The Hidden Cost of Bush’s War

http://news.independent.co.uk/world/middle_east/story.jsp?story=463502

Independent 14 November 2003

The hidden cost of Bush’s war

Concern about fatalities among Western forces in Iraq
tends to overlook another ghastly statistic: the
spectacularly mounting toll of the severely wounded.
Andrew Buncombe reports on America’s invisible army of
maimed and crippled servicemen

It has been three months since Sergeant Mike Meinen
lost his right leg in Iraq and just two weeks since he
received a new one. He is still getting used to the
prosthetic, still adjusting to its feel, the way it
looks, the way in which his injury has changed his life
for ever. Remarkably, he refuses to be bitter either
about the Iraqi guerrillas who maimed him or about the
people in Washington who sent him to war.

"I can’t be upset for what has happened. We went to
Iraq for a reason, there were obviously going to be
casualties," said 24-year-old Sgt Meinen, father of a
five-month-old daughter, Abigail, who was born when he
was in Iraq. "I can’t be upset that I was among them...
I am proud of what I have done."

Sgt Meinen, of the 43rd Combat Engineer Company, 3rd
Armoured Cavalry Regiment, is among thousands of
wounded soldiers who have returned from Iraq to
uncertain futures, months of difficult and often
painful treatment and an American public largely
unaware that so many troops are being injured every
day. The reality is that, just as Iraqi hospitals
struggled to deal with the number of wounded civilians
during the invasion of the country, so military
hospitals in the US are now overflowing with wounded
Americans.

Advances in body armour and battlefield medicine mean
that an increasing number of soldiers such as Sgt
Meinen are surviving injuries that even just a decade
ago would have killed them. As a result, while the Bush
administration is able to point to a relatively modest
number of US fatalities in Iraq yesterday the total
stood at 396 there is a huge number of severely wounded
soldiers whose injuries and fate go largely unreported.
Mr Bush has ordered that the media should not be
allowed to photograph coffins containing the bodies of
those killed in Iraq, and the return of injured US
troops also goes largely unpublicised. This is no
coincidence. Senator Patrick Leahy of Vermont told the
Senate last month: "The wounded are brought back after
midnight, making sure the press does not see the planes
coming in with the wounded."

But for visitors to the Walter Reed Medical Centre in
Washington where Sgt Meinen and two comrades who were
injured in the same rocket-propelled grenade attack
were treated the wounded are very much on display.
Indeed, at this hospital, which deals with injured
soldiers (as opposed to sailors or marines), there is
barely room for non-war casualty patients.

Last week all but 20 of the hospital’s 250 beds were
reportedly taken up with soldiers injured in Iraq,
where there are now some 35 attacks on US forces every
day. Fifty soldiers had lost limbs often more than one
while dozens of others were being treated for burns or
shrapnel wounds. Others require psychiatric help.
Officials say that 20 per cent of the wounded have
suffered "severe brain injuries" while 70 per cent had
wounds with the "potential for resulting in brain
injury". About 600 have been dispatched to a specialist
burns unit in San Antonio, Texas.

On the fifth floor of Walter Reed, where soldiers such
as Sgt Meinen and his comrades Pte Trystan Wyatt and
Sgt Erick Castro receive physical therapy, staff have
reportedly put up a bulletin board with their patients’
photographs. It is crammed full of pictures of young
men. "We didn’t start the board when the war began,"
Mary Hannah, a therapist, told the Los Angeles Times.
"Even the most experienced people here it’s beyond
their imagining. These are our babies and they just
keep coming, coming, coming."

The facilities at Walter Reed, the army’s main hospital
in the US, are so crowded that the 600 or so rooms set
aside for families of the injured are apparently
insufficient and people are doubling up. The Pentagon
is paying to put up hundreds more at local hotels.

"I don’t think this is going to go away," said the
hospital’s director, Major-General Kevin Kiley. "Our
people are pedalling as hard and fast as they can. We
can do this for a long time but at some point if there
is no let-up the casualty demand will have to start
affecting what Walter Reed is. The whole hospital is on
a war footing and emotionally involved. The broader
challenge is how do you keep up the battle tempo for a
long period of time?"

The first stopping-off point for almost all injured
soldiers evacuated from Iraq is the US Regional Medical
Centre in Landstuhl, Germany, about 100 miles south-
west of Frankfurt. To date they have treated a total of
7,714 ill and injured troops. Of these, the Pentagon
says 937 had suffered so-called combat injuries, as
opposed to non-hostile injuries, though these numbers
are disputed by independent experts. "One is going to
get you a Purple Heart [a medal for troops injured in
battle] and one is not," said a Pentagon spokesman,
explaining the difference. "One’s for wounds inflicted
by the enemy. It could be any type of injury inflicted
by someone who wishes to cause you harm."

