Wednesday, November 29, 2006

Frederick News-Post Covers Combat PTSD

Alison Walker-Baird of Maryland's Frederick News-Post offers two well-written articles on combat PTSD today. The paper's Karen Gardner files another, too. Well done, News-Post!

From Walker-Baird's Stress Wounds:

The face of Post Traumatic Stress Disorder is changing. Far from the misguided stereotype of a wheelchair-bound, unemployed, middle-aged man, today's veteran with PTSD looks more like Spc. Christopher Clayton of Hagerstown, like your next-door neighbor. The 29-year-old Maryland Army National Guardsman returned from Iraq in May after 18 months in combat, greeted with hugs and beaming smiles from wife, Erika, and two young daughters.

He works full time and is pursuing a career in nursing. But a year and a half of constantly being on edge left this loving husband and father with depression and mood swings, and a diagnosis of PTSD. He's getting help. More than 400,000 veterans from the wars in Iraq and Afghanistan are expected to do the same.

Solid information, including stats and personal accounts, in all three pieces. Click on 'Article Link' below tags for more...

Continuing from Stress Wounds:

People with PTSD often don't experience symptoms until months or years after the traumatic experience. Despite the predicted flood of veterans needing mental health services, significantly fewer troops have served in Iraq and Afghanistan than in past conflicts such as the Vietnam war.

The U.S. Census Bureau estimates 8.2 million veterans served in Vietnam, making up more than 30 percent of all U.S. veterans, and about 3 million served in the Persian Gulf War. Studies have estimated from 19 percent to 31 percent of Vietnam veterans developed PTSD at some point, with between 9 percent and 15 percent still having the disorder by the end of the 1980s.

Among Gulf War veterans, 1997 and 2003 studies found 2 percent to 10 percent were still suffering from PTSD a decade after returning from deployment.

Plenty of stats on the relationship between injuries and the heightening of PTSD risk:

For every service member who dies in Iraq, nine have been wounded but survived. While more troops in Iraq and Afghanistan are surviving injuries that would have killed them in past wars, they are at risk of developing PTSD. Being wounded in a traumatic experience puts one at a significantly greater risk of developing PTSD than someone who was not injured, several recent studies found.

In the Vietnam and Persian Gulf wars, 24 percent of the wounded died. About 1 in 10 troops injured in Iraq has died, the lowest rate of any U.S. war.

They have survived with the help of better equipment and medical care than in past wars, but the weapons used in Iraq today leave many with lifetime disabilities or disfigurement. Pentagon data show more than half of troops injured are hurt so badly they can't return to war.

Military surgeons reported a high incidence of blindness, multiple amputations, burns and significant brain damage, according to Dr. Atul Gawande's study on modern war casualties published in the New England Journal of Medicine in December 2004.

Roadside bombs have caused about half of U.S. troops' injuries and deaths in Iraq, the Department of Defense's Defense Manpower Data Center reported.

Walker-Baird's second piece, Soldier faces new battle with PTSD, is an inside look into one solider's journey home from combat:

He spent 18 months in Iraq, constantly wound up and never letting his guard down. When the veteran returned home to his family, the stress didn't disappear as easily as changing into civilian clothes.

For this Hagerstown man, the wake-up call was his 3-year-old daughter telling her dad he was too angry. Spc. Christopher Clayton was living with Post Traumatic Stress Disorder.

Spc. Clayton, a member of the Frederick-based Alpha Company in the 1-115th Infantry Regiment of the Maryland Army National Guard, didn't experience symptoms of the disorder until several months after he came home.

Gardner contributes another personal account in The strength to find help: A Vietnam veteran takes steps toward healing:

Curtis Callender served in Vietnam. He went on to serve in the Army for an additional 25 years, retiring 15 years ago. It wasn't until less than a year ago, however, that he was diagnosed with Post Traumatic Stress Disorder.

Mr. Callender, 62, a native of Texas, works for the Military Amputee Research Program at Fort Detrick. After Vietnam, he became a medic in the Army and retired as a sergeant major. But something wasn't right. "I cried if I saw anything war related," he said. "I thought it was a weakness in my personality."

War movies, war stories, just about any reminder of war set him off. And as he got older, the tears came more often. He had been to see George Kauffman, the Veterans Service Officer for the Maryland Department of Veterans Affairs, at his Frederick office. "George is the one who thought I should get checked," he said.

Please read the rest, and then consider thanking the Frederick News-Post for this important coverage. Way to go!

A Look at the VA's Women Veterans Health Program

This month's featured article at the National Women's Health Information Center ("The Federal Government Source for Women's Health Information" and a division of the U.S. Department of Health & Human Services) is by Carole L. Turner, RN, MN, CNAA, and Director of the Women Veterans Health Program.

Entitled The Veterans Administration and the Women Veterans Health Program: Caring for a New Generation of Veterans, I've included it in full here for those interested in learning more.

Click on 'Article Link' below tags for more...

Re-printed in full here for educational purposes:

The July 17, 2006 issue of Business Week declared that the Veterans Health Administration's (VHA) health care system delivers the best medical care in America. The article praised VHA for its lower costs, higher quality and safety, and the computerized medical record system that allows data sharing among all facilities. The article goes on to say, "if you want to be sure of top-notch care, join the military." TIME magazine's August 27, 2006 issue reiterated that theme in "How VA Hospitals Became the Best." The VHA system—made up of 154 hospitals and 875 clinics—is the nation's largest health care system, providing care to millions of eligible veterans nationwide.

Another surprising secret about Veterans Administration's (VA) health care is the Women Veterans Health Program. Women are the fastest growing segment of eligible VA health care users. Women currently represent 15 percent of the active duty force, 20 percent of new military recruits and 17 percent of National Guard and Reserve forces. Presently women represent 5.5 percent or about 1.7 million of the 24.4 million veterans nationwide. This number is projected to increase to 10 percent by the year 2010. Women veterans account for about 1 in every 100 adult female patients in the United States today and the majority are seen outside of the VA health care system. Few clinicians, however, know about women's history of military service or the possible impact of that service on their physical and mental health or quality of life.

Women have participated in every conflict in the U.S., beginning with the War for Independence. Often disguised as males in those early conflicts, women have a long and distinguished record of service to their country and are now a vital and integral component of our military. In the current conflicts in Iraq (Operation Iraqi Freedom) and Afghanistan (Operation Enduring Freedom), about 10 percent of troops are women and they are exposed to combat conditions that earlier generations of women veterans seldom experienced.

