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Dan Froomkin

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How Many U.S. Soldiers Were Wounded in Iraq? Guess Again.

Posted: 12/30/11 10:20 AM ET

Reports about the end of the war in Iraq routinely describe the toll on the U.S. military the way the Pentagon does: 4,487 dead, and 32,226 wounded.

The death count is accurate. But the wounded figure wildly understates the number of American servicemembers who have come back from Iraq less than whole.

The true number of military personnel injured over the course of our nine-year-long fiasco in Iraq is in the hundreds of thousands -- maybe even more than half a million -- if you take into account all the men and women who returned from their deployments with traumatic brain injuries, post-traumatic stress, depression, hearing loss, breathing disorders, diseases, and other long-term health problems.

We don't have anything close to an exact number, however, because nobody's been keeping track.

The much-cited Defense Department figure comes from its tally of "wounded in action" -- a narrowly-tailored category that only includes casualties during combat operations who have "incurred an injury due to an external agent or cause." That generally means they needed immediate medical treatment after having been shot or blown up. Explicitly excluded from that category are "injuries or death due to the elements, self-inflicted wounds, combat fatigue" -- along with cumulative psychological and physiological strain or many of the other wounds, maladies and losses that are most common among Iraq veterans.

The "wounded in action" category is relatively consistent, historically, so it's still useful as a point of comparison to previous wars. But there is no central repository of data regarding these other, sometimes grievous, harms. We just have a few data points here and there that indicate the magnitude.

Consider, for instance:

  • The Pentagon's Defense and Veterans Brain Injury Center reports having diagnosed 229,106 cases of mild to severe traumatic brain injury from 2000 to the third quarter of 2011, including both Iraq and Afghan vets.
  • A 2008 study of Iraq and Afghanistan veterans by researchers at the RAND Corporation found that 14 percent screened positive for post-traumatic stress disorder (PTSD) and 14 percent for major depression, with 19 percent reporting a probable traumatic brain injury during deployment. (The researchers found that major depression is "highly associated with combat exposure and should be considered as being along the spectrum of post-deployment mental health consequences.") Applying those proportions to the 1.5 million veterans of Iraq, an estimated 200,000 of them would be expected to suffer from PTSD or major depression, with 285,000 of them having experienced a probable traumatic brain injury.
  • A 2008 study published in the New England Journal of Medicine found that 15 percent of soldiers reported an injury during deployment that involved loss of consciousness or altered mental status, and 17 percent of soldiers reported other injuries. (Using that ratio would suggest that 480,000 Iraq vets were injured one way or the other.) More than 40 percent of soldiers who lost of consciousness met the criteria for post-traumatic stress disorder.
  • Altogether, the Iraq and Afghanistan Veterans of America group estimates that nearly 1 in 3 people deployed in those wars suffer from post-traumatic stress disorder, depression, or traumatic brain injury. That would mean 500,000 of the 1.5 million deployed to Iraq.
  • The single most common service-connected disability is actually hearing loss. A 2005 Department of Veterans Affairs research paper found that one third of soldiers who had recently returned from deployments in Afghanistan and Iraq were referred to audiologists for hearing evaluations due to exposure to acute acoustic blasts, and 72 percent of them were identified as having hearing loss. Richard Salvi, head of the University of Buffalo's Center for Hearing and Deafness announced recently that "as many as 50 percent of combat soldiers in Iraq and Afghanistan who come back have tinnitus" because of the intense noise soldiers must withstand.
  • The Department of Veterans Affairs' list of potential deployment health conditions includes chronic fatigue syndrome, depression, fibromyalgia, hearing difficulties, hepatitis A, B and C, leishmaniasis (also known as the "Baghdad boil"), malaria, memory loss, migraines, sleep disorders and tuberculosis.
  • The VA's web page on hazardous exposures warns that "combat Veterans may have been exposed to a wide variety of environmental hazards during their service in Afghanistan or Iraq. These hazardous exposures may cause long-term health problems." The hazards include exposure to open-air burn pits, infectious diseases, depleted uranium, toxic shrapnel, cold and heat injuries and chemical agent resistant paint. The VA provides no estimates of exposure or damage, however.
  • A 2010 Congressional Research Service report, presenting what it called "difficult-to-find statistics regarding U.S. military casualties" offers one indication of how the "wounded in action" category undercounts real casualties. It found that for every soldier wounded in action and medically evacuated from Iraq , more than four more were medically evacuated for other reasons.
  • The Armed Forces Health Surveillance Center's most recent monthly report found that the proportion of returned deployers who, around 3 months after their return, rated their health as “fair” or “poor” was 10 to 13 percent. More than 20 percent said their health was worse than before they were deployed; a similar number had "exposure concerns" and more than 27 percent reported depression symptoms.
  • A March 2010 report from the Institute of Medicine concluded that many wounds suffered in Iraq and Afghanistan will persist over veterans' lifetimes, and some impacts of military service may not be felt until decades later.


