Fifteen years ago today, 19 al-Qaeda terrorists hijacked four American planes, used them as guided missiles, brought down the World Trade Towers, severely damaged the Pentagon, and four terrorists were overpowered by Americans over a field in Pennsylvania. The suicide terrorist attacks killed 2,996, caused more than $100 billion in damages and stole America’s innocence.
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According to a new Pew Research Center poll, the 9/11 attacks continue to be a powerful memory for Americans: 91 percent of adults remember exactly where they were or what they were doing when they heard about the terrorist attacks.
So how has the 15–year “war on terror” changed America? Looking back and forward, can Americans really believe they are safer?
First a bit of history, the “war on terror” rightly started in the tribal nation of Afghanistan. Brand-new President George W. Bush summoned his top advisors to the Oval Office and chose Cofer Black, former CIA whiz, to implement a devastating retaliation for the nearly three thousand deaths. Black offered no mercy and told the rookie president that this effort required a few hundred specially trained military forces, 110 CIA officers, direct firepower, a bunch of money and his plan would end with what Black called – using an old Angola War expression – “when this is all over, the bad guys are going to have flies walking across their eyeballs.”
After 10 weeks, Black and his stealth-fighting machine proclaimed victory. All the Taliban cities, as well as their government, had been toppled.
In a 2013 Men’s Journal interview Black was asked if he briefed the Russians about the impending attack and how the Ruskies responded to his plan. They said, “You’re really going to get the hell kicked out of you.” Black replied, “We’re going to kill them – we’re going to put their heads on sticks… and you know what, the Russians loved it! After the meeting was over, two senior Russian officials, whom I will not name, said to me, ‘Mr. Black, finally America is acting like a superpower!’”
The follow through earned Black and the US the respect that had been sorely lacking.
The success should have ended there. But as we know, it didn’t. Bush ensnared the country into an ill-defined and ill-conceived “war on terror” that continues today.
Whether you agree with the “war on terror” or not, the consequences are very real and very alarming. With the advent of comprehensive counterinsurgency, COIN or nation-building, thanks General Petraeus, the taxpayers have spent trillions of dollars in a region made up of tribal nations.
Case in point, in a recent interview, Commander of Afghanistan US and NATO Forces, General John Nicholson told PBS the war’s progress is tedious. “We’re trying to build an airplane while in flight, OK? So they’re fighting a war while we’re trying to build an army. This is very hard,” he explained.
It must be said that the “war on terror” falls under the asymmetrical category. The sneaky “stateless” armies must be defeated with clear goals and end-state solutions. It’s here where the most powerful armed forces on the planet have stumbled.
In his book the Field of Fight, retired Army three-star General Mike Flynn describes the best way to defeat marauding radical Islamic terrorists. Flynn says to win the battle against radical Islam we must destroy the jihadi armies, kill or capture their leaders, discredit their ideology, create a 21st-century alliance and must hold countries, like Saudi Arabia, accountable for supporting terrorism.
“The best plan gives you the most options at the last possible minute. Right now we don’t have the best plan. A real strategic discussion about what it is that we are trying to achieve. Is it the defeat of radical Islam? It has to be beyond that and that’s where an alliance of nations has to get it together,” Flynn said.
It cost Osama bin-Laden roughly $500,000 to bring down the Twin Towers and Pentagon. In return, the US has suffered tens of thousands of casualties and flushed away trillions of dollars into the Middle East black hole. Plus, hundreds of thousands of Middle Easterners have died and more than 12 million of refugees are now stateless. Newt Gingrich said this week the US has failed so badly in the Middle East that we are giving the number one state sponsor of terrorism, Iran, $1.7 billion in cash, just like a drug cartel.
“So 15 years after 9/11, we’re not winning. We’re not winning in Afghanistan. We’re not winning in Iraq. We’re not winning in Syria. We’re not winning in Libya. We’re not winning in Yemen,” Gingrich emphasized (mimicking Donald Trump). He’s right.
