The Other Victims of Battlefield Stress; Defense Contractors’ Mental Health Neglected
by T. Christian Miller, ProPublica – February 26, 2010 1:48 am EST
On the one-year anniversary of her husband’s suicide, Barb Dill breaks down at her husband’s tombstone. Wade Dill, a Marine Corps veteran, took a contractor job in Iraq. Three weeks after he returned home for good, he committed suicide (Francine Orr / Los Angeles Times / Redding, CA / July 16, 2007).
REDDING, Calif. — Wade Dill does not figure into the toll of war dead. An exterminator, Dill took a job in Iraq for a company contracted to do pest control on military bases. There, he found himself killing disease-carrying flies and rabid dogs, dodging mortars and huddling in bomb shelters.
Dill, a Marine Corps veteran, was a different man when he came back for visits here, his family said: moody, isolated, morose. He screamed at his wife and daughter. His weight dropped. Dark circles haunted his dark brown eyes.
Three weeks after he returned home for good, Dill booked a room in an anonymous three-story motel alongside Interstate 5. There, on July 16, 2006, he shot himself in the head with a 9 mm handgun. He left a suicide note for his wife and a picture for his daughter, then 16. The caption read: “I did exist and I loved you.”
More than three years later, Dill’s loved ones are still reeling, their pain compounded by a drawn-out battle with an insurance company over death benefits from the suicide. Barb Dill, 47, nearly lost the family’s home to foreclosure. “We’re circling the drain,” she said.
While suicide among soldiers has been a focus of Congress and the public, relatively little attention has been paid to the mental health of tens of thousands of civilian contractors returning from Iraq and Afghanistan. When they make the news at all, contractors are usually in the middle of scandal, depicted as cowboys, wastrels or worse.
No agency tracks how many civilian workers have killed themselves after returning from the war zones. A small study in 2007 found that 24 percent of contract employees from DynCorp, a defense contractor, showed signs of depression or post-traumatic stress disorder, or PTSD, after returning home. The figure is roughly equivalent to those found in studies of returning soldiers.
If the pattern holds true on a broad scale, thousands of such workers may be suffering from mental trauma, said Paul Brand, the CEO of Mission Critical Psychological Services, a firm that provides counseling to war zone civilians. More than 200,000 civilians work in Afghanistan and Iraq, according to the most recent figures.
“There are many people falling through the cracks, and there are few mechanisms in place to support these individuals,” said Brand, who conducted the study while working at DynCorp.”There’s a moral obligation that’s being overlooked. Can the government really send people to a war zone and neglect their responsibility to attend to their emotional needs after the fact?”
The survivors of civilians who have committed suicide have found themselves confused, frustrated and alone in their grief.
“If I was in the military, I’d at least have someone to talk to,” said Melissa Finkenbinder, 42, whose husband, Kert, a mechanic, killed himself after returning from Iraq. “Contractors don’t have anything. Their families don’t have anything.”
Some families of civilian contractors who have committed suicide have tried to battle for help through an outdated government system designed to provide health insurance and death benefits to civilian contractors injured or killed on the job.
Under the system, required by a law known as the Defense Base Act, defense firms must purchase workers’ compensation insurance for their employees in war zones. It is highly specialized and expensive insurance, dominated by the troubled giant AIG and a handful of other companies. The cost of it is paid by taxpayers as part of the contract price.
But the law, which is designed to provide coverage for accidental death and injury, blocks payment of death benefits in the case of almost all suicides. Cases linked to mental incapacity are the lone exception, judges have ruled.
A joint investigation last year by ProPublica, ABC News and the Los Angeles Times revealed that contract workers must frequently battle carriers for basic medical coverage. While Congress has promised reforms, there has been no discussion of changing the law when it comes to suicides involving civilian defense workers.
The military, by contrast, allows survivors to receive benefits in cases in which a soldier’s suicide can be linked to depression caused by battlefield stress.
