Old Wounds, New Warriors

• Published date: 01 April 2016
• Author: Michael D. Gambone,John Riley
• DOI: 10.1177/0095327X15590387
• Date: 01 April 2016
• Subject Matter: Articles

Article

Old Wounds, New

Warriors: The Problem

of Contractor Medical

Care during and after

Contemporary

American Contingency

Operations

John Riley

1

and Michael D. Gambone

2

Abstract

American overseas military operations have become dependent upon private con-

tractors. Thousands of these individuals have suffered casualties as a consequence of

employment in high-risk parts of the world. American policy has consistently failed

to meet the medical needs of hundreds of thousands of contractors. The root

source of this problem is the nature of contracting itself. It is a system defined by a

commercial transaction rather than the common bond shared between a citizen and

the state. The current and future of costs of this basic disconnect are significant.

Contractor casualties have risen at exponential rates. More broadly, policy makers

must also confront the state’s obligations to employees who are assuming the risks

of outsourced citizenship, a question that pertains to American contractors

returning home as well as the vast majority of local national workers left to their

own devices once Washington declares its mission complete.

1

Department of Political Science, United States Air Force Academy, CO, USA

2

Department of History, Kutztown University of Pennsylvania, Reading, PA, USA

Corresponding Author:

Michael D. Gambone, Department of History, Kutztown University of Pennsylvania, Reading, PA 19512,

USA.

Email: gambone@kutztown.edu

Armed Forces & Society

2016, Vol. 42(2) 344-361

ªThe Author(s) 2015

Reprints and permission:

sagepub.com/journalsPermissions.nav

DOI: 10.1177/0095327X15590387

afs.sagepub.com

Keywords

private contractors, health care, injuries, reform

‘‘You go to war with the army you have, not the army you might want or wish to

have at a later time.’’

1

This oft-cited quote was former Secretary of Defense Rums-

feld’s response to a question from a soldier from the Idaho National Guard’s 116th

Armor Cavalry Brigade, who was asking why vehicle armor in Iraq was in short sup-

ply. At the time of the exchange, 2004, the improvised explosive devices (IEDs) lit-

tering Iraqi and Afghan roads were turning the lightly armored Humvees and

personnel carriers into death traps. The soldiers’ solution was to weld pieces of

scrap metal to the vehicles—hillbilly armor—and they hoped it would provide a

modicum of protection.

2

By 2005, IEDs were the number one killer of US troops

in Iraq.

3

Troop improvisation allowed the missioninIraqtocontinuealbeitata

very high cost.

In a similar vein, private contractors becamethe improvisedsolutiontoUSdefi-

ciencies in manpower and capabilities in the Iraq War. Dubbed ‘‘Liberate and

Leave,’’

4

US war plans called for a quick overthrow of Saddam Hussein’s regime

with a revolutionary small force of approximately 150,000 US ground forces

5

that

would rapidly scale down to 30,000 by August 2003 and 5,000 by 2006.

6

‘‘Mission

Accomplished,’’ however, dissolved into a Pyrrhic victory as it became clear that

the United States had no meaningful plan for stabilization or nation-building oper-

ations.

7

The failure to provide adequate post-invasion security quick ly led to a

virulent insurgency that threatened to propel Iraq into chaos. Lacking the capacity

to provide even basic services to the Iraqi people, US policy makers improvised

and turned to private contractors in order to fill the gaps. From trucking to con-

structiontoprovidingsecurity, contractors became the linchpin of the stabilization

efforts.

Often overlooked is the high price these individuals paid for their efforts.

8

Between September 1, 2001, and March 31, 2014, the Department of Labor

(DOL) reports that 50,406 contractors employed by the US government fi led

a claim for being injured while working in Iraq.

9

One thousand six hundred and

seven of those injuries resulted in death. DOL reports similar numbers for

Afghanistan (29,922 total claims and 1,510 deaths). As discussed below, these

statistics vastly underrepresent the real damages suffered by contractors. Not

only do they fail to account for the number of injured contractors employed

by other countries (such as those employed directly by Iraq, Afghanistan, or coali-

tion partners), significant barriers to American-employed contractors have also led

to chronic underreporting.

The deaths and wounds suffered by military contractors are an inevitable conse-

quence of their participation in American military operations abroad. Yet, strikingly,

despite a very long historical relationship between the US government and the

Riley and Gambone 345