here is no disputing the number of American troops who have died in the war on terror. At press time, more than 2,590 soldiers had lost their lives, according to U.S. Department of Defense numbers.
But the number of wounded is not clear-cut. In fact, that count is elusive. DoD numbers have tallied 17,702 wounded.
“Basically, that’s everybody who has been through the major military hospitals, like Walter Reed Army Medical Center,” said Kryn Westhoven, spokesman for the New Jersey Department of Military and Veterans Affairs. “There are some who are not counted in that roll-up, and the numbers are not broken down by state.”
New Jersey Gov. Jon S. Corzine has asked the department to track the number but the task is “nightmarish,” according to Westhoven, particularly since the federal Health Insurance Portability and Accountability Act (known as HIPAA) does not allow patients’ medical information to be reported because of privacy issues. HIPAA covers both the civilian and military populations.
“Let’s say a soldier comes back and he’s the walking wounded. He just needs physical therapy, but he is nonetheless wounded,” Westhoven said. “Let’s say he comes back to Fort Dix. He might go to a local doctor for two to three months for physical therapy and then be on his way. He might receive a 10 percent disability. He might have no disability. He might be fine afterwards. The point is, he’ll never truly be tracked.”
When Michael White, a database/Web designer for a Georgia cell phone company, heard conflicting news reports about casualties in Iraq, it bothered him enough to create www.icasualties.org, a Web site that has become a national reference point for war statistics. White, who calls the continuous effort to keep up the site a “labor of conscience,” does so on his own, for no compensation.
A few other people at other locations in the country and the world have joined him in combing through all available data to get the very best information. White has been working for the past two months on a way to pinpoint the number of wounded because he will not post any casualty without verification.
“The DoD says its does not release the names of the wounded out of respect for the individuals,” said White, who searches a variety of places to find names of the wounded and is struggling to nail down a reliable method of gathering such information. “I’ve been trying to codify exactly what we know about names of wounded and how they were wounded and where they were wounded. Boy, it’s just eating me up.”
The DoD Wounded in Action numbers confound him for other reasons, too.
“It doesn’t include non-hospital wounded, but there’s more to it than that,” he said. “It’s also possible that a soldier is wounded, goes back to battle, is wounded again and that gets counted twice. So as to what the actual numbers are, it’s anybody’s guess. Then that soldier could die. He could be counted twice in the wounded and then be among the dead.”
Yet another question confounds the count: What is a wound? While soldiers with closed head injuries and amputated limbs — areas of the body left unprotected by Kevlar vests — tend to be taken to the major hospitals, there are other serious conditions treated at local medical centers.
The incidence of respiratory illnesses, endemic diseases and mystery illnesses outnumber the incidence of the brain and limb wounds, according to Stephen Robinson, a Desert Storm veteran and executive director of the National Gulf War Resource Center. Yet these conditions are more or less off the media radar.
“Iraq is not an OSHA-approved workplace,” Robinson said. “So people are having extreme environmental exposures. Extreme heat and extreme cold and fine sand. The sand in Iraq is approximately two microns. It’s respirable. If any bacteria, any petroleum products, any chemical or biological agent lands on or bonds itself to that silica, it then can be ingested through the fine sand into your lungs.”
Soldiers also are contracting endemic diseases in Iraq, such Leishmaniasis, a blood-borne disease transmitted by the bite of a sandfly. It can linger in the bloodstream for years and may manifest itself initially as fatigue and malaise, Robinson said. Or it can lay dormant for a long time and tamper with the immune system.
A question just as large is whether the medical services budget of the federal Department of Veterans Affairs can handle the rush of young veterans into the system.
The budget is up 69 percent since President Bush took office and it would rise by 11 percent next year under Bush’s budget, according to Associated Press reports. But the White House budget office is assuming the budget can absorb cuts for three years in a row after that.
Currently, the budget is set at $24.5 billion and would increase to $27.7 billion in 2007 under the president’s budget, the AP reports. But it would take a 3 percent cut in 2008 and stay below $27 billion for the next four years. Though war on terror veterans constitute only 2 percent of the VA patient caseload, many have complex wounds that require expensive care.
So far, so good with the New Jersey VA Health Care System, according to spokeswoman Sandy Warren, who reports there currently are 970 returning veterans from Operation Enduring Freedom and Operation Iraqi Freedom enrolled in the system. A total of 873 have been seen and treated “for a variety of medical issues.” There are no waiting lists, she said.
A big question, though, according to John Rowan, national president of Vietnam Veterans of America, is whether the system can withstand the influx of both War on Terror veterans and Vietnam veterans who are filing belated Agent Orange-related claims as fallout from their exposure manifests in their older years.
“They don’t understand how the Vietnam veterans are seriously affected with diabetes and prostate cancer so many years after the fact. We’re twice as likely to have prostate cancer if we’ve been exposed to Agent Orange,” he said. “All these things are coming out now when we’re in our 50s and 60s.”
He has been lobbying in Washington, D.C., for more dollars for Vietnam veterans, he said, and he always will because caring for veterans is part of the cost of war.