Hundreds of soldiers have committed suicide since the war in Afghanistan began in 2001, according to studies by the Army and the Department of Veterans Affairs. In response, the Defense Department has become more active in trying to prevent suicide than its hired contractors, military experts said.
The military is “aggressively trying to reach people and do intervention beforehand and set up suicide awareness programs,” said Ian de Planque, a benefits expert at the American Legion, the nation’s largest veterans group. “Awareness of it has increased. I don’t know that it’s transferred over to the civilian sector at this point.”
Birgitt Eysselinck has spent years trying to prove that her husband’s death in Iraq was related to stress from his job with a company specializing in the removal of land mines and explosive ordnance. So far, courts have sided with the insurance firm, Chicago-based CNA, in denying Eysselinck’s claim. (CNA declined to comment, citing privacy reasons.)
Eysselinck, 44, said that neither federal judges nor insurance adjusters understand that civilian contractors face many of the same risks in Iraq and Afghanistan that soldiers do. Her husband, Tim Eysselinck, endured mortar attacks and frequently traveled across Iraq’s dangerous highways, she said.
“There is a huge percentage of contractors who are silently suffering,” Eysselinck said. “That obviously puts them and their families at risk. Communities are bearing the brunt of this, especially the families.”
* * *
Wade Dill was working at a local pest control company when he decided to take a job with KBR in Iraq in late 2004. The money was good – almost $11,000 a month for handling extermination and hazardous material disposal, more than double his normal salary.
“He said this was our opportunity,” Barb Dill said. “He could start a college fund for our daughter, pay off the mortgage and have a nice retirement. He told me at his age, 41, he didn’t know if he had enough years left in him to give us what he wanted.”
Wade started that December, working on bases in central and northern Iraq. Violence was ever present. A base near Mosul was shelled frequently. He told Barb that a mortar landed close enough to temporarily deafen him. Once, he called her sobbing.
“My husband never cried, ever,” she said. “Marines don’t cry. A young man, a soldier, had put a pistol to his head and blown his brains out. And Wade had to go in and clean up after they removed the body – he had to clean up brain matter and blood. It really upset him.”
Barb Dill noticed a change in her husband when he returned home for a visit in December 2005. The couple had been high school sweethearts, married for 15 years. They had troubles, but had always worked them out. Now, he seemed moody and often angry, lashing out at her and their daughter, Sara.
“He would say hateful things to me and our daughter – things he had never said before.” Dill said. “This was a man that loved his little girl and his wife. He always called us his girls.”
When Wade returned for another visit in June 2006, he abruptly quit his job and began acting erratically, Dill said. He ripped the wiring out of appliances, smashed mirrors and poured lighter fluid on their furniture.
After a few weeks, Wade took a room at a local motel. On July 15, he asked Barb to come see him. Their conversation spiraled into a confrontation. Frightened and angry, Barb sped off in her car. The next day, the Shasta County coroner’s office called to tell her that Wade’s body had been found in the room.
“He told me that he was sick and needed help,” Dill said. “I told him to get help and then we would talk. The last time I saw him was in my rearview mirror.”
Dill soon found herself in financial difficulty. Her husband had always taken care of the bills. He had spent lavishly with his higher salary, buying two BMWs during trips home. Now, Dill discovered the couple was $300,000 in debt on their mortgage and car loans.
She plunged into depression, struggling to cope with her daughter’s grief and the sense that she had failed her husband in his time of need. She sold the cars and nearly lost her home after falling behind on mortgage payments.
She suffered mostly by herself. Except for a handful of Web sites, no support groups exist for widows of civilian contractors. The federal government offers no counseling for civilians returning from work in war zones.
Dill said that she felt abandoned by everyone: her husband’s employer, the insurance company and especially the federal government, which oversees the Defense Base Act system through the Labor Department.
“Shouldn’t our government be responsible for the companies they hire?” Dill said. “Shouldn’t our government take care of its own people, who are doing jobs our government, ultimately, wanted them to do?”
* * *
Survivors of civilian contractors whose death is related to their work in Iraq have the right to apply for compensation benefits that pay up to $63,000 a year for life.
