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
On Sunday the world collectively sighed when news broke the most wanted terrorist and brainchild of 9/11 was finally killed. Osama bin Laden was hiding in plain sight-in a Pakistan town with major military bases, academies and neighbors.
After nearly 10 years of searching for bin Laden, U.S. intelligence agencies finally put the puzzle pieces together and it doesn’t reflect well on Pakistan.
According to the Obama Administration, higher-up boots on the ground in Afghanistan determined last summer that Pakistanis may not be helping U.S. and NATO forces, but instead assisting the Taliban and al Qaeda terrorists by providing safe havens and tipping them off to planned missions led by the Coalition forces.
However, to make that statement plausible, means someone in the military or intelligence didn’t do their homework, because in 2003/04, a plan was hatched by Army Lt. COL Anthony Shaffer entitled “Operation Dark Heart.” He reported that Pakistan officials were not friends of the U.S., and they were playing both sides of the war efforts.
In the midst of Intel gathering, COL Shaffer, who was running the Defense Intelligence Agency in Afghanistan, discovered credible intelligence that Pakistan was home to the “al Qaeda Hotel.” Multiple intelligence officers pin-pointed the town of Wana, located in Pakistan about 20 miles from Afghanistan, as a base where the Afghan insurgency would hold-up and re-group.
COL Shaffer and others determined the “al Qaeda Hotel” was much more than a resting point, “it was a full-blown military headquarters for insurgents.” The problem was the facility was located in Pakistan and the U.S. respected their sovereignty too much to cross the border without permission. And permission would have meant the insurgents would be tipped off to the U.S. raid.
Armed with this new information, COL Shaffer decided to draw up a mission- that became known as “Operation Dark Heart.” “I was hopeful that my superiors would give me a thumbs up to implement Dark Heart, especially since there was strong likelihood the site housed a high value target (HVT).” COL Shaffer said that HVT was al Qaeda’s number two leader, Ayman al-Zawahiri, an Egyptian-born doctor who adheres to the radical Islam theology and most likely contender for the al Qaeda top job.
During a preliminary presentation, COL Shaffer was given the green light to develop Operation Dark Heart. Shaffer says it only took about two weeks to draw up detailed plans. And only a few days gain approval from U.S. commanders in Afghanistan. “It was good news,” he thought.
While COL Shaffer was planning the offensive he remembered his hero, George Patton’s statement; “In war, the only sure defense is offense and the efficiency of offense depends on the warlike souls of those conducting it.” With that in mind COL Shaffer put together a plan to break the back of the insurgency.
Operation Dark Heart seemed to be on the road to becoming a reality, in fact, COL Shaffer learned the Coalition General, supported the operation was confident that COL Shaffer’s approach would lead to success. However, the General would leave Afghanistan before Shaffer’s plan was operational.
The new General in charge of the Afghan War didn’t share the enthusiasm for Dark Heart and informed COL Shaffer it was over and the U.S. would not cross the Pakistani border without permission. Operation Dark Heart was being shelved.
During the planning stages of Dark Heart Shaffer feared the CIA would inadvertently leak the details regarding the operation to the ISI. “Once the Pakistanis knew, the Taliban would find out,” COL Shaffer stated.
He speculated that his intelligence regarding Wana, home of the al Qaeda Hotel had eventually been shared with the Pakistanis, who then “let al-Zawahiri escape…probably deliberately during the Battle of Wana,” Shaffer told Playboy magazine.
Specifics regarding Operation Dark Heart, which could have led Americans to the capture of Al Qaeda’s number two leader, Dr. Ayman al-Zawahiri, were eventually panned by Coalition Lieutenant General David Barno.
While Shaffer’s Dark Heart plan to penetrate the so-called “al Qaeda hotel” in Wana, Pakistan was shot down, his Intel proved to be on target. Ultimately the Pakistani Army engaged Taliban forces in Wana and surrounded one of bin Laden’s deputies.
However, Dark Heart weighed heavily on COL Shaffer and the U.S.’s inability to fight the war effectively led the Colonel to write a book detailing his Afghanistan War experiences. The book aptly titled “Operation Dark Heart” chronicled gritty details regarding Pakistan’s and U.S. complicity with insurgents and the contents eventually led to the Pentagon stepping forward, objecting to the recount of the war and trying to quash the tell-all book.
That book, which was originally approved by Department of Defense, would become a battle royal last summer. In the end the DoD would purchase all 10,000 first editions from the publishers, St. Martin Press, forcing them to re-release a heavily-redacted book. The orgional contents of the book even caused a bidding frenzy on eBay, many wanted to know what the Pentagon was trying to cover-up.
Flash forward to the bin Laden raid in Abottabad, Pakistan. As details of bin Laden’s demise emerged one couldn’t help but compare many of the principles behind Dark Heart to the raid on the Osama compound over the weekend.
When COL Shaffer was asked about the similarities he replied with humbleness. “It took awhile and I don’t know how much of my Operation Dark Heart plan they used, but I’m honored to have played a small role in bin Laden’s demise.”
Shaffer says, “It never came out in the book, because they made me lose it, but if Operation Dark Heart hadn’t been stopped, we might have broken the back of Al Qaeda…my guess is that the DIA forced the cuts [from my book] to minimize this incredibly bad call on a mission that might have led to the capture of Al Qaeda’s number two.”
If the military followed through with Shaffer’s plan to break the back of al Qaeda one wonders how many lives could have been save?
Pakistan’s role in the War on Terror
It appears that sometime in the past few years the major players in the military and intelligence fields finally came to the conclusion that Pakistan could not be trusted.