One reason for the protracted war may be the US Foreign Military Sales (FMS) program. American arms and technology companies export, firearms, fighter jets, tanks, as well as Patriot Missile batteries.
The big winner in the Department of State’s 2017 budget includes $5.7 billion for Foreign Military Financing. The main recipients of the proposed budget will be Israel ($3.1 billion), Egypt ($1.3 billion), Jordan ($350 million), Pakistan ($265 million), and Iraq ($150 million).
While the Middle East tops the list, funding for Africa in 2017 will double from last year. Due to ISIS’ expansion into Africa, countries like Mali, Somalia, and Nigeria will see an influx of American weaponry. But why do American leaders want to militarize the African continent? Of course, the prominent argument is; “if the US doesn’t do something then other countries will do it.” However, no other country on the planet finances military sales like the US.
The US and its band of misfit coalition partners have implemented a massive military build-up on the Arabian Peninsula and Israel. Let’s take a look at the military arsenal provided to a few coalition partners, most of which are also classified as human rights violators according to the State Department (link to other FMS article).
For the last three years, the US has provided tens of billions of dollars in military weaponry through Foreign Military Sales (FMS) to the United Arab Emirates (UAE); population 5.6 million, Qatar; population 2.1 million, Kuwait; population 2.7 million and the Kingdom of Saudi Arabia (KSA); population 27.3 million.
The US has also provided both offensive and defensive weapon systems – some are designed to protect against airborne missile retaliation and air attacks. For example, the US supplied Qatar ($9.9B), Kuwait ($4.2 billion), and UAE ($1.1B) with Patriot anti-missile systems and UAE also acquired a $6.5B theater anti-air defense (THAAD) system. This type of weaponry typically protects against missile attacks from such weapons as SCUDs and the MLRS (Multiple Launch Rocket Systems) like the 880 launchers the Islamic Republic of Iran operates. The MLRS has a range of approximately 300 kilometers, making it easily capable of reaching any of the Gulf States of Kuwait, Qatar, UAE, and even KSA.
America also sold KSA $6.7 billion worth of KC-130 aerial refueling tankers, the UAE $4 billion and KSA $6.8 billion of munitions including “bunker buster bombs,” (typically used to attack harden targets like nuclear facilities); Qatar a $1.2 billion early warning radar suite; KSA $1.3 billion for 30 patrol boats for use in the Gulf of Hormuz; KSA $4 billion to upgrade its national guard; Qatar spent $3 billion on Apache Longbow attack helicopters used for special operations insertions. The list also includes the Globemaster long-range air transport planes, Javelin missiles, F-18’s and F-16’s, and Sidewinder anti-air missiles.
Also for last few years, the US has been quietly aiding the rebel insurgency in Syria trying to overthrow the Iranian-backed government of Bashir al-Assad. There have been multiple news reports, (including this report) that the US provided weapons collected from deposed Libyan Dictator Qaddafi and moved them through its CIA clearinghouse in Turkey to supply al-Qaeda-linked extremist groups opposing the Assad regime. It’s worth pointing out that both Qatar and KSA have been major supporters of the anti-Assad insurgency that evolved from a national rebellion and morphed into a major jihadi operation.
Details of this massive military build-up can be found on the Department of State (DoS) website. The DoS oversees Government-to-Government defense transfers through the Foreign Military Sales (FMS) program and is implemented through DoD’s Defense Security Cooperation Agency.
Interestingly, “(I)n addition to FMS, the Department of State also issues export licenses to US companies providing defense articles and services through our Direct Commercial Sales (DCS) efforts, usually after an intensive interagency review to ensure that exports further US foreign policy and national security interests,” a State Department official said. However, “Export license information is not disclosed by the Department due to restrictions under the Arms Export Control Act and International Traffic in Arms Regulations, but general information is released from DCS.”
