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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.

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[Editor's note: The original version of this story repeated a paragraph.]

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This may be especially true because US forces in Iraq include an unusually high percentage of National Guard and Reserve soldiers, says military analyst Marcus Corbin at the Center for Defense Information in Washington. Many of these troops are older men with wives, families, and established positions in their professions and communities.

Lessons from Vietnam

"I think there is actually something different about reservists getting taken from their jobs and families and getting killed or shot up, compared to active duty troops, even though in theory there shouldn't be," says Mr. Corbin. "[It] cuts closer to home maybe."

One of the lessons of Vietnam, according to veterans and historians of that war, is to prepare for the emotional and psychological needs of returning soldiers - especially those who have seen heavy combat.

"In some ways, the wounded and injured present greater challenges for the nation," says retired Army Col. Dan Smith. "They suffer not just physical pain and sometimes long rehabilitation but all too often psychological scars and the loss of self respect."

Part of addressing this need is greater public understanding of what's being asked of men and women in the armed services.

"Folks [need to] understand the dangerous nature of the profession even when bad guys are not shooting at you in a hot war," says retired Army Col. Scott Snook, disabled in a friendly-fire incident during the 1983 US invasion of Grenada. For example, says Colonel Snook (who now teaches at the Harvard Business School), the Army alone experiences some 250 noncombat-related fatalities a year due to accidents, illnesses, and suicide.

It took Vietnam vet Lee Thorn more than 20 years after he returned home to California in 1966 to seek the help that led to his diagnosis of severe PTSD. He now receives free medical care and disability pay from the government.

Help from comrades

Every few weeks, Mr. Thorn also takes part in a VA-facilitated "rap group" with similarly diagnosed Vietnam vets - most of whom have Purple Hearts for physical wounds.

"The first step was knowing that there were other guys like me," says Thorn, who was a bomb loader on an aircraft carrier. "I had 30 years of nightmares, and I haven't had any in the last five years."

This resulted in his ability to start and operate a nonprofit organization that works for reconciliation in heavily bombed Laos by providing health, education, technology, and economic development services there.

Strong support for vets

"Increasing health, increasing effectiveness in the world is what keeps me going back" to the group sessions with other vets, says Thorn.

Over the years, some have argued that the VA's functions should be part of the Defense Department. But that is very unlikely to happen for political reasons. Veterans' groups are only slightly less influential than the AARP.

"Many of the costs that fall under the VA never get much publicity or figure into debates on the costs of overseas military actions," says Ivan Eland, senior fellow at the Independence Institute in Oakland, Calif. "Certainly, the VA expenses should be part of the DoD budget. But even if this is not politically possible, we can at least add such costs in a government-wide estimate of the costs of the war."

Is there a political lesson in all of this?

"The public will put up with substantial casualties when there's a point to the action," says Mr. Corbin of the Center for Defense Information. "But when a war and occupation of a foreign country were started under false pretenses, are going badly, and there's no exit scheduled, look out."

Says Mr. Thompson of the Lexington Institute, who generally supports the US invasion of Iraq: "It's still a dirty business with horrendous human costs, costs that for some veterans will persist over many decades."