In a report released by the London School of Economics last year, the authors provided specific details that Pakistan’s Inter-Services Intelligence (ISI) were closely aligned with Afghan insurgents. Perhaps even more troubling is a report from the United Nations that illustrates that the ISI is currently working with jihad groups inside Afghanistan trying to undermine the U.S./NATO operations.
In recent months many high-ranking U.S. officials have accused Pakistan of collaborating with terrorists in the region. Admiral Mike Mullen, the U.S. Joint Chiefs of Staff chairman said earlier this year that, “It’s fairly well known that ISI has a long standing relationship with the Haqqani network (a faction of the Taliban). And Haqqani is supporting, funding, training fighters that are killing Americans and killing coalition partners…that’s the core (issue) that I think is the most difficult part of the (Pakistan) relationship.”
As war dragged on it became increasingly clear that Pakistan was not forthright about their ties to terrorist networks. In an interview with NBC’s Brian Williams, Leon Panetta, Director of the CIA, acknowledged that Pakistan was kept in the dark about the bin Laden operation.
“The Pakistanis did not know…And that was deliberate on our part that this would be conducted as a unilateral mission. President Obama had made it very clear to the Pakistanis that if we had good evidence as to where Osama bin Laden was located we were going to go in and get him,” Panetta said.
Perhaps even more concerning about the complicity Pakistanis have with insurgents inside their country is the fact bin Laden’s hide-out compound is home to many of Pakistan’s premier military bases and retired military residences- it’s hard to believe they didn’t noticed something strange about the million-dollar hide out bin Laden lived in for the past five years.
The bottom line is that after meticulous preparation by U.S.military Special Forces – America got bin Laden. And the message being spread around the world today is the elite U.S. military and intelligence officers will not stop hunting terrorists and there is no place to hide.
In the end, COL Shaffer agrees with Panetta on a few points. American intelligence and the Obama Administration learned from the failed and disastrous Iran hostage rescue as well as the Somali Black Hawk Down missions.
“(Those events) were clearly part of the debate,” Panetta said. “This was a risky mission…and the President obviously felt that we had that obligation to act.”
The gamble certainly paid off, but if America wants to keep the momentum going, COL Shaffer says it’s much like electoral politics in America it’s, “Ohio, Ohio, Ohio.” And in the Middle East it is “Pakistan, Pakistan, Pakistan.”
Up next: Navy SEALs get the job done.
© Copyright 2011 Kimberly Dvorak All Rights Reserved.
After reviewing Afghan custom records, the Wall Street Journal reported that during a three-year period more than $3.1 billion in U.S. dollars left Afghanistan through the airport destined for Middle Eastern countries like Dubai and Abu Dhabi. More than $3 billion has been shipped from a country the CIA Fact Book claims only collected $1 billion in taxes annually.
However, U.S. officials believe the number to be much higher. A senior U.S. official said one courier alone removed $2.3 billion in the second half of 2008 and into 2009.
Investigators believe the cash is being siphoned from legitimate Western aid programs and being declared, placed in suitcases and pallets, and shipped to safe havens with the knowledge of the U.S. and NATO officials. For example, NATO gave Afghanistan approximately $14 billion last year.
“More declared cash flies out of Kabul each year than the Afghan government collects in tax and customs revenue nationwide. It’s not like they grow money on trees here,” said one U.S. official investigating the corruption and Taliban. “A lot of this looks like our tax dollars being stolen. And opium (poppies), of course.”
President Karzai’s brother, Mahmood, who coincidentally is a U.S. citizen (under investigation for racketeering in the U.S.), contends it is the political opponents who are skimming money and sending it out of the country.
“Yes, millions of dollars are leaving this country but it is all taken by politicians. Bribes, corruption, all of it,” Mahmood Karzai says.
Even more perplexing is the fact Mahmood Karzai fears nothing and even dares the U.S. to investigate. “Let’s find out who is taking it. Let’s not go on rumors.” He continues to explain that he has talked with U.S. officials about this corruption and maintains his innocence when it comes to profiting from U.S. contracts.
Afghanistan’s Finance Minister Omar Zakhilwal confirmed there is missing money at a press conference, “We do not even know about it. We don’t know whose it is, why it is leaving, or where it is going.”
Senior officials are complaining that money is leaving faster than anyone realizes. “You get boxes loaded on the back of airplanes. You get guys, literally, bringing boxes of cash onto the plane.”
Another method used to get money out of Afghanistan is the airport’s VIP area. Often the VIPs are driven straight to their planes where they load their cash directly on board and fly off, according to Afghan General Asif and U.S. officials.
General M. Asif Jabar Khail, the chief customs officer at Kabul airport, described a recent incident where he came across one VIP who was taking undeclared millions out of the country and when they tried to stop the VIPs flight to Dubai, they were met with fierce opposition from higher-ups in the Afghanistan government. “It came from very, very senior people. They told me there was an arrangement with the central bank and told me to let it go.”
President Hamid Karzai sees the money changing hands differently. “Making money is fine and taking money out of the country is fine. The relatives of government officials can do this, starting with my brothers. But there’s a possibility of corruption.” If this is true why does America and NATO continue to send billions to such a corrupt country?
Middle men just making a buck
The preferred method of money transfer in Afghanistan moves through “hawalas.” This is a system the Muslim countries have used for many centuries.
The rules surrounding the money changers or “hawala” are sketchy and the handlers keep track of millions/billions in a simple notebook. There is no electronic process for the centralized government to monitor the money exchanging hands.
According to U.S. officials, Afghan couriers reportedly name the hawala responsible for handling the first transfer of the money as well as the second handler accepting the cash in other countries like Dubai.
