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Daily Column
US Papers Tue: Maliki demands full 2011 pullout
Veterans' brain injuries go unnoticed and untreated
By DANIEL W. SMITH 08/26/2008 01:50 AM ET
There’s not a great amount of Iraq coverage today, but there’s some stories worth reading. The ongoing SOFA saga is covered, as well as the fact that US veterans with brain injuries are often not getting the help or attention they need. Also, the curious story of Senator Joseph Biden’s son’s service in Iraq complicating the question of his succession to his father’s seat at the Senate, in the event of an Obama/Biden victory.

From Iraq
Campbell Robertson and Riyadh Mohammed of the New York Times, and also Amit R. Paley of the Washington Post report that, on Monday, Prime Minister Nouri al-Maliki demanded a complete U.S. military withdrawal from Iraq by 2011 as he embarked on an attempt to win support among Iraqi leaders for a draft security accord with the United States. There is obviously a lot of behind the scenes action going on. Maliki is getting more specific by the day, and U.S. officials are getting less so. The Post reported that Maliki's public comments appeared to be an attempt to extract further concessions from American officials, less than a week after both sides said they had agreed to remove all U.S. combat troops by the end of 2011, if the security situation remained relatively stable, but leave other American forces in place. The U.S. plan is to leave as many as 40,000 troops to continue to assist Iraq in training, logistics and intelligence for an undefined period. That is what was reported in all the papers in the past week, but speaking before a gathering of tribal leaders in the Green Zone, Maliki said that the United States had agreed to withdraw all troops -- not just combat brigades -- as part of a security accord governing U.S. forces in Iraq, and that the withdrawal schedule must be firm. American officials said no accord had been reached and insisted that any withdrawal be based on conditions at the time. "There is an agreement between both sides that no foreign soldiers will be in Iraq after 2011," Maliki said. He added that the accord "must be based on a specific deadline for the withdrawal of foreign forces and that it should not be open." Maliki and U.S. officials cautioned that differences remained over the complex accord, known as a status-of-forces agreement, and that talks were continuing. "An agreement has not been signed, and so from our perspective, there is no agreement until there's an agreement signed," said Tony Fratto, a White House spokesman. "But any decisions on troops will be based on the conditions on the ground in Iraq. That has always been our position; it continues to be our position." U.S. officials, however, have signaled willingness to compromise with Maliki's government in order to sign an agreement by the end of President Bush's term. There is additional pressure because the United Nations' authorization for American troops to remain in Iraq expires at the end of the year; if no accord is signed before then, U.S. troops will have no legal basis to remain in the country. The Times version highlights that the prime minister is under intense political pressure to take a hard line against the Americans, even as his government engages in the back-and-forth of negotiations. Graffiti can be seen on the walls in Shiite districts of Baghdad saying, “Iraq for sale: See Maliki.” Mr. Maliki also said that there were other parts of the security pact on which the sides had yet to agree. Those points of dispute, he said, include Iraqi approval of American military operations and the conditions under which American soldiers will be granted immunity. “There are some articles on which we are stopped,” he said. “Unless these articles are changed, it will be hard for this agreement to pass.” U.S. officials have insisted that American troops be immune from Iraqi law, both on and off military bases and regardless of whether they are off duty. In his speech, Maliki said that would be unacceptable. "We will not jeopardize the blood of Iraq's sons by giving open immunity," he said. Underlying Maliki's remarks is the political reality that he must sell the accord to a fractious political establishment and the Iraqi public, which to a large extent views the U.S. military presence as an occupation that should end as soon as possible. Iraq is prepared to grant immunity to American soldiers who are on bases or are conducting military operations, the Iraqi government spokesman, Ali al-Dabbagh, said in a telephone interview, but insists that they be subject to Iraqi law in any other circumstances. Hadi al-Ameri, an Iraqi lawmaker, said immunity was “the most complicated issue remaining.” Mr. Dabbagh said there was also disagreement over whether Iraqi detainees could remain in American custody. Iraq has been demanding that anyone detained by American forces be turned over to the Iraqi authorities within 24 hours. *USA Today’s print edition posted after the “Media Watch” deadline, so was not included in an earlier version of this post. Charles Levinson chimed in, too, with added quotes from U.S. military trainers in Iraq saying that much work remains to be done. The U.S. has just begun building the logistics and support networks for the country's security forces, which now number 581,000 soldiers and police. "From our perspective, there's so much work to be done in building forces that it's going to take time," said Col. Steven Wujciak, a spokesman for U.S. military trainers in Iraq. "Of course, whatever echelons above us and the political people decide is up to them." For a good understanding of how this all is playing out in the Iraq press, and how different people are being given different quotes, check out Iraqslogger Amer Mohsen’s “Iraqside”, posted below. The Times article also includes the news that, according to a military statement, an American soldier was shot in the Adhamiya neighborhood of Baghdad. The soldier was transferred to a military facility, where he died of his wounds.