According to the State Department, in the case of either FMS or DCS, the United States takes into account political, military, economic, arms control, and human rights conditions in making decisions on the provision of military equipment and the licensing of direct commercial sales to any country, in accordance with the Conventional Arms Transfer Policy, the Arms Export Control Act, and relevant international agreements
“Review and monitoring are an integral component of the process for US- origin defense articles delivered to any recipient nation. This is to make sure that those articles are being used in the manner intended and are consistent with our legal obligations, foreign policy goals, and values,” a Senior State Department official said.
And both State and Defense argue that Middle Eastern countries have agreed to work toward US security interests and abide by President Obama’s foreign policy doctrine.
However, looking at the current Middle East conflicts finds every country focused on sectarian protectionism, especially since the Obama administration has seemingly checked out. It is essential that this high-tech arsenal provided to foreign nations by US defense contractors be carefully monitored. The consequences of equipment falling into the wrong hands can be deadly, as it was for flight MH17 in Ukraine.
As the impact of ISIS’ offensive continues to sink in, US intelligence officials contend ISIS did not just randomly explode on the scene in 2014, they claim to have been reporting to high-level government officials the rise as well as the expansion of ISIS since 2012. This murderous organization is largely fueled by Qatar and Saudi Arabia. Deputy Assistant Secretary of State Brett McGurk testified before a Committee claiming, “The ISIS’ operations are calculated, coordinated and part of a strategic campaign led by its Syria-based leader, Abu Bakr al-Baghdadi.”
“This was a very clear case in which the US knew what was going on but followed a policy of deliberate neglect,” said Vali Nasr, the Dean of Johns Hopkins University’s School of Advanced International Studies and a former State Department adviser for the Middle East. During its assault in the region, ISIS received protection from KSA and Qatar. Both nations warned the US not to interfere with ISIS’s march to conquer northwestern Iraq and its turn west toward Syria and Jordan. America obeyed and ISIS gobbled up the region and spoils of war that included American tanks, helicopters, and artillery.
Many military experts said the opportunity to strike ISIS came and went when the 7,500-man Islamic Army crossed the wide-open Damascus-Baghdad Highway.
Military generals said the terror group was vulnerable to air attack with minimal collateral damage concerns. In the end, ISIS got its free passage from Mosul to eastern Syria with US inaction, which was tantamount to acquiescence.
“We oppose all foreign intervention and interference. There must be no meddling in Iraq’s internal affairs, not by us or by the US, the UK or by any other government. This is Iraq’s problem and they must sort it out themselves,” Saudi Prince Mohammed told the UK Telegraph. Just in case that bad intel was on the horizon, the Saudis immediately moved 30,000 combat troops to protect its border with Iraq.
Many Middle East policy experts say the Sunni’s view of ISIS as an Iraqi Sunni revolution against their Shiite oppressors is myopic and portends a broader Islamic war between Sunnis and Shiites.
From the US perspective, the ISIS campaign presents a myriad of conflicts. Qatar and KSA are major recipients of billions of dollars worth of US weapons through FMS, yet their direct support of ISIS, a terrorist group, means Qatar and KSA meet the definition of state sponsors of terrorism and should be banned from participation in the military program. Nevertheless, the end user certificates and export licenses are routinely approved by the State and Defense Departments, including an $11 billion sale to Qatar. (The Pentagon has refused multiple efforts to release the end-user agreements to this reporter as requested under FOIA.)
Furthermore, Qatar, KSA, and Kuwait are listed as Tier 2WL (Watch List) and Tier 3 under U.S. anti-trafficking in humans reports, which require a waiver by President Obama stating the sale is in national security interests. To the outside world, the US ostensibly appears to be violating its own anti-terrorism and anti-trafficking laws to provide sophisticated weapons systems to these human rights violators.