These hawala’s are the backbone of the Afghan financial sector and the State Department discloses that 80-90 percent of all the monetary matters pass through the primitive hawala system.
While this fraud is sure to anger the U.S. taxpayer, there is even more money being carried through Afghanistan’s porous borders. Afghan officials claim there is more than $10 million that crosses the border each day. This adds up to an additional $3.65 billion a year.
Officials agree that much of the insurgency money is derived from the illicit opium trade, as drugs have long been an easy way for rebels to earn the capital needed to fight a war.
Part four; Terrorism’s down-payment in the form drugs and U.S. aid money
© Copyright 2011 Kimberly Dvorak All Rights Reserved.
President Obama said that the Department of Veterans Affairs will begin the process of making it easier for veterans suffering from post-traumatic stress disorder (PTSD) to get the treatment and benefits they need.
“Just as we have a solemn responsibility to train and equip our troops before we send them into harm’s way, we have a solemn responsibility to provide our veterans and wounded warriors with the care and benefits they’ve earned when they come home,” Obama said in a weekly radio address.
“We also know that for many of today’s troops and their families, the war doesn’t end when they come home,” Obama admitted. “Too many suffer from the signature injuries of today’s wars: post traumatic stress disorder and traumatic brain injury (TBI). And, too few receive the screening and treatment they need.”
For many returning war veterans they “have been stymied in receiving benefits” because they had to produce a plethora of paperwork and prove they suffered a traumatic event that caused PTSD. The President insisted that streamlining the process would “help both the veterans of the Afghanistan and Iraq Wars, along with generations (veterans from other eras), who have served and sacrificed for the country.”
However the Chairman of the House Veteran Affairs Committee, Rep. Bob Filner (D-CA) says soldiers shouldn’t prove they have PTSD, but they should have to prove they don’t. The Congressman has worked tirelessly on these issues and believes the military is letting down the soldiers by not decompressing these guys once they return from the battlefield.
The new PTSD regulations will relieve veterans from proving a single wartime moment that caused the hopelessness and fear. Now veterans only need to show evaluators they served in a region where there would be cause to fear the reprisal of terrorist attack.
“I don’t think our troops on the battlefield should have to take notes to keep for a claims application. And, I’ve met enough veterans to know that you don’t have to engage in a firefight to endure the trauma of war,” Obama said.
The American Legion’s Veterans Affairs and Rehabilitation Division Barry Searle concurs; “This requirement seems to be a step backward in an otherwise commendable move by the VA. Private healthcare providers should be given the opportunity to work with veterans and diagnose those who suffer from PTSD.”
Searle points out that if the VA has real concerns about the treatment methods of PTSD assessment standards, “it should create a certification process for private practitioners that would satisfy its requirements.”
If the government opened up returning veterans to the Tri-Care health program, which is similar to a PPO health care plan, the private sector doctors could alleviate the backlog for PTSD/TBI treatment.
“When the VA makes claims they have enough doctors on staff to take care of the PTSD cases they are wrong. I just went to the La Jolla, CA VA and they said there was a hiring freeze for psychiatrists,” Filner said. “It’s baloney; we don’t have enough psychiatrists to treat these guys and girls.”
One congressional analysis reportedly put the cost of the new changes at $5 billion
A senior department official said the price tag is “relatively small.” Under the older system bureaucrats claimed veterans eventually received the treatment they needed and hoped the new “stealthy process” would speed up the wait time. White House Senior staffers said the new process should also bring the cost of treating PTSD down.
The Veterans Affairs Department Secretary, Eric Shinseki complimented the new PTSD treatment process and said the new directive was another critical step forward in providing an easier process for combat veterans seeking health care treatment and disability compensation. The new VA regulation was published in the Federal Register last week.
“This nation has a solemn obligation to the men and women who have honorably served this country and suffer from the often devastating emotional wounds of war,” Secretary Shinseki said. “This final regulation goes a long way to ensure that veterans receive the benefits and services they need.”
By publishing a new regulation in the Federal Register it clears the way for the VA to simplify the process for a veteran to claim service connected PTSD immediately. In return the VA reduces the evidence needed if the trauma claimed by a veteran is related to fear of hostile military or terrorist activity and is consistent with the places, types, and circumstances of the veteran’s service.
Shinseki said the science-based regulation relies on evidence that concludes a veteran’s deployment into a war zone is link enough to increase the risk of developing PTSD.
Looking back at PTSD pitfalls
In the past, VA claims adjudicators were required to corroborate that a non-combat veteran actually experienced a stressor related to hostile military activity. The new rule simplifies the development that is required for these cases and will make it easier for those serving to receive the treatment they have been denied in the past.
However, it’s Rep. Filner’s view that the military “has a much deeper problem.” Filner also alludes to the stigma attached to PTSD. “The military doesn’t want to know the full extent of the problem; they just don’t want to know.”
Nevertheless the VA expects this new rule will decrease the time it takes the VA to decide access to care.
Shinseki claims there are more than 400,000 veterans currently receiving compensation benefits that are service connected for PTSD. Congressman Filner challenges this number and believes the number is much greater than anyone is willing to admit and the VA could not handle an influx in veterans coming forward.
In the private sector, PTSD has been a medically recognized anxiety disorder that can develop from seeing or experiencing an event that involves actual threatened death or serious injury to which a person responds with intense fear, helplessness or horror, and is not uncommon among war veterans.