Dill applied, asserting that her husband’s PTSD made him an exception to the rule against payments in suicide cases. Her claim was denied by AIG, KBR’s insurance provider.
She protested, sending her claim into a dispute resolution system run by the Labor Department. Her case is still grinding its way through the system, which can take years to produce a final result.
Experts hired by the family and the insurance company differed on what led to Wade Dill’s suicide.
A psychiatrist hired by her attorney found that job stress in Iraq was one of the factors that drove Wade to suicide: “The bottom line is that the combination of physical separation and work-related stress resulted in increasingly emotional distance, greater distortion of the relationship, increasing emotional intensity, and a pattern of increasing erratic behaviors that culminated in suicide,” wrote Charles Seaman, an expert in PTSD.
A Labor Department examiner recommended that AIG pay the claim, but the company refused. AIG and KBR declined comment about the case. In court filings, AIG has argued that the Defense Base Act does not cover suicides.
AIG attorneys also have said that Wade Dill’s actions were related to marital and family problems. A psychiatrist hired by AIG testified at a hearing in San Francisco in January that he had performed a “psychological autopsy” on Wade Dill based on interviews with his family and court documents.
The psychiatrist, Andrew D. Whyman, said his evaluation led him to conclude that Dill suffered from depression and that his suicide was unrelated to the violence he witnessed in Iraq.
“Take out the Iraq experience, (the suicide) would have happened,” Whyman testified. “He had a choice. … He could have chosen not to do that.”
Barb Dill insists her husband came back from Iraq a changed man.
“No matter how strained our relationship could get at times, we always pulled out of it with no problem,” Dill said. “Iraq changed all that.”
Now, she said, she is trying to hold her life together. A final decision in her case is not expected for months.
“We’re just slowly sinking,” she said. “It’s hard to be strong.”
Watch a preview of ‘Disposable Army,’ a documentary currently being produced by Mark Crupi, which contains interviews with Barb Dill and T. Christian Miller.
Disposable Army: Read the complete coverage of injured defense contractors and their struggles to receive promised medical care.
Write to T. Christian Miller at T.Christian.Miller@propublica.org.
By LINDA A. JOHNSON
Associated Press Writer
Quickly giving morphine to wounded troops cuts in half the chance they will develop post-traumatic stress disorder, according to a provocative study that suggests a new strategy for preventing the psychological fallout of war.
Researchers at the U.S. Naval Health Research Center led the study of about 700 troops injured in Iraq from 2004 through 2006.
“It was surprising how strong the effect of the morphine was,” said study leader Troy Lisa Holbrook, an epidemiologist at the naval center. The findings were published in Thursday’s New England Journal of Medicine.
Whether the Pentagon will adopt the practice on the battlefield remains to be seen. Dr. Jack Smith, acting deputy assistant secretary of defense for clinical and program policy, said in an e-mail that the “very interesting findings” are “likely to stimulate further research.”
About 53,000 troops returning from Iraq and Afghanistan have been treated for PTSD, a disorder in which someone who has endured a traumatic event keeps re-experiencing it and the fear it caused. Patients often have trouble with work, relationships, substance abuse and physical ailments.
Researchers have been testing ways to treat it, and the new study looked at whether fast and strong pain relief can help prevent it.
It was unclear whether it was the fast pain treatment or something specific to morphine that made the difference.
But researchers theorize that simply easing pain might reduce the severity of the psychological trauma, or that prompt relief might alter the way the brain remembers the attack or injury – in essence, causing the mind to file away the episode as less traumatic.
Troops in the study initially were treated at military medical facilities in Iraq, mainly for wounds caused by roadside bombs, bullets, grenades or mortar fire. A few dozen had burns or were hurt in crashes or falls. The decision on whether to give morphine was up to the individual doctor, based on the patient’s condition.
Of the 696 troops in the study, 493 – about 70 percent – were given morphine, most within an hour of injury. Two years later, 147 of them had developed PTSD. Of the 203 not given morphine early on, 96 developed PTSD.