Services for women in VA date back to 1982 when a Women Veterans Advisory Committee was appointed to address the inequalities for women veterans. The Veterans Health Care Act of 1992 allowed the VA to dramatically improve its programs for women veterans and move toward a goal of establishing state-of-the-art facilities and programs that focus on women's health. This helped create an environment that is warm, comfortable and private. The legislation authorized VA to provide gender-specific services and general reproductive health care and sexual trauma counseling to eligible women. It also authorized eight Comprehensive Women's Health Centers located in Boston, MA, Southeast PA, Durham, NC, Chicago, IL, Los Angeles, CA, San Francisco, CA, Minneapolis, MN, and Tampa, FL.

Services for women have steadily expanded and improved. VA has responded to the growing number of women veterans by targeting programs and facilities to meet their unique health care needs. Today, the Women Veterans Health Program extends to all VA facilities with comprehensive health care for women veterans as the rule, rather than the exception. The Women Veterans Health Program Strategic Plan guides efforts to ensure that women veterans receive the care they need. As part of the strategic planning process, the program identified and developed our mission and vision. The program mission is: Promote the health, welfare and dignity of women veterans, and their families, by ensuring equitable access to timely, sensitive, quality health care. Our vision is: Improve the health of the Nation by providing the highest quality services for all eligible women who served in the military. The strategic plan, now in its second five-year cycle, has produced outcomes that show success in the quality of care being delivered.

The Women Veterans Health Program provides a full range of medical and mental health care services, including:

* Preventive health screening
* Primary care
* Gynecology services
* Reproductive health care including maternity care and infertility evaluation
* Screening, counseling, and treatment for sexual trauma, substance abuse, post taumatic stress disorder and domestic violence
* Homeless programs
* Vocational rehabilitation
* Patient education
* Research

This most recent war has seen an unprecedented number of women experiencing the same situations as their male counterparts, not only in combat, but also upon returning home. They can face both physical and emotional readjustment. VA operates a variety of specialized outpatient post traumatic stress disorder (PTSD) programs, including seven outpatient Women's Stress Disorder and Treatment Teams. Forty-four Returning Veterans Outreach, Education and Care programs were established in an effort toward early identification and management of stress-related disorders. The National Center for Post Traumatic Stress Disorder has come to be viewed as a world leader in PTSD research. Current research is being done on the unique issues and behaviors specific to women deployed to a war zone so that VA can gear programs accordingly.

For the first time, VA is treating women veterans with multiple traumas, including loss of limbs and traumatic brain injury. These veterans, who most likely would have died in previous wars, face many challenges in their recovery. VA has established "polytrauma centers" to focus on the immediate rehabilitation of these soldiers located in Minneapolis, MN, Palo Alto, CA, Richmond, VA and Tampa, FL.

In addition there are 207 community Veterans Centers nationwide specializing in readjustment counseling for veterans. Started in response to the Vietnam war, many Veterans Centers now have a designated Global War on Terror (GWOT) outreach person whose job is to provide presentations to returning veterans regarding VA and Veterans Center services available to them (particularly counseling for readjustment issues, PTSD, and Military Sexual Trauma (MST)). These outreach workers are GWOT veterans themselves.

Unfortunately, a number of veterans, both male and female, have experienced sexual trauma during their military service. A program, originally established to treat women who were victimized, immediately identified that men have suffered this indignity as well. VA provides priority health services and mental health counseling and treatment for all eligible veterans who have experienced MST. It is important to know that MST counseling is available even if a woman did not report the incident when it took place.

VA is concerned about MST because any type of trauma can have lasting effects on physical and mental health. Trauma counseling can help veterans to better cope with a past experience of MST and to regain their confidence, self-esteem, and hopefully, improve their quality of life.

This MST program is but one example of improvements made as a result of the efforts of the Women Veterans Health Program that have also improved the quality of care for men. As another example, focus on improving privacy for women consumers has resulted in changes that have improved the environment of care for male veterans as well.

Every VA Medical Center has a Women Veterans Program Manager who helps women with establishing their eligibility, understanding their benefits, and getting their health care in the VA system. The VA Women Veterans Health Program continues to recognize the unique needs of those women who have served and strives to provide them the quality care that they so richly deserve.

For more information about the Women Veterans Health Program, please visit us at www.va.gov/wvhp.

Current as of November 2006

Some OEF/OIF Troops Returning Addicted to Military-Given Meds

From the Milwaukee Journal-Sentinel:

Families are alarmed by military statistics showing that 80% of soldiers who have been flagged with 'mild' symptoms of post-traumatic stress disorder have been sent back to Iraq and Afghanistan, many with anti-depressant pills aimed at ensuring they can still fight. ...

Maj. Gen. Paul Mock, commander of the 63rd Regional Readiness Command for the Army Reserves, told an Army convention last month that he doesn't think the infrastructure is in place to treat all returning troops who need mental health care, especially in rural areas. "When they don't get the kind of mental health screening - or physical - history tells us they will turn to coping mechanisms," said Steve Robinson, director of government relations for Veterans for America, a 35,000-member organization. He says many of the hundreds of soldiers he has interviewed are addicted to medications given to them in the field, such as painkillers and sleeping pills. But the soldiers are not getting the therapy that normally goes with such medications, Robinson said.

Adam Reuter, a 23-year-old former Army specialist from Atlanta who was stationed near the Syrian border, said a medic simply handed him a plastic bag filled with pills with no instructions after he was tossed out of a Humvee in an accident. The bag contained Percocet, Vicodin, Tylenol with codeine, a muscle relaxant, Motrin and Naproxen. He said he went back for more and developed a dependency that he is still trying to shake. More >>

Click on 'Article Link' below tags for related posts...

Increased Deployment Tempo Strains Military Family Ties

From yesterday's Washington Post front page:

This week, U.S. troops will have been fighting in Iraq longer than they did in World War II, with no relief in sight. Soldiers from 1st Brigade preparing at Fort Stewart for their third Iraq tour have been spending as much time in Iraq as at home. The rotations -- a year in Iraq followed by a year at home -- dictate soldiers' most intimate decisions: They mandate when troops can marry and have children. They sever relationships that cannot sustain the stress of absence or danger. And they lead some couples to pray for the war to end.

