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U.S. combat injuries rise sharply
Three-month total in Afghanistan surpasses 1,000

By Ann Scott Tyson
Washington Post Staff Writer
Saturday, October 31, 2009

More than 1,000 American troops have been wounded in battle over the past three months in Afghanistan, accounting for one-fourth of those injured in combat since the U.S.-led invasion in 2001.

The dramatic increase in amputees and other seriously injured service members comes as October marks the deadliest month for U.S. troops in Afghanistan.

Expanded military operations, a near-doubling of the number of troops since the beginning of the year and a Taliban offensive that has included a proliferation of roadside bombings have led to the great increase in casualties. U.S. troops in Afghanistan are suffering wounds at a higher rate than those who were serving in Iraq when violence spiraled during the military "surge" two years ago. In mid-2007, 600 U.S. troops were wounded in Iraq each month out of about 150,000 troops deployed there. In Afghanistan, about 68,000 troops are currently installed, with about 350 wounded each month recently.

Pentagon press secretary Geoff Morrell acknowledged that the casualties in Afghanistan have surpassed Iraq surge proportions and noted that the violence in Afghanistan is directed more against U.S. and other coalition forces, whereas it was heavily sectarian in Iraq. "It shows you how we are the targets and how effectively they are targeting us," Morrell said.

He noted that Defense Secretary Robert M. Gates has become concerned about the rising number of wounded and has ordered thousands of additional support troops to Afghanistan to look for, and minimize, the roadside bombs.

Military doctors say the nature of the Afghanistan casualties is reminiscent of those in Iraq in 2007. "We're seeing similar types of injuries from Afghanistan that we saw in Iraq" before and during the surge, said Lt. Col. Shelton Davis, chief of physical medicine at Walter Reed Army Medical Center in Washington.

More than 1,000 improvised explosive devices, or roadside bombs, exploded or were found in Afghanistan in August, more than double any monthly total until this summer. The bombs account for 70 to 80 percent of U.S. and coalition casualties in that country, according to Lt. Gen. Thomas F. Metz, director of the Pentagon's Joint Improvised Explosive Device Defeat Organization.

Metz told military reporters this week that IEDs are now the "weapon of choice" for Taliban fighters. The bombs are so powerful, he said, that they can take out the latest mine-resistant vehicles the Pentagon has employed to protect troops. In addition, insurgents have begun targeting troops on foot. He said that the rise in bombings has coincided with the doubling of U.S. troop numbers this year and that further troop increases -- now under consideration by President Obama -- would bring more bombs.

As U.S. ground forces moved in this year, Metz said at a House Armed Services Committee hearing this week, "the enemy was ready with a very thick array of IEDs. . . . Those soldiers and Marines ran into those IEDs, and it was what we predicted."

Walter Reed's Ward 57 provides wrenching proof of the devastating effectiveness of the bombs, with patients suffering amputations, spinal cord damage, traumatic brain injuries and fractures.

On Aug. 18, Lt. Dan Berschinski, 25, of Peach Tree City, Ga., was serving as a platoon leader with the Stryker brigade combat team in Kandahar province, where the roads were laced with bombs and his unit had to operate without engineer support or mine-detection equipment. His platoon was crossing a footbridge when a bomb threw Berschinski to the ground, deafened a sergeant and blew up Pfc. Jonathan Yanney, a radio operator. An initial search located part of Yanney's shredded helmet, pieces of a boot and some small body parts that Berschinski said team members put in a plastic bag.

Realizing that not only the roads but also the foot trails were too dangerous, Berschinski and his men moved on by walking through shin-high water. Regrouping in a mud-walled compound later that day, Berschinski was passing a gate when another bomb blew up underneath him, bouncing him off a wall and tossing him back into the crater that had formed.

"I immediately reached down -- up, really, since I was upside down -- for my legs. I could tell they were gone," Berschinski said in a written account provided by his family. His right leg and hip and his left leg above the knee were amputated. According to Metz, few soldiers have survived stepping on such bombs.

But the survival rate among the wounded is greater than in previous conflicts because of improved first aid, quick evacuations to field hospitals and better armored protection.

Busy wards in wartime

As more wounded flow in, hospitals must adjust. "We can open more beds as needed and bring on more staff as needed. As you can imagine, that is not without its own challenges," said Col. Paul Pasquina, chief of orthopedics and rehabilitation at Walter Reed and the Bethesda National Naval Medical Hospital. He noted that although military medical personnel are in demand stateside, they also must deploy overseas.

"The ward is pretty full now," said Tracy Glascoe, a physician assistant on Ward 57.

One significant challenge, she said, is helping wounded troops transition from a regimen of constant ward care so that they can work on further physical rehabilitation.

Resting the stub of his right leg on his hospital bed one day last week, Spec. Harrison Ruzicka, 23, said he is eager for physical therapy. Ruzicka, who is from North Carolina knows he faces a long recovery but said he was thankful to be alive after a bomb flipped his armored vehicle into a river on Aug. 7.

He recalled being pinned under the vehicle and fearing he could drown in the river. He said he screamed for help but quickly realized no one was there. He somehow got loose, swam to the embankment and dragged himself onto land with his arms. He knew his legs were broken. "I didn't want to look at them because I would have put myself in shock," he said.

He started calling for his good friend, vehicle driver Sgt. Jerry R. Evans Jr., 23, of Eufaula, Ala. "I was in his wedding party," Ruzicka said. "There was no response. Nothing from him."

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