Exposing the World of the Poor

aka, the Other Walter Reed. 

Some highlights from the Washington Post’s breaking “reports about substandard conditions and bureaucratic tangles that affected the care of injured soldiers who had returned from Iraq and Afghanistan” (my emphases here and throughout):

There’s the substandard housing:

Behind the door of Army Spec. Jeremy Duncan’s room [in Building 18 at Walter Reed], part of the wall is torn and hangs in the air, weighted down with black mold. When the wounded combat engineer stands in his shower and looks up, he can see the bathtub on the floor above through a rotted hole. Signs of neglect are everywhere: mouse droppings, belly-up cockroaches, stained carpets, cheap mattresses.

The “warehousing” approach for outpatients:

…5 1/2 years of sustained combat have transformed the venerable 113-acre institution into something else entirely — a holding ground for physically and psychologically damaged outpatients…they outnumber hospital patients at [the pristine] Walter Reed 17 to 1…”

Accompanying food insecurity, mental illness, and drug abuse:

…overworked case managers fumble with simple needs: feeding soldiers’ families who are close to poverty…Seventy-five percent of the troops polled by Walter Reed last March said their experience was “stressful.” Suicide attempts and unintentional overdoses from prescription drugs and alcohol, which is sold on post, are part of the narrative here…

The demoralizing, inefficient and confusing bureacracy:

Life beyond the hospital bed is a frustrating mound of paperwork.  The typical soldier is required to file 22 documents with eight different commands — most of them off-post — to enter and exit the medical processing world…Sixteen different information systems are used to process the forms, but few of them can communicate with one another.  The Army’s three personnel databases cannot read each other’s files and can’t interact with the separate pay system or the medical recordkeeping databases.”

Having to prove you merit the services:

The disappearance of necessary forms and records is the most common reason soldiers languish at Walter Reed longer than they should, according to soldiers, family members and staffers. Sometimes the Army has no record that a soldier even served in Iraq. A combat medic who did three tours had to bring in letters and photos of herself in Iraq to show she that had been there, after a clerk couldn’t find a record of her service.

Adverse impacts to an already ailing system from privatizing lower-paying,lower-skilled support services:

…”patient care services are at risk of mission failure” because of staff shortages brought on by the privatization of the hospital’s support workforce

The systemic nature of the problem:

Stories of neglect and substandard care have flooded in from soldiers, their family members, veterans, doctors and nurses working inside the [military medical, including the VA] system. They describe depressing living conditions for outpatients at other military bases around the country, from Fort Lewis in Washington state to Fort Dix in New Jersey. They tell stories — their own versions, not verified — of callous responses to combat stress and a system ill equipped to handle another generation of psychologically scarred vets. 


Yet, this is the alternative universe from how we usually categorize the poor:

Maj. Gen. George W. Weightman, [now former] commander at Walter Reed, said…a major reason outpatients stay so long, a change from the days when injured soldiers were discharged as quickly as possible, is that the Army wants to be able to hang on to as many soldiers as it can, “because this is the first time this country has fought a war for so long with an all-volunteer force since the Revolution.”

As such, there is the usual hyper-active level of political shaming, finger-pointing and promises of reparations reserved for such seemingly unusual, if manmade, disasters, with once again, Bush catching on too late.  Apparently, he “first learned of the troubling allegations regarding Walter Reed from the stories this weekend in The Washington Post.”


I’ll let Wesley stick to the analysis of the political fallout.  What matters to me is the similarities between the living conditions of the nation’s poor and vulnerable U.S. military personnel, two overlapping populations.  I come from a family and community where the Army was a way out; it worked for my dad and one uncle, not so much for the others (though their tattoos are something to see).  Today, two of those uncles face the potential loss of their kids to military service, and in one of them, I’ve never seen such a quick, passionate flood of anger in his face as when he denounced at Christmas dinner the Army and the “lies” they tell to recruits.  This, 40 years later, from a man who now limits his excitement to golf, beer, and plumbing. 

Scholarly research ($) likens the U.S. Armed Forces to a “welfare state” with “similar social welfare purposes.”  A frightening thought when extreme poverty (50% of the federal poverty level, or about $9k/year for a family of four) is at an all-time high here, an alarming 1.7M veterans lack healthcare ($), and women vets are at a significantly greater risk for homelessness than civilian women ($).  (I could go on and on with these studies – gotta love Google Scholar.)

Due to the Iraq war, the Army “to fill its ranks nationwide…in fiscal 2005 accepted its least qualified pool in a decade — falling below quota in high school graduates (87 percent) and taking in more youths scoring in the lowest category of aptitude test (3.9 percent).”  This poor population may look different from the one I’m often describing, it’s whiter and rural than my usual urban emphases, but the struggles, policy challenges, and geographic and cultural segregation are the same.  If you’re like me, you have very few peers in the military (excepting some Officers, perhaps).  Yet, if you’re also like me, the military-as-opportunity rubric is still relevant in your family and community – and pride in service accompanies that. 

I’ve spent most of tonight reading the coverage of this fiasco and thinking about this post.  I hope my readers won’t miss the insidious, socio-economic underbelly of this long-in-coming crisis.


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