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The Human Cost of War: Mark Benjamin on Casualties
According to UPI investigations editor Mark Benjamin’s latest report, the number of U.S. medical evacuations from Iraq has passed 18,000.

“Most of the casualties in any conflict are not necessarily people who are struck by the enemies bullets,” Benjamin tells me. “They’re people who are in car accidents, people who blow out their shoulders or knees, people who get very sick, people who have a variety of ailments that have to be removed from combat. They push themselves hard. They work 18-20 hours a day. They drive thousands of miles and lift heavy items. They take, what some people would consider, dangerous vaccines and drugs. There’s a whole list of reasons why soldiers could get ill or injured in combat besides getting hit by the enemy. Understanding that human cost of war is an important part of reporting on a conflict.”

Mike Kaspar and I phoned Benjamin from the KUCI studios at the University of California at Irvine, where our radio show Weekly Signals originates. Benjamin won the 2004 Fourth Estate Award, the American Legion's top journalism honor, for his reporting last October on the conditions at Fort Stewart, Georgia where more than 600 sick, wounded and injured soldiers, many of whom served in Iraq, were held in hot cement barracks without running water while they waited, sometimes for months, for medical care.

“Most of the people who were at Fort Stewart would say the situation was pretty dire," Benjamin says. "Basically, the Fort Stewart medical authorities were overwhelmed by the number of troops being deployed in and out of Operation Iraqi Freedom, plus an influx of National Guard and Army Reserve troops — which represent an increasing percentage of the troops fighting in this war. The Fort Stewart authorities, I would say, “warehoused” the soldiers. This is in Georgia. It was very very hot during the summer. It was hot when I was there in October. There was no running water or bathrooms in the buildings. I met a soldier with a crushed foot who had been waiting months and months to get medical treatment. It was a very serious situation. The Pentagon and Congress acted pretty aggressively in reaction to that story.”

What with all the new sick and injured, is there a lesson we can learn from Fort Stewart?

“The Pentagon and the military have gotten very good at acute warfare injuries,” Benjamin says. “In other words, if you’re injured by an improvised explosive device in Baghdad and you lose a leg, the Pentagon will move very quickly. The battlefield medics are extremely good at what they do. They’re very fast. They move people out of Iraq and to Landstuhl, Germany or to Walter Reed Army Medical Center here in Washington after Landstuhl, very quickly.”

Benjamin pauses and takes a deep breath. “However,” he says (and it’s a long exhaled however), "those are not the majority of people who are getting injured in this war. A very small percentage of acutely wounded people go to Landstuhl or Walter Reed, where the President visits. The large majority, thousands and thousands of soldiers, are returned to Fort Bragg. They’re returned to Fort Stewart. They’re returned to Fort Knox. They’re returned to Fort Carson. The situation at those bases and the medical care at those bases is much, much worse. I feel quite confident in saying that my reporting shows that in many cases the medical care at those bases ranges from poor to horrible. Soldiers are waiting a long time for appointments. They do not feel that they are getting good medical care. They don’t feel that people are watching their medication. In many cases, they don’t feel that anybody is taking care of them. The living conditions are in general much better than what I saw at Fort Stewart, but the medical care, often is not.

"So, there are two lines of soldiers. When you turn on your TV, the president is at Walter Reed Army Medical Center. The care there is quite good by all accounts. It's these thousands and thousands and thousands of other soldiers who are out of the limelight that are getting the short end of the stick.”

Why is our government and armed forces treating its sick and wounded this way?

“I would say this," Benjamin says. "My reporting shows an extreme attention to cost throughout the pipeline of soldier care. Essentially, once you get to Landstuhl and from then on out — soldiers are evacuated from Iraq to Landstuhl Germany, generally, and then either to their home bases or to Walter Reed — there does seem to be an amazing amount of attention paid to how much it costs to treat soldiers."

Is that why the care is so poor?

"I don’t know," Benjamin says, "but the two certainly seem to be occurring at the same time. There does seem to be a sad history of not caring adequately for, what a lot of people would call, our American heroes. Whether you support the war or not, these are professionals who take their jobs very seriously and do it, generally, very well. I think most American people would agree that they deserve better.”

How did you get your lead to the Fort Stewart story?

“The chain of command at Fort Stewart did not know I was there, " Benjamin says. "I was there at the invitation of soldiers who had served in Operation Iraqi Freedom and felt that they had exhausted all of their effort to rectify their situation with the chain of command.

"In general, by the time a soldier comes to the press, they’re at the end of their rope. They have tried to go to the Inspector General. They have tried to go up the chain of command. They have tried to go to their member of Congress. And they really are desperate.

"I was at Fort Stewart at the invitation of those troops. I would add that the Pentagon did not like that. In fact two weeks later, I wrote a story about similar conditions that occurred at Fort Knox. When I was with the soldiers at Fort Knox who were showing me around, the chain of command was driving around in cars trying to find me. They did find my photographer and detained him. They didn’t release my photographer until after a call from a US Senator who was following my work very closely. In general, the reaction from the Pentagon to these types of articles has been extremely hostile.”

