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America』s combat veterans
美國的退伍老兵
The waiting wounded
等待的傷員
The government is failing to keep faith with ex-soldiers
美國政府失信於退伍老兵
Mar 23rd 2013 | WASHINGTON, DC |From the print edition
IN WAR, it is said, there are no unwounded soldiers. Bombs that shatter bones also batter brains. Even on the periphery, war afflicts men with aching joints, ringing ears and psychological damage. Imagine, then, the human damage wrought by over a decade of battle.
有人說，戰無不傷。炸彈炸碎了骨頭，也刺傷了心靈。戰爭周邊地區的人們關節疼痛，耳朵轟鳴，心理遭受創傷，痛苦不堪。由此，十多年的戰爭造成的傷害可想而知。
America does not have to. Its wounded warriors are now seeking help in record numbers. Nearly half of its 1.6m soldiers who have served in Iraq and Afghanistan have asked for disability benefits from the government. (Just 21% filed similar claims after the first Gulf war, according to estimates.) With ageing veterans of earlier conflicts also seeking more help, America』s disabled-servicemen population has increased by almost 45% since 2000.
美國就不用想了。美國要求索賠的退伍士兵數量達到了最高點。有160萬士兵參加了伊拉克和阿富汗戰爭，近半數的人都在向政府索要殘疾撫恤金。（據估計，第一次海灣戰爭后僅有21%的人提出相似的訴求）。同時，前幾次戰爭中的退伍老兵現已步入老年，他們也在不斷要求理賠。這樣，2000年以後，美國退伍殘疾軍人的數量增長了約45%。
Some of them may be reacting to a bad economy, perhaps growing shrewder in their pursuit of benefits. But disability claims are also up because of positive developments. Advances in battlefield medicine mean more wounded are surviving their wounds. Mental-health problems once dismissed are now treated seriously. And the Department of Veterans Affairs (VA) has expanded access to benefits for older servicemen who were exposed to Agent Orange in Vietnam or are suffering from Gulf-war syndrome, while easing the requirements for claiming post-traumatic stress disorder (PTSD).
由於經濟不景氣，他們一些人可能會有一些反應。在索賠過程中，可能會變得更精明。但傷殘理賠進展積極，理賠數量也在上升。戰地醫學的進步挽救了大量傷員。心理健康問題的訴求曾經被駁回，現在已嚴肅對待。美國退伍老兵事務部（VA，以下簡稱事務部）在放寬了創傷后應激障礙(PTSD，以下簡稱障礙)理賠要求的同時，還降低受橘劑落葉劑毒害的越戰老兵和患海灣戰爭綜合症老兵提出的理賠門檻。
Having created, by virtue of war, and recognised, by virtue of policy, more wounded veterans, America』s government might have anticipated the challenges they pose. But the system responsible for helping these men and women as they find their ways back into civilian life has been overwhelmed. Ironically, it is Eric Shinseki who oversees this broken bureaucracy. Before becoming Barack Obama』s secretary of veterans』 affairs, the former general earned the ire of George W. Bush』s cabinet by testifying that 「several hundred thousand soldiers」 might be needed in Iraq.
戰爭使更多的士兵受傷，政策也使更多士兵的傷殘得到認證，美國政府已經預料到了這些人帶來的壓力。負責幫助傷殘士兵過上正常人生活的部門已經不堪重負了。具有諷刺意義的是，辛塞奇（Eric Shinseki）是這個爛攤子的負責人，是奧巴馬政府退伍老兵事務部部長。辛塞奇以前當過將軍，因為宣稱需要「成百上千的士兵」參加伊拉克戰爭而引起布希（George W. Bush）內閣的不滿。
Mr Shinseki was right, but now he heads an agency that is both understaffed and ill-equipped. The VA is crumpling under a growing pile of disability claims. In some cases literally: last year the department』s inspector-general said the mounds of paperwork at one regional office threatened the building』s structure. Bureaucrats are completing more claims than ever—over 1m a year in the past three years—and almost three times as many in 2012 as in 2001. But they cannot keep pace with the growing caseload (see chart).
雖然辛塞奇說對了，但眼下他的部門人手不夠、條件簡陋，傷殘理賠文件堆積如山，部門快要崩潰了。部門總監說，去年某地區辦事處呈送了大量的文件，部門的大樓都受到了威脅。現在，要完成的理賠案件比以前都要多――過去三年年均完成量為100萬件之多――2012年幾乎是2001的三倍。
Compound fractures
有創骨折
Nearly 1m veterans are now waiting. On average it takes the VA about nine months to complete a claim. In some big cities the average delay is over 600 days. Those who appeal against a refusal usually wait two years for a resolution. Mr Obama entered the White House with a promise to fix the system, but waiting-times have increased considerably on his watch. Even the navy SEAL who shot Osama bin Laden says he is waiting for his claim to be processed.
