, are taking part in combat.  Quoting a New York Times series entitled Women at Arms:
Of the two million Americans who have fought in these wars since 2001, more than 220,000 of them, or 11 percent, have been women.
Like men, some women have come home bearing the mental and physical scars of bombs and bullets, loss and killing. Women who are veterans of the Iraq and Afghanistan wars appear to suffer rates of post-traumatic stress disorder comparable to those of men, a recent study showed.
Female warriors have additional stresses including incidence of sexual trauma and assault while on active duty.  The New York Times series Women at Arms included anarticle by Steven Lee Myers reporting from Iraq, “Living and Fighting Alongside Men, and Fitting In,” published August 16, 2009:


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