The infusion of military-grade weapons in the region only portends much more war. The war between the Sunnis and Shiites has grown more contentious due to the dysfunction of the Sykes-Picot Agreement of May 1916. Essentially the Agreement drew a twentieth-century map that granted control of Syria, Lebanon and Turkish Cilicia to the French and Palestine, Jordan and areas around the Persian Gulf, Baghdad to the British. That was followed by the 1919 Paris Peace Conference that outlined a “Kurdistan” as an entity by Şerif Pasha, who represented the Society for the Ascension of Kurdistan (Kürdistan Teali Cemiyeti). That promise was never kept and it’s doubtful the Kurds, who are Caucasian or Indo-European and not Arab, will wait another 100 years to establish their own country, one that will control its destiny through its own oil and revenues from oil pipelines from the Caspian Sea.
The complexity of the middle east today reflects Winston Churchill’s description of Russia in October 1939: “I cannot forecast to you the action of Russia. It is a riddle, wrapped in a mystery, inside an enigma; but perhaps there is a key. That key is Russian national interest.” Perhaps Russia is the key to the Middle East today.
Neither agreement ever took into account the tribal nature of the region that will continue to dog the Middle East until new maps emerge, or complete Armageddon is achieved. Until that day, America will continue to find itself under the threat of attack from a region that really doesn’t offer the US much. So are we safer after 15 years of war? Stay tuned!
© Copyright 2016 Kimberly Dvorak All Rights Reserved
While the public focus in Afghanistan is the killing of civilians by an American soldier, little is reported on the toll this war is taking on veterans and their families.
The never-ending war in the Middle East has consequences, serious consequences. According to an October 2011 policy brief the U.S. Armed Services are losing the suicide battle on the home front.
The report concludes that a U.S. veteran kills himself every 80 minutes while Operation Iraqi Freedom/Operation Enduring Freedom service members is committing suicide every 36 hours. These statistics are staggering in light of the fact that only one-percent of the American population serves in the military, yet the military accounts for roughly 20 percent of the national suicide rate.
Veterans and service members report substantial paperwork and even longer wait times as one reason they don’t get the proper treatment for Post Traumatic Stress Disorder (PTSD) or Traumatic Brain Injury (TBI).
Another challenge military personnel face is the stigma attached to the term PTSD. Many service members can be ridiculed by fellow soldiers, told to toughen up by superiors or don’t fill out the required paperwork to seek counsel.
The military disconnect regarding the pervasiveness of PTSD within the military is a contributing factor to suicide. If the military leadership wants to turn the suicide numbers around, mental health care providers must work in concert with commanders to enforce guidelines for PTSD/TBI diagnosis and treatment.
“The responsibility inherent in military service, the importance of tasks assigned to relatively junior personnel and the high level of interaction among unit members establish the importance and usefulness of each unit member, particularly in an operational environment. In contrast, the experience of living in a garrison environment (for active component personnel) or returning to a civilian job (for Guardsmen, Reservists and veterans) or, worse, unemployment, can introduce feelings of uselessness. Individual accounts of military suicide both in the media and in interviews with us echo this sentiment. Over and over, these accounts show that individuals withdrew, felt disconnected from their units and their families, and perceived themselves as a burden,” Dr. Margaret Harrell and Nancy Berglass cited in their study.
While senior military leaders at the Department of Defense say they are exerting more energy than ever before to prevent the skyrocketing suicides, the dysfunctional relationship between DOD and the Veteran Affairs does little to provide adequate treatment options for veterans suffering from PTSD/TBI.
The DOD touts its “Never Let Your Buddy Fight Alone” program as a successful deterrent to suicide. And the VA’s Veterans Crisis hotline said their efforts to recognize the seriousness of suicide prompted nearly 150,000 hotline calls. The VA claims they saved 7,000 “actively suicidal veterans.” Yet, suicides remain alarmingly high.
The military must protect and care for those who voluntarily serve the country and return home with PTSD/TBI injuries. Suggestions made by this report includes; unit cohesiveness (returning soldiers should remain together as a group for at least 90 days after deployment), ensuring the military either has access or hires enough mental health providers to meet the needs of returning soldiers, and Congress needs to establish a federal pre-emption of state licensing, so providers can be treated across state lines.
