Quality Of Soldier Medical Care - Research Paper Example

Quality Of Soldier Medical Care The largest democracy of the world, the United States of America, started its battle against terrorism after the 9/11 brutal attacks by the terrorists on the twin tower. The consequent battle of United States started with the Afghanistan war and after that it continued to Iraq. In both the cases the US Army, by endangering their lives, joined the mortal combat against the terrorism. They are fighting not for their own sake but for the mankind, for the democracy and for their country. The combat is a good versus bad ones. That is a combat to save humanity, to save secularism and to save humanity. That's why they must deserve some special care. Their lives are dedicated to their country because they are determined to sacrifice the lost drop of the blood in the battlefield. As the army men of any nation of the nation have the duty to save us from the outsider attack the society needs to keep them to serve more for the country. However, what happens in America now the warriors are fighting the battle in the territory of Iraq by endangering their life and health but they are not treated well in their country. In this context emerged the Walter Reed Army Medical centre scandal. The debate was regarding the negligence the army men received from the number one army hospitals in USA. It is a quite natural fact that while a soldier is in the battlefield which is far away from his home sometimes he may be nostalgic and that time he wishes to go back home for some days and spend some day with his family members. The authority is quite aware of the nostalgia and the homesickness, which the soldiers suffer from. Sometimes some soldier may pretend to be ill and thereby apply for a leave; by this they make the unfitness an excuse to have a leave to spend some days with family members. In that case the authority does not allow the soldier to be off from the battlefield. Sometimes the long time distance from the family members creates psychological stress on the soldier and by the psychological distress and depression they start to suffer from psychosomatic disorder. In such a situation they need real treatment to recover from the situation but normally the authority has nothing to do in that very situation. The consequence is a long-term depression and the deterioration of health, which can’t be recovered very easily. There may be other cases also. That illness may be genuine but the authority remains in the misperception that the soldier is pretending to be ill to get a leave and does not allow them to leave the battlefield. Sometimes the authority can realize that the soldier really needs some rest or care but the situation does not allow doing so and the soldier, instead of being given a rest, is given some steroid medicines which could be a prompt solution but that might cause some heart or nervous disease. That is very much harmful in the long run for a soldier and that might sometime lead to some terminal disease also. (Hull and Preist, 2007) The negligence that the battalion receives from the medical care unit is prominent from the article by Dana Preist and Anne Hull in the article “Soldiers Face Neglect: Frustration at Army’s Top Level Facility”, published on 18th February 2007. They started with “Behind the door of Army Spec. Jeremy Duncan's room, part of the wall is torn and hangs in the air, weighted down with black mold. When the wounded combat engineer stands in his shower and looks up, he can see the bathtub on the floor above through a rotted hole. The entire building, constructed between the world wars, often smells like greasy carry-out. Signs of neglect are everywhere: mouse droppings, belly-up cockroaches, stained carpets, cheap mattresses.” (Preist and Hull, 2007) This was the situation of the Walter Reed Army medical centre in which the wounded battalions are admitted to get their wound soothed as Duncan was also supposed to be recovered from his severe injury in neck and left ear that he got from the Iraq war and he was almost dead by excessive bleeding. Not only that, we must mention the nearby lodge in which large number of soldiers, who have serious wounds from the wars of Afghanistan and Iraq, are waiting for recovery of the wound which are the symbols of their bravery in the battlefield during the noble combat against the global terrorism. Once upon a time Walter Reed Army Medical Centre had its own glory, but the scenario has been changed entirely by the prolonged battle of United States against the global terrorism for more than five and half years. The authors express that this 113 acre wide land has been converted into a holding ground for the soldiers-both physically and psychologically damaged. Statistics says that among them almost 700 wounded soldiers have been released but they are still in a need of treatment or they cannot be discharged or sent again to the battlefield unless they get the order from the administration. The soldiers are sufferers of various injuries and some posttraumatic psychological strain. The numbers of such cases are growing in an accelerating pace. That definitely brings out shortage of beds and consequently the soldiers have to take