Filner says he has been trying to encourage the military to add an eight week decompression course for all soldiers to attend. “Right now the veterans coming home are asked two questions to self assess a PTSD problem. On top of that many of the Commanding Officers tell them to mark no on the questionnaire so they can get home faster,” Filner explained.
The program Filner describes could take place at their home base with brothers in arms, family members and trained clinicians. “This would be a good dovetail with job training classes as well,” he said.
The costs led to the new VA regulation
The process of change within the giant bureaucracy that is Washington D.C. came about in part by testimony of Barton F. Stichman, Joint Executive Director of the National Veterans Legal Services Program.
“Under current law, VA has to expend more time and resources to decide PTSD claims than almost every other type of claim. A major reason that these claims are so labor intensive is that in most cases, VA believes that the law requires it to conduct an extensive search for evidence that may corroborate the veteran’s testimony that he experienced a stressful event during military service,” Stichman testified to at the House Veterans Committee.
“According to the VA, an extensive search for corroborating evidence is necessary even when the medical evidence shows that the veteran currently suffers from PTSD, and mental health professionals attribute the PTSD to stressful events that occurred during military service.”
“Often there is no corroborative evidence that can be found – not because the in-service stressful event did not occur – but because the military did not and does not keep detailed records of every event that occurred during periods of war in combat zones,” he concluded.
Veterans’ Affairs Subcommittee on Disability Assistance and Memorial Affairs conducted the hearing to discuss the compensation owed for mental health. The hearing addressed the difficulties veterans encounter when they are required to prove stressors in order to receive service-connected compensation for PTSD that occurred as a result of their military service.
A different outcome for British soldiers with PTSD
When looking into PTSD issues in other countries, a report shows the British soldiers are far less likely to demonstrate symptoms of PTSD. Why?
While the numbers of U.S. soldiers suffering PTSD land somewhere in the 20-30 percent range, depending who you talk to, only four percent of British soldiers who served in Iraq or Afghanistan exhibit symptoms of PTSD even though both countries’ warzone veterans have seen comparable levels of violent combat, according to an English study.
“This is truly a landmark study, in its size and rigor, and the findings are surprisingly positive,” said Richard J. McNally, a psychologist at Harvard, told the New York Times. “The big mystery is why we find these cross-national differences.”
Researchers for the British study analyzed answers to mental health questionnaires given to Royal Army, Navy and Air Force members. The results showed that approximately 20 percent suffered some form of mental health issues, including moderate anxiety and depression. Another 13 percent admitted to drinking heavily. However, few were diagnosed with PTSD.
Once researchers began to dissect reasons for the PTSD discrepancies, possible reasons included the use of reservist soldiers and differences in ‘dwell time.’
The mental health study found British reservists were more likely to cope with post-traumatic stress disorder symptoms. Another factor that could determine the successful processing of PTSD may be the fact that British troops serve six-month tours and do not spend more than 12 months in combat in every 36 months.
As far as their American soldier counterparts, U.S. military personnel, depending on their service, can serve more than 12 months at a time with only a single year in between combat deployments.
Living with the aftermath of TBI and PTSD
A common thread soldiers share is their fear of losing loved ones; “Will they still want me.”
It’s a legitimate fear as many end up losing their significant others once the hard work of rehab, reality sets in and they learn their lives will never return to pre-deployment fitness.
“I was in a coma for 12 days and now I’m like a six-year-old in a man’s body,” says S. Sgt., Jay Wilkerson, U.S. Army barracks, Iraq. He suffers from a closed-wound head trauma commonly known as TBI one of the signature wounds of the Iraq/Afghanistan wars.
“Sometimes I can’t remember my own kid’s names… I feel stupid, but my brother helps me. My son’s name is Manny and my daughter is Precious,” Wilkerson tearfully repeats.
His grueling treatment schedule includes memory groups, cognitive-skills training, physical therapy as well as psychology appointments; “All these appointments are meant to build me up and get me where I used to be.”
The Army soldier acknowledges that war is war and no medals will bring him a normal life again, but at least he is making the effort and hopes to regain a sense “normalcy.”
That life of “normalcy” often includes using nonprofit groups like Help Wounded Troops or Wounded Warrior Foundations. They step in when the Veteran Affairs and Department of Defense fall short.
It’s not unusual for wounded veterans to seek financial help while waiting for benefits to kick in. Many soldiers don’t know there are advocacy organizations out there that can assist them with the mountain of paperwork the VA requires. During the sometimes lengthy paperwork process military families can lose their homes, cars and jobs.
These nonprofit organizations provide soldiers with money to pay for rent, electricity, food or even car payments. Without the support from a generous American population these wounded warriors may otherwise fall through the cracks and disappear into homelessness.
The bottom line for the VA to consider is the need to speed up an effective TBI/PTSD treatment program. The process must ensure that there are no military service members left behind or undertreated.
Just as there have been technological breakthroughs in medical treatments, there have been significant advancements in treating TBI and PTSD. The all-volunteer troops serving in a long Middle East war deserve to be treated with the best PTSD/TBI protocol available and then the treatment plan needs to be individually tailored to meet each soldiers needs, according to Dr. Mark Wiederhold who has developed a new virtual-reality based PTSD program.
This often proves the private-sector lays claim to the most up-to-date treatment methods.
However, the VA bureaucracy doesn’t act quickly enough or at all when providing the best care for returning war veterans. One program with a stellar record is Mt. Sinai hospital in New York City. Their TBI treatment employs a rigorous-daily cognitive therapy without the use of drugs.