Another area the military hierarchy must improve is dramatically changing the questions contained in the “Post Deployment” questionnaire.
“As service members return home from deployment, they complete a post-deployment health assessment (PDHA). As part of this assessment, they are asked questions about their physical and mental health, such as, “Did you encounter dead bodies or see people killed or wounded during this deployment?” and “During this deployment, did you ever feel that you were in great danger of being killed?” There are also self-evaluative questions, such as, “Are you currently interested in receiving information or assistance for a stress, emotional or alcohol concern?” While we do not question the contents of the assessment, its administration has been problematic,” the report explained.
According to a 2008 study (Christopher H. Warner et al., Importance of Anonymity to Encourage Honest Reporting in Mental Health Screening After Combat Deployment), when Army soldiers completed an anonymous survey, the reported rates of depression, PTSD, suicidal attempts and an interest in receiving care were two to four times higher than the current PDHA test used by military personnel.
“Likewise, our interviews with veterans uncovered numerous accounts of returning service members whose unit leaders advised them to fabricate answers. Individuals across all services have been told, ‘If you answer yes to any of those questions, you are not going home to your family tomorrow.’” This may be factually correct, but it neglects to inform service members of the implications of answering untruthfully – namely, that they will have difficulty receiving treatment or compensation for mental health problems that appear after their service. As an improvement, the 2010 National Defense Authorization Act requires trained medical or behavioral health professionals to conduct the PDHA evaluations individually and face-to-face, in the hope that service members will respond honestly to a trained health professional. PDHA evaluations individually and face-to-face, in the hope that service members will respond honestly to a trained health professional.”
In conclusion, the study outlined the military’s vulnerabilities concerning the treatment of PTSD/TBI. “Although a goal of no suicides may be unachievable, the increasing number of suicides is unacceptable. Additionally, although benefits and services available from the Veterans Health Administration will likely remain the best system of care for veterans, the DOD has a moral responsibility to acknowledge and understand former service members,” researchers said.
“America is losing its battle against suicide by veterans and service members. And, as more troops return from deployment, the risk will only grow. To honor those who have served and to protect the future health of the all-volunteer force, America must renew its commitment to its service members and veterans. The time has come to fight this threat more effectively and with greater urgency.”
The real question Americans need to ask, “is the 10-year Middle East War worth the cost in blood and treasure? And if so, how do military personnel intend to care for those who suffer the invisible PTSD/TBI wounds?
The clash in Afghanistan is between cultures, religions, and political institutions. Returning warriors continue to complain that Afghanistan will never be molded into a “state” with the ability to be a productive member of the world community. Its tribal tendencies will always shift with opportunities from religious zealots. Bush was wrong to “nation-build” in Afghanistan, and Obama is wrong to continue to feed the corruption and profiteering of Afghan President Karzai’s sect at the expense of American warriors. How do the military/civilian leaders intend to care for soldiers with visible or invisible wounds?
Yes, war is hell, but unless U.S. soldiers are authorized to “win” all Americans should stand together and demand an end to a seemingly endless war.
Following are links to four stories written by this reporter last year questioning the continuation of military/political actions in Afghanistan. The staggering levels of corruption alone should jolt Americans from their complacency; especially since the U.S. debt surpasses $16 trillion.
Part one; http://www.examiner.com/county-political-buzz-in-san-diego/u-s-troops-fight-and-die-to-preserve-shariah-law-afghanistan
Part two; http://www.examiner.com/county-political-buzz-in-san-diego/us-payments-to-taliban-afghan-warlords-threaten-american-nato-troops
Part three; http://www.examiner.com/county-political-buzz-in-san-diego/billion-dollar-corruption-within-the-u-s-picked-afghan-regime
Part four; http://www.examiner.com/county-political-buzz-in-san-diego/terrorism-s-down-payment-the-form-drugs-and-u-s-aid-money-part-4
For more stories; http://www.examiner.com/homeland-security-in-national/kimberly-dvorak
© Copyright 2012 Kimberly Dvorak All Rights Reserved.