There are surely many other data points out there. But a comprehensive tally escapes us. In the meantime, the figure for "wounded" constantly cited by politicians and the media does not come close to reflecting the real cost to the servicemembers who went to fight in George W. Bush's war of adventure and will never be the same again.

We owe it to them to make a full accounting of their sacrifice -- and then never forget it.

Dan Froomkin is the deputy editor of the Nieman Watchdog Project. He is also Senior Washington Correspondent for the Huffington Post.

This post originally appeared at NiemanWatchdog.org.

 

Follow Dan Froomkin on Twitter: www.twitter.com/froomkin

 
 
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03:05 PM on 01/14/2012
Dan Froomkin is one of a kind. Why aren't we reading out the low estimates and full story on Faux, or the networks, or elsewhere in and on the MSM?

http://www.washingtonpost.com/wp-dyn/content/blog/2006/03/31/BL2006033100695.html
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Gestas
Mountain Man
12:12 PM on 01/02/2012
Better yet ..How many Blackwater People were killed in Iraq..?.. The Iraq war was the war that made Profiteering...a legal business enterprise...
03:06 PM on 01/14/2012
They use Blackwater and contractors to be able to say that they use few troops and also to underestimate the number of deaths.
12:40 PM on 01/01/2012
This book is to be neither an accusation nor a confession, and least of all an adventure, for death is not an adventure to those who stand face to face with it. It will try simply to tell of a generation of men who, even though they may have escaped its shells, were destroyed by the war.

All Quiet on the Western Front--Erich Maria Remarque
03:06 PM on 01/14/2012
If only people would it. Trouble is that they are wasting their time here watching cat videos and looking at celebrity skin on the Huffington Post.
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BlairCase
12:01 PM on 01/01/2012
According to the article, "the Pentagon's Defense and Veterans Brain Injury Center reports having diagnosed 229,106 cases of mild to severe traumatic brain injury from 2000 to the third quarter of 2011, including both Iraq and Afghan vets." This figure isn't as shocking as it seems. A study from the National Center for Injury Prevention found that 47% of high school football players say they suffer a concussion each season, with 35% of those reporting multiple concussions in a season. We have about 1.1 million high school football players, so this means about 495,000 high school football players suffer traumatic brain injuries each year. According to the article, "the Iraq and Afghanistan Veterans of America group estimates that nearly 1 in 3 people deployed in those wars suffer from post-traumatic stress disorder, depression, or traumatic brain injury. That would mean 500,000 of the 1.5 million deployed to Iraq." Assuming that a small percent of high school football players also suffer from depressions or post traumatic stress syndrom, we could safely state that 1 in 2 high school football players suffer from post-traumatic stress disorder, depression, or traumatic brain injury.

About 1.7 million Americans sustain a TBI annually. Of these, 52,000 die, 275,000 are hospitalized, and 1.365 million, nearly 80%, are treated and released from an emergency department.

That would mean 500,000 of the 1.5 million deployed to Iraq." However, Most traumatic brain injuries (TBIs) are concussion
10:56 AM on 01/01/2012
But this was just to get ONE MAN. Got that - ONE MAN!. All that death, maiming for life of Americans and destruction of property, and hundreds of thousands of innicent Iraqis - women and children.