After the memorial service [for each of the division's 317 soldiers who have died in Iraq], Lt. Col. Doug Crissman gathered his 1st Brigade soldiers and sent them on leave with a warning not to get hurt, go to jail or go AWOL. "You're all a little bit nervous. Hell, I'm nervous," said Crissman, of Burke, Va., who commands the 2nd Battalion, 7th Infantry Regiment. "The Army is asking us to do some tough stuff."

Then his voice softened as he nudged his troops to be attentive to their families. "I need you to think about this visit a little differently," he said. "Spend time with them. . . . Tell them you love them."

Click on 'Article Link' below tags for more...

In the interest of education, article quoted from extensively.

Continuing:

From courtship to parenting to divorce, the time away at war is having a profound impact on the families of active-duty soldiers, according to interviews with dozens of soldiers from the 3rd Infantry Division and their relatives. The division spearheaded the U.S. invasion of Iraq in March 2003 and returned for a second, year-long tour in January 2005.

For 1st Brigade soldiers such as Frohnhoefer, having children poses a wrenching choice: Leave your wife alone in pregnancy and birth, or miss your newborn's first year.

Frohnhoefer and several others in his brigade opted to start pregnancies soon after returning in January, creating a mini baby boom. Frohnhoefer's second daughter, Haley, was born three weeks ago. Another soldier in the unit had a baby last week.

"We take a lot of pictures," said Frohnhoefer, 28, of Queens, N.Y., as his wife, Audrey, quieted Haley with a pacifier. His biggest fear, he said, is "my kids not knowing me if something were to happen to me."

Unattached troops have their own trials:

For single soldiers, finding a spouse is difficult. Spec. Christian Brown, 25, of New Smyrna Beach, Fla., is afraid that when he leaves next month he will lose the girlfriend he met earlier this year. "She doesn't know if she can handle me being gone," he said, adding that he no longer plans to reenlist.

Other soldiers are arranging hasty marriages before they leave -- for added benefits and to provide for their spouses if they die -- a trend officers discourage because they say it makes soldiers more vulnerable to divorce.

Capt. Neil Johnson, 25, of Crystal River, Fla., said that he wed in November 2004 but that the uncertainty and fear surrounding his Army job led to his divorce in June. "If I had been in Florida, I'd probably still be married," he said. Army divorce rates surged after 2001 and remain elevated, although they fell somewhat last year. Johnson sees more divorces coming. "It seems normal," he said. "No one is surprised."

The problems they face are hard for the rest of us to understand:

Anxiety, depression and psychological trauma from repeated exposure to combat add to the stress, affecting 15 percent to 20 percent of soldiers, said Maj. Christopher H. Warner, a 3rd Infantry Division psychiatrist. Those factors contribute to drinking, drug use and domestic violence among a small percentage of soldiers, officers said.

While some GIs grow more resilient to combat stress, others get worse, Warner said. One soldier attacked by gunfire and bombs repeatedly at Iraqi bridges found himself afraid to drive through underpasses at home. Some soldiers under treatment for combat stress return to war but are screened to see if they pose a risk, Warner said.

Still, the bulk of psychological problems for soldiers relate to home-front issues such as separation and infidelity, he said.

Many soldiers doubt civilians can understand the pressures they face, and they see a widening gap between Army life and what some call "the outside world." "There are times you feel like, 'Why is it us?' " Audrey said. Civilians, she said, "don't have a concept of what we go through."

Please read the rest.

Missing GA Iraq Veteran

As of Dec 1, 2007, this veteran is still missing. Updated details here.

We have another missing veteran -- from Georgia.

You may remember the story of a recently returned Iraq War veteran who went missing at the end of September.

The Ohio vet eventually turned up in Washington state, apparently "with a full beard and mustache and living in the woods. ...He was found coherent, tired and stating he was 'looking for his men'."

Although 'going into the bush' may not be a satisfying conclusion to such missing persons cases, at least families know their loved one is alive.

Have you seen Jason Roark?

Click on 'Article Link' below tags for details and helpline info...

Atlanta's WXIA-TV Channel 11 reported today:

Gwinnett County police are investigating the disappearance of a 26-year-old Iraq war veteran. Jason Roark made it home safe after two tours of duty, but has not been seen in two weeks. Now, his family has turned to a private investigator to help find their son.

The Texas search team, Equusearch has been enlisted to find Roark and it is the same search team that was used to find missing teenager, Natalie Holloway. Several of its members were in Gwinnett County Saturday, trying to retrace Roark’s last steps in hopes of bringing the young man home.

Roark’s mother, Terry hopes that after 17 agonizing days, the Roark family may finally get some answers. "It’s my only child, and he’s been missing for 17 days and I have no whereabouts whatsoever," said Terry Roark.

Surveillance video obtained by Equusearch showed Roark checking into the Gwinnett Inn [in Snellville, Ga.,] at 4:30 a.m. on November 9. That morning, Jason was seen several times walking in the parking lot and driving his black Honda Accord. Surveillance video showed Roark leaving the motel for the last time at 11:04 a.m.

Apparently, the last person to have seen Roark has allegedly given some information to the police which does not jibe with what surveillance cameras picked up on the scene.

Whatever the outcome of the investigation, Terry Roark said she needed answers, even if that answer is devastating. "He served this country, now its time to help him," said Terry Roark.

[Nick Berntson, a college friend of Roark’s and the last person to have seen him alive] is currently being held in the Gwinnett County jail on a probation violation. Equusearch was looking for Jason’s car, a black Honda Accord with a white Florida Gator decal in the back window and Georgia plates with the number ASL-0280.

Anyone with information is asked to call Equusearch’s toll free number at 877-270-9500.

See Channel 11's video report.

Additional details from the Columbus Ledger-Enquirer:

Roark left the Army in October 2005 and had been treated for depression and post-traumatic stress syndrome after returning from Iraq, said his mother, Terry Roark of Dallas, Ga. Roark had started a job as an assistant manager at Texas Roadhouse restaurant in Snellville three months ago, she said.

Terry Roark said she believes her son did not simply disappear on his own. "It's like he was just in a 'poof'," she said. "No sightings, no traces of him anywhere. He has no money, no credit cards, and was last seen in blue jeans and a T-shirt. No coat."

Roark was stationed at Ft. Bragg and served with a Special Operations Forces pyschological unit.

In interviews, his mother has said that his PTSD does not seem to figure into the disappearance. I do hope that they find him, soon.

Again, please call 877-270-9500 with any leads you might have.

