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Iraq war's human toll could be felt for decades

Beyond fatalities, an average of eight American soldiers a day are wounded.

By Staff writer of The Christian Science Monitor / October 1, 2003

Politicians and the press tend to tally the human costs of going to war by counting those killed. So far, that's 311 Americans in Iraq and 88 more as part of "Operation Enduring Freedom" in Afghanistan. If one dates this newly defined "war on terror" back to the 1983 car bomb attack on the US Marine barracks in Lebanon, another 300 or so American lives have been lost.

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But the number of those wounded in action (or injured in combat-zone accidents) is far higher. And while combat deaths have been relatively low since the Vietnam War, the ratio of these nonfatal casualties to war fatalities is increasing - from 3 to 1 in World War II to more than 5 to 1 in Iraq (1,691 to date).

With no end in sight to a substantial US presence in Iraq, the number of nonfatal casualties (now averaging more than eight per day) is likely to keep increasing, experts say. And beyond the human dimension, the costs of such casualties, which tend to be overlooked as part of the cost of national security and foreign policy, will continue for decades as well. Among those costs: rehabilitation, retraining, postcombat counseling, long-term medical treatment, and assisted-living care.

Seen positively, the higher ratio of wounded to killed means more soldiers are surviving their battle injuries. Kevlar helmets, body armor with ceramic plates, and top-notch medical facilities nearby all help.

Attacks more severe

But what this also results in is "a large number of survivors with permanent physical and emotional scars, not to mention profound disabilities," says Loren Thompson, head of security studies at the Lexington Institute in Alexandria, Va. "Not only are some wartime wounds uncommonly complex to treat, but the range of treatments provided - including counseling, assisted living, disability benefits, and so on - can be quite extensive."

One reason: the nature of the attacks on US troops in Iraq these days - rocket- propelled grenades and roadside bombs instead of rifle fire - means that injuries often tend to be more traumatic, including loss of limbs.

The war in Iraq (and in the other theaters of the war on terrorism around the world) is likely to produce other longer-term costs as well. For example, the impact of this conflict in Iraq could mean more instances of Gulf War Syndrome than the 100-hour ground war of 1991, due to much longer periods of exposure to chemicals, depleted uranium, and other toxic substances. (It may already be showing up in the form of more than 100 recent instances of respiratory illness among US soldiers in Iraq.)

Worse than earlier war

"This was by all accounts a vastly dirtier enterprise than the Gulf War was last time," says Larry Seaquist, retired US Navy warship commander and Pentagon strategist.

In addition, the impact of post-traumatic stress - tied to longer periods in the combat zone, more urban fighting, and the likelihood of double tours in Iraq - is expected to be greater as well. Several episodes of suicide and murder of spouses at Ft. Bragg last year by troops recently returned from Afghanistan have officials worried about - and expanding efforts to counter - the effects of post-traumatic stress disorder (PTSD).

"I wouldn't be surprised if we had a real bow wave of such problems still to come," says Captain Seaquist.

Big veterans' budget

All of this puts the spotlight on the overall costs of national defense, in particular the Department of Veterans Affairs (VA), which is second only to the Defense Department in the size of its workforce. The VA expects to spend $59.6 billion this year, nearly all of that on health care and benefits for some 2.7 million veterans now receiving disability compensation or pensions.

As veterans of the wars in Iraq and Afghanistan join that group, says Seaquist, "we may see a freshly invigorated veterans' movement that is asking to make sure that ... veterans' rights are guarded."