Another highly-successful, private sector PTSD treatment facility is located in San Diego, California. The Virtual Reality Medical Center uses virtual reality computer generated programs with physiological readings to monitor soldier’s reactions to incidents that cause them severe anxiety. The success for the $4-6 thousand program is 85 percent. However, the doctors running the virtual reality retraining sessions are working overtime to find ways to improve their success rate to more than 90 percent.
Side affect of war – suicide among soldiers on the rise
Army suicide statistics just released leave military officials trying to reverse a grim trend in the Iraq and Afghanistan wars.
A recent report showed that 32 soldiers killed themselves in June; it is the highest number of suicides in a single month since the Vietnam era. At least 21 took their lives while on active duty and the other 11 were inactive National Guard or Army Reserve.
The Army admits seven of the soldiers killed themselves while serving in Iraq and Afghanistan. “There were no trends to any one unit, camp, post or station,” Col. Chris Philbrick said, of the Army’s suicide prevention task force. “I have no silver bullet to answer the question why.”
With no solutions on the horizon Philbrick said his department will: “look for opportunities we have been facing in terms of the challenges in the Army and continue to prevent these events from taking place.”
There is no doubt that streamlining the TBI/PTSD screening process is a step in the right direction, but what returning war zone soldiers really need is their quality of life.
Oftentimes when soldiers are separated from military service they lose extra-combat pay, housing allotments and their Tri-Care health insurance. The loss of income can split families apart, especially if there is a serious injury to contend with.
A country at war must live up to all the promises they offer military personnel. These brave soldiers should not have to lose their quality of life along with any means to earn an honorable income for their families.
America has done better, but as the “War on Terror” enters its ninth year, it must do better- the all volunteer forces are not expendable on any level.
A hierarchical undercutting in the decision making process in any work environment lends itself to a severe tongue lashing, however, in the military world it requires one of two things- resignation or firing.
This is exactly the position current Afghanistan General Stanley McChrystal finds himself in.
A senior Capitol Hill source says McChrystal will resign, leaving the White House in a pickle as the summer offensive in Afghanistan, already causing heartburn, with no other choice but to regroup with new leadership.
Insiders are also saying Congress is already seeking McChrystal’s replacement and names like General James Mattis of the US Joint Forces Command and Lieutenant General William Caldwell, the current commander of Nato’s Training Mission in Afghanistan are the frontrunners.
However, President Obama hasn’t indicated which way he will go and it is no secret the president’s choice in words calling “Afghanistan the right war,” could come back to haunt him. Americans have lost interest in the Middle East War effort and losing soldiers on the battlefield when the Administration refuses to kill the opium poppy fields is not helping shore up support on the home front.
As word spread yesterday of the Rolling Stone story a universal consensus formed that McChrystal and his entourage crossed the sacred line by criticizing the President and his staff.
“This is clearly a firing offense,” said Peter Feaver, a former official in the Bush White House and strong backer of a fully resourced counterinsurgency strategy in Afghanistan in a Washington Post story.
But military experts also question relieving McChrystal of his leadership role on the eve of a major offensive in Kandahar, which is the most critical of the war, could hurt the Afghanistan war effort. It has also been said that McChrystal was not onboard with the July 2011 timetable for withdrawal.
The Rolling Stone story reads in part; “According to sources familiar with the meeting, McChrystal thought Obama looked ‘uncomfortable and intimidated’ by the roomful of military brass. Their first one-on-one meeting took place in the Oval Office four months later, after McChrystal got the Afghanistan job, and it didn’t go much better. ‘It was a 10-minute photo-op,’ says an adviser to McChrystal. ‘Obama clearly didn’t know anything about him, who he was. Here’s the guy who’s going to run his f-ing war, but he didn’t seem very engaged. The Boss was pretty disappointed.’”
President Barack Obama said earlier that McChrystal is guilty of “poor judgment” but said he will wait to pass judgment until the two meet at the White House.
The top U.S. commander in Afghanistan and his aides also made disparaging comments about Vice President Joe Biden, special envoy Richard Holbrooke, Ambassador Karl Eikenberry and others in the story titled “The Runaway General.”
“Gen. McChrystal is on his way here, and I am going to meet with him. Secretary Gates will meet with him as well,” Obama said Tuesday evening. “I think it’s clear that the article in which he and his team appeared showed poor judgment, but I also want to talk to him directly before I make any final decisions.”
Asked earlier in the day whether McChrystal’s job is on the line, White House press secretary Robert Gibbs said that “everything is on the table.”
McChrystal apologized for the article Tuesday morning.
“It was a mistake reflecting poor judgment and should never have happened,” McChrystal said in a statement. “Throughout my career, I have lived by the principles of personal honor and professional integrity. What is reflected in this article falls far short of that standard. I have enormous respect and admiration for President Obama and his national security team, and for the civilian leaders and troops fighting this war, and I remain committed to ensuring its successful outcome.”
Nevertheless McChrystal received harsh words from Secretary of Defense Robert Gates. “I read with concern the profile piece on Gen. Stanley McChrystal in the upcoming edition of ‘Rolling Stone’ magazine,” Gates said in a statement. “I believe that Gen. McChrystal made a significant mistake and exercised poor judgment in this case. We are fighting a war against al Qaeda and its extremist allies, who directly threaten the United States, Afghanistan, and our friends and allies around the world.”
“Our troops and coalition partners are making extraordinary sacrifices on behalf of our security, and our singular focus must be on supporting them and succeeding in Afghanistan without such distractions. Gen. McChrystal has apologized to me and is similarly reaching out to others named in this article to apologize to them as well,” Gates said. “I have recalled Gen. McChrystal to Washington to discuss this in person.”