From the Gwinnett County Police:

(Thursday 11/09/06) The Gwinnett County Police Department is currently investigating the disappearance of 26-year-old Jason Michael Roark of Snellville.

Roark was last seen by his friend. The two had been drinking together at a local bar in Lilburn. After drinking, the two rented a room at a nearby hotel. The witness told authorities that the last time he saw Roark was when Roark left the hotel at approximately 7AM that Thursday.

Roark was last seen in his ’00 Black Honda Accord bearing Georgia Tag ASL0280. At this stage of the investigation foul play is not suspected, however it has not been ruled out. Anyone with information concerning Jason Michael Roark is asked to call the Gwinnett County Police Department at 770-513-5300.

Source: Gwinnett County Police

Visit My Amazon.com Profile Page/Blog

Although my new Amazon.com Profile page will occassionally have unique posts on events and news regarding my new book, Moving a Nation to Care, PTSD Combat won't quickly be replaced. I would, however, like to invite you to help me build my Amazon.com Profile's recommended reading list.

Click on 'Article Link' below tags for much more...

While doing my research for my book, I did a good measure of reading up on combat PTSD and the Iraq and Afghanistan wars in general. There are some well-written accounts from our troops as well as from their family members.

They'll all be listed in Moving a Nation to Care's bibliography, but I wanted to pass along a few that I'd absolutely recommend anyone read. They'll go far in getting you closer to the subject.

The Last True Story I'll Ever Tell: An Accidental Soldier's Account of the War in Iraq by John Crawford
Chasing Ghosts: A Soldier's Fight for America from Baghdad to Washington by Paul Rieckhoff
War and the Soul:Healing Our Nation's Veterans from Post-traumatic Stress Disorder by Edward Tick, MD
Flashback: Posttraumatic Stress Disorder, Suicide, and the Lessons of War by Penny Coleman
What Was Asked of Us: An Oral History of the Iraq War by the Soldiers Who Fought It by Trish Wood
Down Range: To Iraq and Back by Bridget C. Cantrell, PhD, and Chuck Dean

Please feel free to add your reading suggestions in comments, and I'll be happy to include them on my Amazon.com Profile page...and on my own reading list.

You can check my book's Amazon.com sales rank from this page (it's on the book's main page, too). Wow, currently at #42,833? Hey, did someone just buy a one!? Thanks! Scroll down under my blog post entry on that page, and look for a center column called "Bibliography" to find the sales rank number.

Thursday, November 23, 2006

Thanksgiving Day: Remembering Those We Miss

As most of us head off to be with (or are already with) our loved ones today to share turkey and pie and all the warmth of their company, we take note of how blessed we are to have those moments.

Those moments that matter.

Click on 'Article Link' below tags for more...

From Edward A. Powell, president and CEO of USO Worldwide Headquarters:

The year is full of magic moments -- moments that add meaning to our lives:

a child dashing into your arms
a long, lingering embrace
a quiet chat with an old friend
just a moment's peace, free from tension and fear
These are the moments that most of us take for granted, but that our soldiers at the front seldom have. It's a sacrifice they make for us, so that we here at home can enjoy our precious moments in peace and freedom...and safety.

That's what the USO is all about, and what we do all year long. We deliver the small precious moments, the human touch, a taste of home, a moment to escape the daily grind of war.

Whether it's helping a young soldier settle her family in a foreign land; counseling a child whose parents are both overseas; providing a place of refuge and a chance to call home for GIs in Iraq, Afghanistan, Korea, and all over the world. Whatever it takes to support our men and women and their families, the USO is there....

"Until Every One Comes Home."

Edward A. Powell

Please consider giving this Thanksgiving to the USO. And a warm wish for those who are missing their loved ones this year; may you be together again, soon.

Wednesday, November 22, 2006

Commentary: VA Counselor and Funding Shortfalls a Problem for Returning Troops

A commentary from Monday's Kansas City Star by columnist Kathleen Parker, "Veterans deserve better mental health care":

The biggest problem is simply not enough qualified counselors and not enough government funding to meet current needs. Those needs have grown exponentially, as the number of vets seeking treatment for post-traumatic stress disorder and other mental health issues doubled from 4,467 to 9,103 between October 2005 and June 2006, according to a report last month by a House subcommittee. That’s just the beginning of the wave building now.

Even without additional funding, the Department of Defense could help by increasing access to mental health care for military personnel and their families. Individuals on TRICARE, the military’s health insurance program, can seek counseling from licensed practitioners only after referral from a primary physician.

A veteran’s wife testified before a VA committee last year that her husband, Capt. Michael Jon Pelkey, was treated for everything from back pain to erectile dysfunction rather than PTSD. Pelkey finally was diagnosed properly by a civilian therapist — one week before he killed himself. There can be no more shameful legacy of any war than ignoring veterans’ needs. As Republicans and Democrats vow bipartisan cooperation, they have no greater priority than to simplify veterans’ access to mental health services.

More >>

Monday, November 20, 2006

SFO Bay Area: Attendees Needed @ DOD Task Force Mtg. Tomorrow

Received the following call for help tomorrow afternoon from Amy Fairweather for anyone in the San Francisco Bay Area :

Hello Ilona -

...I will be testifying before the DOD Task Force on Mental Heath tomorrow as will several family members and health care providers. We would like to have a good turn out to show support for veterans and families living with PTSD and to shed light on the DOD's inadequate response. Please forward this to colleagues and friends in the Bay Area.

Amy N. Fairweather, J.D.
Director, Iraq Veteran Project
Swords to Plowshares
1060 Howard Street
San Francisco, CA 94103

Click on 'Article Link' below tags for full press release...

MEDIA ADVISORY
November 16, 2006

CONTACT:
Amy Fairweather (415) 252-4787 ext. 356 (415) 505-6558 afairweather@stp-sf.org
Anne Roesler (408) 205-2199 docondeck@pacbell.net
Michael Blecker (415) 252-4787 ext. 321 (415) 823-0363 mblecker@stp-sf.org

MILITARY FAMILIES AND VETERANS ADVOCATES TO TESTIFY BEFORE DEPARTMENT OF DEFENSE TASK FORCE ON MENTAL HEALTH DESPITE DOD OBSTACLES

WHO: Military Families and veterans’ service providers speak out on post traumatic stress disorder (PTSD) and mental health. Anne Roesler, Advisory Board member of Military Families Speak Out and mother of thrice-deployed Iraq veteran, Amy Fairweather, Iraq Veteran Project Director, Swords to Plowshares, and other family members and mental health providers will speak to the enormous unmet mental health need among service members deployed in Iraq and Afghanistan.

