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Indirect deaths: the massive and unseen costs of America’s post-9/11 wars

by Andrea Mazzarino

Part 2 - Combat Deaths: The Tip of the Iceberg
 
A major task of the Costs of War Project has been to document the death toll among uniformed American troops from our post-9/11 wars, especially in Afghanistan and Iraq. Compared to the 400,000 American deaths (and still climbing) from Covid-19 in less than a year, the approximately 7,000 American military deaths from those wars over almost two decades seem, if anything, small indeed (though, of course, that total doesn’t include thousands of military contractors who also fought and died on the American side). 
 
Even for me, as an activist and also a psychotherapist who bears witness to human suffering on a fairly regular basis, it’s easy enough to grow desensitized to the words “more than 7,000,” since my life hasn’t been threatened by combat daily.

Indeed, 7,000 is a small number compared not just to Covid-19 deaths here but to the 335,000-plus deaths of civilians in our war zones since 2001. It doesn’t even measure up to the 110,000 (and counting) Iraqi, Afghan, and other allied soldiers and police killed in our wars. However, 7,000 isn’t so small when you think about what the loss of one life in combat means to the larger circle of people in that person’s community.

To focus only on the numbers of American combat deaths ignores two key issues. 
 
First, every single combat death in Iraq and Afghanistan has ripple effects here at home. As the wife of a submarine officer who has completed four sea tours and who, as a Pentagon staffer, has had to deal with war’s carnage in detail, I’ve been intimately involved in numerous communities grieving over military deaths and sustaining wounds years after the bodies have been buried. Parents, spouses, children, siblings, and friends of soldiers who have been killed in action live with survivor’s guilt, depression, anxiety, and sometimes addiction to alcohol or drugs.

Families, many with young children, struggle to pay the rent, purchase food, or cover healthcare premiums and copays after losing the person who was often the sole source of family income. Communities have lost workers, volunteers, and neighbors at a time of mass illness and unrest just when we need those who can sustain intense pressure, problem solve, and work across class, party, and racial lines – in other words, our soldiers. (And yes, while the storming of the Capitol earlier this month included military veterans, I have no doubt that the majority of U.S. troops and veterans would prefer to be shot before getting involved in such a nightmare.)

Second, as the testimony of the former Marine I interviewed suggests, many people suffer and die long after the battles they fought in are over. Social scientists still know very little about the magnitude of deaths because of — but not in — war’s battles. Still, a 2008 study by the Geneva Declaration Secretariat estimated that indirect deaths from war are at least four times as high as deaths sustained in combat.

At the Costs of War Project, we’ve started to examine the effects of war on human health and mortality, particularly in America’s war zones. There, people die in childbirth because hospitals or clinics have been destroyed. They die because there are no longer the doctors or the necessary equipment to detect cancer early enough or even more common problems like infections. They die because roads have been bombed or are unsafe to travel on. They die from malnutrition because farms, factories, and the infrastructure to transport food have all been reduced to rubble. They die because the only things available and affordable to anesthetize them from emotional and physical pain may be opioids, alcohol, or other dangerous substances. They die because the healthcare workers who might have treated them for, or immunized them against, once obsolete illnesses like polio have been intimidatedfrom doing their work. And of course, as is evident from our own skyrocketing military suicide rates, they die by their own hands.

It’s very hard to count up such deaths, but as a therapist who works with U.S. military families and people who have emigrated from dozens of often war-torn countries around the world, the mechanisms by which war creates indirect death seem all too clear to me: you find that, in the post-war moment, you can’t sleep, let alone get through your day, without debris on the highway, a strange look from someone, or an unexpected loud noise outside sparking terror.

If the stress hormones coursing through your body don’t wreak their own havoc in the form of painful chronic illnesses like fibromyalgia or mental illnesses like depression and anxiety, then the methods you use to cope like overeating, reckless driving, or substance abuse, very well might. If you are a child or the spouse of someone who has lived through repeated deployments to America’s twenty-first-century wars, then there’s a significant chance you’ll be on the receiving end of physical violence from someone who lacks the tools and self-control to deal peacefully. We aren’t counting or even describing such injuries and the deaths that can sometimes result from them, but we do need to find a way.

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