For Veterans, Pride in Service, and Health Systems Pushed to Limits

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Welcome to THIS IS AMERICA in VOA Special English. I'm Steve Ember.

And I'm Barbara Klein. November eleventh is Veterans Day in the United States. The holiday honors those who served in the military. That describes almost twenty-five million people alive today. This week on our program, we talk about veterans and some current issues they face.


A visitor to the National World War Two Memorial in Washington stands looking at the water rising from the fountains in the middle.

The memorial has an Atlantic side and a Pacific side. The visitor, a man with white hair, walks over to the Atlantic side -- the war in Europe. He looks at the stone block honoring veterans from Massachusetts, his home state.

Fighting in the war was terrible, he says. But being a veteran changed his life.

He explains that he attended college and became an engineer because of legislation passed in nineteen forty-four. The law was known as the "GI Bill of Rights." GI is slang for a soldier.

It provided veterans with money for education. It guaranteed loans for homes and businesses. It helped support veterans who had trouble finding jobs. Today, there is a modern version called the Montgomery GI Bill.

The last military draft ended in nineteen seventy-three. Since then the armed services have been all-volunteer.

Many young veterans today served in Iraq or Afghanistan, or in some cases both.

Military and veterans health systems have faced struggles and criticisms of their ability to meet current needs. Close to thirty thousand American troops have been wounded in Iraq since the war began in two thousand three. Many were severely injured, including lost arms and legs and brain injuries as a result of bomb explosions.

President Bush says the system for managing care is old and needs to be changed.

His proposals are based on suggestions from the President's Commission on Care for America's Returning Wounded Warriors. Some measures can be taken without legislation; others have to be approved by Congress. The president appointed the commission in March after news reports brought the issue to national attention.

In February, the Washington Post reported on problems for soldiers recovering at Walter Reed Army Medical Center in Washington. These included poor living conditions and long delays in decisions about the future of their care and their military service.

The newspaper series raised wider questions and quickly brought promises of improvements.

For example, the Army is developing new teams in an effort to improve case management for wounded soldiers. But the Government Accountability Office recently reported that the Army is having trouble filling positions on these teams. At the same time, long-standing problems remain to be solved.

Last month, Mr. Bush proposed legislation to speed up the process for wounded service members. Now, they go through medical tests and complete paperwork for the Department of Defense. They have to repeat the same process for the Department of Veterans Affairs, the V.A.

The legislation calls for the Defense Department to decide if a wounded veteran could return to active duty. Those too badly injured would be moved to the care of the V.A. The V.A. would rule on the extent of their injuries.

Family members caring for veterans would receive six months of unpaid leave from work so they would not lose their jobs.

Also, all Iraq and Afghanistan veterans could get care for post-traumatic stress disorder, or PTSD. They would not have to prove it was connected to their service.

And other measures are being proposed.

The Veterans' Disability Benefits Commission, in its final report last month, called for an immediate increase in disability payments. The group was established in the two thousand four defense budget.

The commission said Congress should increase payments by up to twenty-five percent. This is being called for as a step toward future measures based not just on work-related losses but losses in quality of life.


Almost one and one-half million men and women have served in Iraq and Afghanistan. Over a four-year period doctors reported about sixty thousand people with PTSD or serious brain injuries.

Several drugs and mental health treatments are used for post-traumatic stress disorder. But a report released last month said most of the treatments are unproven.

The report came from a committee of the Institute of Medicine, part of the National Academies in Washington. The experts found problems with many studies of PTSD treatments.

They decided that there is not enough evidence to make judgments about any medications. In the words of chairman Alfred Berg from the University of Washington in Seattle: "These therapies may or may not be effective -- we just don't know."

The committee said the same thing about most of the psychotherapies. However, the experts found enough evidence to say that exposure therapies are effective in treating people with PTSD. These forms of therapy expose people to a threat in a safe environment to help them deal with their fears.

Still, the experts said they were not suggesting to discontinue any treatment or only use exposure therapies. Doctor Berg said there is an urgent need for high-quality studies of the best possible care.

The committee found that there is not even a generally accepted definition for recovery from the disorder.       

PTSD is the most common service-related mental disorder found in troops returning from Iraq and Afghanistan. Almost thirteen percent of those who fought in Iraq, and about six percent in Afghanistan, are believed to have experienced it.

The Institute of Medicine noted that large numbers of Vietnam veterans and veterans of earlier conflicts have also reported PTSD. And most people who suffer from it also have other conditions such as alcoholism, depression, drug use or anxiety disorders.


The V.A. says about one-third of homeless adults in the United States have served in the armed forces, mostly during the Vietnam War.

The department says an estimated one hundred ninety-five thousand veterans are homeless on any given night. And, it says, perhaps twice as many are homeless at some point during any given year.

The V.A. has special treatment programs and services that were established twenty years ago to serve homeless veterans.

Last year there was a documentary film about homeless veterans called "When I Came Home." It tells the story of an Iraq war veteran with PTSD named Herold Noel. In one scene, he talks about living in his automobile in New York.


HEROLD NOEL: "You want to see my home? You want to see my home? My home is right there. That's my home. You understand? There's my home."

The press materials for the film included a newspaper story about Herold Noel in the New York Post in January of two thousand five. The story said he was seeing a psychiatrist at a V.A. hospital and had been given three different drugs for his PTSD. But he needed housing for his family. He went to an emergency assistance office in the city. The story said he was told there was no more government-assisted housing available.

The documentary shows how his life changes after meets Paul Rieckhoff. Mr. Rieckhoff is the founder of an organization called Iraq and Afghanistan Veterans of America. The movie follows Herold Noel as he becomes active and receives media attention. It shows him going to Washington to ask Congress for more help for other veterans.


Three years ago, Illinois Army National Guard pilot Tammy Duckworth was flying in a Black Hawk helicopter near Baghdad. A rocket struck the aircraft. She lost both legs and suffered severe injuries to her right arm.

She says veterans of the Korean and Vietnam wars helped her through her painful recovery with support and advice.

Last year she was a Democratic candidate for Congress. It was her first campaign for public office. She lost the election. But she now serves as director of the Illinois Department of Veterans Affairs.

Another veteran, Joyce Robinson, keeps a book of memories. One of them is a photograph of a young woman in the military. That was her, more than sixty years ago. She served in the Army occupation forces in Japan after World War Two. Joyce Robinson says she is happy she served, and glad to be a veteran.


Our program was written by Jerilyn Watson and produced by Caty Weaver. I'm Steve Ember.

And I'm Barbara Klein. Our programs are online with transcripts and MP3 files at Join us again next week for THIS IS AMERICA in VOA Special English.