The Unseen Toll Of War: Female Amputees From Iraq And Afghanistan

Between 2001 and 2012, more than 1,500 US military personnel were amputees as a result of the conflicts in Iraq and Afghanistan. From mid-2008 to 2010, the rate of blast injuries resulting in traumatic limb amputation in US Forces in Afghanistan was higher than in Iraq. By 2010, blast injuries to US Forces in Iraq had decreased to almost zero, while a significant increase was observed in Afghanistan.

In the UK, at least 20 military personnel suffered traumatic limb amputations in Iraq, and 237 in Afghanistan between April 2006 and December 2011.

While I was unable to find specific numbers for female amputees from Iraq and Afghanistan, the sources do mention that soldiers who have lost limbs will require costly and constant medical care, and that their families will also face a significant burden.

US soldiers with genital injuries

Genital injuries are a sensitive topic that is not often discussed, but they are a serious issue affecting US soldiers. From 2001 to 2013, more than 1,400 US troops suffered genital injuries in Afghanistan and Iraq, with an average age of 24. These injuries are caused by blasts from improvised explosive devices (IEDs) and other bombs, which are often planted on fences or above ground to maximize the damage inflicted on soldiers' legs and genitals. The survival rate for soldiers with genital injuries is high, but it involves repeat surgeries, re-imagining relationships, and dealing with the possibility of never enjoying sex or having children again.

Types of Genital Injuries

Genital injuries can vary widely, and there is no characteristic pattern among those who suffer penile injuries. Some common types of genital injuries include:

• Damage to the penis, scrotum, or testicles
• Urethral injuries
• Bladder injuries
• Renal and ureteral injuries
• Testicular damage or amputation
• Infertility

Impact of Genital Injuries

Genital injuries can have a range of physical, psychological, and emotional impacts on soldiers. Physically, they may require repeat surgeries and long-term testosterone supplementation. Psychologically, they can lead to sexual dysfunction and post-traumatic stress disorder (PTSD). Emotionally, soldiers may struggle with re-imagining their relationships and wondering if they will ever be able to enjoy sex or have children again.

Support for Soldiers with Genital Injuries

There is a lack of support and resources available for soldiers with genital injuries. While some military and VA treatment facilities offer counseling and support groups, many of these programs are not well-publicized or easily accessible. In terms of fertility treatments, the military health program Tricare covers diagnoses of illnesses that can cause fertility issues and correction of medical issues but does not cover in vitro fertilization (IVF) or artificial insemination. The VA also does not offer IVF as a treatment option.

Public Discourse on Genital Injuries

There is a lack of public discourse and awareness about genital injuries affecting US soldiers. These injuries are often not discussed in pre-deployment briefs or included in conversations about the consequences of war. This silence may be due to the sensitive nature of these injuries and the potential for providing information to enemies about the effectiveness of their weapons. However, advocates and family members of affected soldiers are pushing for a more open dialogue and increased awareness of this type of casualty of war.

UK amputation statistics

The UK has seen a significant number of military and civilian amputees, with various causes ranging from traumatic injuries to medical conditions. Understanding the extent of amputations in the UK is essential for developing support systems and healthcare policies. This report will provide an overview of amputation statistics in the UK, focusing on military personnel and civilians, with an emphasis on female amputees where data is available.

Military Amputees

According to UK government statistics, between 1 April 2015 and 31 March 2020, there were 132 UK service personnel who sustained traumatic or surgical amputations. This number decreased over the years due to a reduction in operational tempo in combat zones. Specifically, there were fewer than five UK service personnel with injuries resulting in amputation due to the conflicts in Afghanistan and Iraq during this period.

The nature of combat and protective gear has also contributed to the incidence of amputations. While body armour has improved survival rates, the extremities remain vulnerable to blast injuries, particularly in dismounted troops.

