LANDSTUHL, Germany—While thousands of American military personnel have been seriously injured in Iraq and Afghanistan, accurate and timely information about the number of U.S. casualties is not being provided by the mass media or the Pentagon. Unlike the war in Vietnam, images of wounded U.S. soldiers from Iraq are rarely seen.
The Pentagon first released U.S. casualty figures from Iraq on July 9, 2003—four months into the conflict. Today, current Pentagon figures do not include casualties from the worldwide war on terror, or the conflict in Afghanistan.
Atop a densely wooded hill overlooking this small town near the French border lies the sprawling Landstuhl Regional Medical Center (LRMC), where some 12,000 U.S. service men and women have been brought to receive primary medical treatment before being flown to military hospitals in the United States.
LRMC with its numerous wings and annexes is the medical center for 60,000 U.S. military personnel in the Kaiserslautern area and provides tertiary level care for 300,000 Americans in the European Command area, according to Marie Shaw, spokeswoman for the hospital. Tertiary care is hospital care requiring highly specialized skills, technology or support services.
Landstuhl handles wounded soldiers for all coalition member countries and has treated injured personnel from 40 nations. Built in 1938 as the campus of the Adolf Hitler School for Youth, the hospital is now the largest American hospital outside the United States and serves as the primary medical treatment center for casualties of U.S. operations within Europe, Southwest Asia and the Middle East.
U.S. bases in this area, which is known as the Pfalz, include Ramstein Air Base and Landstuhl. These were built in the early 1950s after an agreement was signed between the French High Commissioner—in the French occupied area—and the U.S. government.
Local officials and historians are unaware of the Franco-American agreement that originally provided the legal basis for U.S. bases in this southwest region of Germany.
“Nobody really knew what was going on,” commented the director of Ramstein’s museum on the agreement that preceded the construction of the U.S. bases in the area.
LRMC and Ramstein Air Base pay no taxes and make no direct contribution to the local government although they have large populations and occupy huge tracts of land.
According to spokesperson Marie Shaw, most of the U.S. casualties from Iraq and Afghanistan pass through Landstuhl. The most common injuries are from shrapnel. But an unknown number of casualties are flown directly to the United States.
Wounded U.S. personnel are airlifted from combat support hospitals in Baghdad for an 8-hour ride to Ramstein on C-141 aircraft and then bussed three miles to Landstuhl.
During the first Gulf War, from 1990-1991, LRMC treated 4,000 American casualties. The invasion and occupation of Iraq, called Operation Iraqi Freedom, and the worldwide “war on terror” begun in Afghanistan, or Operation Enduring Freedom, have resulted in three times as many—some 12,000 service members—being evacuated to Landstuhl and repatriated for medical treatment.
Lt. Col. Richard Jordan, a physician, who directs the Deployed Warrior Medical Management Center at Landstuhl, oversees the coordination of all medical evacuations from the Middle East. I interviewed him in his hospital office on Feb. 5 and he told me the following:
“Since the first plane arrived from Iraq on March 16, 2003, we have evacuated 11,400. We’ve been very busy. The most we had in one day was 168 [wounded]. We have had 60-hour weeks. We’re saving lives.”
Asked about the most common kind of injuries among the wounded-in-action soldiers, he replied that, “blast injuries are far and away the most common.”
He pointed out that Kevlar vests worn by U.S. troops in the field protected the torso and soldiers, who would otherwise have been killed in previous conflicts in which body armor was not available, had survived. Nonetheless, they were still left with serious limb and face wounds.
He also revealed that about 30 percent of the evacuated military personnel were currently being returned to duty and of the 30-40 service members currently being evacuated to Landstuhl every day, about 10 to 12 percent had been wounded-in-action.
Slobodan Jazarevic, a trauma and vascular surgeon, is a member of the Florida National Guard who has served in Iraq and is currently working at LRMC. He told me that injuries were devastating.
He left his practice in Palm Beach to serve what he calls the “just cause” in Iraq and Landstuhl.
For Maj. David A. Johnson, administrative director at RMC, it is not only traumatic but “our new steady state.”
February statistics from the Deployed Warrior Medical Management Center show that 11,652 soldiers from Iraq and Operation Enduring Freedom have been treated at Landstuhl. Of these, only 1,232—roughly one in 10—returned to duty; 10,420 required further medical treatment.
Ms. Shaw, the Belgian-born civilian spokeswoman for LRMC, confirmed that 90 percent of the U.S. personnel evacuated from Iraq and Afghanistan had been sent to the United States for further treatment.
When I asked her about the number of casualties caused by hostile action, she responded that LRMC did not keep records of the cause of the casualties.
She told me that LRMC currently has between 160 and 320 beds and a staff of 1,700 but has the space and personnel available to quickly increase its capacity.
“We had 1,000 beds set up during the first Gulf War. In 1988 when we had the Ramstein air show disaster we handled 580 casualties in one night,” she added.
On the issue of LRMC provided psychological counseling for the seriously wounded soldiers and amputees, she pointed out that “ time is very short” and most of the wounded are moved on to the United States in a matter of days. She admitted that amputees are still in a state of shock.
Casualty figures released on Feb. 3 by the Department of Defense from the invasion and occupation of Iraq indicate a significant gap with the figures I was given at the hospital.
Lt. Col. Jordan said Landstuhl had received 11,400 from Iraq, while the Pentagon has only reported a total of 2,996 U.S. wounded in the occupation of Iraq.
Jordan’s figure of 11,400, however, represents service members “requiring medical care” from all causes, hostile and non-hostile. Reportedly, some soldiers wounded in action have been classified as non-hostile injured, e.g. when a truck rolls over or some other type of accident occurs.
For Operation Enduring Freedom, which includes all the countries other than Iraq where the “war on terror” is being waged—from Arabia and Uzbekistan to the Philippines—the Pentagon has released a figure of 107 dead. These Pentagon statistics did not include the wounded.
However, the government gives a figure of 522 killed in Iraq since President Bush unleashed his “shock and awe” devastation on that nation.
When AFP asked Pentagon spokesman Jim Turner why the Pentagon did not provide current statistics on the number of wounded in the global war on terror, he replied: “You are the first reporter who has ever asked.”
Turner dismissed the claim that political directives from the Pentagon are being imposed to minimize casualty figures from Iraq and Afghanistan.
Regarding the discrepancy of some 8,000 casualties, Ms. Shaw told AFP that one should compare the hospitalization rates of a population the size of the deployment “downstream” with a city of similar size in the United States.
Asked about the seeming scarcity of images of wounded U.S. military personnel in the mass media, she said there were “plenty of them.”
She denied there were Pentagon directives to prevent images of injured servicemen from reaching the public.
A recent straw poll done by National Public Radio found that the American public had no idea how many U.S. military personnel had been wounded in Iraq and Afghanistan.
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