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>Post-Traumatic Stress Disorder in the Foreign Service

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Whenever someone mentions “post-traumatic stress disorder,” or PTSD, most people probably think of combat veterans returning from war zones. You might think of soldiers during and after the Vietnam War, and you might even think of some of the popular Hollywood movies that have highlighted the phenomenon, such as “Born on the Fourth of July” or “The Deer Hunter.”

However, we tend to neglect PTSD’s effects on Foreign Service members who are placed in dangerous countries where violence is common. Such positions are termed “unaccompanied danger posts,” locations where family is not permitted to live with the Foreign Service member stationed there.

In Iraq there are provincial reconstruction teams, or PRTs, consisting of contractors who work in a particular province to meet and coordinate with Iraqis. To do this, PRT members require a heavily armed presence with them at all times. Kirk Johnson (whose interview with EPIC you can read here), a former USAID employee in Baghdad and a PRT member in Fallujah for four months, describes the heightened security risk involved with traveling outside a PRT enclave.

Foreign Service members often return from Iraq demonstrating a number of PTSD-related symptoms, including insomnia for up to several months, the most common symptom, an “easy to startle” response for several months and irritability and anger outbursts.

Sources vary regarding the prevalence of PTSD among Foreign Service Officers and the military. Some suggest that PTSD affects 40% or more Foreign Service and military members. The treatment available for returning Foreign Service members is voluntary and inadequate, prompting the Concerned Foreign Service Officers to issue a warning to members of the Foreign Service.

On June 19th, in the face of PTSD in foreign service members, the House Foreign Affairs Subcommittee on the Middle East and South Asia urged the State Department to make debriefings mandatory for civilian employees returning from Iraq and Afghanistan. A July 5 New York Times top story also cited the lack of health care availability for contractors working in Iraq. Tending to their health is the first step in the process of addressing PTSD in non-military persons and we encourage this move by the subcommittee. That said, we still require more data on the extent of PTSD in the Foreign Service and we must provide these individuals with the mental health care they require.

I recognize that you can’t talk about the effects of the Iraq war without at least mentioning the enormous psychological toll the conflict has on Iraq’s men, women and children, an issue we have written on in the past. It is an issue that will take an enormous amount of effort to address and one that cannot be ignored or forgotten in this conflict.

>EPIC IN ACTION: Taking the Fight for Refugees to Congress

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Well over 2,000 letters. A week of processing, formatting, and preparing. Two exciting days of hand-delivering to House and Senate offices. Now, at last, we at EPIC would like to thank YOU for taking action on behalf of Iraqis displaced by violence.

Armed with your constituent letters, EPIC staff and volunteers stormed about 300 House and 94 Senate offices. We met with relevant Foreign Affairs staff members in nearly every office, explaining to them about the 2 million Iraqi refugees overwhelming infrastructure in Jordan and Syria, and additional 2 million Iraqis displaced internally.

Our primary objective was to secure support and cosponsorships for recent legislation that would help Iraqi refugees and Internally Displaced Persons (IDPs). The

I personally visited about a quarter of the offices in the House and half in the Senate, and I can tell you without hesitation that our message is having an impact. From my experience, staffers with Senators Jon Kyl (AZ), Robert Menendez (NJ), Herbert Kohl (WI), and Debbie Stabenow (MI) were particularly receptive, as were House staffers for Representatives Sheila Jackson-Lee (TX), Vito Fossella (NY), Cathy McMorris Rodgers (WA), and Mike Doyle (D-PA). My fellow volunteers reported similar success in a number of other offices, and overall we are extremely encouraged and excited about the prospects for both bills.

In fact, we’ve had such a terrific response that we’ve decided to keep the Action Center open indefinitely. That means in case you missed out last week, you can still send letters on behalf of Iraqi refugees to your Members of Congress through EPIC. Particularly, we want to encourage EPIC supporters from South Dakota, Mississippi and Nebraska to act, because those are the three states whose Senators we didn’t get to visit this week. But no matter what state you’re from, please take action – and if you already have, keep passing the link along to your friends!

We will continue to periodically hand-deliver your letters to Congress for you (a service for which the popular advocacy business Capitol Advantage charges $8.50 per letter, but we provide to our members for free*), and keep you updated on the results.

THANK YOU for helping to make this action a great success!!!

*your generous donations make our work possible.

>Don’t Forget About the Children

>Yesterday in The Washington Post, a story on the psychological impact on children in the war offered some startling evidence. With over two million child refugees, the intensity of their experiences and trauma is far-reaching.