Stateside
On the front page of the New York Times, Lizette Alvarez adeptly covers that the sometimes subtle or delayed symptoms of traumatic brain injuries sustained by many U.S. veterans from Iraq and Afghanistan go unnoticed and untreated all too often. It is worth reading in its entirety, especially for veterans and their families. Soldiers with symptoms which may seem very obvious are often turned down when requesting disability benefits, or may be given the further dishonor of having their injuries denied completely. Recent studies are making progress in gaining understanding of what happens to victims of a traumatic brain injury (TBI), but many veterans are being left behind. Alvarez focuses on Former Staff Sgt. Kevin Owsley, who sustained two concussions while serving in Iraq in 2004. “You keep doing your job with your injuries,” said Mr. Owsley, 47, an Indiana reservist who served as a gunner for a year outside Baghdad beginning in March 2004. “You don’t think about it.” But more than three years after coming home, Mr. Owsley’s days have been irrevocably changed by the explosions. At first, Owsley said, doctors missed his traumatic brain injury. “She told me nothing was wrong with me, but she gave me like 18 different medications, for pain, to go to sleep, for lots of other things,” he said of his first visit to a Veterans Affairs doctor at a facility in Fort Wayne, Ind. Later that year, another veterans hospital said he had mild traumatic brain injury, post-traumatic stress disorder, anxiety, hearing loss and injuries to his hand, ankles, eye and back. He was rated 100 percent disabled by the Veterans Affairs Department. Yet Mr. Owsley, referring to his Purple Heart denial letter, said he felt his injuries had gone unrecognized by the military “because there was no blood” and because he chose to work through his pain. As many as 300,000, or 20 percent, of combat veterans who regularly worked outside the wire, away from bases, have suffered at least one concussion, according to the latest Pentagon estimates. About half the soldiers get better within hours, days or several months and require little if any medical assistance. But tens of thousands of others have longer-term problems that can include, to varying degrees, persistent memory loss, headaches, mood swings, dizziness, hearing problems and light sensitivity. These symptoms, which may be subtle and may not surface for weeks or months after their return, are often debilitating enough to hobble lives and livelihoods. To this day, some veterans — it is impossible to know how many — remain unscreened, their symptoms undiagnosed. Mild brain injury was widely overlooked by the military and the veterans health system until recently. Mr. Owsley’s request for a Purple Heart, given to troops wounded or killed in action, was denied by the military, a devastating blow. Others say that their mild brain injury entitled them only to low disability payments, or, if the diagnosis was inconclusive, to none at all. “The criteria remains ambiguous,” Mr. Baker said. “The military way underrates T.B.I. and its symptoms.” Says Dr. Alisa D. Gean, the chief of neuroradiology at San Francisco General Hospital and a traumatic brain injury expert who spent time treating soldiers at Landstuhl Regional Medical Center in Germany. “We’re at the tip of the iceberg of understanding it. It is one of the most complicated injuries to one of the most complicated parts of the body.” It was not until 2006, three years into the Iraq war, that the Departments of Defense and Veterans Affairs began to pay close attention to mild traumatic brain injuries. The Pentagon last year opened the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, a clearinghouse for treatment, training, prevention, research and education. This year it is spending a record $300 million on research for traumatic brain injury and post-traumatic stress disorder. “We are more attuned to brain injuries now,” said Lt. Col. Michael Jaffee, the director of the Defense and Veterans Brain Injury Center. “There has not been as aggressive an effort before.” That effort begins with screening. As of May, service members who deploy longer than 30 days will undergo neurocognitive testing before leaving, to establish a baseline for changes that may occur later, and again upon returning. At the same time, soldiers in battle who lose consciousness or feel dazed after a blast or other event must be screened by a medical provider and are either approved for duty in the field, told to rest for several days on base or sent to Landstuhl for further evaluation. Last year, Veterans Affairs started screening all Iraq and Afghanistan war veterans who come in for clinical help. So far, 33,000 of 227,015, about 15 percent, have screened positive for mild brain injury since April 2007.

Ben Pershing of the Washington Post reports that it is possible that Delaware Senator Joseph Biden’s son, Beau, (currently Delaware’s state attorney general) could be selected to take over his father’s seat at the Senate, in the event of an Obama/Bidon presidential victory. Beau Biden is also a captain in the Delaware Army National Guard, though, and is scheduled to head to Iraq, on October 3 for a deployment of roughly a year. That would appear to put him out of the running for an appointment to the Senate by Delaware's governor. Though Beau Biden could seek an early return from his deployment, there has been no indication that he wants one, nor does it seem that shortening his service in Iraq would help his political future. A spokesman at the state attorney general's office said yesterday that Beau Biden would not comment on the possibility of a Senate appointment.

Christian Science Monitor, Wall Street Journal, no Iraq coverage.

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