有近100萬的老兵正在等候賠償。事務部平均需要9個月才能完成一宗賠償，而某些大城市平均完成的期限則要600天之多。上訴失敗的人通常要等上兩年才能結果。奧巴馬就職時說，要進行整頓，但他上台之後等待的時間又延長了，就連射殺本•拉登的前海豹突擊隊員還在等候結果。
Efforts to improve training and streamline processing have shown little in the way of results. The VA now says it hopes that by 2015 it will be able to process all claims within 125 days. Yet veterans of Iraq and Afghanistan have grown accustomed to rosy projections that come to naught.
雖然已經做出努力來改進培訓並使理賠流程合理化，但收效甚微。事務部說，希望能在2015年前能夠在125天之內完成理賠。但是，伊拉克和阿富汗戰爭的退伍老兵已經習慣了樂觀的前景化為泡影。
A grim result of this bottleneck is that in the past fiscal year over $400m in retroactive benefits was paid to family members of veterans who died waiting. One such veteran was Scott Eiswert, a National Guardsman who returned from Iraq in 2005. Tortured by nightmares of roadside bombs and fallen comrades, Eiswert took to drink. When the doctors at the VA at last found time to see him they diagnosed him with PTSD. But the VA rejected his disability claims, on the ground that his condition could not be tied to specific incidents from his service. In 2008, after learning that his unit was going back to Iraq, he took his own life.
去年美國財政拔款400萬美元，對等待無果而死的退役士兵家屬追加賠償，導致了瓶頸出現，由此產生的後果非常嚴重：斯科特（Scott Eiswert）便是一位。2005年，他從伊拉克戰場返回家鄉，但終日夢見路邊炸彈和逝去的戰友，為擺脫困擾他就借酒澆愁。最後，事務部的醫生抽時間來看他，診斷他患有障礙。鑒於，他的狀況可能和服役時執行任務無關，他的傷殘索賠被駁回。2008年，他得知所在的部隊又要返回伊拉克時，自殺了。
About 20% of Iraq and Afghanistan veterans are thought to suffer from PTSD, though many do not report their problems. Instead they try to dose themselves. A VA study found that veterans suffering from PTSD or depression were about four times more likely to have drug or drink problems. Too many end up in the same desperate place as Eiswert. The VA reported that, on average, 22 veterans committed suicide each day in 2010. Last year more active-duty soldiers took their own lives than were killed in combat.
約20%的伊拉克和阿富汗戰爭的老兵被認為患有障礙，但是很多人都沒有說明自己的情況，他們就給自己注射針劑治療。事務部研究發現，患有障礙或抑鬱症的退役士兵是吸毒者或酗酒者的四倍多。很多人跟艾斯維特（Eiswert）一樣絕望，都是自殺身亡。事務部有報道說，2010年每天平均有22人自殺。去年，自殺的現役士兵比在戰鬥中致死的還要多。
In 2010 the VA eased its requirements for PTSD claims so that, as Mr Obama put it, soldiers in war zones don』t have to 「take notes to keep for a claims application」. (Eiswert』s family did receive benefits in the end.) But the preponderance of invisible ailments like PTSD makes today』s disability claims more complicated and harder to sort through. Those who were injured in earlier wars typically received compensation for at most a handful of problems; today』s veterans often report ten or more issues each.
2010年，事務部放寬了「障礙」理賠要求，奧巴馬便說，戰場的士兵不必「為索賠記日記了。」（艾斯維特的家人最終也獲得了補償。）但今天，像障礙這樣無形的疾病使傷殘理賠認證更複雜、更困難。早年在戰爭中受傷得到補償的的士兵最多也申報不了多少問題，而現在的退役士兵每人都會申報十項或者更多的問題。
Many afflicted veterans feel isolated. 「There』s just not a lot of people who understand what PTSD is like,」 says Derek Coy, a former marine who waited 13 months for his claim to be approved. Volunteer groups have stepped in, organising disaster-relief missions, bike rides and protests against the VA. The camaraderie, at least, can be therapeutic.
很多受折磨的士兵感覺都被拋棄。「這沒有多少人知道什麼是障礙，」德里克•科依（Derek Coy）說。他曾是一名海軍陸戰隊員，等了13年才得到理賠答覆。有些退役士兵自發地組織起來，騎自行車進行宣傳，抗議事務部。至少，兄弟手足情可以緩解痛苦。
Veterans already tormented by demons and tangled in red tape face further anxieties on the home front. Those recently returned from wars abroad have an unemployment rate 1.7 points higher than the national one. Encouraged by the first lady, Michelle Obama, some firms, including Walmart, IBM and GE, have created programmes to hire more veterans. But veterans』 advocates talk of an inability to translate war-related skills into civilian job qualifications. A soldier who drove a bulldozer in Iraq must get a certificate before doing the same job back home.