It’s all too easy to forget about the children in this war when talking about stress disorders, internally and externally displaced persons, and other devastating consequences lost in this consistent sea of violence. It’s all too easy to to forget that, while incredibly harrowing for the average citizen in Iraq, it’s ten times worse for a child. Lacking in many of the psychological coping mechanisms possessed by their elders, and gained only through years and life experience, many children simply do not know how to react to the violent images they see day in and day out.

“In a World Health Organization survey of 600 children ages 3 to 10 in Baghdad last year, 47 percent said they had been exposed to a major traumatic event over the past two years.” Abdul Muhsin, a psychiatrist in Baghdad, is concerned that over this time, the number of cases of psychological problems exhibited in children has, and will continue to increase exponentially. He is taken aback, rightly so, when he sees children playing with toy guns and emulating rocket propelled grenade attacks on cars passing by – he is worried that this generation will be more violent than that of Saddam Hussein’s.

Given the increased consistency of violence in Iraq, it seems as though children are both consumed by fear, and are finding solace from that fear in replicating the life they see on the streets – markedly disastrous alternative outlets for their psychological ailments. Due to the “stigma attached to such ailments,” children are simply not being treated – “As many as 80 percent.” Meanwhile, for the lucky children who still have their parents to look after them, their mother and father simply call in for advice, hardly the most effective method of treatment.

Many childhoods will be summed up with gunfire, fear, and damaging psychological trauma. This is a situation that needs to be addressed immediately. Children are extremely vulnerable in this conflict and these events are being ingrained in their memory as we speak. To have hope in the situation is to have hope in the future generations that rebuilding the country will fall on. Right now those future generations are being done incalculable damage. For the future of Iraq, and for the well being of countless children, we need a solution now.

UNICEF is calling for 20 million in aid to help accomplish their goals in Iraq. Only 11 percent has been received to date. This is unacceptable; the U.S. should be taking a much greater role in helping to alleviate one of the worst refugee crises in history.

YOU can still take action on behalf of Iraq’s refugees. We continue to hand-deliver your letters to Members of Congress, and are keeping our action center open until the U.S. government passes serious, comprehensive legislation to assist not only children, but all those displaced by violence in Iraq.

>LAST CHANCE

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It’s not too late — we still need your help to alleviate the worst humanitarian crisis in the Middle East in 60 years. Tell your Members of Congress to support legislation protecting and assisting millions of displaced Iraqis. To increase the impact, we’re going to hand-deliver every single letter to Congress tomorrow, June 22nd. That means today is your last day to take action!

Remember: 2 million Iraqi refugees have fled to Jordan, Syria, and neighboring states, and approximately 2 million Iraqis have been internally displaced within Iraq itself. That’s 4 million Iraqis who have been forced out of their homes as a result of the U.S. invasion and ongoing sectarian violence.

These people have suffered enough. Do something about it now.

Besides being a humanitarian tragedy, the displacement of Iraqis is having a destabilizing effect on the region. Host countries just can’t handle the floods of refugees, and internally displaced persons may be recruited by al Qaeda and other terrorist cells looking to exploit their anger and frustration.

Your letters make a huge difference in pressing our policymakers to step forward and protect Iraqi refugees and internally displaced persons. We have 1,500 collected so far, but we need far more. So please, take two minutes to personalize our pre-written letter to Congress, and maybe pass the link along to a few friends.

It’s the least we can do.

>Taking Action on World Refugee Day

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In nearly every way, the U.S. has fallen short in helping Iraqis displaced by violence.

We failed to provide sufficient resources for refugee host countries overwhelmed by the crisis. We failed to resettle significant numbers of refugees in our own country, admitting only two in as many months. And we even failed to provide for many who have risked their lives to help our forces and organizations in Iraq.

Earlier this year, the U.S. announced an agreement with UNHCR to resettle 7,000 Iraqi refugees. UNHCR made plans to identify and recommend these refugees to the U.S. by July, while the U.S. pledged $18 million toward the resettlement of these individuals. Six months have passed. What’s the status of this agreement? UNHCR, under-funded and stretched for staff, has managed to identify its 7,000 refugees ahead of schedule. Unfortunately, the U.S. has not yet funded the $18 million it promised.

As a result, nearly 4 million Iraqi refugees and internally displaced persons (IDPs) face an uncertain future. Act now to support crucial legislation that restores their hope and ends the U.S. pattern of failure.