As the nine-year “War on Terror” rages onward, high suicide rates, multiple deployments and lack of psychological treatment for Post Traumatic Stress Disorder (PTSD) alarms military personnel and many point to the real cost of the Middle East offensive will be health care after the war has ended. This disparity will likely exact a large toll on the nation’s military readiness in future conflicts.
Several reports including the Rand Study, Harvard Study and Dole-Shalala Commission find that the real cost of the war effort will come long after the fighting has ended and soldiers seek treatment for a myriad of injuries they suffered on the battlefield.
The signature injuries and perhaps the hardest to document are the elusive and well-hidden Traumatic Brain Injury or TBI and PTSD.
When soldiers return from the Middle East they are subjected to a plethora of details that need to be taken care of so they are able to receive adequate treatment, make their adjustment to life outside the battlefield and return to their families.
Since most deployments last months if not more than a year, most returning service members hastily scan through the mountains of paperwork in an effort to get home quickly.
Among the forms each soldier receives is a self-assessment for PTSD. When asked what the questions consist of and how many questions are on the PTSD evaluation form, Walter Reed Army Medical Center, Gigail “Gail” Cureton media relations said, “That’s not information we release.”
However, the question doesn’t lie with how many or what the content of the questionnaire contains, but the fact it is a self-assessment. Many soldiers may not show signs of TBI/PTSD until weeks or even months after they return home and as many reports cite there are simply not enough military trained staff to adequately take care of the men and women who serve in conflict zones overseas.
The Harvard Study concluded that the Veterans Health Administration (VHA) is already overwhelmed by the volume of returning veterans and the seriousness of their health care needs, and it will not be able to provide high quality of care in a timely fashion to the large wave of returning war veterans without greater funding and increased capacity in areas such as psychiatric care.
The study also pointed out the Veterans Benefits Administration (VBA) needs structural reforms
to deal with the high volume of pending claims and that the present claims process is unable to handle the current volume and will be completely inadequate to cope with the high demand of returning war veterans once the troops come home next summer.
With regard to the budgetary costs of providing disability compensation benefits and medical care to the veterans from Iraq and Afghanistan over the course of their lives the estimates range from the $350 – $700 billion and this scares many in Congress.
The Harvard Study concluded that the money needed to care for the soldiers depends on the length of deployment, the speed they claim disability benefits and the inflation rate of pending health care costs.
This staggering cost of medical treatment threatens to further bankrupt the Department of Defense and VA agencies and cause grave concern to some on Capitol Hill.
Yet, the summer offensive in Afghanistan rolls onward and injuries and death tolls continue to mount.
Key recommendations the Harvard Study suggests include more staffing in preparation for the influx of soldiers, increased funding especially in the mental health care treatment, funding of “Vet Centers” and perhaps the toughest is the need to restructure the benefit and claim process the VA uses.
Currently there are 37 bills, two resolutions, and two amendments to bills relating to Post Traumatic Stress Disorder and/or Traumatic Brain Injury somewhere in the legislative process. At least 11 of these deal with both issues. Of these bills, resolutions and amendments, three are now law (H.R. 2647, H.R. 3288, S. 1963), but none solves the problems facing returning veterans.
In a recent Military Times article the Veterans Affairs Department was asked how they should handle the tsunami of soldiers headed their direction. “In my judgment, it cannot be fixed,” said Peter Levin. “We need to build a new system, and that is exactly what we are going to do,” said the Veterans Affairs Department’s chief technology officer.
Among the plethora of issues facing the VA is the current backlog of 1.1 million claims that are awaiting decisions and how to best fix the error rate that hovers around 17-25 percent margin.