That worked out to a 53 percent lower risk of developing PTSD for those treated early with morphine. No other factor, such as the nature or severity of injuries, had much effect on the chances of developing PTSD, Holbrook said.
“These are provocative and thought-provoking findings that should lead scientists to investigate the underlying mechanisms” in future studies, said JoAnn Difede, a PTSD researcher at New York-Presbyterian/Weill Cornell Medical Center.
Difede and Barbara Rothbaum, who heads the Trauma and Anxiety Recovery Program at Emory University School of Medicine, said that until more research backs up the findings, the study probably won’t lead to many more patients in civilian emergency rooms getting morphine.
“At this point, I don’t see it having a huge impact” for civilians, Rothbaum said.
A second study in the journal found that Army wives were more likely to develop depression or sleep problems the longer, or the more times, their spouses were sent to Iraq or Afghanistan.
That study, by researchers at the University of North Carolina and elsewhere, examined medical records for outpatient care of about 250,000 wives of active-duty soldiers from 2003 through 2006.
Compared with wives whose husbands stayed home, those whose husbands were deployed for up to 11 months were 18 percent more likely to be diagnosed with depression and at least 20 percent more likely to be diagnosed with sleep disorders, anxiety and acute stress.
For wives whose husbands were deployed for more than 11 months, problems were even more common: They were at least 24 percent more likely to be diagnosed with depression or anxiety, and about 40 percent more likely to be diagnosed with acute stress or sleep problems.
The researchers didn’t have data showing whether husbands were deployed or at home when the wives were being treated for mental health problems.
That meant the scientists couldn’t conclude whether those problems were caused by worries about the spouse’s safety and the difficulties of being a single parent, or by stress caused by the returning spouse’s psychological problems or other behavior changes.
“I suspect that if you look at the Reserve and National Guard wives, the toll might be even worse,” because they have less social support than families living in a military community, Rothbaum said.
She said the effects of deployment on children also need to be studied so the military can figure out how to provide more help to families.
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On the Net: http://www.nejm.org
Guess we never think of it much, the things that change your life from one day to the next. Somehow I never thought that day on September 11th that the world would change as it has. And for some it didn’t, only for those who have somehow even in the smallest way be touched by the sands of a distant land they may or may not have seen.
How such small degrees of seperation in this world there are. A man boards a plane, his intent is to destroy it, and a few years later a woman finds herself wondering why someone does not speak to her suddenly, that someone went to work or to fight in the land where that man who destroyed the plane came from. All because of his actions, she is there wondering what happened.
Small wounds, vastly different from those inflicted on 9/11, to the troops, the contractors, the families, but wounds non the less.
Would those wounds have happened had that man never got on that plane?
Would the two never have met? Never had loved? Never had suffered that broken heart? Would it have been better that way?
For the people who have not been touched by this war, they will never understand how deeply it is felt in the hearts and souls of those that have felt the hot winds blow across their cheeks, even from thousands of miles away. We are forever changed. We have no way of undoing it, only the hope that someday We will understand and make peace with it and with each other.
Cindy you are a my hero. Of all the people I have ever known, your courage to go through the things you have, you are amazing. You found your break in the clouds and you sailed through to see the other side. May I find my own break in the clouds someday and see what things you have.
A bend in the road there, a stop taking two minutes longer than it should, an internet search, a simple hello……..fate……we never know what will change us or when……only that when it does it may twist us inside out, give us unmeasurable joy or unbearable sorrow…..a man gets on a plane, who knew?
