The real cost of a war with Iraq to the American people may be incalculable in ways we have not considered. When we invade Iraq this time, unlike the last, we could sustain far more casualties than we did in Desert Storm. Iraqs Army may have folded quickly in Kuwait, but they will be defending their homes and families from an invader this time and might not give in so easily.
Most worrisome is the possibility that Saddam will use chemical or biological weapons that would significantly increase the number and severity of combat casualties.
The Gulf War was over so quickly that the militarys ability to care for battlefront casualties was not tested. There is a serious concern that the military may not be able to adequately care for the wounded in the coming invasion, in particular if there are massive numbers of casualties from chemical or biological weapons.
Immediately following Desert Storm the General Accounting Office (GAO) began submitting a series of reports to Congress critical of the militarys ability to care for combat casualties and protect our troops from chemical or biological attack. The GAOs first full analysis was done in 1992.
The GAO found serious shortcomings in the Department of Defenses ability to deliver medical care during combat operations. The report is titled "Operation Desert Storm" and notes:
"Full Army medical capability not achieved. Operation Desert Storm revealed many weaknesses in the medical capabilities of the U.S. Armed forces.
"We found that understaffed and inadequately supplied and equipped medical units in Operation Desert Storm might not have been able to provide adequate care if the predicted number of casualties had occurred. Also, the medical units were not staffed and equipped to provide non combat care and were unable to support the evacuation of casualties from the combat theatre or to receive large numbers of chemically contaminated casualties. Other medical force problems included (1) large numbers of non-deployable medical personnel due to unacceptable physical conditions, lack of required skills, and mismatches in medical specialties (2) a widespread lack of training for the wartime mission; and (3) inadequate or missing equipment and supplies."
By great good fortune, the number of casualities in the Gulf War was well below the estimate. Had there been a chemical or biological attack, the results could have been tragic.
The GAOs 1996 report found the same deficiencies in the militarys preparedness to provide medical care to the wounded, and once again, serious deficiencies in the ability to treat casualties of chemical or biological attacks. The criticism had little impact on the military.
From the GAO report: "The officials believe that MSRP (medical strategic readiness plan) would have been given higher visibility and priority for implementation if it had been published with the signature of the Secretary of Defense or Deputy Secretary of Defense rather than the Assistant Secretary of Defense for Health Affairs."
In short, because the military was not ordered to undertake reforms by the Secretary of Defense they ignored the GAOs recommendations.
The GAO followed this report with one in 1998 and another in 2001. Each of these reports finds the military had failed to adequately address the problems raised in the very first GAO analysis done immediately following the end of the Gulf War.
The 2001 GAO report was particularly critical of the militarys ability to care for casualties of chemical or biological (CB) attack. "Relatively few military health care providers have been trained to a standard of proficiency in providing care to CB casualties. The Army tested their front line medics and found that their knowledge of how to treat CB casualties was low. Those medical personnel who are trained cannot always be located to serve in forward medical stations, because the military has not established a tracking system to identify them."
The report points out that while troops have received training in counter measures for a biological or chemical attack "no realistic field exercise of medical support for a CB attack has been concluded. As a consequence, medical readiness for CB scenarios cannot be ensured."
The possibilities of a chemical or biological attack are a given low priority in training exercises by the Pentagon. Commanders find the protective suits cumbersome to use in simulated combat exercises. They frequently allow the troops to remove pieces of the protective equipment, such as gloves, that slow them down in war games. The mindset of the military is that such attacks simply will not occur. That is perhaps wishful thinking in dealing with Saddam Hussein, who, we are told repeatedly, has such weapons at his disposal, and has used them in the past.
The Pentagon freely admits, in the 2001 report, that its medical units, if faced with large numbers of casualties from a chemical or biological attack, would be completely overwhelmed. While the admission is frank, it does not explain the militarys failure to implement planning or training for such an attack. The GAO found that Department of Defense health officials acknowledged that they did not know how many casualties they could handle.
The GAO report concluded in part, "The probability of U.S. forces encountering CB agents during worldwide conflict remains high. However we found that the likelihood of CB casualties receiving proficient medical care remains low."
There has been little or no fundamental change in the militarys ability to deal with large numbers of casualties. The military remains as unprepared today to deal with a biological or chemical attack as they were during Desert Storm despite twelve years of warnings.
Another, even more alarming, GAO report presented to Congress in October of 2002 exposes the vulnerability of our troops to Saddam’s madness. If Saddams henchmen do use weapons of mass destruction to attack our troops, the American soldiers, sailors, airmen, and Marines will not have adequate chemical warfare clothing to protect them from the deadly effects of these toxins.
In testimony before the Subcommittee on National Security, Veterans Affairs, and International Relations, Raymond J. Decker, Director of Defense Capabilities and Management, painted a grim picture of the Pentagons ability to protect our troops from a chemical or biological attack.
His report showed that a good deal of the protective clothing in the military supply line is already past the expiration date and cannot be relied upon to protect our troops in the field. Replacements are not arriving in military inventories in time to issue them to our soldiers if we are to invade Iraq within the next few months.
Worse, yet, the military may not have enough components of the chemical warfare suits to make them effective even if they could be issued in time. The chemical warfare suit alone cannot offer protection. The suit is only one part of the necessary protective clothing. There must be a gas mask, filters, hood, gloves and boots, or an "ensemble," the term used by the GAO, to offer adequate protection. The military units that the GAO examined had critical shortages in each of the several components necessary to ensure protection for the troops. Consequently, the GAO found the risk of potential deadly contamination was high.
In his conclusion Decker said in part: "A real gap remains between the priority and emphasis given chemical and biological defense by the DOD and the actual implementation of the Program. Many needed improvements need to be realized. Furthermore we are concerned that without the leadership and commitment of the department to address the long term conditions we have identified, the service members of our country may be at risk in a contaminated environment."
For the normally deferential GAO this was as strong a statement as they could make. Mr. Decker, in an interview for this story, said he remains very concerned that our troops may not be able to protect themselves from a sustained chemical or biological attack.
The Chairman of the Sub-Committee, Congressman Christopher Shays of Connecticut issued a statement following Deckers presentation. The statement says in part: despite prolonged and costly efforts to improve CB defense doctrine, tactics and material, seemingly intractable problems still plague the effort to defend against chemical and biological attacks."
Shays notes in his statement that shortages of the protective clothing ensemble exist in some branches of the service while other units have surpluses of the equipment. Some units sold suits on the Internet as excess, while other units were forced to delay training because they did not have suits.
Our troops could be subject to a chemical or biological attack without the protective clothing to defend themselves. A single drop of the VX gas on exposed skin, as Secretary Powell pointed out before the United Nations, is fatal.
If there were such an attack, there would be mass casualties because of faulty equipment, which would overwhelm the military’s rudimentary medical system. We may very well face a more terrible national tragedy than we did on September 11th..