We Served Too: Some Thoughts After Benghazi Regarding Resilience of Civilians Deployed in Conflict Zones and High Threat Security Posts

Soldiers are well trained and prepared psychologically to face armed conflict. Civilian contractors, government servants and diplomats -- who serve alongside and in support of our military -- are not as well trained, prepared or supported pre, during and post deployment as their military counterparts.
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Currently thousands of American civilian workers -- from military contractors, to civilian and foreign service workers (representing the Departments of State, Justice, Commerce, USAID, etc.), as well as reservists and former military who return to do civilian service, bravely serve our nation -- deploying into conflict zones such as Iraq and Afghanistan and into high threat security posts such as Pakistan, Libya and elsewhere. Last year four of these civilians, U.S. Ambassador Christopher Stevens, information officer Sean Smith, and two embassy security personnel Tyrone Woods and Glen Doherty gave the ultimate sacrifice -- these four were killed in Benghazi, Libya as they served our nation.

Soldiers are well trained and prepared psychologically to face armed conflict. Civilian contractors, government servants and diplomats -- who serve alongside and in support of our military -- are not as well trained, prepared or supported pre, during and post deployment as their military counterparts. Yet in recent years we see that they are deployed by the thousands, into uncertain and anxiety-provoking environments. And these facts have serious implications for the psycho-social resilience and physical welfare of our civilian forces deployed in high threat security environments.

And in light of the deaths of a U.S. Ambassador and three of his colleagues, one must ask about the high number of civilians who are crucial to U.S. diplomatic, humanitarian and military efforts around the world -- how are they being treated? Are their sacrifices recognized, honored in any way? Are they adequately prepared and trained prior to their deployments into danger zones, supported in theater, and are their needs being met once they return home -- some of them physically injured or psychologically traumatized? Or are they our unsung heroes, an invisible but massive civilian force serving without recognition for the sacrifices that they too have made in behalf of our nation -- some of them struggling to recover without help after their service to our country?

We know that civilians serving in war and high threat security posts sustain injuries and psychological trauma just as their military counterparts do. However, unlike wounded warriors who are -- at least in theory -- offered healthcare, rehabilitation and support services by the U.S. military, civilians who are maimed or psychological traumatized after serving in conflict zones or high threat security posts often find that they are on their own in regard to obtaining needed services. And some find they must battle their insurance companies to get even basic needs addressed in terms of addressing their wounds sustained in service of our nation.

Already in 2009, according to an LA Times report, many civilian contractors who served in Iraq and Afghanistan found themselves battling their insurance companies to get prosthetic devices for blown off limbs, mental health care, basic services and the like. Moreover, the LA Times reported that over forty percent of claims regarding serious injuries and more than half related to psychological stress by these civilian heroes were rejected by their insurance companies .

While recent scandals with the U.S. Veterans Administration has brought to light the problems wounded warriors face when trying to get health care for medical care from artificial limbs to psychological treatment and other basic services from wounds sustained in service of our nation -- no one it seems is asking what are the needs of those on the nonmilitary side of the house -- the civilian workforce who also served. Are they being met?

In an early effort to study these unsung heroes -- the invisible workforce that both sustains and supports our military while also working alongside it in promoting diplomatic and humanitarian solutions, my NATO colleagues and I put together a pilot study of psycho-social resilience to traumas encountered in Iraq which was published in 2012. In our pilot study we found that exposure to high-threat events including mortar fire, IEDs, bombings and sniper fire resulted in endorsements by respondents -- often up to twenty percent -- of posttraumatic and acute stress symptoms in these civilian workers including: peritraumatic dissociation, flashbacks and traumatic re-experiencing, feeling physically nervous with reminders of the event, amnesia for parts of it, avoidance behaviors, feeling alienated and isolated, emotionally numb, uneasy about the future, feeling jumpy and agitated, sleep disturbances, having difficulty concentrating, panic and anxiety, somatization, depression and even suicidal ideation. Clearly on the psycho-social side many of these civilians paid a high price for service under threat.

To date, very little else has been done in terms of looking at and promoting the resilience of our civilians that serve in conflict zones and high threat security environments. Today a small group of us launched a new initiative named We Served Too (found at www.WeServedToo.org) to begin to give better care and recognition to the needs of these civilian heroes and to raise awareness to their needs. The initiative is only beginning but we believe that civilians serving in conflict zones and high threat security environments need a forum to tell their stories, share their pictures, tell their needs and to gain the recognition they deserve. Just as we take care with our military, we must give care and attention to them as well--to study their needs and then adequately and fully prepare them for deployments, to support them while in theater, and to serve their needs from injuries (both psychic and physical) upon their return back home.

As a civilian who served in her own small way in Iraq (supporting the U.S. Defense Department in building the Detainee Rehabilitation Program) and as a spouse of a U.S. diplomat who served in conflict zones, I want to say in behalf of all civilians who have given years of their lives in overseas service inside conflict zones and high threat security posts--service for which they paid a dear price -- that we need also to proudly proclaim -- We Served Too!

Anne Speckhard, Ph.D. is Adjunct Associate Professor of Psychiatry in the Georgetown University Medical School and author of Talking to Terrorists: Understanding the Psycho-Social Motivations of Militant Jihadi Terrorists, Mass Hostage Takers, Suicide Bombers & "Martyrs" In the last decade she interviewed over four hundred terrorists, suicide bombers, terrorist supporters, family members, close associates and hostages. She also conducted psychological autopsies with a Chechen colleague on over half of the 112 Chechen suicide bombers investigating what put them on the terrorist trajectory and what motivated them to explode themselves.

Miller, Christian & Smith, Doug (2009) Injured war zone contractors fight to get care. April 17, Los Angeles Times.

Speckhard, Anne; Verleye, Gino & Jacuch, Beatrice (2012) Assessing Psycho-Social Resilience in Diplomatic, Civilian & Military Personnel Serving in a High-Threat Security Environment during Counter-Insurgency and Counter-Terrorism Operations in Iraq. Perspectives on Terrorism Volume 6 (3) http://www.terrorismanalysts.com/pt/index.php/pot/article/view/speckhard-assessing-psycho-social/403

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