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The Battle Continues: After Veterans Stop Fighting the Enemy, They Continue the Struggle Against their Wartime Injuries

The challenges of America’s veteran Soldiers, Marines, Sailors, and Airmen almost never stop after they’ve returned home from their service. Even though they may be finished fighting our enemies abroad, they frequently continue their battle against injuries and illnesses sustained as they were fulfilling their duties to our country. A Kaiser survey in 2013 revealed that over half of Iraq/Afghanistan service members polled admitted to suffering a physical or mental health problem as a result of their service.1

As a result of our military’s excellent medical corps and state-of-the-art protective equipment like body armor, more service members than ever survived wounds that would have been fatal in previous wars. But the caveat to this otherwise-remarkable fact is that we must now fulfill our responsibility to our veterans and tend to their wounds as they return from overseas. The health challenges they face are unique, almost entirely unlike those faced by any other demographic in America. Here is a list of some of the most common and devastating problems that our veterans live with:

  1. Mental health challenges. Not all wounds are physical. The Institute of Medicine estimates that 20% of returning veterans suffer from post-traumatic stress disorder, a condition that develops after experiencing extreme fear, helplessness, or horror, all common emotions in battle. PTSD causes victims to continually relive their trauma, producing great anxiety in their daily lives. Furthermore, studies have shown that having PTSD exacerbates other medical conditions.2

    PTSD is joined by lesser-appreciated behavioral disorders that also commonly affect veterans. Substance abuse, binge drinking, depression, and suicide are all-too-common issues that destroy our veterans’ quality of life. Many of these both stem from and worsen other war-related medical problems. Ultimately, veterans with mental health problems feel alienated from society and suffer significant strains on their relationships with loved ones. Research suggests that these mental health disorders are highly treatable, but not enough veterans are currently able to utilize mental health care.3


  2. Traumatic brain injury. Deemed the “signature wound” of Operations Iraqi Freedom and Enduring Freedom, wartime TBI is usually caused by being near intense explosions, a common occurrence due to our enemy’s predilection for explosive devices. The powerful shockwave from these explosions can cause injury to the brain. At first, medical professionals mostly recognized severe TBIs were it was clear that damage had occurred. Veterans with severe TBI require rehabilitation to recover their ability to function in everyday life. For many who do not get the support they need, life will never be the same. Overtime, doctors realize that even mild and repetitive TBIs were causing unseen damage to our veterans, finding a relationship between frequent exposure to explosions and other negative effects, like PTSD, depression, and chronic headaches.4

  3. Loss of limb and paralysis. Our recent enemies have chosen violent and explosive weapons to employ against our military. In addition to causing the spike in traumatic brain injuries, these weapons produce devastating wounds to extremities that often require amputations. Over 1,500 service members in Operations Iraqi Freedom, Enduring Freedom, and New Dawn suffered a major limb amputation.5 Additionally, bullets and shrapnel from bombs can tear through nerves and the spinal cord, causing paralysis. Both loss of limb and paralysis result in our veterans losing a significant part of themselves and their everyday function. America’s advanced medical knowledge in rehabilitation can get veterans back in action to be able to live their normal lives despite their injuries, but only if we can get our veterans to the medical care they need and deserve.

  4. Genitourinary injury. It is often a problem we don’t often talk about, but has major implications on the lives of our veterans. Nearly 1,300 service members in the recent wars fell victim to injury to their genitals or urinary system, often as a result of improvised explosive devices.6 Very limited attention and research has been devoted to this kind of injury, but what little there is indicates that it deeply affects our veterans. Although limbs can be replaced by prostheses, medical technology has little to deal with loss of function of sexual organs. Veterans with genitourinary injury may be unable to have children, have difficulty in intimate relationships, and suffer from other mental health problems. These injuries are clearly a major concern for veterans that need more attention and discussion if we are to do right by our soldiers.

