Chris Preble’s post last week on the Washington Post series about wounded U.S. soldiers lost in the outpatient wilderness at Walter Reed Army Medical Center has also caused me to dwell on this all too painful cost of war.
 
Like Chris I too am a Navy veteran, albeit back towards the end of the Vietnam War, and though I saw no combat, am all too familiar with the shabby way wounded veterans can be treated. Those who don’t remember the way it was for Vietnam veterans should go rent a copy of Born on the Fourth of July .
 
Though I touched on this in a January post I think it is worth revisiting.Though Congress and the Defense Department are now in full indignation mode, scheduling oversight hearings, making repairs, including whitewashing the walls (how is that for irony?) at the now infamous Building 18, Secretary Gates warning that officials will be held accountable (Notice anyone fired yet? No, neither have I), appointing an independent commission to investigate, and, of course, blaming the messenger, as in accusing  the Washington Post of presenting a one-sided picture, the truth is that the situation is going to get worse, a lot worse, before it gets better.
 
First, consider the numbers. The total number of wounded, is far greater than generally thought. As the Linda Bilmes study I previously cited noted, as of last September more than 50,500 US soldiers have suffered non-mortal wounds in Iraq, Afghanistan and nearby staging locations.  While not all of those are the traumatic type, like those at Walter Reed, enough of them are the sort of wounds that keep on giving, pain and suffering that is, so that both the military and the VA systems will be running full tilt for years to come. By the way, Bilmes estimates that at least 700,000 veterans from the global war on terror will flood the system in the coming years.
 
Also consider that after discharge many of the soldiers and marines will return to their hometown. Given where the All Volunteer Force has been recruiting from in recent years, rural areas outside metropolitan area, as this analysis by the University of New Hampshire Institute’s Carsey Center noted, they will be lucky to have one doctor in their town, let alone one knowledgeable about prostheses, or a place to go to for physical rehabilitation. They might easily have to travel hundreds of miles for the medical care they require.
 
The U.S. military health care system is in trouble. And, in fact, if we bothered paying attention, the signs have been there for some time.
 
Joseph Galloway, former senior military correspondent for Knight Ridder Newspapers, wrote last week of his McClatchy Newspapers colleague Chris Adams’ Feb. 9 report that even by its own measures, the Veterans Administration isn’t prepared to give returning veterans the care they need to help them overcome destructive, and sometimes fatal, mental-health problems.

Nearly 100 VA clinics provided virtually no mental-health care in 2005, Adams found, and the average veteran with psychiatric troubles gets about a third fewer visits with specialists today than he would have received a decade ago.
 
Just last weekend an American Psychological Association task force warned that the U.S. military is not fully addressing the needs of troops and family members traumatized by war.

Then consider what happens when U.S. military personnel go from the military medical system over to the Veterans Administration. Newsweek reports that a jump in disability claims in recent years has created a bottleneck. The VA confirms it is coping with a backlog of 400,000 applications and appeals; 75 percent of them were still within a “reasonable” reviewing time frame, he says. Yet, most of those claims were filed by veterans of previous wars (a veteran can file or appeal a claim even decades after discharge). As more servicemen and women return from Iraq, the backlog is likely to increase.

None of this is going to be fixed anytime soon. We’ll be hearing horror stories for decades to come. That would explain why, according to Army Times, soldiers at Walter Reed Army Medical Center’s Medical Hold Unit say they have been told that they must not speak to the media. The Pentagon also clamped down on media coverage of any and all Defense Department medical facilities, to include suspending planned projects by CNN and the Discovery Channel.

Oh, one last thought. What does it say about President Bush that he can not only carry on, but actually reinforce a policy, i.e., the Baghdad surge, which will have the effect of producing even greater number of American military wounded?

As the knowledgeable Peter Galbraith writes in the New York Review of Books:

President Bush’s plan has no chance of actually working. At this late stage, 21,500 additional troops cannot make a difference. US troops are ill prepared to do the policing that is needed to secure Baghdad. They lack police training, knowledge of the city, and requisite Arabic skills. The Iraqi troops meant to assist the effort are primarily Kurdish peshmerga from two brigades nominally part of the Iraqi army. These troops will have the same problems as the Americans, including an inability to communicate in Arabic.

Bush’s strategy assumes that Iraq’s Shiite-led government can become a force for national unity and that Iraqi security forces can, once trained, be neutral guarantors of public safety. There is no convincing basis for either proposition. The Bush administration’s inability to grasp the realities of Iraq is, in no small measure, owing to its unwillingness to acknowledge that Iraq is in the middle of a civil war.

Related posts:

1. Nothing is Too Good For Our Boys So That’s What We’ll Give Them: Nothing: Part 3
2. Nothing is Too Good for Our Boys, Redux
3. Afghanistan: I don’t believe in miracles
4. Put Up or Shut Up