In addition to the UN-U.S. agreement, the U.S. House of Representatives is considering the “Responsibility to Iraqi Refugees Act of 2007″ (H.R. 2265). Introduced by Representatives Earl Blumenauer (D-OR) and Christopher Shays (R-CT), this bill would allow more Iraqis safe and legal passage into the U.S. and establish a Special Coordinator for Iraqi Refugees and Internally Displaced Persons to respond to the crisis. It would also establish special provisions to help protect Iraq’s most vulnerable refugees, including women-headed families and those who are in extreme danger of persecution for being affiliated with the U.S. in Iraq.

Yesterday, Senators Ted Kennedy (D-MA) and Gordon Smith (R-OR) introduced the “Refugee Crisis in Iraq Act.” Although the bill does not go as far as H.R.2265, it is the most comprehensive legislation in the Senate for meeting the rapidly growing needs of Iraqis displaced by violence.

If you believe in what we are doing and want to create positive change yourselves, please Write to your Members of Congress urging them to support these bills. EPIC will hand-deliver your letters in honor of World Refugee Day. Together, we can help hundreds of thousands of vulnerable Iraqis and turn U.S. failures into successes.

>Meet Kirk Johnson

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As we honor World Refugee Day, the EPIC Ground Truth Project is excited to share part 1 of our in-depth interview with a rising champion for the human rights and needs of Iraq’s most vulnerable refugees.

From January to December 2005, Kirk Johnson worked tirelessly with the U.S. Agency for International Development (USAID) to help rebuild war-torn Iraq — first as an information officer at USAID/Iraq’s Baghdad headquarters, and later as USAID’s first regional coordinator for reconstruction in Fallujah. When a near-fatal accident during a vacation prevented him from returning to Iraq, he began to write about his experience and soon became a passionate advocate for America’s responsibility to protect Iraq’s most vulnerable refugees, including former colleagues and others at risk for their affiliation with U.S. government agencies.

In Part 1 of our interview, we talk with Kirk about his time with USAID, what he learned along the way, and his recommendations for going forward. Later this week, we will release Part 2, examining Kirk’s current efforts to protect and resettle Iraqis who are at extreme risk for being affiliated with U.S. efforts in Iraq.

Kirk Johnson’s story exemplifies the difference one person can make in the lives of the Iraqi people. For World Refugee Day, rally with EPIC, Kirk and hundreds of EPIC supporters by sending a letter to your Members of Congress, urging them to do more to assist and protect Iraqi refugees. With nearly 1,000 already delivered, we are well on our way to reaching our goal of 3,000 constituent letters.

It’s not too late to send your personalized letters to Congress. Take action to protect Iraqi refugees right now.

>National Call-In Day for Refugees

>Thanks to the thousand of you who have taken action through EPIC to contact your members of Congress to urge them to support and protect displaced Iraqis. For the rest,

Meanwhile, today our friends at Refugees International are calling on President Bush to play a leading role in addressing the Iraqi refugee crisis by increasing the amount of U.S. assistance for Iraqi refugees to $290 million. This is less than one quarter of one percent (0.25%) of the amount spent on the military aspects of the war.

Iraq is now the fastest growing refugee crisis worldwide, with more than four million Iraqis having been forced from their homes and thousands more following every day. This escalating emergency threatens recovery in Iraq and the stability of the entire region. The United States must act aggressively to improve regional and international security by making sure the necessary funds are provided to U.S. and UN agencies to protect the health and safety of Iraqi refugees.

With a single phone call, join thousands of Americans and make your voice heard. Help us convince President Bush that World Refugee Day is the perfect opportunity to announce his support for assisting Iraqi refugees.

Check out Refugees International’s action center, where they have provided the White House comment line phone number, a simple script for what to say, and all the additional background info you need.

Picking up the phone may seem like a big effort but this is not going to take more than a minute of your time – you dial the number, leave a brief message, and that’s it. It couldn’t be easier. So don’t wait. Take action now.

>Film Review: My Country, In Fragments

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In our country, it’s easy to get an inside view on the lives of others, their interactions, and the motivations behind their choices. Biographies, interviews, and even personally interacting with our fellow Americans gives us a pretty good understanding of who we are as individuals and a country.

To gain that kind of insight into other cultures, however, is more difficult. Our most basic line of information is the news, and in the case of Iraq, what the news depicts and what life is really like over there

Iraq in Fragments takes a different angle. Broken up into three parts – each showing Iraq’s respective sects – the film has a broader narrative. From chronicling a young Sunni boy’s decision of whether to stay in school or continue working with an abusive friend of his Grandmother, to the extent of Moqtada al-Sadr’s influence on his Shia followers, the film touches on a variety of dispositions in Iraq. The third and final part of the documentary depicts life in a Kurdish brick maker’s home. While an odd way to end the piece, it leaves you with a sense of hope - as if the more peaceful Kurdish North could somehow provide a blueprint for the rest of the country.

