How to count the casualties in Iraq

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Ten thousand medical evacuations from Iraq, and counting. Statistically, it doesn't sound like much, not out of well more than 1 million Army and National Guard. But that number, like a small spot on an X-ray, indicates approaching disaster.

In mid-November, the U.S. Army Surgeon General's Office put the number of soldiers medically evacuated from Iraq between March 19 and Oct. 30 at more than 9,200. This includes those killed and wounded in action, injured in noncombat incidents and accidents, and sick. It excludes those treated in-country and those who developed significant problems after leaving Iraq.

These people cannot be efficiently replaced. And their loss has profound and dangerous implications for the Army, for Iraq, and for the world.

Of the 2,000-plus troops evacuated for wounds, far fewer than normal will return to duty. In prior wars, wounded soldiers often went back to their units, forming a veteran core, or were assigned to supporting units and training commands. But in Iraq, soldiers are now wounded less by gunshot, thanks to improved body armor, than by improvised explosive devices and rocket-propelled grenades. The results are often catastrophic.

In Iraq, the "Million Dollar Wound" -- the one that gets you out of combat but lets you recover -- is scarce, indeed.

The Army report also notes that 2,500 soldiers were evacuated for noncombat conditions caused by vehicle and other accidents, and health problems aggravated, if not caused, by the harsh living conditions. These numbers can be expected to increase dramatically as fatigue and hardship wear soldiers down.

Obviously, no army engaged in deadly contact can function without a steady stream of replacements. The problem lies in generating those replacements.

By law, no service member can deploy overseas without at least six month's training. Six months doesn't get you a fully qualified basic infantryman. Helicopter mechanics, computer specialists, Arabic linguists: These take years. The Army has not released information on the MOS's (Military Occupational Specialties) of the MedEvacs, but it is reasonable to assume that, in all those crashed helicopters and ambushed convoys, a lot of skills and experience were lost.

Further, a combat unit worn down to 70 percent of its strength loses effectiveness. The soldiers still fight. But 30 percent casualties means units can no longer maneuver and cover each other as effectively. The work load remains the same, but fewer soldiers are available to do it. Probably a goodly chunk of the leadership has been lost. Cumulating fear and grief take their toll.