Troops who have served in America's 'war on terror' suffer at historic levels from psychological wounds and brain injuries. Taimur Khan reports from New York
Back from Iraq, US veterans fight the effects of war
NEW YORK // Nicole Goodwin was a private in the US army when she gave birth to her daughter Shylah on March 16, 2003. Four months later she was in Baghdad, fighting a war.
Most of her tour was spent on base, serving guard duty and helping distribute supplies, but she still saw an Iraqi man shot to death, nearly died in an insurgent mortar attack and witnessed a friend temporarily lose her mind in the aftermath of the massive bombing that decimated UN headquarters. She also says she was raped by a fellow soldier, a common experience among the growing proportion of women in the US military.
But the battles did not stop when she left. "There's a part of me that is always going to be in Iraq," she said.
Of the 2.5 million troops who have served in America's "war on terror" in Iraq and Afghanistan, 1.6m have transitioned to a civilian life plagued by high rates of homelessness and unemployment. Advances in armour and medical technology have allowed an unprecedented proportion of troops to survive their injuries, but they suffer at historic levels from psychological wounds and brain injuries.
"These consequences will be one of the lasting costs of the Iraq war," said Manan Trivedi, who was a medic with one of the first units into Iraq during the invasion, and who conducted an early study for the Department of Veterans Affairs (VA) on the prevalence of post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) among post-9/11 veterans.
Of the 270,000 Iraq and Afghanistan veterans who have been examined by the VA for potential PTSD, about 150,000 have been diagnosed with the condition and given benefits. The VA also says 22 veterans commit suicide every day, on average.
When she returned to New York in 2004, Ms Goodwin, a single mother with little support or guidance from the army, was soon homeless, her life beginning to fray. "I fought one war just to come back to another."
The city streets and buildings were festooned with American flags and yellow ribbons in support of the troops, but it was not loud nationalism she was looking for to help ease her return to civilian life.
"I really saw the dark side of the human race there, but I couldn't afford to break down, so I put up an invisible shield," Ms Goodwin said. "If you really accepted the devastation of Iraq it would crush you. You can't do that while you're at war."
But at home, she found that the wartime emotions felt permanent ("you never connect the same as before"), leaving her angry at the people around her for whom the war was an abstraction rendered in news headlines.
"A lot of veterans are looking for validation that these things happened, that they went to Iraq, to Afghanistan. But the place they live in now is so strikingly different and most people just don't understand what it was like to be in war," she said.
But day-to-day survival left her with little time to address the roots of her malaise.
Ms Goodwin and her daughter first moved in with her mother, but an already tense relationship became dysfunctional and they soon left, staying with friends as long as they could. After a while, she said, "I didn't know where my next meal was going to be."
She applied for transitional housing benefits from the VA, but they did not allow children in the facilities and so they were sent to the city's emergency shelter system. Night after night, Ms Goodwin and Shylah crisscrossed New York, getting food and some sleep at whatever shelter had an empty cot.
In 2011, 141,000 veterans spent at least one night in a homeless shelter, according to government data. Of these, around 10 per cent were women, up from 7.5 per cent in 2009.
Ms Goodwin eventually got a job and an apartment, but soon the repressed experiences began to haunt her. "I had major depression and PTSD because of the Military Sexual Trauma", or MST, as it has become known.
The festering mental wounds, she said, led to a series of neuroses including hoarding rubbish and agoraphobia. Child services finally deemed her an unfit mother, and she lost custody of Shylah.
"I lost my job, I lost my daughter, I lost everything," she said. "I nearly lost my life."
A quarter of all women in the military will suffer sexual assault during their service, according to the defence department. MST is also more highly correlated with PTSD than combat trauma, according to Kayla Williams, an Iraq war veteran who is now a fellow at the Truman National Security Project, a Washington-based think tank.
"There is something about MST that is particularly difficult to recover from," said Ms Williams, who wrote a book about her experiences in Iraq, Love My Rifle More Than You. "The military is struggling to cope with the problem."
Treating mental health crises is crucial to addressing homelessness and persistently high unemployment among veterans. "All of these things are so interrelated," said Ms Williams.
Ryan Charles, 24, served with an infantry division in Iraq for two years, sweeping roads for improvised explosive devices. "We were those people who were first up for any and everything," said Mr Charles.
When he was honourably discharged last year he returned home to Brooklyn but could not find work. He says the army did little to prepare him for a career in the civilian world, failing to provide basic help with job applications or to advise him on which military skills would be transferable.
Unable to find a steady job, he was soon homeless, living out of his car, unsure how to obtain the veterans' benefits that might have helped steady his transition.
He also began to experience the early symptoms of PTSD. He could not sleep, and when he did there were nightmares. His short-term memory was short circuiting. Instead of seeking help at the VA, he began to drink alcohol and smoke marijuana to cope.
Many veterans say they do not seek help when they begin having trouble with PTSD because there is stigma around it as a sign of weakness. "PTSD is common with a lot of my buddies, but for us infantry guys it was looked down on," Mr Charles said.
He finally sought help at the VA but, he said, "their best answer was to give me some drugs, some money, and tell me to deal with it". With the underlying causes still unaddressed, he says he will not go back.
He sought help finding work from Black Veterans for Social Justice, a non-profit organisation in Brooklyn that runs on grants from the federal department of labour. Case workers there helped him access the GI Bill, which pays veterans' tuitions and provides housing subsidies, and Mr Charles is now studying design in college.
Organisations such as BVSJ are often a lifeline for struggling veterans, but the federal budgets that sustain them face drastic shortfalls after the automatic across-the-board cuts that resulted from Congress's inability to agree on a budget deal.
Helping veterans find employment "should be bipartisan no-brainers", said Mr Trivedi, who also ran for Congress last year. "But still they use veterans as pawns in their budget battles and that's disgraceful."
For all of the immense challenges that veterans face, many say they do not regret their decision to serve. "I would do it again for the people who were there with me, the people who died," said Mr Charles, expressing a common sentiment.
Ms Williams, who served as an Arabic linguist with a military intelligence unit, met the soldier who would become her husband on a mission in Iraq.
Those memories, of course, are tempered.
Ms Williams was attached to an artillery unit that had commandeered a farmer's fields. The man came out of his house with his young, terrified daughters. "I want freedom, I want democracy," the man told her, "but not like this."
"And there was nothing I could do but leave a packet of Skittles for the girls when we drove away," she said. "It seemed really symbolic."
The anniversary is also symbolic for Ms Goodwin, who has now found a measure of peace by holding her wartime experiences up to the light and examining them through creative writing, which she studies at New York University. After losing her daughter, she went to counselling and then began to focus on writing and work. She now works for a non-profit group that helps homeless people.
She has her daughter back, too.
Last month, they celebrated Shylah's birthday together on a cold afternoon in the Manhattan neighbourhood of Harlem. It took 10 years but this, she said, "is a rebirth".