這些退役士兵受魔鬼的折磨，還受到繁瑣程序的糾纏，在國內還面臨著更多的焦慮。最近從戰爭返家士兵的失業率比國內高1.7百分點。一些公司，比如沃爾瑪（Walmart），國際商用機器公司（IBM）和通用公司（GE），應第一夫人米歇爾•奧巴馬的號召，已經決定招聘更多的退役士兵。但有些退役士兵說不能把戰時技能運用到日常生活中，因為戰時會開推土機的士兵要想在國內工作必須取得相應的資格證書。
Washington』s budget-cutting is unlikely to help. Flag-waving politicians are loth to slash the VA』s funding. But overall cuts in spending will disproportionately hurt veterans, who made up 28.3% of the federal government』s new hires in 2011. The numbers had been increasing, thanks in part to an administration effort to take on ex-soldiers. Naturally, many of them joined the Pentagon, which has suffered the largest cuts of any department.
華盛頓財政削減計劃也幫不上多大忙。有些政治家愛國主義狂熱，都不願意削減事務部的資金。因為政府支出的削減會不同的傷害退役士兵，2011年他們占政府新僱員的28.3%。某種程度上還要感謝政府吸納退役士兵的努力，就業士兵的數量還在上升。通常他們會到五角大樓工作，補充到人員流失最多的部門。
As America draws down its remaining troops in Afghanistan, the challenges facing veterans may become larger still. A bureaucratic wall separates America』s ex-soldiers from the benefits they have earned, and it is growing higher as more veterans confront it. Many of those still serving in Afghanistan will come home seeking compassion, only to find new battles in store.
雖然美國還要吸納從阿富汗返回的士兵，但退役士兵還會面臨更大的挑戰：行政管制，這樣就得不到應有的補償。而且還會有更多的士兵受到管制，管制還會加強。那些仍在阿富汗服役的士兵本想回家找些安慰，到頭來卻發現面前仍是新的戰鬥。
From the print edition: United States
美國的退伍老兵
The waiting wounded
等待的傷員
The government is failing to keep faith with ex-soldiers
美國政府失信於退伍老兵
Mar 23rd 2013 | WASHINGTON, DC |From the print edition
IN WAR, it is said, there are no unwounded soldiers. Bombs that shatter bones also batter brains. Even on the periphery, war afflicts men with aching joints, ringing ears and psychological damage. Imagine, then, the human damage wrought by over a decade of battle.
有人說，戰無不傷。炸彈炸碎了骨頭，也刺傷了心靈。戰爭周邊地區的人們關節疼痛，耳朵轟鳴，心理遭受創傷，痛苦不堪。由此，十多年的戰爭造成的傷害可想而知。
America does not have to. Its wounded warriors are now seeking help in record numbers. Nearly half of its 1.6m soldiers who have served in Iraq and Afghanistan have asked for disability benefits from the government. (Just 21% filed similar claims after the first Gulf war, according to estimates.) With ageing veterans of earlier conflicts also seeking more help, America』s disabled-servicemen population has increased by almost 45% since 2000.
美國就不用想了。美國要求索賠的退伍士兵數量達到了最高點。有160萬士兵參加了伊拉克和阿富汗戰爭，近半數的人都在向政府索要殘疾撫恤金。（據估計，第一次海灣戰爭后僅有21%的人提出相似的訴求）。同時，前幾次戰爭中的退伍老兵現已步入老年，他們也在不斷要求理賠。這樣，2000年以後，美國退伍殘疾軍人的數量增長了約45%。
Some of them may be reacting to a bad economy, perhaps growing shrewder in their pursuit of benefits. But disability claims are also up because of positive developments. Advances in battlefield medicine mean more wounded are surviving their wounds. Mental-health problems once dismissed are now treated seriously. And the Department of Veterans Affairs (VA) has expanded access to benefits for older servicemen who were exposed to Agent Orange in Vietnam or are suffering from Gulf-war syndrome, while easing the requirements for claiming post-traumatic stress disorder (PTSD).
