Catastrophe (36 page)

The Coalition for an Airline Passengers’ Bill of Rights has written a model code that should be passed immediately by Congress and signed by the president. It is a real code—unlike the phony one proposed by the DOT’s task force—and it would give passengers real power to force adequate service.

It requires airlines to:

1. Establish procedures to respond to all passenger complaints within twenty-four hours and with appropriate resolution within two weeks.
   
2. Notify passengers within ten minutes of a delay of known diversions, delays, and cancellations via airport overhead announcement, on aircraft announcement, and posting on airport television monitors.
   
3. Establish procedures for returning passengers to terminal gate when delays occur so that no plane sits on the tarmac for longer than three hours without connecting to a gate.
   
4. Provide for the essential needs of passengers during air-or ground-based delays of longer than three hours, including food, water, sanitary facilities, and access to medical attention.
   
5. Provide for the needs of disabled, elderly and special needs passengers by establishing procedures for assisting with the moving and retrieving of baggage, and the moving of passengers from one area of airport to another at all times by airline personnel.
   
6. Publish and update monthly on the company’s public web site a list of chronically delayed flights, meaning those flights delayed thirty minutes or more, at least forty percent of the time, during a single month.
   
7. The formal implementation of a Passenger Review Committee, made up of non-airline executives and employees but rather passengers and consumers—that would have the formal ability to review and investigate complaints.
   
8. Make lowest fare information, schedules and itineraries, cancellation policies, and frequent flyer program requirements available in an easily accessed location and updated in real time.
   
9. Ensure that baggage is handled without delay or injury; if baggage is lost or misplaced, the airline shall notify customer of baggage status within twelve hours and provide compensation equal to current market value of baggage and its contents.
   
10. Require that these rights apply equally to all airlines code-share partners, including international partners.
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How odd that, in the United States of America, it should be controversial to require an airline to provide food, water, sanitary facilities, and access to medical attention for flights delayed more than three hours! But it is. Legislation to implement these recommendations was killed in the Congress last year.

The coalition, headed by Kate Hanni, is battling hard for your rights and deserves your support. Join or send a donation to them at www.flyersrights.org.

Here is a list of the members of the oversight committees in the House and the Senate. Don’t wait until you’re stranded to write them to demand passage of the passenger’s bill of rights! (If you do wait, bring stationery on your next flight so you can write them nasty letters while you’re sweltering on the ground. The airline won’t provide it!)

Post-Traumatic Stress Disorder in Our Military

In January 2009, more American soldiers killed themselves than were slain by enemy combatants.
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The stresses and traumas of war, unabated even by today’s high-tech military environment, are taking a larger toll among our military than all the roadside bombs, ambushes, and suicide bombers combined. This quiet catastrophe has the military scrambling for answers. One senior Army official, speaking anonymously, called the phenomenon “terrifying. We don’t know what is going on,” he added.
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Twenty-four soldiers committed suicide in January 2009. That is six times the total of the previous January.
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Colonel Kathy Platoni, the chief clinical psychologist for the Army Reserve and National Guard, cited multiple deployments, the stigma associated with seeking treatment, and, ironically, the excessive use of antidepressant medication as possible reasons for the problem. (Antidepressants have been found to increase suicide rates, particularly among people aged eighteen to twenty-four.)
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The past year has seen a troubling growth in the suicide rate among our men and women in uniform. CNN reported that the military suicide
total for 2008 was “the highest annual level of suicides among soldiers since the Pentagon began tracking the rate 28 years ago.”
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One hundred and twenty-eight soldiers are confirmed to have committed suicide in 2008; another fifteen died from suspected suicides.
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Marine suicides also rose from twenty-five in 2006 to thirty-three in 2007 to forty-one in 2008.
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One underlying factor contributing to the rise in depression and suicide among our fighting forces is that the entire military and veterans’ establishment is geared to treating physical wounds—not wounds of the mind, which are less easily detected but equally dangerous.

Let’s not forget that the second most significant casualty of the war in Vietnam—after the 58,000 Americans who died there—was the massive social disruption it caused in the lives of an entire generation of returning veterans.

Hundreds and hundreds of thousands—perhaps millions—of minds were shattered by the experience of fighting in Southeast Asia. An entire generation was scarred by drug abuse, alcoholism, spousal abuse, unemployment, suicide, and hopelessness because of the hell to which they were exposed during their tours of duty.

Today we face a similar problem with the 1.6 million soldiers who have fought in Iraq and Afghanistan. In the coming months they will be returning home in increasing numbers, and we must not let them down as we did those who fought for us in Vietnam. We must help them to come to grips with their experiences—to learn how to survive them, lest they be crippled by nightmares, flashbacks, delusions, depression, or worse.

Unfortunately, there is scant evidence that the VA is making the necessary adjustments to deal with this impending crisis—despite the massive increase in its funding that President Obama has proposed. Much more needs to be done to alert Congress and the administration to the horrific issues faced by returning veterans.

Though Obama and the VA seem eager to assure these vets that they will receive free health care, good homes, and, if possible, jobs, they don’t appear to be giving equal emphasis to the need to help restore healthy minds.

The disaster is the post-traumatic stress disorder (PTSD) from which these returning veterans will suffer. The catastrophe is how slowly our government is coming to grips with how to treat it.

Though the military has made progress in training leaders on how to deal with depression and PTSD, Colonel Platoni says, “there is still a huge problem with leadership who shame them when they seek treatment.”
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The macho culture of “suck it up, kid” is still very much with us.