While veterans are waiting for their claims to be processed or reprocessed they run into all kinds of problems with managing their daily expenses which can lead to the loss of their cars and homes.
“It looks like we are going backwards rather than forward,” Congressman Bob Filner (D-CA) said. “No matter how much we raise the budget, no matter how many people we hire, the backlog seems to get bigger. People die before their claim is adjudicated. They lose their home. They lose their car,” Filner explains in the same Military Times article.
Solutions, however, are harder to come by in the bureaucratic quagmire of Washington DC. The VA Secretary
Eric Shinseki suggests the VA needs to hire more people to process claims. But what the VA really needs is more medical staff to treat the influx of soldiers suffering from TBI/PTSD and this process takes years to train workers something the VA does not have.
The VA hierarchy is looking at a three-to five-year range to fully train medical professionals to take care of the “War on Terror” veterans.
In the meantime, soldiers will be asked to wait.
The Rand Study titled “Invisible Wounds of Wars – Psychological and Cognitive Injuries, their consequences and services to assist recovery,” further delves into the serious problems returning soldiers face when it comes to treatment.
The study focuses on post-traumatic stress disorder, major depression and traumatic brain injury. These injuries were at the forefront “not only because of current high-level policy interest but also because, unlike the physical wounds of war, these conditions are often invisible to the eye, remaining invisible to other service members, family members and society in general. All three conditions affect mood, thoughts, and behavior; yet these wounds often go unrecognized and unacknowledged. The effect of traumatic brain injury is still poorly understood, leaving a large gap in knowledge related to how extensive the problem is or how to address it,” the report summarized.
In July of 2007, President Bush received a report on a study his administration requested. Oftentimes when reports are commissioned, facts are dissemination, parties questioned and recommendations made. However more often than not these commissioned reports are read, talked about and put away in a drawer with no further thought of change.
Nowhere is this more true than the bipartisan report the Bush Administration requested from Bob Dole and Donna Shalala; “Serve, Support, Simplify Report of the President’s Commission on Care for America’s Returning Wounded Warriors” dated, July 2007.
The 40-page report suggested the Department of Defense and VA should develop integrated care teams of physicians, nurses, and allied health professionals from relevant specialties like, social workers and vocational rehabilitation staff.
These teams would be able to create injured service members’ initial ‘Recovery Plans,’ which would start with a comprehensive clinical evaluation upon return from the war theater.
The DoD and VA would direct staff at military medical facilities to complete these Recovery Plans and a plan be created for all service members who have been seriously injured since the beginning of the Afghanistan and Iraq conflicts. This would make future treatment of wartime injuries easier to document and get benefits to those who served in a time efficient manner.
The Dole-Shalala report also drove home the point that DoD and VA needs to work with the Commissioned Corps of the Public Health Service and Department of Health and Human Services to develop a cadre of well-trained, highly-skilled Recovery Coordinators (however these coordinators only added another layer of bureaucracy and their results have been negligible).
At the conclusion of the Dole-Shalala report they included results from an Operation Enduring Freedom and Operation Iraqi Freedom survey. The numbers were not encouraging.
It is thought that many young people join military service as a way to earn money for a college education, but the report found that only 21 percent of demobilized reservists and 31 percent of retired/separated service members actually enrolled in an educational program leading to a degree. It is also worth pointing out that OEF/OIF soldiers are suffering from unemployment numbers in the 20-30 percent range.
When it comes to understanding the claim and benefit process the numbers were even more disturbing.
Approximately 38 percent of active duty, 34 percent of reserve component and 38 percent of retired/separated service members are “very” or “somewhat” satisfied with the disability evaluation system. Only 46 percent of active duty, 36 percent of reserve component, and 40 percent of retired/separated service members say they “completely” or “mostly” understand the military’s disability evaluation process. While 42 percent of retired/separated service members who filed a VA claim report that they “completely” or “mostly” understand the VA claims process. All of these numbers give the DoD and VA a failing grade.
