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Opinion

Adding insult to injuries

| Saturday, Oct. 1, 2011

Only the U.S. military could build a defensive wall of words — "dismounted complex blast injury" (DCBI) — around the bare fact that single, double, triple, even quadruple amputations are up sharply among U.S. forces on foot patrol in Afghanistan. So are associated pelvic, abdominal and genital injuries, according to a newly released report.

Even the antiseptic language of the report is excruciating, as when it calls for "further refinement" of "aggressive pain management at the POI (point of injury)" or highlights the need to train more military urologists in "phallic reconstruction surgery."

It isn't management but prevention that is called for.

These grievous injuries have increased because more U.S. forces are on foot patrol in Afghanistan. More Americans are on foot patrol in Afghanistan because counterinsurgency strategy puts them there. Every story I've seen on the new amputation report makes this connection.

An Associated Press account is typical: "The counterinsurgency tactic that is sending U.S. soldiers out on foot patrols among the Afghan people, rather than riding in armored vehicles, has contributed to a dramatic increase in arm and leg amputations, genital injuries and the loss of multiple limbs following blast injuries."

But what exactly this counterinsurgency (COIN) tactic is designed to accomplish remains off the radar.

The fact is, Uncle Sam is asking young Americans to risk limbs and urinary function to win something not only intangible but also fantastical. They walk the bomb-packed byways of Afghanistan to win -- to "earn" -- "the trust of the Afghan people." This is the mythological, see-no-Islam quest that drives U.S. COIN strategy.

One year later, the Army is reckoning with the carnage and after-care requirements that are consequences of this key tactic of COIN strategy. It is high time for the rest of us to reckon with them, too. Is COIN working• Is the burden of suffering that the nation is placing on the military worth the return• Frankly, when it comes to winning "the trust of the Afghan people," is there any return?

These questions didn't come up in the new report, naturally. Which isn't to say the report was devoid of political consciousness.

By way of background, the report defines "dismounted complex blast injury" as a new pattern of injury. The definition is: "An injury caused by an explosion occurring to a Service Member while dismounted in a combat theater that results in amputation of at least one lower extremity at the knee or above, with either amputation or severe injury to the opposite lower limb, combined with pelvic, abdominal or urogenital injury. This definition is not meant to define a subset of injuries for policy-making decisions."

Oh, yeah?

Diana West is the author of "The Death of the Grown-up: How America's Arrested Development Is Bringing Down Western Civilization" and blogs at dianawest.net . She can be contacted via dianawest@verizon.net .

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