And yet a US President was taken out with just ONE MAN! (and if they were lying - no more than than two).

And the masses swallow it.
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zogimperator
is this microbiology?
09:15 AM on 01/01/2012
As long as it's cheaper to ignore the full spectrum of traumas associated with combat, the Powers That Be will do so. This is the Washington approach to everything -- Massage the numbers until they look less like failure, then call it victory.

It's how they keep the real number of under- and unemployed below 15%, as well. And that's another statistic that bedevils our veterans, of course.
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irrenmann
won't read your angry replies :D
09:10 AM on 01/01/2012
"In the meantime, the figure for 'wounded' constantly cited by politicians and the media does not come close to reflecting the real cost to the servicemembers who went to fight in George W. Bush's war of adventure and will never be the same again."

Don't pretend to care about these people only to use their problems to score cheapo political points at the end. You know a great many of them don't feel that way about the war at all, so if you're supposedly concerned with getting them help, then focus on that.
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patient i am
i've run out of patience
10:15 AM on 01/01/2012
he called it exactly what it was--georges war of adventure. and thousands will pay the price for the rest of their lives while the rest of american hides under the sheets--or goes shopping.
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Paul Abrams
02:16 AM on 01/01/2012
The Iraq War was a disaster, and so was the so-called surge, those of us who opposed it knew that there would be a day we would leave, and the country would default to whatever political situation will arise anyhow, and nothing the US did was going to change centuries of hate and distrust among the various elements of Iraqi society, a country assembled by the British so that internal conflicts would enable them to rule more easily.
That said, I think Mr Froomkin should compare apples to apples. I suspect there were at least as many non-reported injuries in Vietnam and Korea as there were in Iraq--PTSD being one of those.
I am a physician and cared for many veterans during my training, and there is no question in my mind that the ravages of war are dramatically under-reported, and Froomkin helpfully points that out.
Vietnam taught us that we should not conduct a land war in Asia. Iraq that we should not do that in the Middle East. Is that enough? Or, do we need to learn that again on the other continents as well?
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George Hoffman
Drive into your dreams.
06:45 AM on 01/01/2012
Paul, thank you for your insight. I was a medical corpsman in Vietnam. So I saw the human face of war at the base hospital. I never thought America would commit another foreign policy blunder on the epic scale of Vietnam. I thought, as painful as it was for our country, we had learned our lesson. So I was opposed to the war in Iraq. How else would I feel after what I saw during my war? I wouldn't wish war on my worst enemy.
And I am unfortunately living proof of how under-reported the injuries were in Vietnam. I was awarded a disability compensation last September, 2010 - I have a mild case of ischemic heart disease - to due to my exposure to Agent Orange over four decades ago. But the government excluded "blue water" veterans from the provision. They served on the ships in the South China Sea. But the ships regularly docked at the bases along the shore for provisions. And among the provisions were undoubtedly taking on fresh water - the same water I showered in and drank at the mess hall. I don't know but I think the "blue water" veterans made the potential pool of legitimate injured just too high and probably would have driven up the funding for compensation. I only got this compensation because I was on land on a base that had been heavily sprayed with Agent Orange.
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patient i am
i've run out of patience
10:30 AM on 01/01/2012
George, thank you for your service.
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BlairCase
10:41 AM on 01/01/2012
I served as a artillery forward observer with the 101st Airborne in Vietnam. I now have a fairly serious case of ischemic heart disease, but I never thought to connect it with Agent Orange or Vietnam. Did you have much trouble convincing the VA that your heart problem was service connected?
11:26 PM on 12/31/2011
How dare you? What part of "WE DON"T KNOW AND WE DON'T WANT TO KNOW" did you not understand?
09:03 PM on 12/31/2011
Why does no one worry or talk about the murders in the US in the last 10 years of Iraq?
09:17 PM on 12/31/2011
Could you please explain your question?
12:34 AM on 01/01/2012
Because its not relevant to this story.....and if you must talk about it here, its because killing lower income people and keeping crime high is profitable to the powers that be.