The prevalence of PTSD has become more and more apparent as the wars in Iraq and Afghanistan have dragged on. Everyone in the military was shocked when a Pentagon study estimated that 10 percent of the returning soldiers met the military’s criteria for PTSD.
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Out of 222,620 soldiers returning from Iraq and Afghanistan that it evaluated in its recent study, the Pentagon found that 21,620 had the condition.
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Of those diagnosed with PTSD or depression, 80 percent reported having seen combat, fired their weapon, and watched people being killed or wounded. Of those who tested negative, only half had had these searing experiences.
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The New England Journal of Medicine
puts the rates even higher. In its study of four combat units (three Army and one Marine) returning from Iraq or Afghanistan, the
Journal
found that 17 percent of the Iraq veterans and 11 percent of those coming home from Afghanistan suffered from PTSD.
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But the most recent study—by the RAND Corporation, a nonprofit research organization, in April 2008—shows that, with repeated deployments, the problem is escalating sharply. RAND says that 20 percent of the veterans of both the Iraq and the Afghan wars—300,000 men and women in total—will suffer from PTSD or serious depression by the end of their tours of duty there.
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The study also found that 19 percent report that they experienced a possible traumatic brain injury while deployed.
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And 7 percent have both PTSD and possible traumatic brain injury.
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RAND estimates that it will cost $6.2 billion to treat the PTSD, depression, and traumatic brain injuries of the returning soldiers.
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“There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan,” said Terri Tanielian, the project’s coleader and a researcher at RAND. “Unless they receive appropriate and effective care for these mental health conditions, there will be long-term consequences for them and for the nation. Unfortunately, we found there are many barriers preventing them from getting the high-quality treatment they need.”
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PTSD was first officially diagnosed in 1980 at the request of Vietnam veterans organizations. Once known as “shell shock” or combat fatigue,
post-traumatic stress disorder can develop after witnessing or experiencing a traumatic event.

USA Today
notes that PTSD “produces a wide range of symptoms in men and women who have experienced a traumatic event that provoked intense fear, helplessness or horror.” The paper notes that soldiers “re-experience traumatic events through flashbacks, hallucinations, or nightmares. Often these are triggered by exposure to anything that reminds them of the trauma. Among the symptoms are “troubled sleep, irritability, anger, poor concentration, hypervigilance, and exaggerated responses.”
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Those who suffer from PTSD may “feel depression, detachment or estrangement, guilt, intense anxiety and panic, and other negative emotions. They often feel they have little in common with civilian peers; issues that concern friends and family seem trivial after combat.”
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During nightmares, they may even strike their spouses or partners but remember nothing about it after waking up.

Perhaps the most serious part of the Pentagon’s recent study of Iraq and Afghanistan veterans was its finding that fewer than 40 percent of those afflicted by PTSD have sought help.

“You can’t just say that I’ve got a hundred programs, therefore, I’ve done my job,” said Steve Robinson, the executive director of the National Gulf War Resource Center. “This study indicates that the sickest veterans who need the most help won’t go.”
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The study documents the horrors to which Iraq soldiers are exposed. Ninety percent reported being shot at; half reported having handled a dead body.
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The New England Journal of Medicine
study found that 95 percent of Marines and Army soldiers in Iraq had been shot at. Fifty-six percent had killed an enemy combatant. And 94 percent had seen bodies and human remains.
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This is the stuff of nightmares and flashbacks.

“There are no clear enemy lines, non-stop pace, the war surrounds the soldier 360 degrees. The enemy can be man, woman or child. This is an extremely stressful situation,” said Steve Robinson.
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According to Fox News, “Robinson said men and women who in the past would have died in the field have survived thanks to advanced body armor, but in many cases the soldiers are living with severe, life-altering injuries or are watching their friends grapple with them. In other cases, many of the less injured are National Guard and Reservists who are being sent back to the theater two and three times.”
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The New England Journal of Medicine
study suggested that about a quarter of returned soldiers were drinking excessively. One researcher said, “I know from walking and talking to people that more like 75 percent are indulging in excessive alcohol to self-medicate, to escape.”
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Fox News spoke with Barbara Critchfield, a counselor at Shoemaker High School near Fort Hood in Texas, where nearly 80 percent of students
had parents deployed overseas. Now that their parents have started returning from the front, they say, their behavior is causing concern among the students.

“Some talk about fathers, who all they want to do is drink and sleep—we know there is PTSD,” she said. “I don’t know how far-reaching it is, they might be isolated incidents, I don’t know.”
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But many of those suffering do not go for treatment.

As CNN reports, on his second day in Iraq, Staff Sergeant Georg-Andreas Pogany saw an Iraqi body that had suffered severe trauma, and he suffered what he considered a nervous breakdown. “I wasn’t functioning. I was having physical symptoms. I was having a behavioral reaction,” he recalled.
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“After struggling through the night, he said he decided to tell his superior officer out of fear that if we do go out on a patrol and I do freeze up, that could have consequences too.” Instead of receiving the help his condition required, however, he was cautioned
not
to seek treatment. “He was told to reconsider for the sake of his career, he said.”
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“The message was: ‘Hey, you’re a coward. You’re acting like a coward.’”
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The New England Journal of Medicine
study confirmed other evidence that those who need help most are the least likely to seek treatment. “Of those whose responses were positive for a mental disorder, only 23 to 40 percent sought mental health care. Those whose responses were positive for a mental disorder were twice as likely as those whose responses were negative to report concern about possible stigmatization and other barriers to seeking mental health care.”
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