It seems that the military is very concerned with images — the filming of sick and wounded and especially images of the dead coming home in flagged-draped coffins is taboo. How does the press feel about this censorship?

“The media is not allowed to take still photos or any kind of images of the coffins coming off the planes at Dover Air Force Base,” Benjamin says. “And I think there is a certain amount of censorship going on, both inside the media and outside the media. Yes, we in the media have now been barred from filming Dover, which a lot of reporters and editors think is unfair. There’s also been some censorship in the media itself. For example, we had that horrible situation the other week in Fallujah where the bodies of some American civilians were burned and mutilated and hanged. You could argue all day about this, but I think — and I think some editors I know would say — ‘that’s war… welcome to the show.’ I think, in general it’s best for the media to err on the side of disclosing every bit of it. Even though some of it may be extremely unpleasant.”

Has the military given a reason for the censorship at Dover?

“I don’t know whether or not they’ve given a reason,” Benjamin says, “but I can’t imagine what that reason would be other than they don’t want us to see the coffins coming back from Iraq.”

In an earlier report filed by Benjamin, he interviewed Steve Robinson, the executive director of the National Gulf War Resource Center. Robinson voiced concern about the “psychological and neurological evacuations” from the war in Iraq. So, I ask Benjamin about the controversial anti-malaria drug Lariam which has a record of complications.

Lariam is a drug that was invented by the army — the Walter Reed Institute of Research," Benjamin says. “It passes the blood brain barrier and in some percentage of users appears to have some very serious side effects. For example, the food and drug administration now says on Lariam’s label that it can cause psychosis, aggression, paranoia, thoughts of suicide and delusions. There is concern that the Pentagon has used it very widely in Afghanistan and very widely in Iraq. This is interesting because you don’t need to use Lariam with the type of malaria that’s in Iraq.”

What is the military doing about this situation?

“The Pentagon recently announced that it’s going to do a study. It will take up to two years to find out what the impact is on the health of the soldiers who have taken this drug. And just this week the Veterans’ Administration announced that it separately will began looking at the health and mental capacity of soldiers who have taken this drug to find out whether, frankly, it may be driving soldiers crazy and potentially to suicide. I would add that at the same time, the Pentagon is looking at a cluster of what is now 24 soldiers who have apparently committed suicide on the ground in Iraq and Kuwait in 2003. The Pentagon is saying that a very small percentage of those soldiers — possibly 4% — have taken Lariam. To be completely frank, I’m not convinced they’re right about that, so that story is still developing.”

How many soldiers overall have taken the drug?

“Just about all the soldiers in Afghanistan have at one time or another taken Lariam,” Benjamin says. “There are somewhere between 7,000 and 10,000 soldiers in Afghanistan at any given time. Iraq, of course is a different ball of wax — 130,000 soldiers on the ground. The Pentagon has said a number of different things depending on when you ask them about how many soldiers have taken Lariam in Iraq. They have said almost none. They have said 45,000. They have said 80.000. I have been to Fort Stewart, Fort Knox, Fort Benning, Fort Bragg, Landstuhl, Walter Reed and Fort Carson. There certainly are a lot of soldiers around saying that they took the drug and a surprising number who are saying they are having mental problems because of it. Now, that’s not a scientific study. But, the anecdotal evidence would indicate that it’s not almost none who have taken Lariam.”

Is there any profit motive behind the military’s use of Lariam?

“Not as far as I can tell. The company that profits primarily from the manufacturing of Lariam is its producer La Roche, a very large Swiss pharmaceutical manufacturer,” Benjamin says. “After the drug was invented by the Walter Reed Army Institute of Research, they licensed it to La Roche. La Roche sells it back to the Army."

Are there any other major reports of Lariam complications?

“The Army isn’t the only group that has had problems with Lariam. The Peace Corps has used it in West Africa for almost a decade and there are many Peace Corps Volunteers who have said they had serious problems with this drug.”

“There’s an interesting little twist to the Lariam story that goes like this: Lariam is one of only three drugs that you can take to prevent very aggressive forms of malaria. The most aggressive form of malaria is resistant to Chloroquine — a drug that’s been around since Vietnam that prevents malaria. If you’re dealing with Chloroquine-resistant malaria you have to either take Lariam or daily pills of Doxycycline which is an antibiotic. There is also a new drug called Malarone. The Pentagon appears to have deployed soldiers to Iraq and told them to take Lariam — again we don’t know how many, somewhere between zero and 80,000. What’s interesting is that there is zero, as far as I could tell, or very very very little Chloroquine-resistant malaria in Iraq at all.”

Did the Pentagon need to use Lariam at all in Iraq?

“The Pentagon said, as of February 25 in testimony before Congress, that they were no longer going to use Lariam because they had discovered that there is no Chloroquine-resistant malaria in Iraq. So they didn’t need to use it," Benjamin says. "That’s interesting because before the war in Iraq started, I looked at the Center for Disease Control's website and it very clearly stated that in Iraq there was no Chloroquine-resistant malaria. It says it to this day. My reporting seems to show that either the Pentagon didn’t call the CDC or look at the CDC’s website, or they just screwed up.”

— Nathan Callahan, April 14, 2004



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