Magazine article The Spectator

The Terrible Price That Is Paid by the Forgotten Casualties of War

Magazine article The Spectator

The Terrible Price That Is Paid by the Forgotten Casualties of War

Article excerpt

Jonathan Foreman says that the focus upon the death toll in the Afghan conflict obscures the high numbers of soldiers who have suffered catastrophic wounds - and the scandalously inadequate compensation they have been offered once home in a land unfit for such heroes

It is not easy to measure success and failure in counter-insurgency warfare. Modern military establishments have all sorts of 'metrics', as they call statistics, but the politicians and the general public tend to focus on one measure alone: fatalities, and our fatalities at that.

The deaths in Afghanistan of other Allied forces rarely make the headlines (though the loss of ten French troops in a single 2008 ambush did reach the front pages), and numbers of enemy dead are rarely mentioned at all.

The number of civilian casualties during the recent pre-election allied surge in southern Afghanistan has remained unclear. This is partly because the Nato-led Coalition doesn't want to be in the business of Vietnamstyle body counts, and perhaps because it is not easy to know who counts as a civilian in a conflict where one side eschews uniforms and in which a 14-year-old boy could easily be a combatant. This is frustrating because it makes it that much harder for the public to know 'how we are doing' and what, if anything, has been gained by all the sacrifices.

So - is it worth it? Much has been made of the 200th British military death in Afghanistan. However, those who are committed to the war in Afghanistan might point out that 200 fatalities over eight years works out at a lower death rate than the conflict in Northern Ireland between 1969 and 1977, and obviously at a much lower rate than in the Falklands war where 250 British servicemen died in three months. (We tend to forget that the IRA killed 146 members of British security forces in 1972 alone, about the same number that were killed by enemy forces during the entire Iraq war. ) They point out that 200 fatalities is not a vast number in a country with a population of 61 million, and in which 200 young people were killed as a result of knife crime in the past year alone. The Danish contingent has suffered greater losses both in proportion to the size of its force in Afghanistan and in terms of Denmark's population.

However, the true story is that the war in Afghanistan is taking a far, far greater toll than most people realise. A much more telling statistic than the number of dead is the number of wounded. Even more important than this is the number of severely wounded men and women and the startling ratio of wounded to dead. In the second world war the ratio of dead to wounded was 1:4.

During the Vietnam war there were 15 wounded men for every American fatality in theatre. In Afghanistan and Iraq the ratio for British and American troops is between 1:30 and 1:40.

With all the focus on fatalities, not enough attention has been paid to the wounded.

Why are so many wounded in Afghanistan?

The first answer is to do with our improved technology. The body armour, plus dramatic advances in battlefield medical care (such as fast-clotting bandages and tourniquets that can be applied with one hand) mean that those who would have died in past conflicts are kept alive. And there have been great improvements in transporting critically ill patients by air. The other answer, perhaps the most significant one, is that Improvised Explosive Devices or IEDs -- military jargon for home-made bombs and land mines - wound many more than they kill.

Beginning in the first world war, Allied wounded were sorted into three categories of medical 'triage'. If you had a level-one injury, it meant you could be patched up and sent back to the front. Someone with a level-two wound might be able to return to the front in a matter of weeks. A level-three wound required long-term medical treatment and if the patient survived, he would be unlikely to return to the front. Today, in Afghanistan, a significant proportion of our wounded soldiers are so-called 'tier-four' casualties. …

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