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Many Americans may not realize that veterans continue to fight after they return home. The enemy? A number of disabling physical and mental health issues, many of which are caused by adversaries camouflaged with invisibility. A way we can honor our veterans this Fourth of July is to bring awareness to these muted battles they continue to fight, long after the war is over.

According to Dr. Stephen Hunt, national director of the U.S. Department of Veterans Affairs Post Deployment Integrative Care Initiative, "Folks returning from combat have a constellation of health concerns, including physical issues, psychological issues and psychosocial issues concerning things like work and family.” Conditions include:

  • Musculoskeletal injuries and pain
  • Mesothelioma
  • PTSD and depression
  • Heart damage
  • Bacterial infections and other infectious diseases
  • Hearing loss and impairment

A number of these illnesses have traceable roots back to invisible, wartime carcinogens that have been a threat since the birth of chemical warfare in World War I. Others are caused by the intrinsically traumatic and distressing experience of combat, while some symptoms, such as fatigue, pain and cognitive issues such as memory loss and difficulty concentrating, remain elusive still.

Mental Illness

One of the most common afflictions of returning veterans is that of PTSD, a mental illness caused (for veterans specifically) by a variety of intangible factors including witnessing horrible and life-threatening situations, the politics and actions of war, and war location. Symptoms include severe anxiety, flashbacks, and uncontrollable thoughts and nightmares, all which can worsen over time.

It’s estimated that at least 20% of Iraq and Afghanistan veterans, 12% of Gulf War veterans, and an estimated 30% of Vietnam War veterans have or have had PTSD, though many experts agree that the actual numbers, considering unreported and undiagnosed cases, is likely much higher.

In addition to PTSD, there are reports of other mental health issues such as depression and substance abuse.

Furthermore, a recent study published in the Journal of Internal Medicine suggests a startling correlation between mentally ill veterans and additional medical illnesses. The Walter Reed Army Medical Center in Washington, D.C., reported that 54% of veterans with PTSD also had sleep apnea, compared to only 20% of non-military PTSD patients. There is also a high correlation between veterans with PTSD and the development of dementia.

Exposure to Toxins

Throughout the history of war, soldiers and other military personnel have been made vulnerable to a host of toxic chemicals, agents and materials used as weapons, in artillery and in other equipment. Hunt states, “Environmental agents and toxic chemicals are very common in combat theaters, and we need to watch [these vets] closely.”

In WWI, chemicals including tear and mustard gas, along with lethal agents like phosgene and chlorine, were employed in the trenches. Exposure to these toxins can lead to diseases such as skin cancer, leukemia, immunosuppression, and more.

In World War II, nearly every ship used by the Navy was built using several tons of asbestos in the insulation, pipes, walls, and doors. Countless military base structures and transport vehicles were also made with the carcinogenic substance up through the Vietnam War. As a result, mesothelioma is one of the most serious and fatal diseases faced by veterans today, with many still at risk due to its twenty to fifty-year latency period.

Vietnam’s claim to infamy is the use of Agent Orange, a phenoxy herbicide used to clear native vegetation from United States bases in areas throughout Vietnam. Exposure caused cancer and birth defects in the children of veterans.

The Gulf War brought about its own disease known as Gulf War Syndrome — a chronic multisymptom disorder caused by exposure to nerve agents like sarin, uranium munitions, pesticides, vaccines, and smoke from burning oil wells. Symptoms and conditions that result include heart damage, skin rashes, arthritis, gastrointestinal issues, respiratory disorders, and neurological problems.

Current Threats

In addition to the persistent mental health issues that affect veterans past and present, another example of an unnecessary and relatively covert threat are burn pits on military bases, which set fire to toxic materials including batteries, munitions, and asbestos. One survey of 2,000 service members conducted by the Iraq and Afghanistan Veterans of America showed that three-quarters have been exposed to the smoke from the pits, and over half noted feeling symptomatic as a result of the exposure, citing cases of respiratory issues and leukemia.

This Fourth of July, let’s commemorate both the fallen and those who remain struggling among us by spreading awareness of the silent enemies not covered by the media. As Hunt states, “This is a population that has unique health care needs that need to be addressed [...] by a team. We can't do it without [...] the knowledge and presence of the community."

The more light we are able to shed on the mindless use of harmful substances and the physical, psychological, disabling effects of the mental ramifications of war, the better we will be able to protect and serve those who have protected and served us.