WHAT: Sen. Boxer’s amendment to the 2006 defense appropriations bill requires the DOD to conduct public hearings throughout the country regarding mental health care within the armed services.

The DOD informed Senator Boxer’s office on Friday November 17th that the public testimony portion of the open hearing will begin at 4:35 pm, leaving just 25 minutes for families and others to speak. It has since assured advocates that they will extend the meeting if necessary to receive testimony. However, it has provided no instruction for public participation on the Task Force website.

Despite these efforts to operate below the radar, military families and advocates will attend the hearings and provide testimony regarding the real life mental health impact of deployment and the barriers to care in the military community.

WHEN: Press conference Tuesday November 21st, 4:00 pm.
DOD Open briefings,1:00 pm to 5:00 pm. Public testimony, 4:35 pm.

WHERE: Double Tree Hotel San Francisco International Airport, 835 Airport Boulevard, Burlingame.

WHY: 450,000, one in three, Iraq veterans return from deployment with post-traumatic stress disorder or other mental health needs. Suicide among active troops has skyrocketed. PTSD and Traumatic Brain Injury are the signature wounds of theses wars, and yet the military has failed to ensure timely and adequate mental health resources for those enduring the sacrifices of deployment.

War causes wounds and suffering that last beyond the battlefield. Our mission is to heal the wounds, to restore dignity, hope, and self-sufficiency to all veterans in need, and to reduce homelessness and poverty among veterans. Learn more about the work of Swords to Plowshares, and ways in which you can help, by visiting our website at www.stp-sf.org.

San Francisco Chronicle: Civilian Contractors Tell of Insurance Co. PTSD Denials

Very interesting piece from the San Francisco Chronicle:

Thompson was paid $1,850 a week while he was there -- far more than he had been earning before the war. 'And I'll tell you right now, it wasn't worth it,' he said. Thompson said he survived several roadside bombs, mortar and rocket attacks, and countless small-arms firefights as he transported supplies for U.S. troops along Iraq's perilous roads. He returned from Iraq without physical injuries.

But his war wounds are evident in the cocktail of prescription medications he takes every day -- for hostile behavior, hallucinations, depression, insomnia, anxiety, anxiety-related tics and spasms, and hypertension, all symptoms he says he developed during his time in Iraq.

Two doctors in North Carolina have independently diagnosed Thompson with post-traumatic stress disorder, a psychological ailment with symptoms that typically include anxiety, loss of sleep and flashbacks. The government has acknowledged that he is disabled, and he receives a $1,224 monthly Social Security payment. But Thompson says his claim for treatment for post-traumatic stress disorder was denied by American International Group Inc., or AIG, the insurance company for KBR, on the grounds that there was not enough medical evidence of his trauma.

Click on 'Article Link' below tags for more...

Continuing:

The [civilian contractors'] policy entitles the contract workers to reasonable and necessary health care for the rest of their lives, free access to an attorney, and weekly compensation for the time doctors' orders prevent them from working. But Gary Pitts, a Houston lawyer who represents more than 200 civilian contractors and their families with claims against AIG, said claims that involve post-traumatic stress are rarely honored.

"Generally, AIG doesn't pay for any PTSD treatment, and the reason is because PTSD is not like having a leg blown off," said Pitts, who represents Thompson and more than 30 other clients who have been diagnosed with post-traumatic stress disorder. "It's a gray area."

A gray area?

Psychological Bulletin from APA: Females Have Higher Rates of PTSD

From HealthNews-Stats:

Males experience more traumatic events on average than do females, yet females are more likely to meet diagnostic criteria for Posttraumatic Stress Disorder (PTSD), according to a review of 25 years of research reported in the November issue of Psychological Bulletin, published by the American Psychological Association (APA).

The authors reviewed 290 studies conducted between 1980 and 2005 to determine who is more at risk for potentially traumatic events (PTE) and posttraumatic stress disorder (PTSD) – males or females? The results of the meta-analysis found that while males have a higher risk for traumatic events, women suffer from higher PTSD rates. PTSD is defined as an anxiety disorder precipitated by a traumatic event and characterized by symptoms of re-experiencing the trauma, avoidance and numbing and hyperarousal.

From the review, researchers David F. Tolin, PhD of the Institute of Living and Edna B. Foa, PhD, of the University of Pennsylvania School of Medicine found that female study participants were more likely than male study participants to have experienced sexual assault and child sexual abuse, but less likely to have experienced accidents, nonsexual assaults, witness death or injury, disaster or fire and combat or war. Sexual trauma, the authors conclude, may cause more emotional suffering and are more likely to contribute to a PTSD diagnosis than other types of trauma.

Click on 'Article Link' below tags for related posts...

Moving a Nation to Care: Now Available for Pre-Order

My upcoming book, Moving a Nation to Care: Post-Traumatic Stress Disorder and America's Returning Troops, is now available for pre-order.

If you've been one of my partners on this journey from ePluribus Media, Veterans for America, Iraq and Afghanistan Veterans of America, National Gulf War Resource Center, SoapBlox/Chicago, Daily Kos, My Left Wing, Political Cortex, Booman Tribune, Blue Force, TPM Cafe, or Gen. Wes' Clark Community Network, thank you.

My appreciation for your heart and hands on this issue! Onward...

Click on 'Article Link' below tags for pre-ordering details galore...

A few ways to pre-order Moving a Nation to Care:

Or compare prices easily all on one page.

Don't want to use a credit card online?
Reserve a copy at your local Border's store.

Border's will contact you when Moving a Nation to Care arrives in their store and on their shelves (sometime in May 2007), ready for pick-up. Pay for it with cash or credit card at the check-out counter as you normally would.

[Lastest update to this page: 24 Feb 07].

Book Reviews
See the book review page for full list.

From Unsolicited Opinion:

Moving A Nation to Care: Post-Traumatic Stress Disorder and America’s Returning Troops is a timely and important reminder that war’s costs are often more subtle than the obvious dead and wounded casualties. Regardless of one’s view of the wisdom of any particular war, author Ilona Meagher clearly demonstrates that the psychological wounds of war require as much attention as the more visibly injured. Achingly illustrated with examples of soldiers’ experiences after returning from Iraq and Afghanistan, Moving A Nation to Care is a wake-up call to the wider public who may be tempted to dismiss the impact of post-traumatic stress disorder as something that veterans must simply "get over" upon returning to civilian life. ...