shelter in the nearby lodges and apartments that are leased by army. Normally they have to stay for 10 months in average but sometimes the time period exceed 2 years also. If we continue the story of the misery of the wounded army men would be longer and longer. There would be a lot of grievances to be addressed. However, here we have just taken some scenes of the Walter Reed Army Medical Centre. Our objective here is not to criticise that traditionally old hospital. To be more frank it should be unjust on the staffs of the hospital if we blame them blindly for the situation without finding the root from which the problem has stemmed up. In an article titled ‘Walter Reed scandal lifts lid on neglect of US wounded Troops” on the Washington Post dated 10th March, 2007, Barry Grew blamed the federal government, the congress and the pentagon. He has written “That conditions such as those at Walter Reed exist at other military hospitals, and that many disabled veterans get inadequate care and face long, bureaucratic delays in the VA system, are not revelations to US civilian and military policymakers. Such conditions are the end result of inadequate funding and staffing, for which Congress and the White House are both responsible. There have, moreover, been published reports on substandard care and bureaucratic logjams at Walter Reed, Fort Stewart in Georgia and other Department of Defence facilities for years, and government audits have pointed to pervasive problems in the provision of medical care to wounded soldiers” (Grew, 2007) The matter of fact is that during the five and half years continuous war there has been a major problem of wounds. In Iraq and Afghanistan, the US troop has defeated the rivals but actually the situation has not yet been brought under extreme control, nor has the peace process been successful. The insurgent militant groups are still active behind the veil and that’s why there are the phenomena of discrete attacks on the US soldiers such as sudden attack or suicide bombing etc. That's why there is the continuous incidence of injury and deaths of the US battalions. The condition of the ill standard of health treatment received by the US troops who were battling in Afghanistan and Iraq was so serious that the secretary of US Army resigned. On the ground of that situation the then US President George W. Bush wanted a bipartisan committee to investigate ahead of Congressional hearing by opposition. According to the defence officials of the United States the actual fact was that the secretary of US Army was instructed by the Defence Secretary Robert Gates to tender resignation on his failure to provide the better treatment for the soldiers of the Iraq and Afghanistan troop. That scandal was not a very comfortable matter for the President. That's why he started to visit the wounded troupes regularly and in his weekly radio address he announced “Some of our troops at Walter Reed have experienced bureaucratic delays and living conditions that are less than they deserve,” he said.  “This is unacceptable to me, it is unacceptable to our country, and it’s not going to continue.” (Grew, 2007) Mr Bush further announced that he would name the members of that group and mention their deadline to report him back in the next days. He expressed his decision to order the commission to make an evaluation of the treatment of the injured soldiers from the time they left the battlefield to their return to the normal life as veterans. It was revealed that the ranking of the commander in chief declined by the public poll during his operation in Iraq and in the public poll Bush was also condemned for his war strategy to send 20000 additional troupes to make Baghdad secure. In his address in the Democratic Radio, the Connecticut Senator, Joe Liberman, an independent one, said that the soldiers who had serious brain injuries had not got any doctor appointment for many days, he mentioned, “There is not enough staff with the right skills to treat and care for the severely injured troops,” he said.  “And, rooms where some soldiers lived were found to be moldy and infested with rodents. Our nation has no greater moral and patriotic responsibility than to ensure that these brave Americans receive first class treatment, not only immediately after their injuries, but for their entire lives, through the Veterans Administration.” (Eagle World news, 2007) Actually the situation of the Walter Reed army medical centre has generated enough anti war sentiment among the people. People can easily realize the actual consequence of war. Moreover, the problem lies in the fact that the major cause of the miserable situation of the Walter Reed hospital is an old hospital of the United States. In reality, the hospital has not been able to expand its infrastructure to the growing need that is being prominent from the continuous war in Iraq. In the last five years the number of wounded soldiers has grown much but the number of physicians and staff appointed could hardly cope up with the growing number of patients due to the war problem. The problem of the army regarding their treatment and the problem regarding the permission of entry and releasing system and the problem of the negligence of the army