Dan Froomkin , senior Washington correspondent for Huffington Post, reports  at Nieman Watchdog that the Pentagon’s figure of 32,226 wounded seriously undercounts the true casualty rate. Possibly more than a half million of the 1.5 million Iraq war veterans sustained traumatic brain injury or suffer from post-traumatic stress disorder (PTSD), depression, chronic fatigue syndrome, exposure to hazardous substances, breathing disorders, severe hearing loss, migraines, and other uncounted afflictions. “We don’t have anything close to an exact number,” Froomkin writes, “because nobody’s been keeping track.”
The much-cited Defense Department figure [of 32,226 wounded] comes from its tally of “wounded in action”—a narrowly tailored category that only includes casualties during combat operations who have “incurred an injury due to an external agent or cause.” That generally means they needed immediate medical treatment after having been shot or blown up. Explicitly excluded from that category are “injuries or death due to the elements, self-inflicted wounds, combat fatigue”—along with cumulative psychological and physiological strain or many of the other wounds, maladies and losses that are most common among Iraq veterans.
• The Pentagon’s Defense and Veterans Brain Injury Center reports having diagnosed 229,106 cases of mild to severe traumatic brain injury  from 2000 to the third quarter of 2011, including both Iraq and Afghan vets.
• A 2008 study of Iraq and Afghanistan veterans by researchers at the RAND Corporation  found that 14% screened positive for post-traumatic stress disorder and 14% for major depression, with 19% reporting a probable traumatic brain injury during deployment. . . . Applying those proportions to the 1.5 million veterans of Iraq, an estimated 200,000 of them would be expected to suffer from PTSD or major depression, with 285,000 of them having experienced a probable traumatic brain injury.
• Altogether, the Iraq and Afghanistan Veterans of America  group estimates that nearly 1 in 3 people deployed in those wars suffer from post-traumatic stress disorder, depression, or traumatic brain injury. That would mean 500,000 of the 1.5 million deployed to Iraq.
• A 2010 Congressional Research Service report , presenting what it called “difficult-to-find statistics regarding U.S. military casualties” offers one indication of how the “wounded in action” category undercounts real casualties. It found that for every soldier wounded in action and medically evacuated from Iraq , more than four more  were medically evacuated for other reasons.
• The VA’s web page on hazardous exposures  warns that “combat Veterans may have been exposed to a wide variety of environmental hazards during their service in Afghanistan or Iraq. These hazardous exposures may cause long-term health problems.” The hazards include exposure to open-air burn pits, infectious diseases, depleted uranium, toxic shrapnel, cold and heat injuries and chemical agent resistant paint. The VA provides no estimates of exposure or damage, however.
• A March 2010 report  from the Institute of Medicine concluded that many wounds suffered in Iraq and Afghanistan will persist over veterans’ lifetimes, and some impacts of military service may not be felt until decades later.
A Three- to Five-Billion-Dollar War
It was by including the Iraq war’s un(der)counted casualties that Nobel Prize–winning economist Joseph Stiglitz  and Harvard professor Linda J. Bilmes estimated the Iraq war would ultimately cost the United States some $3 trillion  when all health care costs over the soldiers’ lifetimes are factored in. In 2008 they raised their estimate  to $4 or $5 billion. And that’s just the financial cost to the United States.
Whatever the actual numbers are—and the physical and psychic costs are beyond calculation—the American public should press firmly on the White House , Congress , and Veterans Administration secretary Eric K. Shinseki  to ensure that veterans receive high-quality physical and psychological care. It is the right thing to do. Most of the U.S. public opposed  a war with Iraq until it actually started—on the insistence of George W. Bush, Dick Cheney, and Donald Rumsfeld, among other war hawks —but now that the war has run its bloody course, the nation owes it to the veterans to see that they are cared for and that serious and sustained funds are allocated for job training and health care, physical and mental.
There are about 1.5 million Iraq war veterans, and the experience of Vietnam veterans (and the Bonus Army  long before them) shows that these vets, too, will be brushed aside  if the public does not stand by them. The countless thousands of homeless, armless, legless, and hopeless Vietnam veterans  shames this nation, and should not be repeated. We fear, however, that the conservatives corporate interests that have such outsize influence in Washington will fight any further spending on the veterans with whom the politicians so love to be photographed.
You can help by supporting Iraq and Afghanistan Veterans of America , Iraq Veterans Against the War , Veterans for Peace , Make the Connection , and other organizations that work for veterans and their families listed on the “Anti-War” blogroll at the bottom right of this page. Tell members of Congress to support the Veterans Jobs initiative  led by First Lady Michelle Obama and Dr. Jill Biden to press the private sector to commit to hiring 100,000 veterans and their spouses by the end of 2013. Read more about it here .
See also “The Freedom and the Damage Done” in “As ‘End’ of Iraq War Is Announced, U.S. Digs In, Warns Iran ” (10/30/11) and “As Combat Troops Leave Iraq, Where’s Our National Security? ” (8/19/10).
Photo credits: Top photo by Platon, from a portfolio  on American soldiers and their families published in the Sept. 28, 2008, issue of The New Yorker. Middle photo shows Bryan Malone, 22, an Army specialist from Haughton, La., while working with a speech pathologist at Vanderbilt Medical Center Aug. 2, 2007, in Nashville. The scar is a result of a rocket attack on a Baghdad gym where Malone was working out. He now suffers from traumatic brain injury, the “silent epidemic” of the Iraq war (AP Photo/Mark Humphrey). Bottom illustration: Red Cross, World War I Red Cross.