Old Wounds, New Warriors

Published date01 April 2016
Date01 April 2016
Subject MatterArticles
Old Wounds, New
Warriors: The Problem
of Contractor Medical
Care during and after
American Contingency
John Riley
and Michael D. Gambone
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.
Department of Political Science, United States Air Force Academy, CO, USA
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,
Email: gambone@kutztown.edu
Armed Forces & Society
2016, Vol. 42(2) 344-361
ªThe Author(s) 2015
Reprints and permission:
DOI: 10.1177/0095327X15590387
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.’’
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.
By 2005, IEDs were the number one killer of US troops
in Iraq.
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
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
would rapidly scale down to 30,000 by August 2003 and 5,000 by 2006.
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-
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
Often overlooked is the high price these individuals paid for their efforts.
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.
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

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