[I]ndividuals are left to fight their own personal wars as they relive and ponder their actions while the nation that sent them into combat holds on to an an image of war as noble and gallant. The all too vivid examples of drug and alcohol abuse, domestic abuse, murder and suicide in Moving A Nation to Care show that families, friends and the veterans themselves often pay the high cost of combat. If anything, the examples are overwhelming. I found myself dreading each new name because all too often the name introduced a story that ended in death. As difficult as reading these stories may be, however, the examples are necessary to bring attention to something society would rather ignore–the full cost of war.

Fortunately, Moving A Nation to Care is more than a litany of death and despair. It is also the story of activists–veterans and their families–like James Blake Miller, a veteran of the 2004 Marine assault on Fallujah. A photograph of Miller, battle weary, his face covered in dirt and blood, became an icon of Iraq combat, the "perfect image of a valiant and virtuous warrior". These days "...outspoken and open to a fault, suffering with PTSD, Miller no longer represents the mythic soldier. Yet his bluntness is the dose of reality we need...[he] asks us to consider the costs of war for the individual rather than endlessly, and mindlessly, perpetuating the myths of gallant battles and Teflon warriors." Captain Stefanie Pelkey, the widow of Captain Michael Jon Pelkey who committed suicide as a result of PTSD from his year in Iraq is another activist. So are Kevin and Joyce Lucey, whose son Jeffrey also took his own life after returning from Iraq. These dedicated individuals are helping tear down the Defense Department’s "wall of silence regarding PTSD" asking why, in preparing for war, was care for returning troops basically ignored?

For all that Ilona Meagher does in bringing this important issue to the public, even more significant, is the list of resources for concerned citizens presented in the final chapter. This chapter is Ms. Meagher’s effort to "move a nation to care". It offers sources for understanding the experience of war, how to communicate with returning veterans, opportunities for political action and page after page of organizations offering assistance and support to veterans and their families.

From ePluribus Media:

Meagher's book is an attempt to move Americans to action on veterans' rights: She is honest in her concern and this is a book on a topic that has much more relevance to our individual lives, even those of us with no immediate family members in the military, than many of us might think. What happens to the members of our military matters to our lives, no matter who we are. ...

Meagher's book is in three parts. The first two use personal stories to provide an understanding of PTSD for those of us who have never experienced it or war. This first part really has two purposes, to show that although PTSD is nothing new, it is a serious problem indeed. The second gets into the complexities of PTSD in contemporary American society, explaining why PTSD is different for veterans today, given the particulars of the contemporary Iraq and Afghanistan conflicts. In the third part, she brings it home -- literally, discussing, among other things, the impact of quick transport, picking people up from Iraq one day and dropping them home the next -- without any time for adjustment. It's here, also, that she provides lists for the activism that she hopes her "call to arms" will make necessary in each of our hearts -- places to contact, things to do relating to easing the impact of PTSD. In many ways, these are the purpose of the book. The point is to give Americans -- all of us, but particularly the veterans facing PTSD and their families -- information on how to proceed both in dealing with the trauma and in forcing our government to deal concretely with the problem.

The style of Meagher's writing is breezy; there's no anger in the prose. Meagher lets the examples she presents speak for themselves -- and that's good. The outrage is in the violence that PTSD victims have experienced and then recreate (most often against themselves) -- and in the help that comes too little and too late, if at all.

From Amazon.com:

Book Description

Post-traumatic stress disorder (PTSD) in our returning combat troops is one of the most catastrophic issues confronting our nation. Yet, despite the fact that nearly 20 percent of the over half million troops that have left the military since 2003 have been diagnosed with PTSD, and that many who suffer symptoms are unlikely to seek help because of the stigma of this terrible disease, our government and media have remained silent.

Moving A Nation to Care: Post-Traumatic Stress Disorder and America's Returning Troops is a grassroots call to action designed to break the shameful silence and put the issue of PTSD in our returning troops front and center before the American public. In addition to presenting interviews with Iraq and Afghanistan veterans suffering with PTSD, such as Blake Miller, the famous "Marlboro Man," this book will be the most comprehensive resource to date for concerned citizens who want to understand the complex political, social, and health-related issues of PTSD, with an eye toward "moving our nation to care" to do what is necessary to help our fighting men and women who suffer from PTSD.

Ilona Meagher is editor of the online journal PTSD Combat: Winning the War Within and author of the PTSD Timeline, a comprehensive database of PTSD incidents. She has appeared on Fox News and numerous other media outlets.

Robert Roerich, MD, is one of the world experts in trauma therapy and PTSD and a board member of the National Gulf War Resource Center.

About the Author
Ilona Meagher is editor of the online journal PTSD Combat: Winning the War Within. Her collaboration with ePluribus Media has resulted in the PTSD Timeline, a database of reported PTSD incidents. She has appeared in numerous media outlets, and has been interviewed on Fox News about the issue of PTSD in troops returning from Iraq.

Thank you to everyone who has supported this endeavor, most especially the military families and veterans who helped me to write this book, as well as those who continue to serve our country in uniform. A lot of work yet to do...but we have certainly begun.

Saturday, November 18, 2006

Army's 3rd ID to Serve Third Tour

With increasing tempo, comes increased stress and an increase in PTSD risk. A discussion of this and a review of where we stand overall when it comes to Iraq in an informative piece filed by Robert Burns. From AP:

The Army's 3rd Infantry Division, which helped lead the charge to Baghdad at the outset of the war, will return next year and become the first Army division to serve three tours in Iraq. More than 3 1/2 years into the war, the Army and Marine Corps are straining to keep a steady flow of combat and support forces to Iraq while giving the troops sufficient time between deployments for rest and retraining.

Both services are far short of their goal of providing two years between deployments; the 3rd Brigade of the 3rd Infantry, for example, will have spent barely more than 12 months at home when it returns next year. The same is true for the division's 1st Brigade, which officials have said is scheduled to deploy again in January.

The 3rd Infantry, based at Fort Stewart, Ga., is among several units - totaling 57,000 troops - identified by the Pentagon on Friday for deployment in a fresh rotation of forces starting in January. The announcement does not presume any change in troop levels, nor is any major change expected for at least several months.

Godspeed and a safe return to the 3rd ID...