Cable television pundit Sean Hannity said he did understand General McChrystal’s frustration “with how the Obama administration has mishandled the ‘War on Terror.’ “I don’t think Obama takes his role as commander in chief as seriously as he should.”
“What are we to think of a president who only sends 20-to 30-thousand more soldiers in a war in Afghanistan, but not that amount the generals on the ground ask for?” Hannity questioned. “What about a president who resists using the term ‘war on terrorism?’ I don’t think this president is seeking victory in Afghanistan.”
With a drug war raging in Mexico, a defiant Iranian President Mahmoud Ahmadinejad, a Gulf oil spill disaster and a trouble economy will President Obama rock the boat in Afghanistan or move forward with more of the status quo?
The signature wounds of the “War on Terror” are ones not readily visible to the human eye; the disability resides in the mind and body of the soldier and the complexity that is the human brain. Many times these wounds of warfare do not rear their ugly heads immediately, but can manifest when warriors return to their lives in America. Traumatic Brain Injury and Post Traumatic Stress Disorder are the hidden injuries and the new battlefront for military health care professionals.
As the military forges onward into a new century with a streamlined military arsenal, the Department of Defense and Veterans Affairs must now zero in on the complex and unpredictable world of mental health issues.
The science of mental health treatment varies with each recipient and the hidden battles combat veterans fight on a daily basis upon return need to be uncovered in order to restore faith and ensure the health of the military’s readiness for future battles.
While watching the battles unfold on cable news can be compelling, so too are the stories of these everyday heroes who battle physical therapy for visible and invisible injuries. The glamour may be on the battlefield, but the compassion plays out everyday as veterans overcome the odds and stare down the demons of war.
The real war stories
For those who serve during wartime often enter the military knowing full well what may lie ahead. The gritty courage of soldiers, their determination and their love of country makes America’s all-volunteer armed forces the best in the business. If the U.S. wishes to guarantee this tradition the military must keep its promise, as the Surgeon General says Navy Medicine – “World Class Care…Anytime Anywhere” for the military and families of returning warriors.
When soldiers are hurt in the line of duty, they often refer to their injury as “Alive Day” – meaning they are breathing and the hard work of recovering begins anew. A different battle must be waged, one that will test their inner courage and tenacity for life.
One such story comes from the book “Hidden Battles on Unseen Fronts.” The book details many stories of these brave soldiers who must face a new enemy – their own bodies.
For Army SPC Walter Blackston it would be that fateful September day that would result in his call to duty from the Army Reserve. His real-world experiences lent much needed improvements in the way communications were handled for Medevac crews in the Middle East. His confidence and skill garnered him multiple medals and citations while on duty.
However, a week before Blackston was to return home he went out to pick up injured servicemen from a Black Hawk helicopter crash. The chopper went down in the middle of a field, unfortunately for Blackston the large field would be filled with landmines and on his way back to his vehicle with injured soldiers, Blackston’s partner took a bad step- the blast killed the soldier, Blackston survived.
He was stitched up and told to have his injuries checked out when he returned stateside in a week. As it turned out that week-long wait would cost the Army Reservist major nerve-damage in his arms. Blackston would require multiple surgeries for the next three years on his arms and spine – he would also discover symptoms of PTSD and TBI after he recovered from the visible injuries.
Not only did the Army Reservist fight for his life while he received treatment at Walter Reed Army Medical Center he overcame the horrific living conditions at the infamous Building 18. (It was not uncommon to hear military personnel complain of mold, cockroaches, rats and robberies on a regular basis.)
This led to a low point in SPC Blackston’s life. He attempted to commit suicide twice unaware that his yet to be diagnosed TBI was worsening by the day.
As he described, nearly three years later the Army released Blackston and declared him fit for duty, despite the fact that he was treated for PTSD for more than a year. “The scarring was so terrible. The skin had healed like a web under both my arms but they only rated me 20 percent disabled,” he explained.
From this moment Blackston’s life spiraled out of control and he explains there were times when he didn’t know where he was and there was no job waiting for him. Oftentimes it is the wait for VA benefits to kick in that does the soldiers in. First Blackston drained his savings, and then he borrowed money from his family and finally maxed out his credit cards. He lost his house, his car, his fiancée and “his mind.”
While waiting to receive his benefits, Blackston was finally diagnosed with TBI. With the discovery of the new problem he realized his fate was increasingly in his own hands. The benefit folks at the VA were not sympatric to Blackston’s dilemma and asked him to move home with his parents at the age of 47.
However, he was having none of this. Out of frustration he demanded to see a VA supervisor. Once the supervisor entered the room, Blackston removed his shirt and shouted “this is what I live with every day.” The supervisor off the VA was humbled and apologized.
The goal was not to make someone feel sorry for him, but give him the tools he would need to get back on his feet. This episode resulted in a 90 percent disability rating and the new beginning he was looking for. His new paycheck would be $2,500 per month, only a portion of what he made in the private sector, but a start. (Since that was a service-connected injury incurred in combat I question why VA does not counsel these individuals to be reevaluated by DoD as they are probably entitled to a full DoD military disability retirement in addition to their VA benefits. These additional funds from DoD would give Blackston approximately $1,500 tax-free, plus all the benefits that come with a military retirement.)
The Army Reservist’s proactive role in his recovery has given himself the tools needed to go on. He admits thoughts of suicide still come and go, but his new found faith in God has given him the strength he needs to get up everyday.
Although Blackston’s symptoms of TBI are still persistent his commitment to therapy pushes the ball closer to the goal line. “I just want to lead a fruitful life…It’s all on me. And if I had one thing to say to vets like myself it would be, ‘We earned the right to be proud of who we are.’”