men in the Walter Reed medical centre generated huge controversy. However those controversy and the grievances of the people should be addressed carefully and the wounded army should be given more care and tender for the recovery. That's why the effort of the army was to establish some new unit so that the soldiers and battalions who are wounded and need treatment they could be given more importance during the treatment. That was the main foundation part of the war transition unit. The US Army on 14th June 2007, a series of improvement for the medical care and outpatient assistance, established warrior Transition Units through an announcement so that they can be cured and ready for successful contribution to the army or some civil works for active life and citizenship. On 15th June the army established the Warrior Transition Units all over the country. The Army Chief Staff General announced that they would provide best care to the army inpatient and outpatient soldiers so that they could be made fit to render their service for the nation through battlefield. Moreover, he announced that the work already done was not enough and they had the plan for further advancement. They had the plan to include more complex Medical Evaluation Board and Physical Evaluation Board in near future. The army had a plan to play the role of the partner of the ‘Defence Department’ and the “Department of Veteran’s Affair” for the efficient and smooth transition from one organization to another. The Army Medical Action Plan had the target to include some important improvement in leadership and service that could develop a healthcare system characterized by the soldier-centric nature. The examples of the improvements were: a. The Army announced that the US Army Medical Command would merge the Medical Hold Unit for active duty soldiers and Medical Holdover Units for Reserve Component soldiers into single Warrior Transition Units. That single unit would be under the command off the US Army Medical Command. b. The medical command established a provisional warrior transition unit command and a structure of controlling the active and reserve personnel. It would include a primary care manager and a squad leader for each warrior in transition. This was the primary step of the establishment of a formal personal document to resemble the newly established units and the associated positions. The triad is the key factor to synchronize leadership effort and clinical support. c. The Senior Mission Commander would form the Warrior in Transition facilities and he would decide the top priorities for development and replenishment. The Mission Commander would conduct the monthly check up of warriors and their families by calling for monthly meetings. d. The Army arranged a meeting in May with leaders, Soldiers, Family Members, and veterans to discuss about work issues facing Families of wounded Soldiers and Warriors in Transition. Attendees developed the structure, functions, roles, and responsibilities of a prototype Soldier and Family Assistance Centre. These centres were arranged at Walter Reed Army Medical Centre and Brooke Army Medical Centre, and similar capabilities were being established Army wide. e. Policies would allow for non-family members who tendered care to injured Warriors to receive guest lodging. Before this policy change, if a non-medical attendant was not a relative; no procedure was always present for them to have access to guest housing while they cared for their loved ones. While this could appear to benefit single Soldiers more, it was a policy change that could also be applied to non-medical attendants of married Soldiers. f. The Army was developing the database of patient status through an internet-based “joint patient-tracking application” along with a record of the patient and a system of tracking which would be internal to the Defence Department. From point of injury or illness, the Army leadership would improve visibility on location, medical status, and progress of Soldiers care. g. It planned to ascertain an unlined transition between military medical care and in partnership with the VA, Walter Reed was there to co-locate the Veterans Health Administration and Veterans Benefits Associations liaisons with the Warrior Transition Unit case managers to support a continuum of care and benefits. h. Army Medical Command created the MyMEB website on the Army's internal computer system, Army Knowledge Online that provided the opportunity for the warriors to have access the status and progress of their Medical Evaluation Board. A limited release of the MyMEB would commence June 15. This limited release was designed to attract feedback from a focus group of injured Soldiers before their full release. i. The Army called 18 Reserve Component lawyers and paralegals to be active in duty in order to provide additional legal advocacy for warriors who were passing through the Physical Evaluation Board process. These personnel would perform as legal advisers for Warriors in Transition as they had to pass the process of physical evaluation. j. The Army proposed the plan for some other crucial changes as part of this “Comprehensive Army Medical Action Plan”. At the next, the Army would roll out an