09:02 PM on 12/31/2011
To put the Iraq deaths and Injuries in perspective, about 150,000 murders were commited in the US in the 10 years Iraq. Also there were about half a million car deaths.
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WI Patriot
Defending the Constitution.
10:57 PM on 12/31/2011
It is safer in a combat zone with the US Military than in the US. Glad more Americans are figuring this out.
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CoffeeRebel
Blue Collar Liberal with a black belt in sarcasm
08:49 AM on 01/01/2012
The stats you offered are available which is the first reason your argument is irrelevant and. in case you failed to notice there are 317 million people in this country so you can't compare numbers without breaking it down. Third, these are the best of us we lost in Iraq not the drug dealers so frequently killed on streets. Throwing away lives and damaging them for the made up reasons we fought for is a senseless waste which the government is solely responsible for. The government on the other hand tries to prevent fatalities in car accident requiring seatbelts, airbags, banning texring and drunk driving.
The government also does what it can to carch killers and put them where they will not be able to kill again.
Your argument has all these flaws and sound like a desperate attempt to deny the terrible truth of what happen.
03:09 PM on 01/14/2012
Apples and oranges. Every death is tragic, war deaths no less or more so. But war deaths are too often teens and young people, and kids who purposely put themselves in harm's way.
05:34 PM on 12/31/2011
Glad you brought this up. The magnitude of it is staggering and nobody has given it any thought or focus. We think these wars of adventure are fairly innocuous as they only mention the fatalities). If you just count those hit by kinetic trauma- its nearly equal to all the fatalities( in the viet-namn_ war. Our medical care and protective armour has come a long way that made all the difference. Without that this it would have looked a lot more like vietnamn-s statistics.
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BlairCase
07:18 PM on 12/31/2011
The casualtues in Iraq and Afghanistan doesn't come close to Vietnam casualties. Vietnam had 303,704 wounded compared to 32,226 wounded in Iraq and Afghanistan. If every U.S. soldier wounded in Iraq and Afhanistan had died, the number of fatalities would be 36,713, still much lower the 47,359 U.S. combat fatalities in Vietnam.
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WI Patriot
Defending the Constitution.
10:59 PM on 12/31/2011
That is the benefit of a volunteer vs conscript Army, less people die.
03:31 AM on 01/01/2012
I guess the point I was trying to make is. 36,713 would have been a tremendous amount of fatalities and 3/4's vietnams, save for our modern army and marines, and that is huge! People should rethink before we enter more wars of opportunity, especially if it means boots on the ground. All the time television news reported only the fatalities here, yet if we had known the actual number of wounded we would have been shocked. It was managed news.
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tc399
Your personal Eschatologist.
04:25 PM on 12/31/2011
They still haven't given Viet-Nam veterans a fair shake.
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PowerPridePinstripes
27 and Counting!
06:50 PM on 12/31/2011
True statement. I'm an OIF/OEF Vet and each time I see a Vietnam vet I ALWAYS thank them for their service and sacrifice!
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tacevad
American SS Card Carrying Socialist
07:03 PM on 12/31/2011
they is WE and until more of US demand it things will not change
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Kye154
04:17 PM on 12/31/2011
DoD has had a long history of deliberately falsifying the extent of casualities. Agent Orange and the Gulf War Syndrome are but just a few they resisted to recognize in the casuality lisitngs. The reasons are many. Incompetency of the military's medical staff has always been noted, the peer pressure within the military to just "suck it up and march on", and then there is the government's underhandedness to keep the claims down so they don't have to pay the veterans any more than government has to, and the officer corps don't usually give their own troops much consideration, as they are too preoccupied with with their own careers by making rank and moving up. Any veteran who ever served in combat will tell you this to be fact.
04:37 PM on 12/31/2011
And this time, they have the "all-volunteer" force to lean on. As in, hiding it among the poor and minorities that make up the vast majority of forces. As I noted further down this thread, during Vietnam, everyone knew someone in combat, and usually many. And you knew at least one who had come home in a body bag. But I know no one directly in Iraq or Afghanistan.