WOW! The last 36 hours have been something! First let me start with the book. As most know, and have seen the entry, Free Press Publishing sends out a catalog to the book stores so they can order the books they and to put in their store for the next season. Well, night before last, I received 3 copies of the catalog from my editors office. This is sooooo cool! I know I have been working on this book for several months now. Terry and I have been emailing each other almost daily as well write each chapter. Liz and I have emailed about the cover design and what pictures to include. We all have been working very hard on the book. But I have to say, it all didn’t seem real to me. I mean, we all do things in our lives that we think would make a good book or movie topic, but nothing ever happens to it. Then to have several someone’s actually tell you that you should write a book about something you did, that you see as just part of your life and who you are….. WELL, that is totally cool. As each step of this book has been taken, I have become more and more aware of the fact that this is really happening….. it isn’t a dream! But the other day……..well, that really brought it all home for me. When I got those catalogs and opened to the paged marked, and saw the catalog entry with my name on it……….. I was speechless! Now most of ya know, my being speechless is not something that happens very often, but I was, for a few seconds. When the guys in the office saw that I had quite talking in mid-sentence, of course they all wanted to know what it was that I had gotten. I smiled and turned the book around and showed them the page. As much as they have heard about the book and have known that I was doing it, I think they felt as I did about it. Holding this in my hands, made it real for not only me, but for them as well. Some of these guys are new friends and some I have known since I worked for KBR. You would have thought that it was happening to them. I got hugs, hand shakes and a lot of teasing! I was told I have to make sure they ALL get autographed copies! I think I am going to get writers cramp very quick when this thing finally does come out! Anyway, after I made it home, I took the catalog out and really looked at it. There is my name, in print, with a picture of what the cover is going to look like. “WOW! This is so cool! This is really happening!” was my thought. It still blows my mind!
Free Press, June 2006
Cindy in Iraq: A Civilian’s Year in the War Zone
It’s one of the least covered stories in the Iraqi war. Now, the writer of the popular “Cindy in Iraq” blog narrates her harrowing experiences during a year driving trucks as a civilian contractor for Halliburton.
Cindy Morgan was on the front lines of Iraq––not enlisted in the military, but in a job just as dangerous: as a convoy commander leading groups of fifteen to thirty trucks through perilous territory. Having promised her three sons that she would always tell them the truth about what she was experiencing, she started her blog “Cindy in Iraq” as a way to stay in touch with family and friends back home. “Cindy in Iraq” soon became a valuable resource for families of contractors, and those thinking about becoming contractors, as well as a telling story of the disturbing realities facing brave civilian workers.
Here, we see Cindy’s story in full detail—how, after thirteen years’ experience as a truck driver in the U.S., as well as orientation by Halliburton, she still was shocked by what she faced. Unarmed, with virtually no training, one of the only female truck drivers, she became a moving target for insurgents, constantly at risk of being ambushed, shot at, kidnapped, or executed.
Cindy’s journey in Iraq also became a voyage of self-discovery. Having left an abusive husband, she went to Iraq because she was “tired of surviving her life and not living it.” She went to Iraq to find out “who I am and what I am made of here….Honor, integrity, pride and humanity can all be discovered.” As Cindy relays her experiences, both she and the reader are transformed.
Cynthia I. Morgan drove a big rig across the U.S. for thirteen years before venturing into Iraq in 2003, where she was a civilian convoy commander in charge of up to thirty trucks delivering supplies to American bases throughout the war-torn country. After seven months back in the U.S., she returned to Iraq. She lives, usually, in Tennessee.
September 2006
Free Press
Biography and Autobiography
6 x 9, 256 pages
8 pages of black-and-white photographs
Carton quantity: 20
EAN: 978074328640452500
0-7432-8640-5
$25.00 hardcover
$34.50 in Canada
Well, yesterday was the last day of work. What use to be my room, my home, is packed in footlockers and mailed home, or is in a 4x3x3 metal box sitting in the living room waiting to be picked up for shipping back home. Four stark white walls that used to be decorated with tapestries, pictures, and a couple of hand painted wall fans, are now bare. The mirror that I had special made when I got here, because the only one in the flat was in the bathroom and that held the pictures of my boys, is laying in the forayer, wrapped in a blanket and waiting for me to finish building the box around it, in hopes that it will make it home without breaking. I have only my computer, the desk it sits on and a packed suit case sitting open, in the floor, left in this room that has been home to me for the last four months.
