Friday, March 24, 2006

Outsourcing Treatment for Veterans of Iraq

Commentary by Martin Kelly
January 11, 2005

The corporate culture of outsourcing that very possibly led to Abu Ghraib is still alive and well in the Pentagon.

It’s their addiction.

On January 9, Liam McDougall of the ‘Sunday Herald’ reported that GI’s who have fallen into substance abuse as a result of trauma endured while serving in Iraq are being treated at Castle Craig, an up-market Scottish drying-out clinic. The unit has apparently won a large contract to treat military addicts. The cost of each serviceman’s treatment, approximately $2800 per week, is being borne by Tricare. McDougall reported the chairman of Castle Craig, Peter McCann, as saying,

‘We can have up to about four at any one time, but there’s a continuous stream of them coming in. There has been a step up in the numbers since Iraq. We see about 40 a year’.

It was surely bad enough to have one of the state’s most sensitive functions, the interrogation of prisoners, be conducted by civilian ‘contractors’, as is alleged to have happened at Abu Ghraib. However, the soldiers being treated at Castle Craig deserve rather more from the Pentagon who sent them into harms’ way, thereby exposing them to the conditions that have triggered their deterioration.

Also, Peter McCann’s comment raises as many questions as it answers. For how long has the Pentagon been outsourcing the care of its most vulnerable personnel? How many other centres like Castle Craig are used across the world? How many other types of medical treatment are being carried out on US service personnel by the private sector? What is the Pentagon’s total bill for private military treatment? How many personnel have been and are being treated under this regime? And, specifically, since the instigation of hostilities in Iraq? And what has been the concomitant increase in spending on such programs over the last two years?

It is easy to despise those who fall into substance abuse, or who suffer mental collapse because of trauma. In World War One, many British soldiers suffering from shell shock were shot at dawn as cowards, a stain that successive governments have refused to wipe away. A cursory glance at any statistics on suicide will show that the group most likely to kill themselves are young adult males, obviously also the group most likely to fight in any war. Young male soldiers are therefore doubly at risk of trauma not only because they are soldiers; but also perhaps just because they are male.

For decades, the US military has used the principles of overwhelming firepower and force protection to minimise casualties, so GI’s did not have to go ‘over the top’, like doughboys on the Western Front. But despite the advances in military engineering and military science that have made the USA unbeatable in open combat, so, too, there have been two other massive changes in conditions that now seem to have rendered these philosophies ineffective.

Firstly, the culture from which soldiers are recruited has changed; the GI of today comes from the world of easy consumption and MTV, a different world from that which existed when the doctrines were first expounded. Although they are just as tough as their predecessors who fought in Korea and Vietnam, their attitude to warfare will have been shaped by the images with which they have been surrounded all their lives – no previous generation of soldiers has been exposed to so many violent images almost from the cradle. As in so many things, the problem arises when perception meets reality.

Secondly, as William S. Lind has tirelessly argued in these pages, the nature of the warfare US troops are expected to conduct in Iraq is different from that for which they are trained and equipped to fight. These young men and women are doubly stressed by having to engage their opponents in situations where the neck-smiters, heavenly virgin-chasers and Ba’athist dead-enders seem consistently to have the tactical upper hand.

Given these circumstances, it’s perhaps not surprising that PTSD and its bedfellow, substance abuse, should be on the rise among those who have had to fight the battle.

This issue goes directly to the heart of the relationship between the state and its citizen volunteers. Although the USA does more for its service personnel than any other nation, it is still wrong that a citizen in service who suffers any kind of battlefield injury or trauma should be treated by an agency other than that responsible for its infliction – ultimately, the agency that sent the injury’s recipient into danger.

One cannot believe that with all its resources, the Pentagon is not able to perform these duties in-house. Obviously, the DoD is subject to budgetary controls; its budget is massive, but it still has to be managed. It is impossible to believe that there are no additional resources that could be made available for these men and women from the current budget.

One is sure that the treatment they receive at Castle Craig is excellent – if it were otherwise, one would hope the US military would have nothing to do with it, and one is sure that high standards are enforced in every private sector hospital or treatment unit entrusted with the health of American soldiers, wherever it is in the world. But that is not the issue: what is despicable about this is that it is a different expression of the same Bush mentality that bans pictures of returning caskets. The war he started has had casualties, even casualties with conditions the discussion of which may be taboo, at least around him. The fact that he may not want to discuss substance abuse means nothing when his war has helped make it a reality for many others.

Shunting off young men and women to a drying-out house in Scotland is not how a commander should lead his troops.