More than 23,000 U.S. troops have been wounded in combat in Iraq, and over 3, 000 troops have died. That means that for every soldier who has died, roughly seven have survived, and they are surviving with injuries that, in the past, would have been fatal.
The devices causing so many injuries are improvised explosive devices (IEDs). The injuries suffered from these devices have become known as the “signature injuries” of the Iraq War, and the device has become known as the “signature device.” Improvised explosive devices (IEDs) are unique in nature because the IED builder has to improvise with the materials at hand. They are designed to defeat a specific target or type of target, and they generally become more difficult to detect and protect against as they become more sophisticated.
IEDs fall into three categories: a package-type device, a vehicle-borne device, and a suicide (human) device. The package-type IED is generally thrown from overpasses or hidden in some manner and triggered when an unsuspecting patrol comes along. The device can be hidden in potholes, alongside the road, or in just about anything large enough to conceal the material.
The vehicle-borne device uses a vehicle of some sort to carry the device. These IEDs come in all shapes, colors, and sizes which vary by the type of vehicles available — small sedans to large cargo trucks. The larger the vehicle, the larger the amount of explosive that can be used, resulting in a greater effect.
A growing technique in vehicle-borne IED attacks in Iraq has involved the use of multiple vehicles. The lead vehicle is used as a decoy or barrier buster. Once stopped or neutralized and with coalition forces starting to move to inspect or detain – the main VBIED comes crashing though and into the crowd before detonating; thus resulting in an increase of the casualty ratio.
The third type of IED, the suicide or human device, poses a different kind of threat to the soldiers. A “person-borne” suicide bomb usually employs a high-explosive and/or fragmentary effect and uses a switch or button detonation firing system, which the person activates by hand. Although the human-borne device is referred to as a suicide bomber, the goal is not to commit suicide but to kill and injure as many people as possible.
The number of blast-related injuries in the Iraq War is much higher than in previous wars and conflicts with most of the troops returning from Iraq suffering injuries caused by some type of explosive device. According to statistics provided by the Veterans Administration and the Uniformed Services University of the Health Sciences , 32% were injured by improvised explosive devices (IEDs), 15% from grenades and 16% by fragments from IEDs and grenades. Gunshot wounds comprised only 13% of the total.
Those closest to the explosion experience what is known as a “primary blast injury” which can be very damaging. A primary blast injury is caused solely by the direct effect of blast overpressure on tissue. Air is easily compressible, unlike water. As a result, a primary blast injury almost always affects air-filled structures such as the lung, ear, and gastrointestinal (GI) tract. A “secondary blast injury” is caused by flying objects, such as shrapnel, that cause multiple penetrating wounds.
Even with the magnitude of IED-caused injuries, though, the wounded in Iraq have a much greater chance of surviving. In World War II, 30 percent of all injured troops died; 24 percent died in Vietnam. In Iraq, just 9 percent of the injured lose their lives. Improved body armor and advances in battlefield medicine have saved countless lives. Kevlar vests provide protection to the trunk but leave the limbs exposed. Thus, while the chest and abdomen are protected, arms and legs are left open to devastating injuries.
In addtion, today’s headgear offers greater protection against penetrating injuries. However, the headgear is not effective against closed-brain injuries that are the result of IED blasts which “shake” the brain within the skull. These injuries result in traumatic brain injuries or TBIs which can range from life-threatening to mild.
In 2005, Congress provided funding for the establishment of four polytrauma centers located at Richmond, Virginia; Tampa, Florida; Minneapolis, Minnesota; and Palo Alto, California. While four polytrauma centers are a start, the enormity of the care and support our returning veterans will need is staggering.
In calculating the funding needed for his conquest of Iraq and establishing democracy in the Middle East, President Bush and his administration failed to consider just how damaging and devastating the injuries to our soldiers would be. With a higher survivial rate than ever before, being wounded in Iraq is just the beginning of what many times is a life-long struggle to recover.
The sacrifices that our soldiers are making should be uppermost on the minds of Americans, and those sacrifices should not be forgotten when they return home and need care. Every citizen who can speak out should be doing so to let his or her representative know that indifference to and inadequate care for our veterans will not be tolerated.