Civilian Amputees

Amputations among UK civilians have multiple causes, with diabetes being a significant factor. Data from Public Health England shows a rising trend in major lower limb amputations, with 7,545 cases between 2015 and 2018, compared to 6,957 between 2012 and 2015. The risk of amputation is higher among white males, and the prevalence of type 2 diabetes, a major contributor to amputations, is expected to increase.

Other causes of amputations in civilians include severe infections, gangrene, peripheral arterial disease, and trauma. The psychological impact of amputation cannot be overlooked, and support systems are crucial for helping individuals cope with the emotional and physical challenges of amputation.

Female Amputees

While specific data on female amputees in the UK is limited, it is worth noting that the overall statistics include female individuals. The impact of amputation on women can vary, and gender-specific support systems may be necessary.

In conclusion, the UK has witnessed a considerable number of amputations, both in military personnel and civilians. The causes range from combat injuries to medical conditions, particularly diabetes. The psychological and physical repercussions of amputation underscore the importance of comprehensive support systems and healthcare policies. While data on female amputees may not be readily available, it is crucial to recognize their unique experiences and needs in the context of amputation.

US amputation trends

Amputation trends in the US have been studied extensively, with a focus on military conflicts, technological advancements, and healthcare disparities. Here are some key trends and insights:

Military Conflicts:

• The conflicts in Iraq and Afghanistan have resulted in a significant number of amputations among US military personnel, with over 1,500 Americans losing limbs in these wars. The rate of blast injuries causing traumatic limb amputation has increased, particularly in Afghanistan.
• Between 2001 and July 2011, there were 1,221 US service members who underwent major extremity amputations, totalling 1,631 amputations.
• Most amputations occurred at the transtibial and transfemoral levels, with 30% of amputees sustaining multiple amputations.
• The number of amputations increased dramatically in 2010 and the first half of 2011 compared to previous years.
• The rate of amputations among US military personnel in Iraq and Afghanistan is similar to that of previous conflicts, such as the Vietnam War.

Technological Advancements:

• There have been significant advancements in prosthetic technology, with innovations such as the SENSY bionic leg, mind-controlled bionic arms, and improvements in prosthetic exoskeletons, osseointegrated implants, and control mechanisms.
• Telehealth has become more prevalent in the amputation community, especially during the pandemic. While in-person visits remain the norm for prosthetists, telehealth has been utilised for wound care, pain control, mental health counselling, and pre-amputation consulting.
• Brain-computer interfaces show promising developments, with BrainRobotics' bionic hand and the Atom Touch bionic arm inching closer to FDA approval.

Healthcare Disparities:

• Limb loss is more prevalent among people of colour and individuals with lower incomes. Black patients have a limb amputation rate triple that of other racial groups.
• Rural areas and communities of colour have higher rates of amputation.
• Nearly half of individuals who have an amputation due to vascular disease will die within five years, a higher mortality rate than breast, colon, and prostate cancers.
• Diabetes is a significant contributor to amputation, and individuals with diabetes who undergo a lower extremity amputation have a high risk of requiring a second amputation within a few years.

Hollywood and Media Representation:

• There has been a positive trend towards increased representation of people with disabilities in film and television. According to the Geena Davis Institute's annual survey, nearly one in five major TV characters were portrayed as having a disability.
• Notable examples include Zyra Gorecki, the first amputee with a central role on a network TV series ("La Brea"), and Pixar's "Luca," which sensitively depicted congenital limb difference.

Support Groups and Community:

• Online support groups and virtual gatherings for amputees have grown significantly, especially during the pandemic. Platforms like Zoom have enabled more frequent meetings and a wider reach.
• The Amputee Coalition and adaptive sports organisations have embraced virtual programs to support stay-at-home fitness and community connection.
• While digital support platforms are expected to continue, there is also a desire for in-person events and meetings to return as public health conditions permit.

