May 19, 2008 – Two nightmares haunt Robin Milonas.
While serving in Afghanistan in 2004 as an Army Reserve civil-affairs officer, the former lieutenant colonel got lost in a minefield while leading a small convoy delivering school supplies to civilians. Even more troubling is the memory of a man who arrived at the main gate of Bagram Air Base carrying a young boy whose leg had been blown off by a land mine.
“I was an outgoing, energetic, determined good soldier who wanted to make the Army a career,” said Milonas of Puyallup, who just turned 50. “Now I am broken.”
Milonas is one of roughly 180,000 women who have been deployed in Afghanistan and Iraq. While they don’t officially serve in combat, they have experienced life in a war zone where there are no front lines.
And, as they return home, they are increasingly turning to an already overtaxed Department of Veterans Affairs for help. Last year, the VA treated more than 255,000 women vets. The number is expected to double within five years.
In some regions, the surge already has arrived. During the past 10 years, the number of women treated at the VA’s hospital at American Lake outside of Tacoma has risen 80 percent, and the Seattle VA hospital has seen a 42 percent increase.
VA officials say they are better prepared to handle women patients than they were several years ago. But they acknowledge “continual challenges” as they move to open the door to a man’s world where pap smears and mammograms could become as common as prostate exams.
And where “military sexual trauma” would be treated as a serious and growing mentalhealth problem, rather than a subject to be avoided.
“It’s not your father’s VA, it really isn’t,” said Patricia Hayes, the VA’s national director of women’s health care issues. “We have geared up and are gearing up. But there are places that may have gaps.”
Others say the agency is far from prepared. And given the VA’s chronic budget shortfalls and increasing demands from the rapidly growing number of male veterans, the task could be even harder than expected.
“They aren’t ready,” U.S. Sen. Patty Murray, D-Wash., said of VA officials. “Absent a proactive, concerted effort and knowing their limited resources, they (the VA) are struggling with so much this might get lost.”
Murray, perhaps the leading VA critic on Capitol Hill, has introduced legislation requiring studies of how serving in Iraq and Afghanistan has affected the physical, mental and reproductive health of women, and how the VA is dealing with their problems.
“It’s a hard issue, and pouring a huge light on this is a risk, as some will say women just shouldn’t be in the military,” Murray said. “But as more women transition home from the physical and mental wounds of war, and step back into lives as mothers, wives and citizens, the VA must be there for them.”
IT’S PTSD, NOT PMS
Milonas says she’s been stopped three times by police for erratic driving. When she sees a dark spot in the road, she thinks it’s a landmine and swerves. Except for her job teaching special education at Lochburn Middle School in the Clover Park School District, she stays home. She constantly checks to see the doors and windows are locked.
Milonas has been diagnosed with PTSD and receives therapy at the Tacoma Veterans Center. But three times she has been denied a disability rating from the VA, which says Milonas hasn’t proven her problems are related to her service in Afghanistan.
Milonas believes the VA has yet to recognize that even though women are barred from combat, it’s hard for them to avoid the trauma associated with serving in a war zone like Afghanistan.
“The battle is everywhere,” she said.
VA officials say there is no double standard when it comes to disability ratings for PTSD.
“This is the first group of women vets we have seen with this intensity of experience,” said Hayes. “We are not sure what the long-term effects will be.”
The VA has begun a longterm study of 12,000 women veterans.
Women veterans have faced a number of problems, ranging from clinics that don’t have fulltime obstetrician/gynecologists to uncomfortable group therapy sessions where men outnumber women and topics can include sexual assault and harassment.
“I don’t want to say this derogatorily, but women view VA hospitals as male domains,” said Chili Perez, a 58-year-old Mount Lake Terrace Army veteran.
MILITARY SEXUAL TRAUMA
Concern is mounting over the numbers of women veterans suffering from military sexual trauma, which can include rape, assault and harassment. According to the VA, nearly one in five women veterans seeking care have been diagnosed as victims of military sexual trauma, though some believe the figure could be nearer to one in three.
“I was raped by a senior officer,” said a 33-year-old former captain in civil affairs who was based in Tikrit, Iraq, who now lives in Olympia. She said she returned home depressed and suicidal. The woman asked that her name not be used.
“I don’t have a harrowing combat story to tell, but it is relevant,” she said. “Some come back and just get on with their day-to-day lives, but believe me, there will be a surge of people 10 to 15 years from now who will have to face it.”
The woman has nothing but praise for her treatment at the VA, though she said the key was being assigned a strong counselor from the start.
“I think they are getting better at dealing with this, but some still want to blame the victim,” she said.
The VA now offers womenonly group therapy sessions, women vets can request women counselors and womenonly entrances to clinics are being provided.
“A lot of women are reluctant to come into a hospital,” said Jan Buchanan, women veterans program manager for the VA’s Puget Sound Region. “It seems too military to them. They fear they might see their perpetrator.”
But they are coming, and it’s the younger veterans in particular. So, far, 41 percent of the women who have served in Iraq and Afghanistan have sought medical help, at least once, at the VA. That compares with 14 percent of older women and 22 percent of male veterans.
They want birth control, infertility and family planning advice, child care for their children when they are being treated and coverage for their newborns, VA officials say.
“The old saying was, ‘If the Army wanted you to have a baby, it would have issued you one,’ ” said Lourdes Alvarado- Ramos, who rose to the rank of sergeant major in the Army Medical Corps and now is deputy director of the Washington state Department of Veterans Affairs. “But that has changed. The system has been geared to males. Bricks and mortar, clinics and hospitals, they were all thought of as a male place. We need to make women veterans more comfortable with the system.”