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Care for the troops 

Post-traumatic stress, suicide risk, and homelessness plague our returned soldiers��"and those are just the United States' problems

Wars in Afghanistan and Iraq were misguided exercises in haughty presumptions and ineptitude. The result was enormous destruction, fertile environments for terrorism, mass violence, and insurgency. The only beneficiary was the military-industrial complex.

Beside deaths and bodily harm, the war caused severe psychological damage to service members in a variety of forms: post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), chronic traumatic encephalopathy (CTE), and moral injury. More than half of 2.7 million Americans sent to fight in the Afghanistan and Iraq wars are suffering from mental and physical problems. Veterans are more than twice as prone to commit suicide when compared to other civilians and twice as likely to be a fatality in an auto crash.

PTSD is a severe anxiety disorder caused by combat duty. According to the Department of Veteran Affairs, 30 percent of veterans from Iraq and Afghanistan suffer from it. According to the Cleveland Clinic Journal of Medicine, combat veterans are not only more likely to have suicide ideation due to PTSD and depression, they are more likely to act on a suicidal plan. To cope with PTSD, most veterans resort to alcohol and substance abuse.

TBI occurs from a violent blow to the head or body or when an object such as a bullet or shrapnel pierces the skull and enters the brain tissue. Serious TBI can have a wide array of physical and psychological effects: depression, anxiety, loss of self-control, reckless behavior, and verbal or physical outbursts, among others. It is estimated that almost 20 percent of veterans deployed from Iraq and Afghanistan wars have TBI. So far, more than 260,000 have been diagnosed with the injury.

Seven percent of the veterans have both PTSD and TBI. And both are correlated with homelessness. Nationwide, 12 percent of homeless adults are veterans. Among those, 51 percent have disabilities, 50 percent suffer from serious mental illness, and 70 percent have a substance abuse problem. According to Dana Cummings, San Luis Obispo Veterans Service Officer, our county is ranked No. 3 in the nation for the highest population of homeless on the street, and a large portion of homeless people in the county are veterans. There is a stunning contradiction between words and deeds of many on the right. Those who rushed to slap “Support Our Troops” stickers on their autos now show up at county supervisors’ and city council meetings to bitterly complain about “homeless bums.”

CTE is a progressive degenerative disease of the brain caused by repetitive brain trauma. It destroys cells throughout the brain and eventually leads to dementia. CTE often results in severe depression, impulsive behavior, and suicide. According to Dr. Robert Stern, a CTE expert, it partially explains the suicide epidemic among Iraq and Afghanistan war veterans. Currently, CTE can only be diagnosed by examining the brain after death. Presently, there is no cure for CTE.

Moral injury is the most recently identified disorder among the deployed veterans from Iraq and Afghanistan wars. This is a distinct disorder resulting from moral transgression, followed by feelings of shame, guilt, or anxiety causing the individual to withdraw from society. This behavior mode increases suicide risk.

Civilian life norm is to live according to moral values, practice kindness, and do no harm to others. Those fighting in a war cannot live by this moral code. As David Brooks explains, war involves accidental killings, capricious death for one but not another, tainted situations where every choice is murderously wrong. He illustrates this point using actual events, “Insurgents used women and children as shields, and soldiers and Marines feel a totalistic black stain on themselves because of an innocent child’s face, killed in the firefight.”

A Huffington Post article described the struggles of Marine Staff Sgt. Felipe Tremillo, who had two combat tours (“Moral Injury: Healing,” March 20, 2014). Two years after returning from the second tour, Tremillo is still haunted by images of the women and children he saw suffer from the violence and destruction of war in Afghanistan. “Terrible things happened to the people we are supposed to be helping,” he said. “We’d do raids going to people’s homes and people would get hurt.” The moral compromise, the willful casting aside of his own values, broke something inside him, changing him into someone he hardly recognizes or admires.

The soldiers and Marines were dehumanized by the inherent profanity of war, the extraordinary strains and frustrations. Attitude of senior commanders was a contributing factor to desensitization. A few examples: A 15-year-old Iraqi girl was gang-raped, murdered, and her corpse was set on fire; a group of soldiers known as “kill team” hunted and murdered Afghan civilians as a “sport”; Marines massacred 24 Iraqis, including a 76-year old man in a wheelchair, women, and children. Major Gen. Steve Johnson, a commander in Iraq, called the fact that Iraqi civilians were being killed all the time as “a cost of doing business.” Gen. James Mattis told his Marines, “Be polite, be professional, but have a plan to kill everyone you meet.”

According to the Department of Defense, 4,412 U.S. service members died in Iraq and 2,216 in Afghanistan. As of February 2014, at least 21,000 Afghan civilians had died from the war. Civilian deaths from war were 70 percent in Iraq. According to Iraq Body Count, a nonprofit organization, documented Iraqi civilian deaths from war are at least 135,641 to 153,215. The United Nations High Commissioner for Refugees reported that the war forced 2 million Iraqis to become refugees in the neighboring countries. Another 2.7 million were uprooted within Iraq’s borders. A UNICEF survey found that “about 5 percent of Iraqi children aged 0-17 years are orphans who have lost one or both parents.” Between 60 and 70 percent of Iraqi children are suffering from psychological problems, which does not bode well for the country’s future.

One expects that politicians would have learned from the devastating outcomes of Afghanistan and Iraq wars. The Associated Press reported recently, “The Republican Party’s leading presidential contenders on Friday promised conservative activists they would pursue aggressive military action to prevent the spread of global terrorism, including a renewed use of ground forces in the Middle East.” Einstein is often said to have defined insanity as doing the same thing over and over again and expecting different results. If any of these deranged contenders manages to get elected, it would be a rerun of the George Bush and Dick Cheney era. The whole country will be singing, “Happy days are here again.”

Our troops came back with more than physical injuries and exposure to brutality, tragedy, and destruction. They came back with broken spirits and shattered souls. They experienced violations of their own sense of decency, human kindness, and justice. The environment forced them to behave in a manner inconsistent with their deeply held beliefs about what is moral and right. They are hurting from alienation, guilt, shame, and loss of honor.

It is our collective obligation to look after them. We should engage individually and communally to make sure they are cared for. We should help them heal by listening to them and letting them know we understand what they have been through.

To abandon them, when they need us most, would be the sin of our nation.


Zaf Iqbal is past associate dean and professor emeritus of accounting at Cal Poly’s Orfalea College of Business. He volunteers with several nonprofit organizations, including Wilshire Hospice, Good Neighbor Program, and Child Development Resource Center of the Central Coast. He’s past president 
of the San Luis Obispo Democratic Club. Send comments to the executive editor 

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