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Experts Assess Iraq's Horrific Toll
American soldiers help an injured comrade in Iraq, where the war has created a record number of disabled service members.

Experts Assess Iraq's Horrific Toll

Health-care professionals intimately familiar with the war's effects on bodies and minds shared their perspectives at a conference sponsored by Physicians for Social Responsibility, UCLA Extension, and the School of Public Health.

601,027 Iraqis have died as a direct result of war-related violence, according to a peer-reviewed study.

This article was first published in UCLA Today.

By John Ferrari

A STANDING-ROOM-ONLY crowd of more than 140 glimpsed for a day the depth and breadth of the human toll of the war in Iraq at a conference held on campus recently. The grim images and staggering statistics were sobering.

From around the country, health-care professionals intimately familiar with the war's effects on bodies and minds came to Kerckhoff Grand Salon to share their insights and perspectives at the conference, "The Medical Consequences of the War in Iraq," sponsored by Physicians for Social Responsibility, UCLA Extension and the School of Public Health.

Gene Bolles, an assistant professor of neurosurgery at the University of Colorado, said he was stunned by the number and severity of the injuries he saw when he served as chief of neurosurgery at the Department of Defense's Landstuhl Regional Medical Center in Germany between 2001 and 2004. He treated service members injured in Iraq and Afghanistan.

Bolles said he witnessed injuries ranging from bullet wounds to spinal problems — a common ailment caused, he noted, by the heavy weight of the equipment soldiers now carry into combat. While the mortality rate for injured soldiers has been cut to 9%, down from 20% during the Vietnam War and 30% during World War II, the current war is creating a record number of disabled veterans, the neurosurgeon said.

The need to cope with this unexpected influx of veterans has caught the nation unprepared, speakers said.

"We have let our veterans down," said Rep. Bob Filner, D-Calif., of Chula Vista, who called for mandatory federal funding for health care services by the Department of Veterans Affairs. Currently, that funding is discretionary.

Harriet Zeiner, a clinical neuropsychologist with the Veterans Affairs Palo Alto Health Care System, noted that since 1992, VA health care has treated primarily active-duty veterans, rather than retirees.

Improvised explosive devices (IEDs) and landmines account for 65% of combat injuries in Iraq, Zeiner said; many of the remaining injuries, she estimated, are the result of vehicle accidents caused when military drivers resort to evasive driving techniques to avoid IEDs and other threats.

IEDs inflict polytrauma — obvious injuries that combine multiple trauma wounds and brain injury as well as undiagnosed or hidden mild traumatic brain injuries. Both types of brain injuries can result in problems ranging from reduced attention span and problem-solving skills to memory failure and fatigue.

Zeiner estimated that as of March, more than 6,600 service members with undiagnosed mild traumatic brain injuries have been discharged without proper follow-up medical treatment.

While the health problems facing American service members are dire, Iraqi citizens are experiencing far worse effects, the experts said. Even before the U.S.-led invasion in 2003, Iraq was in the throes of a health-care crisis due to the 1991 Gulf War and subsequent U.N. sanctions. The nation's infant mortality rate increased 600% after the 1991 Gulf War, said Dahlia Wasfi, a physician and activist with Global Exchange.

Since 2003, tens of thousands of Iraqis — the count is closer to hundreds of thousands, according to some — have died as a result of the war. The contentious nature of the debate over the number of Iraqi deaths was highlighted last month in the controversy surrounding the release of a Johns Hopkins report on the Iraqi death toll.

David Rush, professor emeritus of nutrition, community health and pediatrics at Tufts University, who examined critics' arguments, found the report to be statistically and epidemiologically sound. Rush noted that while the media and critics focused on one of the report's findings — that a total of 654,965 Iraqis have died from direct and indirect consequences of the conflict — the more important finding is that 601,027 Iraqis have died as a direct result of war- related violence.

UCLA International Institute

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