90,000 Casualties, but Who’s Counting?

by , November 10, 2009

Editor’s note: This article has been updated to reflect new data on total casualties in Iraq and Afghanistan.

Veterans Day arrives tomorrow, and with it, the anticipated harvest of heartbreaking anecdotes driving the press coverage and our ever wandering attention back to less desirable realities: the disfigured but persevering hero, the homeless warrior, the unemployable sergeant, the father or son or daughter who came home a stranger and cannot be reached.

Usually, there is nothing more powerful than a personal story to pound home the cost of eight years of war overseas, but I think today there is something even more disturbing to bear.

It’s the number 89,457 [.doc].

As of Nov. 9, that’s how many American casualties there were in Iraq and Afghanistan since Oct. 7, 2001, when the Afghan war officially began. That includes a tire-screeching 75,134 dead, wounded-in-action, and medically evacuated due to illness, disease, or injury in Operation Iraqi Freedom (OIF), and 14,323 and counting in Afghanistan, or Operation Enduring Freedom (OEF).

That it may sound incredible – even unreal – is understandable. Early attempts to effectively count casualties (outside of battlefield fatalities) had been in earnest, then erratic, but finally dead-ended, frustrated by the Department of Defense, which has always been loath to break down and publicize the data on a regular basis.

One stalwart has always been Veterans for Common Sense (VCS), a nonprofit advocacy group dedicated to advancing the health and readjustment of returning soldiers and veterans. They’ve been diligently aggregating the statistics over time, and thanks to their diligent Freedom of Information Act (FOIA) requests, they can provide casualty reports at a level of detail not currently seen on the DOD’s publicly accessible Web site, DefenseLink.mil.

If we could access the data more easily, more people would know that 196 servicemembers took their own lives while serving in Iraq between March 2003 and Oct. 31, 2009, and there were 35 such suicides in Afghanistan. (These figures, of course, do not include the skyrocketing cases of suicides among all active-duty soldiers and veterans and cases of self-inflicted injury outside both war zones.)

More people would also know that 48,871 servicemembers had to be medically evacuated from the battlefield due to hostile and non-hostile injury, disease, and other medical issues since the beginning of the Iraq War [.pdf]. As of Oct. 31, 11,080 were evacuated for the same reasons from the war zone in Afghanistan [.pdf].

What the DOD does say, is that as of Nov. 4, there were 13,880 servicemembers wounded in action in Iraq who had not returned to duty, while 2,619 had left Afghanistan under the same conditions [.pdf]. That number is climbing faster. According to the Washington Post on Oct. 31, more than 1,000 were wounded in Afghanistan in the last three months, accounting for one-third of the total American casualties in OEF overall.

Thus, the troops are coming home, but in drastically varied degrees of wholeness. In Vietnam, there was one soldier killed for every 2.6 wounded. The vast majority of soldiers are surviving their injuries today (approximately one killed in action for every 11.5 wounded in action, according to current stats for Afghanistan and Iraq), thanks to advanced body armor, better medevac transport, and mine-resistant ambush-protected vehicles. But in tens of thousands of cases, their journey has just begun.

No one should be surprised, then, to hear that some 454,000 Iraq and Afghanistan veterans have already sought medical care from the Veterans Administration (VA) when they came home. That’s 40 percent of the total OIF/OEF veteran population, which is a number that is of course in flux, considering that the war has no end and veterans have five years to apply for care after the end of their service.

As of this summer, of those veterans who sought healthcare at the VA, 45 percent were diagnosed with a mental health condition, according to VA statistics. Twenty-seven percent of these had post-traumatic stress disorder (PTSD).

Based on available resources from the DOD and research by the RAND Corporation, VCS estimates that an estimated 370,000 (or 19.5 percent of) veterans have a traumatic brain injury (TBI) thanks to the high rate of accidents, roadside bombs, and other battlefield explosions and events – plus repeated deployments – in the war. VCS also estimates that some 18.5 percent of veterans come home with PTSD.

"This is very, very serious. The numbers are… bad, OK?" said Paul Sullivan, the bulldog director of VCS. "The good news is veterans are asking for care, and it’s good care. The bad news is there is 454,000 of them."

That’s tens of thousands of men and women and affected families and communities that are all but missing from the mainstream news any other time of the year. Sullivan said this is partly the military’s fault for obfuscating the statistics and working to keep the agony of sacrifice in the shadows.

"It’s still the policy of the United States to minimize concerns about postwar health," said Sullivan. Take the issue of soldiers coming home with chronic health problems allegedly caused by the toxic open-air burn pits in theater. One look at the online discussion boards and it’s clear something over there went awry. Vets are headed to VA facilities in droves with symptoms ranging from respiratory distress to sleep apnea and irregular heart conditions, but the Pentagon still refuses to admit a connection to their wartime exposures.

"They treat it as a public relations issue, not a health issue," Sullivan said. "In our view, we are tired of the government lying, and we’re done with the PR."

Larry Scott, who runs VAWatchdog.org, an invaluable daily monitor of ongoing issues affecting the 23.4 million living U.S veterans, said the 90,591 figure relating to OIF/OEF casualties is valid – and ultimately overwhelming. "People just forget, they don’t realize there is an ongoing cost of war. Whether you agree with the war or not is not the issue. We have to be ready to pay the price."

Looking at it in monetary terms – more numbers – may seem cold, but again, it puts the taxpayers’ burden into shocking perspective. Linda Bilmes and Joseph Stiglitz have identified two scenarios in their book, The Three Trillion Dollar War (2008). One scenario estimates a long-term cost of $422 billion to the federal government for veterans’ health care and disability compensation (given 1.8 million men and women deployed and troop levels falling below 55,000 by 2012). In the other scenario, the U.S. stays in Iraq and Afghanistan another eight years and 2.1 million men and women are deployed, with a price tag of $717 billion

Sullivan estimates that there are about 450,000 disability claims already filed with the VA on behalf of Iraq and Afghanistan vets, based on the official 405,000 figure announced back in February. He said there are approximately 80,000 new claims a month from veterans of all wars. As of Sept. 26, there were more than 951,217 pending claims by all veterans, including 200,679 claims pending appeal (the Veterans Benefits Administration recently reduced that number to 176,000, raising eyebrows at Sullivan’s group).

Rarely do we hear these figures over the din calling for even greater numbers of troops on the ground in Afghanistan. The generals want 40,000 or more, which would exceed the "surge" of 20,000 men and women into Iraq almost three years ago. Soldiers are finally withdrawing from that front only to be shifted to the other one for seemingly more hazardous duty.

"Where is the discussion about making sure that before we send any more troops overseas that we can take care of the veterans we already have and whether we can take care of another flood of them?" asked Sullivan.

Such discussions are indeed hard to come by. As Veterans Day nears, veterans are strangely absent, and for many of us, out of mind. Perhaps Sullivan’s question is best answered by Macy’s full-page Veterans Day sale advertisement in the Washington Post this week, featuring two well-dressed, shiny, happy, pretty people with a bugle and a drum. There are lots of numbers – 30% to 60% off storewide! – but not a veteran in sight.

Read more by Kelley B. Vlahos