Thursday, September 24, 2009

Hundreds of uniformed service members, administration leaders, legislators, health professionals, wounded warriors, family members and concerned citizens gathered in Alexandria last week for the Defense Forum Washington to discuss the unseen injuries of war. The topics included post-traumatic stress disorder (PTSD), traumatic brain injury (TBI) and progress on various pilot projects designed to improve support for wounded service members.

The one-day forum was hosted by the Military Officers Association of America, the nation’s largest association of officers, and the U.S. Naval Institute.

Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, told those who gathered for the event that the challenge to provide proper care and diagnosis for thousands of troops returning home from Iraq and Afghanistan with traumatic brain injuries and post-traumatic stress disorder is just beginning to be understood by top military leaders.

“We are just beginning to deal with the long-term implications of caring for service members and their families whose lives have been changed by the wounds of war,” Adm. Mullen said. “These are 20-somethings who are wounded. These are 20-something spouses with children who have 50, 60, 70 years to live.”

Adm. Mullen urged those attending the forum to look for the best practices within other organizations such as Military OneSource, Operation Homefront or USA Together and to implement what works.

“How do we create a system throughout America that recognizes these needs?” Adm. Mullen asked. “How do we convert the research [on post-traumatic stress and traumatic brain injury] to make it work? We need solutions which are evident and [to] take those and implement them.”

Adm. Mullen stated that he is committed to preventing a repeat of what occurred after the Vietnam War.

“You know, I am a Vietnam veteran. I swore when this war started, not having any idea where I’d end up, and believe me, not expecting to be in this job, that I would do all I could to avoid generating another generation of homeless veterans as we did … coming out of Vietnam and we still, decades later … we’ve not met that challenge for them.

“Shame on us if we don’t figure it out this time around,” Adm. Mullen said. “We can’t do it alone. These are America’s citizens who are going off and doing our country’s bidding without question, and we owe them. This is a debt, and it needs to be the first check we write.”

Throughout the day, panels discussed the implications of unseen injuries and the impact of those injuries on families.

Another recurring theme was that many wounded service members still struggle to overcome the stigma they believe is associated with admitting that they need help.

“All soldiers should go through counseling when they redeploy, make it mandatory for all. Everyone goes through stress; it’s just different levels of stress for different situations. This includes family and kids. We need to recognize this and not re-enforce the stigma about counseling,” said the U.S. Army Reserve’s top officer, Lt. Gen. Jack C. Stultz.

During his address to the forum, Gen. Stultz offered solutions to the ongoing stresses faced by service members and their families. He and his wife recently celebrated the opening of an Army Strong community center in Rochester, N.Y. He explained that the center provides the support of a military installation to families that are not physically near one.

Command Sgt. Maj. James H. Franklin of the Army Air Operation Group, a panelist for “Managing the Battlefield & Beyond - A Leadership View,” suggested the stresses warriors experience can be combated through initial training initiatives.

“There’s a short period of time for individual training on these issues,” Sgt. Franklin said. “When a soldier runs into problems, the issue goes to squad leader level, and those individuals are not fully trained to ID such an issue.”

Sgt. Franklin said combat stress teams are attached to hospitals, yet “that is pretty challenging when soldiers are on the hillside.”

“These squad leaders on the ground are the first line of defense; he needs to be able to identify these symptoms,” Sgt. Franklin said.

“Community heals; isolation kills,” said Army Reserve Lt. Col. David Rabb, director of psychological health, 63rd Readiness Support Command at Moffett Field. He opened the “Implications of Unseen Injuries” panel by sharing what he learned from the battlefields of Iraq.

Col. Rabb stated that he has tried to bring the Department of Defense and the Department of Veterans Affairs into the community and to bring the community into the VA and DoD. They are large organizations and do great by themselves but they can do better by working together, according to Col. Rabb.

“Outreach means you have to go beyond your organization, beyond your department, beyond your service because trauma does not stay in its lane,” Col. Rabb said.

Retired Army 1st Lt. Rebecca Ludwick said she attended the forum looking for assistance from top military and VA officials. She sustained a spinal-cord injury during a combative training exercise.

“I was injured during combative training in February 2007 at Fort Sill, Okla.,” Lt. Ludwick said. “Because it was not an injury sustained in combat, I was denied benefits. I am depressed and lonely. My husband is currently in Afghanistan, and I am here alone.” Lt. Ludwick says the system has failed her.

Leslie Kammerdiener, who sat on the “Caring for Families and Caregivers” panel, said the VA has failed to provide ample support for her and her injured son, Army Cpl. Kevin Kammerdiener. He was severely wounded in Afghanistan in May 2008. Mrs. Kammerdiener told the forum that when her son arrived at the VA facility in Tampa, Fla., Labor Day weekend in 2008, they were unaware he was coming.

“The hospital had no medicine for him, no bed and no food for his feeding tube. My son went 30 hours without being fed,” Mrs. Kammerdiener said. “It’s a very sad thing that this country - your Army or your VA or whatever - has let us down so incredibly. And I am asking you to step up to the plate and take care of somebody who went over there and did what you asked them to do.”

“Post-traumatic stress is a tremendous challenge for us. We are improving screening for our troops. There will be no veteran left behind,” said VA Assistant Secretary L. Tammy Duckworth, who oversees public and intergovernmental relations at the agency.

Online links suggested by forum participants include:, and

Susan Oliver Nelson is a writer living on Fort Belvoir. She is an Army spouse.

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