extensive academic programme on Post Traumatic Stress Disorder and Traumatic Brain Injury for all its Soldiers and leaders. This program would consist of a standardized presentation; commanders would start to inform and train both Soldiers and leaders. The teaching materials and visual support products were in the final stages of development and were passing through thorough review by military and civilian health professionals. The Army was developing proposals for the establishment of “Traumatic Brain Injury and Post Traumatic Stress Disorder Centres of Excellence” to provide nationwide education and training to Army leaders, clinicians, Soldiers and their Families. Locations were yet to be chosen, but that must support area coverage of the United States, operating much like the Defence Veterans Brain Injury Centres. (Boyce, 2007) In the year 2007 the Army founded 35 warrior transition units (WTUs) at Army installations to make a bridge through the employment of supporting personnel for injured Soldiers. The transition units started to provide critical support to wounded Soldiers. Such soldiers were supposed to require six months of intensive care and the requirement for complex medical management—and their family members. The units possessed ample number of doctors, nurses, squad leaders, platoon sergeants, and psychological professionals. These leaders were entitled with the responsibility to ensure that wounded soldiers’ needs were fulfilled, their care was properly coordinated, and their family members should also be cared. (US Army Human Resource Command, 2008) An army official said that an army professional assumes combat as his best work and the next to best is the work of healing of a person from physical, psychological and emotional wound. This was his comment during the Warrior Transition Leadership and Training Conference. Since the period of mid 2007, 35 Warrior Transition Units have been worldwide established. They have been endowed with the basic a primary responsibility- to heal the injured people. A head of Army Medical Action Plan that called for establishing the Warrior Transition Units Brig General Michael S Tucker argued: “There has to be a place for these Soldiers to convalesce and heal, and possibly one day return to duty,” (Tolzmann. 2008) Moreover, Tucker said ‘‘It’s more than just healing the physical wound itself. It’s the healing of the body, mind and spirit — the holistic approach to care,” (Tolzmann. 2008) The newly established units were the centre of the Army Action Plan identified about 150 items the system that were required for the uplift of the system. For example the army had allocated $173.5 million for the better housing allocation of the injured soldiers. That was spent on the Operation and Maintenance of the housing plans. The amount of allocation for the Military Construction Fund of Warrior Transition Unit facilities and projects accounted for $ 1.2 billion. Army's acting Surgeon General, Maj. Gen. Gale S. Pollock argued that those newly established Warrior Transition Units would perform with more excellence than the replaced Medical Hold Companies. According to Pollock these units would introduce more sophisticated system for a higher degree of excellence. Dr. (Col.) Elspeth Ritchie, Behavioural Health Consultant to the Army Surgeon General, opined, "When we talk about 'holistic' care we talk about the whole person. Holistic care, as the Army doctor describes, is about not only the medical aspects of healing, but the psychological, social, and cognitive aspects in conjunction with the Soldier's career goals and aspirations”. (Sheftik and Holder, 2007) This type or organization has provided a great opportunity for the injured warriors those are not able to return to the battlefield. In earlier days while a warrior had to retire from the army due to an injury they had to face the problem regarding their next step to do. To live like a civilian is a major worry to them. They have spent a huge time of their life in military and due to that cause they are not much habituated to the civil life. The military work is some kind of typical work the job skill of which is not transferable. However, in this life of serving the wounded warriors they remain close to their military lives. The WTU heads in the Kansas decided that the injured warrior who would not be able to go back to their military lives would be given the opportunity to learn the normal business and other office work skills by approaching to ‘Welcome Home to Heroes Foundations’ in order to create some network of warrior internship in which the workers would be given some training of the daily life jobs through which they could get earning opportunity. Hence the WTUs are providing the mutual opportunity to the soldiers and citizens to be close to each other. Col. Lee Merritt, commander of the Warrior Transition Battalion at Fort Riley mentioned that “The WIN provides a mutually positive opportunity for the Soldiers and the community his is Fort Riley stepping out to do right by our injured and ill Soldiers, and this benefits the Greater Fort Riley community, by putting valuable Soldier skills, experience and discipline assets into the local business community.” (A Soldier’s