Friday, November 17, 2006

Times Argus: Some Troops Self-Medicating in Field

From Cox News via the Barre-Montpelier Times Argus:

Experts say the PTSD rate among Iraq veterans could well eclipse the 30 percent lifetime rate found in a 1990 national study of Vietnam veterans because soldiers still on active duty are being deployed longer and more often to Iraq and more doctors are aware of the disorder and will properly diagnose it.

But a study released in May by the Government Accountability Office, the investigative arm of Congress, found that nearly four in five service members returning from Iraq and Afghanistan who may have been at risk for PTSD were not referred for further mental health evaluation. The Pentagon was unable to explain to the GAO why some were not referred for care.

Medical experts say mental health and substance abuse problems are intertwined. And drugs ranging from marijuana to prescription anti-depressants are easily accessible in Iraq, according to interviews with more than a dozen soldiers who served there.

Soldiers said they used banned substances as a way to mentally escape the violence around them. Others said pills were handed out by medics in the field. John Crawford, a 28-year-old former Florida National Guardsman with the Army's 101st Airborne Division, said soldiers in his unit drank alcohol, some took steroids, 'pretty much everyone took Valium' and 'some did all three.'

Click on 'Article Link' below tags for related posts...

Times: British PTSD Figures and Court Cases

From the British Times:

A SOLDIER has been awarded £375,000 after becoming the first member of the Armed Forces successfully to sue the Ministry of Defence for suffering post-traumatic stress while serving in Iraq. ...

Four soldiers were involved in test-firing when the barrel ignited. One soldier lost an arm and has been granted substantial compensation.

The three others were not physically injured but all put forward claims that they had suffered post-traumatic stress after witnessing the grievous wounds to their comrade. ... The MoD said that there were six other claims over post-traumatic stress disorder (PTSD) in the pipeline, including the two soldiers involved in the test-firing incident.

Hundreds of soldiers returning from Iraq have been suffering from mental health problems, according to the latest official figures. Of the 1,897 cases, 278 were classed as PTSD sufferers. The figures do not include personnel who have received treatment since leaving the Armed Forces.

Click on 'Article Link' below tags for related posts...

British Iraq Vets Also Dissatisfied with Government Healthcare, PTSD Treatment

Wednesday, November 15, 2006

Charlie Rose Roundtable Discussion With Three Iraq Vets

Hat tip to IAVA for providing the video of founder Paul Rieckhoff appearing with two other Iraq vets -- Daniel Anfang and David Myers -- on Charlie Rose to speak of their service, their frustrations on and off the battlefield, and the combat buddies they'll remember forever.

Click on image to view the program in full. The veterans' roundtable is found in the second half of the show, at 32:50.

LTE: Enough Lip Service Re: Post-War Aftercare

A Letter to the Editor in Maine's Morning Sentinel:

America's military needs to stop giving lip service to the aftercare it provides for the returning traumatized soldiers of today's "war on terror."
Currently, the United States military disavows the existence of PTSD (Post-Traumatic Stress Disorder) and the devastating impact it has upon the lives of these soldiers. Our country must be accountable and required to take care of all those who have made sacrifices protecting our freedoms. Anything less is an insult to all members of the service and a disgrace to our country and all veterans.

I am deeply aware of this problem as my son, an Army Ranger, has returned from combat in Afghanistan unable to receive needed treatment he deserves.

Michael Smilek, veteran U.S. Navy
Farmington

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Monday, November 13, 2006

Sioux City Journal: Catching Up with Returning Troops

From theSioux City Journal:

Many troops undergo an emotional letdown when they return from combat, Ward said. 'A lot of our service members have experienced something so much bigger than themselves. It's huge to be over there and serve,' he said.

'Whether the war is popular or not, you felt like you made a difference at the individual level you were at. You were doing it for your brothers next to you -- your fellow soldiers -- or by interacting with the Iraqi people. (The soldiers) knew they were making a difference, to be part of something so big.'

The best way for soldiers to adjust may be to share with others the accomplishments in Iraq, Afghanistan and elsewhere, Schild said. 'We have a story tell, and we need to tell that story,' he said.

Schild said the unit's successes included: helping Iraqi police forces take over security; finding weapons during house checks; helping catch a top Al Qaeda leader; and providing security so the first Iraqi police station was finished without being blown up by insurgents.

Charlie Battery left its mark, as Iraq continues toward democracy, he said. 'An Iraqi sheik told us it would take three big elections, or 12 years, before this (new government) starts to work,' Schild said.

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Albany Times Union Delivers Exhaustive PTSD Piece

Dennis Yusko at the Albany Times Union writes a stellar piece on the issues surrounding combat PTSD. "War's pain comes home" is a Page 1 article that ran on Sunday, spanning 4 online pages. Well worth the time to read it, here's a snippet of the opening:

For nearly a year, Christopher DeLara sped ruthlessly around Baghdad's lawless streets, riding adrenaline and paranoia as he dodged hidden bombs and insurgents.

But 18 months after his return to the U.S., doctors no longer allow the Army administrative specialist- turned-gunner to get behind the wheel. The 33-year-old veteran's readjustment to civilian life is tormented by sudden blackouts, nightmares and severe depression caused by his time in Iraq. Since moving to Albany last June, DeLara accidently smashed the family minivan, attempted suicide, separated from and reunited with his wife and lost his civilian driving job.

'I go from a job where I'm taking care of everything to coming back and being lucky if I know who the hell I am, or don't have a breakdown,' DeLara said from his living room couch, his eyes glazed and droopy from prescription drugs.

DeLara is among more than 38,000 Afghanistan and Iraq veterans fighting war's invisible wound -- post-traumatic stress disorder. The twin post-9/11 conflicts are generating a record number of PTSD cases, and the skyrocketing number of troops seeking care has Veterans Administration hospitals scrambling to provide increased services for the disorder.

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We've Arrived...on Yahoo! Italia

Well this is definitely a first.
My publisher, Ig Publishing, and my upcoming book appear in Italy's Yahoo! Health section. From Fiera del libro: la malattia vista dagli editori per il grande pubblico:

Il futuro nei blog? Se lo stand in Fiera di Castelvecchi è tappezzato dalle copie di Pulsatilla, anche in America c’è chi scopre nei blog un’opportunità di business editoriale. Una piccola casa editrice, Ig publishing, si dedica interamente alla scoperta di blog in Rete, pronti per essere pubblicati. “Devono essere dedicati ad un unico argomento; cerchiamo blog rigorosamente monotematici”, ha spiegato la proprietaria Elizabeth Clementson a Publishers Weekly; quella dei blog è la soluzione ideale per un piccolo editore, prosegue: “Li pubblichiamo in tre mesi dalla raccolta del materiale”, precisa. Ad aprile uscirà Moving a Nation to care, di Ilona Meagher, dedicato ai soldati americani che sviluppano il disturbo post-traumatico da stress di ritorno dalla guerra in Iraq.

