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U.S. sent medically unfit soldiers to Iraq, Pentagon acknowledges

WASHINGTON—To meet the demand for troops in Iraq, the military has been deploying some National Guard and Army Reserve soldiers who aren't fit for combat.

More than a dozen members of the Guard and reserves told Knight Ridder they were shipped off to battle with little attention paid to their medical histories.

Those histories included ailments such as asthma, diabetes, recent surgery and hearing loss. Once in Iraq, the soldiers faced severe conditions that aggravated their medical problems, and the medical care available to them was limited.

David Lloyd, a 44-year-old mechanic with the Tennessee National Guard, died of a heart attack in Iraq last August. His wife, Pamela Lloyd, said her husband didn't know he'd had a problem, but his autopsy showed three blockages in his coronary arteries.

"He should have never been deployed," she said. "He was supposed to have been given a thorough physical. He had none. The only thing he had was the shots."

"They funneled us through the medical part: boom, boom, boom," said Michael Scott, an Iowa National Guardsman who had a herniated disc. "They let it be known they weren't real interested in hearing about stuff. `No, you're fine right now.'"

A memo from the European Regional Medical Command in Germany, where many injured soldiers were sent, criticized the pre-deployment medical screening and said soldiers who were unfit for Iraq were having to be sent home. Deploying them was a risk to their health and an added cost for the military, it said.

The memo contained the concerns of Col. Holly Doyne, a physician based there at the time. Doyne has been deployed to Kuwait and couldn't be reached for this article. Another Army medical officer, who didn't want his name used, confirmed that Doyne's memo was distributed to various stateside medical officials and commanders.

Michael Kilpatrick, a top Pentagon health official, acknowledged that some medically unqualified troops have been sent to Iraq but said "the percentages are extremely small." He said the Pentagon was taking steps to improve medical screening.

How many soldiers are unfit is unclear. Each soldier who spoke with Knight Ridder said he or she knew of others who—like themselves—were sent to Iraq despite health problems ranging from allergies requiring refrigerated medications to heart disease.

Several also said many soldiers weren't given physicals but only were asked a few cursory questions about their health by the medical screeners.

Gerry Mosley, a retired first sergeant with a reserve unit from Mississippi, said the practice of sending medically unqualified troops was widespread in the Guard and reserves. "It wasn't about healthy troops," he said in an interview. "It was about the number of troops."

"Soldiers with medical conditions that would be adversely affected by deployment were `rubber-stamped' as fit for duty," Mosley says in testimony prepared for a congressional hearing next week on military health care. "Medical profiles were ignored."

All the soldiers interviewed by Knight Ridder said their units and the medical officers who screened them, either after they were activated or at their mobilization sites, were aware of their medical conditions.

The problem was worrisome enough to trigger concerns last April at the European Regional Medical Command.

Doyne's memo said pre-deployment screening was "clearing individuals for movement to the combat zone without knowledge of the medical system limitation in the combat theater. ... OIF (Operation Iraqi Freedom) is NOT peacekeeping. It is combat. The medical support is austere."

It said the problem was a "KEY medical issue" and went on to say, "Frankly, we are burning out a lot of time and effort on shipping back folks who never should have come in the first place. Also runs a high risk of damaging folks."

The memo added: "Current practice of taking the theory of `if they are on duty they are OK' is not working. Nor is the assumption that if they have been found fit for duty by a medical board in the past they are fit."

Kilpatrick, the Defense Department's deputy director of deployment health support, said the Pentagon was requiring more scrutiny of a soldier's medical background before he or she is shipped overseas.

"We just need to do a better job educating our medical providers—the people doing the pre-deployment screening—of the importance of making this on an individual basis," he said.

Of the 120,000 or so troops in Iraq, about 40 percent, or nearly 50,000, are National Guard and reserves. Kilpatrick said that if even 1 percent were medically unfit, that was 500 soldiers who were likely to become patients at military hospitals.

Nearly every one of the soldiers interviewed had to be medically evacuated out of Iraq because battlefield conditions exacerbated their health problems.

"That's a tremendous medical logistical burden," Kilpatrick said.

Sen. Christopher Bond, a Missouri Republican who co-chairs the Senate's National Guard Caucus, said he "raised unshirted hell" with Army brass when he learned that it had deployed medically unfit troops.

"There's no question that they screwed up badly," said Bond, who co-chairs the caucus with Democratic Sen. Patrick Leahy of Vermont. "This should have never happened."

The disclosure that the military has deployed medically unfit troops adds to a larger pattern of problems plaguing its ability to monitor its soldiers' health.

Knight Ridder reported last March that the military wasn't medically screening troops both before and after deployments, as required by law. Those screenings were supposed to include pre- and post-deployment blood tests.

Congress mandated the tests in 1997 to prevent a recurrence of Gulf War Syndrome, the mysterious malady that's affected some soldiers who fought in the first Persian Gulf War.

In addition, the General Accounting Office, the investigating arm of Congress, has found that the military has been lax in keeping up with its medical reporting. Guard and reserve troops are required to undergo medical examinations every five years, and every two years for those over 40.

The GAO also is looking into the problem of National Guard and reserve troops being kept for long periods in "medical holds" at several bases while their conditions are evaluated.

A high-ranking noncommissioned officer in the Army Reserve, who didn't want his name used for fear of reprisals by his superiors, has been assigned to the medical hold at Fort Knox, Ky., since last summer. He had had surgery on his neck for a bulging disc two months before his unit was activated earlier last year.

His doctors had told him to limit his activities for six months, and not to lift anything heavier than 30 pounds. But the officer said that after looking at his medical records and asking him to raise his arms above his head, the medical screening officer at Fort Snelling, Minn., where his unit reported in January 2003, told him, "You seem to be good to go."

By last March, he was in Iraq carrying 75 pounds of equipment on his back daily. Constantly in pain, he was taking heavy doses of ibuprofen and acetaminophen.

By May, he'd been sent home and began an odyssey through military hospitals, ending with a metal plate in his neck to replace the surgically repaired disc that had fragmented during his deployment.

"It's a nightmare," the officer said. "I believe my neck would have healed up if I had time. The pain was leaving, and now I'm stuck with the pain again."

"They seem to want to think that we are malingerers," said Debra Rockwell, 41, an Illinois reservist with an engineering unit who has arthritis in both hips and had to be sent back to the States. "Most of us would like to stay in the Army and do our jobs. We're not doing this to get out."

Scott, the Iowa National Guardsman, said his herniated disc was the reason for his medical discharge from the military in 1995. He said he never got it corrected, but the Army allowed him to re-enlist in 2001 so he could earn his 20-year retirement benefits. Then his unit was called up for Iraq.

"I told them about my back," said Scott, a 43-year-old truck driver. "I was told to let sleeping dogs lie." He said he didn't have his medical paperwork, and "they didn't seem real interested. I was breathing. I had a pulse. They needed bodies."


(Goldstein reports in Washington for The Kansas City Star.)


(c) 2004, Knight Ridder/Tribune Information Services.