US amputation rates

Nearly 2 million people in the US are living with limb loss. The main causes are vascular disease (54%) – including diabetes and peripheral arterial disease – trauma (45%) and cancer (less than 2%). Approximately 185,000 amputations occur annually in the US. In 2009, hospital costs associated with amputation exceeded $8.3 billion.

Amputation rates are highest among African Americans, who are up to four times more likely to have an amputation than white Americans. Nearly half of those who have an amputation due to vascular disease will die within 5 years – a higher mortality rate than that of breast, colon, or prostate cancer. Up to 55% of diabetics who have a lower extremity amputation will require amputation of the second leg within 2-3 years.

Amputation rates have long been higher in rural America. However, a 2021 study found that in cities, the highest rates are associated with poverty and being Black. More than 75% of patients undergoing major amputations lived in metropolitan areas, and over half of the zip codes with the highest amputation rates were in cities.

The US military has also recorded a significant number of amputees. According to data released by the US Army Surgeon General's Office in 2012, more than 1,500 Americans had lost a leg or arm in combat in Iraq or Afghanistan, and hundreds had suffered the amputation of multiple limbs.

US Military Amputation Rates

A 2008 study of US military casualties in Afghanistan and Iraq between October 1, 2001, and June 1, 2006, found that 5.2% of all serious injuries (7.4% of major limb injuries) resulted in major limb amputation. The mechanism of injury for 87.9% was some form of explosive device.

A 2012 study of major extremity amputations sustained by US service members from January 2001 through July 30, 2011, found that there were 1,221 amputees who met the inclusion criteria. These amputees sustained a total of 1,631 amputations. The number of amputations performed each year increased dramatically in 2010 (196) and the first half of 2011 (160) compared to 2008 (105) and 2009 (94). Most amputations occurred at the transtibial (683, 41.8%) and transfemoral (564, 34.5%) levels. Thirty percent of the amputees (366) sustained multiple amputations, and 14% of all amputations (228) involved the upper extremity.

A Washington Post article from 2011 reported that doctors and nurses treating soldiers injured in Afghanistan had begun speaking of a new "signature wound" – two legs blown off at the knee or higher, accompanied by damage to the genitals and pelvic injuries requiring at least a temporary colostomy. Twice as many US soldiers wounded in battle in 2010 required limb amputations than in either of the two previous years. Three times as many lost more than one limb.

US soldiers with multiple amputations

Limb amputation has been a common injury in the Iraq and Afghanistan conflicts. A study of US military casualties from October 1, 2001, to June 1, 2006, found that 5.2% of all serious injuries resulted in major limb amputation. The rate of blast injuries causing traumatic limb amputation among US forces has increased since the surge of troops in Afghanistan.

Dismounted Complex Blast Injury (DCBI)

DCBI is a pattern of multiple lower limb amputations, with associated severe abdominal, pelvic, or genitourinary injuries. It has been reported as increasing in frequency among US troops in Afghanistan since 2010.

Statistics

• From mid-2008 to 2010, the rate of blast injuries resulting in traumatic limb amputation in US Forces in Afghanistan was higher than in Iraq.
• In 2010, blast injuries to US Forces in Iraq declined to near zero, while a significant increase was observed in Afghanistan.
• In 2010, a total of 196 US military personnel suffered the loss of at least one limb, increasing to 240 in 2011.
• 30% of the amputees (366) sustained multiple amputations.
• 14% of all amputations (228) involved the upper extremity.
• 127 amputees (10%) underwent their amputation more than 90 days after the injury.
• Twice as many US soldiers wounded in battle in 2010 required limb amputations compared to the previous two years.
• Three times as many lost more than one limb.
• The number of amputations performed each year increased dramatically in 2010 (196) and the first half of 2011 (160) compared to 2008 (105) and 2009 (94).
• Most amputations occurred at the transtibial (683, 41.8%) and transfemoral (564, 34.5%) levels.
• Soldiers with more than one extremity amputated accounted for 2% of wounded soldiers in World War I, 5% in World War II, and 19% in the Vietnam War.

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