Stories like these are not uncommon with the Operation Iraqi Freedom and Operation Enduring Freedom veterans. What the military should be embarrassed about is not that these guys come home battered and broken, but the treatment or lack thereof for these volunteer forces.
Not only do they give their body and minds for this country if they are injured they often lose their families in the process. The romantic notion of World War II (albeit the men in WWII died on the battlefield and didn’t survive catastrophic injuries the “War on Terror” soldiers are now surviving) when men went to war and came home to adoring significant others, is less likely. Today’s soldiers face a myriad of hidden injuries, loss of income and find themselves in the bureaucracy health care.
Self-assessment of PTSD is not working
In the private sector if a patient is diagnosed with a psychological ailment they are given a battery of tests by a trained professional in the mental health field. When soldiers return from the warzone they are given a questionnaire “self assessment” to determine their mental state.
The screening questions revolve around the traumatic events they faced on the battlefield; “Have you had nightmares about it or thought about it when you did not want to? Have you tried hard not to think about it or went out of your way to avoid situations that reminded you of it? Are you constantly on guard, watchful or easily startled? Do you feel numb or detached from others, activities or your surroundings?”
Approximately 30 percent of the armed forces questioned about mental health last year reported having some trouble acclimating to life stateside. Of these numbers the VA doesn’t have the clinical practitioners needed to treat all the returning soldiers.
This is where the Department of Defense and VA need to open up all available resources, including TRICARE and allow returning soldiers to get treatment, with state-of-the-art remedies from the private sector. It has been estimated that treating PTSD within the military ranks would take approximately three years. And just as there’s more than one way to skin a cat, there is more than one way to treat PTSD.
As of 2009 the VA trained more than 1,200 mental health providers while the DoD has more than 600 mental health clinicians for the delivery of PTSD treatment.
Currently the military relies on multiple pills to alleviate mood swings. The soldiers take uppers, downers and sleeping tablets. One veteran even admitted he was taking up to 40 pills a day and still he wasn’t improving.
It wasn’t until this veteran found Dr. Rick Levy, a clinical psychologist who specializes in mind-body medicine, did this soldier’s quality of life improve. For those who are open to alternative treatments, they can obtain sanity without heavy drugs. After years of medicated treatments, Dr. Levy was able to use psychotherapy and clinical hypnosis as a method to abate PTSD and curtail other medical problems that often require medication.
With all the tools from Dr. Levy, the veteran was able to reduce his pill count to just three. He now leads a productive life. Once he learned the story behind the story, this soldier was able to regain control over his life with clinically guided meditation.
While this treatment may not work for everyone, the military needs to accept alternative methods of treatment for PTSD to ensure the mental health of all our military personnel.
I know best
From day one armed forces are taught to think about the mission first, their unit second and themselves last. So when the mission is complete, military personnel are sent home and the questionnaires presented many soldiers don’t answer openly or honestly for fear they may break the military code.
Take Army Second Lieutenant Sylvia Blackwood-Boutelle. She was called to duty and would serve in Iraq. She would be serving on the front lines as a reporter for the military. Her ability to report the news alongside Time magazine and the New York Times was exciting to Boutelle. The only caveat the military expected was for her to report positive stories.
Upon her return home to her family Boutelle was asked to take the PTSD questionnaire. She exhibited positive factors on her first assessment. She displayed all the symptoms for PTSD; however she was having none of it. She asked to retake the test. She admitted later that she had answered every question differently because she didn’t want to ruin her career.
“I’m a high-energy person. I figured I could deal with it myself,” Boutelle explained. This method of dealing with her emotions landed her back in Iraq until she couldn’t stay busy enough to push the PTSD aside.
Her emotional state continued to unravel without professional treatment. Once she realized she needed therapy she reached out and overcame the stigma associated with PTSD. “You have to get ‘team you’ together. You can’t be afraid to ask for help,” Boutelle said.
She remains in the Army and hopes to pursue a writing career when she finishes her PTSD treatment.
The sad truth of warzone trauma
In the words of Dr. Joseph, Roshi, MD, PhD, “Ours is a disposable culture; our children, our elders, our ill and infirm…are often ignored, overlooked, forgotten or mistreated.” He goes on to explain the impacts of war are legend and the invisible wounds radiate deep and wide into a person’s life.
Dr Roshi also believes Congress can’t fix the problem by simply throwing money at it. The real fix will come in the form of effective treatment for mental health issues, for the soldier and their family. Inside the broken mind a soldier can provide immeasurable strength, he says. “Resilience runs deep, but its resources need to be nurtured,” Roshi said. “It is like a seed that has been buried in a disaster; it needs tending, attending.”
Another doctor, Mitchell Tepper, PhD, MPH admits changes need to be made in the mental health care arena.
“Our service members get some of the nation’s best medical and physical rehabilitation services, but access to mental health services is both limited and often ineffectual, as it is in the civilian health care arena. We need to work more aggressively to identify and get into treatment those struggling with depression, combat-related stress, PTSD and mild brain injury.”
To that end, Dr. Roshi concludes that families affected by the side-effects of war also need to gain mental health care treatment to ease the burdens associated with care-giving duties and sporadic behaviors related to TBI and PTSD symptoms.
There are countless stories like these across the country. Many service members are able to cope with the extreme environment that war presents and those soldiers are to be commended for their service to America.
But for those who come back with major injuries, nightmares, amputations and the inability to return to a normal life, the U.S. owes those more. They given up their quality of life, many lost their significant others to divorce while others taken their lives. For the ultra- tormented soldiers who turn to drugs and alcohol to suppress their fears and depression, the DoD and VA need to do more.