Click on 'Article Link' below tags for the hilarious translated version...

Very, er, interesting!

The future in the blog? If the stand in Fair of Castelvecchi is upholstery from the copies of Pulsatilla, also in America there is who discovers in blog opportunities of business publishing. One small publishing house, Ig publishing, dedication entire to the discovery of blog in Net, ready for being is published to you. “They must be dedicates you to an only argument; we try rigorously blog monotemati to us”, has explained the owner Elizabeth Clementson to Publishers Weekly; that one of the blog is the ideal solution for a small publisher, continues: “We publish Them in three months from the collection of the material”, specifies. To you open them will exit Moving to Nation to beloveds, of Ilona Meagher, dedicated to the soldiers Americans who develop the post-traumatic disturbance from stress of return from the war in Iraq.

Eccellente, Italia!

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Saturday, November 11, 2006

Military.com: Moving Video Tribute to Veterans

Click on image

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Veterans Day

As we remember veterans of all wars today, a look at the conditions faced by our current crop is also in order:

About 1.3 million troops have served in Iraq and Afghanistan (GAO)
86,000+ already granted VA disability, 30,000 claims still pending review (GWU National Archives)
38,000+ already receiving VA care for psychological injuries (Stars & Stripes)
20,000+ returned with polytraumatic injuries (Iraq Coalition Casualty Count)
Final percentage of troops expected to have PTSD, unknown (reasonable expectation: 10-35%)

2844 dead in Iraq. Another 350 in Afghanistan.
Keeping their families and battle buddies in mind today, and hoping you spend this weekend safely near those you love the most. Thank you, troops and vets.

Friday, November 10, 2006

Chicago Council on Global Affairs Hosts Author Trish Wood [UPDATED]

What Was Asked of Us:
An Oral History of the Iraq War by the Soldiers Who Fought It
By Trish Wood, Bobby Muller (Introduction)
Reviewed by ePluribus Media

[ order | excerpt | interactive website | video intro/trailor]

Visit my Flicker account to view photos from Wednesday evening's public program featuring author Trish Wood and vets Bobby Muller and Garett Reppenhagen (more details).

Click on 'Article Link' below tags for much more...

“The Iraq War: A True Account by the Soldiers Who Were There”

View entire program online courtesy of C-Span BookTV

Introductory remarks by
Marilyn Diamond
Chicago Council on Global Affairs President's circle board member

Many if not most people in the United States today hold well-entrenched positions on the Iraq War. In the current political climate, it is hard not to be distracted by rhetoric and posturing. The recent leadership change at the Pentagon does little to clarify our ongoing involvement in the region. However, regardless of your position on the conflict, the case remains that we are, in fact, at war. And as citizens we have an important responsibility to educate ourselves as accurately as possible on the situation in the region.

Recent world events such as North Korea’s nuclear tests and Iran’s pursuit of nuclear energy have diluted media coverage of the ongoing and arguably escalating conflict in Iraq. But with over 100,000 American troops currently serving in Operation Iraqi Freedom, it is imperative that we remain acutely concerned about the situation on the ground and the condition with which our soldiers, our families, and our friends face every day.

It is for this reason that we are so deeply grateful to have our panel with us this evening to share their first candid accounts and opinions of the war. Trish Wood has won multiple awards as an investigative reporter. She has been honored by the Canadian Association of Journalism, the Canadian Science Writer’s Association, the Radio-Television News Director’s Association, the National Magazine awards, and New York Film Festival. She has been working with veterans of the Iraq War for more than two years. Her book, What Was Asked of Us, shares personal accounts of soldiers in Iraq. In her documentation of both successes and failures, her collection of interviews movingly describes anger, pain, pride, sadness, confusion, fear and courage. It is the first account allowing soldiers in Iraq to speak at length about their emotions and their experiences.

The book details, as one of the soldiers being interviewed poignantly explains, what happens when people speak to each other with rifles?

Bobby Muller was a Marine infantry officer in the Vietnam War where he suffered a bullet wound that left his paralyzed. He went on to found Vietnam Veterans of America Foundation and is a vocal advocate for the rights of veterans and the rights of civilian victims of war. Recently, he also founded Veterans for America, a group seeking to meet the unique needs of a new generation of veterans.

Garett Reppenhagen served as an Army sniper scout in Baquba, Iraq, in 2004 immediately after finishing a tour in Kosovo. He is the one of the soldiers in What Was Asked of Us. We are fortunate to have such a knowledgeable and experienced group with us tonight to discuss this critical topic.

What Was Asked of Us
By Trish Wood, Bobby Muller (Introduction)
Reviewed by ePluribus Media

"Most people say, O God, it was terrible, this and that. God, I loved it. I loved every firefight I was in because for those few brief seconds nothing else matters." -- Joseph Hatcher, Iraq vet

[ order | excerpt | interactive website | trailor]

Veterans for Peace: Veterans Day Events

From my ePluribus Media colleague, Jim Starowicz, a handy list of Vets Day events taking place tomorrow across the nation:

Over twenty VFP Chapters are either holding their own events or participating in local parades.

Saturday, November 11, you can join the makers of "The Ground Truth," Iraq Veterans, and AOL in an online chat. You can purchase your own copy of The Ground Truth here.

Military Families Speak Out will be traveling to Washington DC to "Stop the Backdoor Draft" between November 9th and 11th. On Saturday, November 11, they will be planting flags at the National Mall for each soldier killed in Iraq.

Cindy Sheehan and Gold Star Families For Peace are saying, "Sit down for Change, Stand UP for Peace" with actions in Washington DC between November 6th and 9th.

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Wednesday, November 29, 2006

Monday, November 27, 2006

Sunday, November 26, 2006

Thursday, November 23, 2006

Wednesday, November 22, 2006

Monday, November 20, 2006

Sunday, November 19, 2006

Saturday, November 18, 2006

Friday, November 17, 2006

Thursday, November 16, 2006

Wednesday, November 15, 2006

Monday, November 13, 2006

Saturday, November 11, 2006

Friday, November 10, 2006

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