Dole-Shalala also believe the DoD and VA needs to create a single, comprehensive, standardized medical examination and that it be administered by the DoD. The single examination would serve Department of Defense’s purpose of determining fitness so the Veteran Affairs’ can determine the initial disability rate.
If service members are found unfit because of their combat-related injuries Dole-Shalala say they should receive comprehensive health care coverage and pharmacy benefits for themselves and their dependents through DoD’s successful TRICARE program.
When it comes to TBI and PTSD many see psychological problems as nonsense. It is up to the DoD to intensify its efforts to reduce the stigma associated with PTSD and ensure they question all returning war-theater soldiers to set benchmarks for future treatments.
Part of this process could include strengthening family support programs; expand DoD respite care and extending the Family and Medical Leave Act for up to six months for spouses and parents so they can care for their seriously injured soldiers.
Now that Congress has passed a health care reform bill, private insurance companies will begin the arduous task of transferring all medical records onto a new electronic data base. However, it may make sense for the Department of Defense and Veteran Affairs to ‘jointly’ develop an interactive “My e-Benefits” website that provides a single information source for all service members to access. Most agree that the DoD and VA is a small microcosm of the American population making it the perfect organization to integrate the electronic medical record keeping program.
The consolidation of electronic medical records should be tied to a Social Security number, similar to how the Social Security retirement program is currently operated. Military experts say this process would cut red tape for veterans when it comes to receiving services in either the DOD or VA.
Currently the military medical programs operate on entirely different systems causing unnecessary delays in care and headaches for those attempting to navigate the complex DoD/VA benefits system. The creation of an e-benefits page would allow soldiers to have a one-stop site to chart their benefits and be reminded of important deadlines and treatments.
Lastly, understanding the unquantifiable problem of Post Traumatic Stress Disorder requires an immense amount of work something the military has been reluctant to embrace.
The self-assessment for PTSD must be changed and it has been suggested an in-depth test administered by psychological health care professional that is better qualified to determine the PTSD problems the returning war veterans may or may not have.
The 2007 estimates on soldiers suffering from PTSD of varying degrees of severity affects approximately 12 to 20 percent of returnees from Iraq and six to 11 percent of returnees from Afghanistan. However, most psychological medical professionals believe that number to be much higher as many don’t return with symptoms right away and a future event could trigger the PTSD at anytime.
Through 2007, 52,375 soldiers have been seen in the VA for PTSD symptoms. Severe and penetrating head injuries or TBI can be readily identified, but cases of mild-to-moderate TBI can be more difficult to identify and their incidence is much harder to determine.
A recent report indicated that approximately 35,000 returnees were believed to be healthy after a screening test; however 10 to 20 percent had apparently experienced a mild TBI during their deployment. Medical experts agree that those soldiers who suffer from TBI will most likely have PTSD. Multiple deployments automatically increase the odds of soldiers getting both TBI and PTSD during the Middle East conflict.
Once a soldier is severely injured in the ‘War on Terror’ their life will be forever changed. However, what remains unchanged is the quality of life issue. The earning ceiling for those who survive amputations, serious head trauma and other debilitating injuries will be in play the moment the injury occurs.
The earnings/loss payments are supposed to make up for any reduced earning capacity and quality-of-life issues. Nevertheless these payments that are meant to compensate for permanent losses of various kinds of injuries needs to be reviewed to provide better reimbursements for those who will have trouble reentering the civilian workforce.
If service members are found unfit because of their combat-related injuries they should receive lifetime, comprehensive health care coverage and pharmacy benefits for themselves and their dependents through DoD’s favorable TRICARE program.
Daily stressors will continue to plague soldiers the rest of their lives, at the very least the government can ensure money matters are not a part of the equation for the injured soldier and their families. Americans would do well to remember that these soldiers made a life-long sacrifice to ensure the freedom and safety of all – as a result they need to be honored with integrity and respect.