Starting off in such an eccentric fashion, and ending in much the same way – leaving only the middle to offer footage familiar to our understanding – Iraq in Fragments leaves you yearning for just a little more. But that’s the brilliance of it; before you’re able to discern exactly why they chose to concentrate on these particular stories and not explore more traditional avenues, it’s over. It leaves you wanting an insiders’ view on more Iraqis’ lives. As with My Country My Country, we are offered a unique perspective on regular citizens instead of suicide bombings and tragedy.

Through both films, I came to understand how Iraqi citizens make it through the day. I understand why they are hopeful. And ultimately, that’s the key: an understanding. Until we understand the situation, we cannot solve it.

These two documentaries let us in on Iraq’s best kept secret: its people.

>Father’s Day and That Place Called Vietnam

>Yesterday viet vet said… “Does anyone remember a place called Viet Nam?” While I have never been to a place called Vietnam, I feel close to it.

My dad served two tours in Vietnam (1967 and 1970). He retired a Major in the U.S. Marine Corps. Although my brothers and I continued the family tradition of military service, it was not until recently that my dad and I began sharing

A place called Vietnam was also a topic of conversation this morning on NPR. Morning Edition’s Renee Montagne interviewed Sen. Jim Webb (D-VA) about his family’s military tradition and about serving, even in conflicts they don’t support. Webb, a Vietnam veteran, was elected last November as a leading critic of the U.S. war in Iraq. His son, Marine Lance Cpl. Jimmy Webb, just returned from a 9-month tour with the 1st Battalion, 6th Marine Regiment, in Anbar, Iraq. Here’s an excerpt:

Webb: …whatever the politics of a war are, for people who believe in their country, and who are willing to step forward and take those risks because they believe in their country. It sounds intellectually odd, but emotionally it’s correct.

Montagne: How do you reconcile that as a person in uniform and actually fighting?

Webb: You know, I got that same question from a young Marine a few years ago when I visited Quantico. His question to me was, “I don’t believe in this what we’re doing. I don’t think it’s the right way to go. What do I do when one of my Marines asks me that question?” And I said I’ll give you the same answer that I used to give myself during Vietnam. And that is that the war isn’t going to go away whether or not you or I like it — we’re talking as young second lieutenants, not as senators here — and, given that, my instincts, my responsibilities are to do the job and to get as many people back as I can. And that’s really the duty of a young military leader.

The Richmond Times-Dispatch reports the Senator is proud of his son’s service and that of his son’s unit. “What they did has kind of become the hallmark for how to operate out of Anbar province,” said Webb.

I expect Senator Webb and his son will have a very interesting conversation over the weekend, and I anticipate they will both learn a lot from each other as my dad and I continue to learn from each other as we share what we know about America’s experience in Iraq and a place called Vietnam. Thanks viet vet for your national service and for lobbing a damn good question into the fray.

>”Emotions Don’t Solve Problems”

>Clearly a chord was struck yesterday. A chord that resonated for 51 comments: A record on our blog. What I was so amazed with was the passion and enthusiasm exhibited by the postings. What was also interesting was how split down the middle posters were. When one comment would go up arguing one side, it would be followed almost immediately by the opposing view.

One of the more prominent comments that was made I feel needs a little more discussion. “I think the message from one side of this debate was the fact that it is human nature to become emotional, but what next? Emotions don’t solve problems, even though they may spark interest and hope for change. I think we look toward EPIC and the rest of the NGO community to relay these stories in a way that is not bias and overwrought – Anonymous.”

That is both a valid concern and an unfair implication. Ignoring for a minute the rest of the NGO community, I don’t think it’s reasonable to imply that EPIC only deals with emotions when discussing these issues, neglecting solution-based ideas. Our mission here at EPIC is to bring you the stories and interviews that you won’t find anywhere else, and yes, they are often emotional. But the reason you won’t find them anywhere else is because we go straight to the source. We feel the most important voices are those of Iraqis and those who work in the country. They know what’s going on because they live it. They are the solution.

We are extremely happy that this blog has received so much attention and encouraged so much action (over 600 letters and counting!), but I want to make it clear that we are not an emotion-focused institution, we are a solutions-focused one. I hope there is as much debate on the next series of posts because while debates are inherently guided by emotion, when an exchange of ideas ensues, real solutions emerge.