Mind, 2008) As there are many arguments in favour of the Warrior Transformation Units there are some arguments against it. According to a media firestorm the Warrior Transformation Units are meant for the care of the injured soldiers but the irony is that in the government care centres the number of troupes that are getting care are more than necessary. A research by the associated press has revealed that the number of patients has increased from 5000 in June 2007 to 12500 in June 2008 (more than double). The main cause behind the jump is that there are thousands of soldiers who have minor wounds take the opportunity to get free care. The more ridiculous thing is that among these huge numbers of patients only 12% has injury from the battlefield. (Redorbit, 2008) So far we have studied the findings say that the WTUs were established at a juncture while the story of the misery of the wounded soldiers and the negligence of the higher authority and the medical centre came into broad daylight by the articles of the newspapers. The WTAs were established by the army in order to provide the best treatment and care for the soldiers who were wounded in war. Gradually the institutional process gained its momentum and it spread all over the country. The effort can unambiguously be marked as a humanitarian effort by the government. The project could be performed in a better way if the government had used some directive or law regarding this. It was an expensive project as the number of injured soldiers was large due to the situation of Iraq and Afghanistan. The soldiers who had injuries should be taken care properly. But the problem is that in the selected centres for military healthcare there was a shortage in the infrastructure for the gradually accelerating number of war injured people. There was shortage of room, shortage of doctors, nurses and shortage of equipments. Moreover, the long and bureaucratic process of admission and release were not very comfortable for the wounded warriors. All of these things together generated a public wrath against the system in the largest democracy of the work. In this ground the new system of WTU always deserves some applause. The improved system of administration, the philanthropic rules and regulations, the tenderness of care always claimed high praise from any person of common sense. The most significant advantage of such project is the facility to be closer to family. That would always encourage the injured soldier by providing an emotional boost up. Not only that this programme has a positive impact on the social life of the injured soldier. The people who would not be able to return in battlefield would enjoy the charm of the army life by joining such organization. All these things are better. However, the system could be improved. Had the government passed the law that after completion of the course every young doctor would have to serve the WTUs that definitely are mutually beneficial for the young doctors and the patients also? One more thing we should say before concluding; such WTUs must have an efficient screening system so that before admitting any soldier it could be judged whether the soldier really needs to be admitted. In that case the chances of over expenditure would be minimized. References: 1. A Soldier’s Mind (2008) Fort Riley Launches Warrior Internship Network, available at: http://soldiersmind.com/2008/05/15/fort-riley-launches-warrior-internship-network/ (accessed on April 24, 2009) 2. Boyce, P. (2007): Army's Newest Units to Address Soldier Medical Care and Transition Nationwide, available at: http://www.army.mil/-newsreleases/2007/06/14/3614-armys-newest-units-to-address-soldier-medical-care-and-transition-nationwide/ (accessed on April 24, 2009) 3. Eagle World News (2007) “US Army Secretary Resigns Amid Walter Reed Scandal”, available at: http://www.eagleworldnews.com/2007/03/04/us-army-secretary-resigns-amid-walter-reed-scandal/ (accessed on April 24, 2009) 4. Grew, B. (2007) “Walter Reed scandal lifts lid on neglect of US wounded Troops” Published by the International Committee of the Fourth International, available at: http://www.wsws.org/articles/2007/mar2007/reed-m10.shtml (accessed on April 24, 2009) 5. Preist, D and Hull, A (2007). “Soldiers Face Neglect: Frustration at Army’s Top Level Facility” Washington Post, available at: http://www.washingtonpost.com/wp-dyn/content/article/2007/02/17/AR2007021701172.html (accessed on April 24, 2009) 6. Redorbit (2008), “Army Reexamines Warrior Transition Units”, available at: http://www.redorbit.com/news/health/1596158/army_reexamines_warrior_transition_units/ (accessed on April 24, 2009) 7. Sheftik, G. and Holder, F. (2007) Today In The Military, Available at: http://www.military.com/features/0,15240,152058,00.html (accessed on April 24, 2009) 8. Tolzman, M. (2008) Warrior Transition Units’ mission second only to combat, say officials, available at: http://www.dcmilitary.com/stories/012408/stripe_28046.shtml (accessed on April 24, 2009) 9. US Army Human Resource Command. (2008), Warrior Transition Units, available at: https://www.aw2.army.mil/about/transition.html (accessed on April 24, 2009) Published by the International Committee of the Fourth International Read More