There are no comparable figures for British combatants.
We know that 52 British servicemen have died in Iraq,
19 of them since "major operations" officially ended on
1 May. But the Ministry of Defence says that it cannot
give any figure for the number of wounded, and none of
the defence think-tanks feels able to venture an
estimate. One reason is believed to be the extensive
involvement in the war of British special forces the
MoD is extremely secretive about the SAS and SBS.

The sick and wounded from Iraq arrive at Ramstein Air
Base near Landstuhl on huge transport planes. Around 30
new patients arrive every day, straining the resources
of the hospital, which has had to request additional
doctors to boost the medical staff of 1,800. Apparently
the hospital had not been expecting the number of less
seriously wounded soldiers it has had to treat for road
traffic injuries and ailments such as kidney stones
(which were commonplace during a summer in which many
troops became dehydrated).

In a recent interview with The New York Times, the
hospital’s senior officer, Colonel Rhonda Cornum, said
the situation in Iraq meant that the demands being
placed on the staff and resources at Landstuhl would
not go away any time soon. "You can’t work people 60
hours a week for ever," she said. "People have to take
leaves. They’ve got to go to school. You can’t run it
as a contingency when it has obviously become a steady
state."

She added: "This is never going to be a quiet medical
centre again. Our people are proud and privileged to be
doing it. But we don’t have any illusion that it’s
going away."

In addition to the advances in medical treatment, more
soldiers are surviving as a result of better equipment.
Most troops in Iraq are equipped with $1,600 (£950)
Kevlar vests and $325 helmets. The vests, the thickly
woven material of which is designed to "catch"
projectiles, are fitted with ceramic plates that cover
the most vulnerable areas. As a result, most injuries
two out of three involve the arms or legs. Around 100
troops have lost arms, legs, hands or feet in the
operation to oust Saddam Hussein and occupy Iraq.

While the body armour cannot stop all injuries, the
result is that many more troops are surviving than in
previous conflicts. Estimates suggest that during the
current war in Iraq the ratio of wounded to dead stands
at eight to one. In the Second World War the ratio was
three to one, while even in the 1991 Gulf War the ratio
was four to one. Most deaths occur within half an hour
of a soldier being injured, usually as a result of
massive blood loss. Survival rates soar if he or she
can be airlifted to a medical centre within an hour of
being wounded.

Most of those seriously hurt receive excellent
treatment. Sgt Meinen and his comrades have been fitted
with titanium and graphite prosthetics. Speaking by
telephone from his home in Colorado, close to his base
at Fort Carson, Sgt Meinen was upbeat. "It’s really
nice," he said of the false limb. "It’s better than I
thought. I am doing physical therapy now I say I am on
vacation."

Mr Wyatt, who also lost a leg in the same incident in
the city of Fallujah on 25 August, has been fitted with
a $100,000 prosthetic that attaches to the stump of
what was his upper thigh. The so-called C-leg
"understands" when to bend as a result of built-in
microprocessors that detect stresses 50 times per
second.

"When we first got here I felt I was screwed and
thought I would never walk again," said the 21-year-
old. "The rocket went through my leg like a knife
through butter. It was a terrible scene with the three
of us... there was just blood and muscle everywhere.
It’s hard to see your comrades hurt, but there are a
lot of people here farther down the line with the same
injuries. It definitely gives you hope."

Many of the wounded appear optimistic, hopeful that
with retraining and treatment they may be able to
return to the armed forces and continue their careers
in some sort of capacity. They hope their sacrifice has
not been entirely in vain. But there are increasing
numbers of veterans from former wars and relatives of
soldiers who fought in Iraq speaking out against the
ongoing operation and demanding that the troops be
brought home. They say it suits the Bush administration
not to draw attention to the number of wounded and to
ignore the effect on the recruitment and retention of
troops as well as public opinion.

"The general sense is that it’s politically damaging to
the Bush administration. It makes it more difficult for
them to continue their policies in Iraq,"said Wilson
Powell, director of Veterans for Peace. "It may be that
those policies are changing. There is a sense that they
are trying to accelerate their withdrawal of troops."

Mr Wilson, 71, a veteran of the Korean War, said that
for a family, the effect of a relative being wounded
could be worse than that of them being killed. "Post-
traumatic stress disorder goes on for decades. It can
affect marriages, relationships with children," he
said. "With a death people can move on, people get on
with things. If they are wounded, you might have
someone who is 50 per cent disabled, who has a sense of
shame, who is angry or bitter."

Sgt Meinen is not in that position, at least not yet.
For the time being he is focusing on getting better, on
learning to use his new limb and enjoying his daughter.
"I love being a father. She learns so much every day,"
he said.

Of what happened in Iraq he says he is glad that he and
his comrades came home alive. "I always told them I
would take them to the worst places in the world, but
that I would always bring them out," he said. "They
believed in me. All three of us wanted to be there.