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.