I stand at the window that looks out over the Persian Gulf and watch the sun rise as it has for every day that I have been here. It is a beautiful, colourful scene. I am on the 17th floor and have a great view of the Gulf. So much has changed inside this room, but it still looks the same outside. Will I miss it? Yes! Am I glad to get out of here? Yes! I, like many others have mixed feelings about the next few days. Home phone numbers and email addresses are being exchanged with the promises that we will keep in touch and we will let the other know if we find another contract job here or somewhere else. Many guys are calling the wife back home almost every day in preparation of their homecoming. Some are making their plans and finding flats because they have new jobs, or are going to stay a while and look for one. And still yet others, like me, have made plans to go on a vacation before going home and are making the final arrangements for that.
The contract has ended. The job is over. But I, like many other here, will never forget what I’ve seen and done, where I’ve been and who I’ve met. Unlike KBR, that has mostly American workers, IAP has had a multi-national force here. The United States, Great Britain, Australia, Wales, New Zealand, and South Africa are just some of the countries that we all come from. Despite the differences between us, we came together, did a job and did it well. I have loved meeting all these people and have become friends with several. To learn a little about other countries and their people, has been great. But the down side to that is some of these people I will never see again. Some that I would like to say, I can call friend, I won’t have the chance or hope, that I could just bump into them somewhere after I get home. Oh, I am sure, that if I stay doing contract work in foreign countries, I will run into one here and there, but ya never know about things like that. So for now, I have a few phone numbers, a few email addresses, and the hope and promise that we will stay in contact with each other, to hold on to. It has been a great four months! I will miss my new friends!
First off, I want to say that my son, Kenny, is ok and I talked to him this afternoon. He is pissed, as well as I am, but he is fine. Now let me tell you the story of my last few days and how cruel some folks can be.
A couple of days ago, about 0200 in the morning, I talked to my son in an YM. He told me that he was going out on his extended patrol. I know what that means and where it is. That afternoon, as I was pulling into the yard after doing a local mission, my phone rang. The call went like this…..
Is this Ms. Morgan?……
Yes it is…….
I was told to call you, because no one else will. Your son has been hurt…………….
How bad? Where is he? Is it life treating? ……..
It is not life treating and he is not being sent to Germany……………….
OK, then how bad is it?………
Ma’am, I can’t tell you any more than that. I am not supposed to be making this call and could get into trouble for it………..
Ok, tell me what you can. How do I find out more?………..
Ma’am, that is all I can tell you. You will get a call in a few days.
Then he hung up.
Since then, I have been going nuts. I talked to several military and they said they would see what they could find, but to be leery of calls like that, that are not official. It could be a hoax. I can’t imagine anyone playing that kind of hoax on someone, but I didn’t tell the family back home of this. I didn’t want to worry them, just in case it was. So the last few days have been total hell for me. I have talk to the Red Cross, their computers were down. I talked to military Chaplin, he said it would take him a few days to get me some information, but he would try. I talked to every military person I came across it see if they knew how I could confirm that my son was hurt. I even had one LT check the causality list for me. I have cried, I have screamed, and I have just plain gone out of my mind the last few days. I could not get any information at all. It is going to take time was the best I could get from anyone.
Then today, I walked into my room after my local and clear my screensaver and see Kenny signed on in Yahoo Messenger. I about fell out. I couldn’t get to my computer and type fast enough. I told him what I was told and he assured me that he is fine. Nothing has happened to him. He is going to inform his C.O. and he says that they will try to find out who made the call. I have been sitting here making calls for the last hour to let everyone over here know that he is ok. All my friends here have been such a great support and are relieved to hear that Kenny is ok. I just don’t know what to do with my anger now. I hope I never find out who did this because they will wish they had never known my name. How can someone be so cruel?
Anyway, through all this I have found that this has happened before and not just with soldiers and their families, but also civilian contractors. So please, everyone, if you get a call like this, make sure they identify themselves and get as much info on them as well. There are some very sick people out there. I don’t want anyone to go through what I have the last few days. I am going to go have a good cry now and thank God that my son is ok.