  5. Chronic pain and musculoskeletal problems. People often fail to recognize pain as a serious medical problem for veterans, even though it can be severe, persist throughout life, and erode the willpower and quality of life of our service members. Nearly 20% of veterans from OEF-OIF suffer back pain and joint problems.7 This pain can be debilitating for soldiers, and often plays a key role in worsening mental health disorders. When veterans do not get proper and regular care for their pain, they can also develop substance addiction that further exacerbates their health problems.

  6. Chemical, biological, and physical exposure. Being in the military has always required our service members to expose themselves to hazardous chemicals. Our military is frequently in contact with such hazards like depleted uranium, asbestos, lead, radiation, and contaminated water. Many of these substances can result in cancer or infertility over the long-term. On foreign soils, dangerous and unfamiliar diseases can affect our soldiers, such as malaria, tuberculosis, and West Nile Virus, diseases which are aggressive, difficult to treat, and sometimes require treatment for life. Dust and soot inhalation can produce serious lung damage, and constant exposure to loud noises regularly causes hearing loss.

  7. Barriers to access to healthcare. Perhaps the overarching problem for veterans facing health challenges is the difficulty in actually acquiring adequate healthcare. Unfortunately, the Veterans Affairs Health Administration has been swamped with the quantity of veterans who need care, creating a large backlog of people waiting for.8 Many fixes have been proposed and enacted to varying degrees of success, including the standardization of VA forms, moving to an electronic record system, and the passage of the Veterans Access, Choice, and Accountability Act of 2014. However, the problem is far from fixed, and many veterans are still stuck in the pipeline waiting to be seen by doctors.

Imagine a soldier with a constellation of these health challenges, and you may understand how dire their situations can be. Medical technology in our country is often able to improve the health struggles of our veterans measurably, but we need to pay more attention to the challenges they face and the resources they need. When our current medical knowledge is unable to solve a problem, we need to devote more resources to research to solve those problems. In short, our commitment to our brave military members should not end when they come home, because we know that the fight does not end there. And if you are a veteran seeking care, please see Veteran Resources for trusted and reliable resources that can help you.

1 Washington Post and Kaiser Family Foundation. After the Wars - Post-Kaiser survey of Afghanistan and Iraq war veterans - Results and survey methodology. 2013. http://apps.washingtonpost.com/g/page/national/after-the-wars-post-kaiser-survey-of-afghanistan-and-iraq-war-veterans-results-and-survey-methodology/901/

2 Frayne SM, Chiu VY, Iqbal S, et al. Medical care needs of returning veterans with PTSD: their other burden. J Gen Intern Med. 2011;26(1):33-9.

3 Hoge CW, Grossman SH, Auchterlonie JL, Riviere LA, Milliken CS, Wilk JE. PTSD treatment for soldiers after combat deployment: low utilization of mental health care and reasons for dropout. Psychiatr Serv. 2014;65(8):997-1004.

4 Hoge CW, Mcgurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med. 2008;358(5):453-63.

5 Fischer, H. A Guide to U.S. Military Casualty Statistics: Operation Inherent Resolve, Operation New Dawn, Operation Iraqi Freedom, and Operation Enduring Freedom. 2014. Congressional Research Service. 7-5700, RS22452.

6 Bob Woodruff Foundation. Intimacy After Injury. 2014. http://bobwoodrufffoundation.org/wp-content/uploads/2014/10/IntimacyAfterInjuryReport2015.pdf

7 Haskell SG, Ning Y, Krebs E, et al. Prevalence of painful musculoskeletal conditions in female and male veterans in 7 years after return from deployment in Operation Enduring Freedom/Operation Iraqi Freedom. Clin J Pain. 2012;28(2):163-7.

8 Maffucci, J. The Battle to End the VA Backlog. 2014. Iraq and Afghanistan Veterans of America. http://media.iava.org/2014BattleToEndtheVABacklog_PRINT.pdf

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