America is built with the courage of those who serve in the armed forces; they should never feel like they let anyone down or take their own lives because they fail to receive adequate treatment. The men and women in uniform must be treated with respect and dignity.
In a world filled with movie stars, professional athletes and comic book superheroes – Americans should always remember the true heroes are the unsung leaders in the military, their guts, candor and determination to serve proudly should be the benchmark by which children look to when it comes to heroes they can believe in.
References and organizations that focus on veterans
Give an Hour- founder Barbara Romberg focuses on national network of mental heath professionals who provide free mental health services to U.S. troops and their families.
VA Suicide Prevention Hotline- Focuses on military veterans in immediate trouble.
Polytrauma Transitional Rehabilitation Program- Located at the Minneapolis VAMC, this program focuses on the TBI and PTSD issues that accompany major trauma.
Rick Levy, PhD- is a licensed psychologist in private practice who is the leading pioneer in mind-body medicine. His groundbreaking work has garnered him media exposure on Prime Time, FOX News, ABC and other print publications.
Dissemination and Training Division of the National Center for PTSD- located in the VA’s central office in Palo Alto Health Care System. Studies based on evidence-based psychotherapies.
Come Home Project/Deep Streams Zen Institute- Dr. Joseph Bobrow Roshi, MD, PhD. Focuses on alternative treatment for TBI and PTSD issues.
The Sexual Health Network, Inc. and SexualHealth.com- This organization deals with the sexual issues that accompany major trauma, TBI and PTSD. These conditions can dramatically impair a person’s capacity for intimacy.
Veterans Education Project- A group that trains veterans to share their stories and life lessons with classrooms and communities. The group also supports military families to provide support for veterans and educate others on the issues troops face on their long journey home.
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.
On a sunny and warm afternoon in San Diego, first lady Michelle Obama and her daughters toured the largest military installation in the county, Camp Pendleton, paying special attention to the families of those enlisted in the nine-year war in the Middle East.
The visit comes on the heels of a particularly rough week on the base – five members of the Pendleton marines lost their lives during the uptick in the summer surge in Afghanistan.
“In the wars in Afghanistan and Iraq, no Marine base and few bases anywhere has sacrificed more for America, more lives, more wounded warriors, than your families and your colleagues,” Mrs. Obama said. “And today, we honor all of our fallen heroes, including the Camp Pendleton Marines who gave their lives just this past week; Sergeant Brandon Bury, Lance Corporal Derek Hernandez, Corporal Donald Marler, Sergeant John Rankel, and Lance Corporal Michael Plank.
“Our prayers and support are with these fallen Marines and their families, and with all the Gold Star families who are here with us today. As one Pendleton wife put it so eloquently, she said, `We’re the voices and spirits of the boys and girls who didn’t come home.’ And as a nation, we join with you in honoring their memory as you and your families find the strength to carry on and to live the lives that would make your loved ones so proud,” the first lady said. She expressed her deep condolences to the families who have paid the ultimate price.
Military brass has indicated that the effort to rid Afghanistan of the Taliban will result not only in a tough fight on the battlefield, but more casualties. The latter doesn’t sit well with family members on the base, but unfortunately it’s expected from those committed to winning the “War on Terror.”
“Some of the most inspiring people I’ve ever met are the men and women in uniform,” Mrs. Obama said in front of hundreds of military personal and family members. “You all take my breathe away every time I’m on a base.”
Michelle Obama met privately with members of the military in close-door sessions to get the pulse of what a nation at war can do better to help those left behind dealing with the day-to-day task of shuffling kids to school, shopping and paying the bills.
She made sure those in attendance knew her priority was to broaden the country’s understanding of military personnel. “I want to help the country better understand the incredible service of you and your families. And to make sure your voices are heard back in Washington and make sure your needs are met.”
Recognizing the high suicide rate in the military associated with the “War on Terror,” Mrs. Obama will urge members in Congress to pay special attention to the mental health aspect of a long war and multiple deployments.
She also issued a national challenge to those in the audience encouraging every sector of American society to “to mobilize and take action and engage our military families.”
The throngs of young faces in military fatigues were excited to catch a glimpse of the first lady. These young recruits showed no sign of fear at the thought of deployment to the Middle East. In fact, it was the opposite, they were anxious to get into the fight and put their months of training to use and bravely serve America.
“It’s like training for the football team, you spend all summer working hard and getting it right and once the season begins you want to suit up and help your team win,” said one Marine when describing the enthusiasm of young soldiers eagerness to join the fight in the Middle East.
However, the war wasn’t the only thing on the minds of young Marines. P.F. Villavazo barely has high school in his rearview mirror and he says he is worried about where the country is headed and if there will be any jobs. “Being here (at Michelle Obama speech) is cool and exciting, but I’m concerned about the oil spill as well.”
Other speakers included area Congresswoman Susan Davis (D-San Diego) and Senator Barbara Boxer (D-CA) who finds herself in a tough reelection bid. If Boxer’s speech at first lady’s tour on Camp Pendleton is any indication of her shot of keeping her seat, the Senator is in a heap of trouble.
While the first lady spoke with thoughtful words and compassion in her voice, Boxer stumbled while reading her speech about how she has been there for the troops. “I’ve never heard of her and she really looked out of place,” said Private Harding. “At least Michelle Obama seemed to care about us.”
In a moment of levity, Obama joked about her husband’s pick for the NBA finals, the Lakers, and expressed his love for the game of basketball.
As the event concluded the first lady stayed behind for 20 minutes signing autographs, posing for pictures and shaking many hands.