由於經濟不景氣，他們一些人可能會有一些反應。在索賠過程中，可能會變得更精明。但傷殘理賠進展積極，理賠數量也在上升。戰地醫學的進步挽救了大量傷員。心理健康問題的訴求曾經被駁回，現在已嚴肅對待。美國退伍老兵事務部（VA，以下簡稱事務部）在放寬了創傷后應激障礙(PTSD，以下簡稱障礙)理賠要求的同時，還降低受橘劑落葉劑毒害的越戰老兵和患海灣戰爭綜合症老兵提出的理賠門檻。
Having created, by virtue of war, and recognised, by virtue of policy, more wounded veterans, America』s government might have anticipated the challenges they pose. But the system responsible for helping these men and women as they find their ways back into civilian life has been overwhelmed. Ironically, it is Eric Shinseki who oversees this broken bureaucracy. Before becoming Barack Obama』s secretary of veterans』 affairs, the former general earned the ire of George W. Bush』s cabinet by testifying that 「several hundred thousand soldiers」 might be needed in Iraq.
戰爭使更多的士兵受傷，政策也使更多士兵的傷殘得到認證，美國政府已經預料到了這些人帶來的壓力。負責幫助傷殘士兵過上正常人生活的部門已經不堪重負了。具有諷刺意義的是，辛塞奇（Eric Shinseki）是這個爛攤子的負責人，是奧巴馬政府退伍老兵事務部部長。辛塞奇以前當過將軍，因為宣稱需要「成百上千的士兵」參加伊拉克戰爭而引起布希（George W. Bush）內閣的不滿。
Mr Shinseki was right, but now he heads an agency that is both understaffed and ill-equipped. The VA is crumpling under a growing pile of disability claims. In some cases literally: last year the department』s inspector-general said the mounds of paperwork at one regional office threatened the building』s structure. Bureaucrats are completing more claims than ever—over 1m a year in the past three years—and almost three times as many in 2012 as in 2001. But they cannot keep pace with the growing caseload (see chart).
雖然辛塞奇說對了，但眼下他的部門人手不夠、條件簡陋，傷殘理賠文件堆積如山，部門快要崩潰了。部門總監說，去年某地區辦事處呈送了大量的文件，部門的大樓都受到了威脅。現在，要完成的理賠案件比以前都要多――過去三年年均完成量為100萬件之多――2012年幾乎是2001的三倍。
Compound fractures
有創骨折
Nearly 1m veterans are now waiting. On average it takes the VA about nine months to complete a claim. In some big cities the average delay is over 600 days. Those who appeal against a refusal usually wait two years for a resolution. Mr Obama entered the White House with a promise to fix the system, but waiting-times have increased considerably on his watch. Even the navy SEAL who shot Osama bin Laden says he is waiting for his claim to be processed.
有近100萬的老兵正在等候賠償。事務部平均需要9個月才能完成一宗賠償，而某些大城市平均完成的期限則要600天之多。上訴失敗的人通常要等上兩年才能結果。奧巴馬就職時說，要進行整頓，但他上台之後等待的時間又延長了，就連射殺本•拉登的前海豹突擊隊員還在等候結果。
Efforts to improve training and streamline processing have shown little in the way of results. The VA now says it hopes that by 2015 it will be able to process all claims within 125 days. Yet veterans of Iraq and Afghanistan have grown accustomed to rosy projections that come to naught.
雖然已經做出努力來改進培訓並使理賠流程合理化，但收效甚微。事務部說，希望能在2015年前能夠在125天之內完成理賠。但是，伊拉克和阿富汗戰爭的退伍老兵已經習慣了樂觀的前景化為泡影。
A grim result of this bottleneck is that in the past fiscal year over $400m in retroactive benefits was paid to family members of veterans who died waiting. One such veteran was Scott Eiswert, a National Guardsman who returned from Iraq in 2005. Tortured by nightmares of roadside bombs and fallen comrades, Eiswert took to drink. When the doctors at the VA at last found time to see him they diagnosed him with PTSD. But the VA rejected his disability claims, on the ground that his condition could not be tied to specific incidents from his service. In 2008, after learning that his unit was going back to Iraq, he took his own life.
去年美國財政拔款400萬美元，對等待無果而死的退役士兵家屬追加賠償，導致了瓶頸出現，由此產生的後果非常嚴重：斯科特（Scott Eiswert）便是一位。2005年，他從伊拉克戰場返回家鄉，但終日夢見路邊炸彈和逝去的戰友，為擺脫困擾他就借酒澆愁。最後，事務部的醫生抽時間來看他，診斷他患有障礙。鑒於，他的狀況可能和服役時執行任務無關，他的傷殘索賠被駁回。2008年，他得知所在的部隊又要返回伊拉克時，自殺了。
About 20% of Iraq and Afghanistan veterans are thought to suffer from PTSD, though many do not report their problems. Instead they try to dose themselves. A VA study found that veterans suffering from PTSD or depression were about four times more likely to have drug or drink problems. Too many end up in the same desperate place as Eiswert. The VA reported that, on average, 22 veterans committed suicide each day in 2010. Last year more active-duty soldiers took their own lives than were killed in combat.
約20%的伊拉克和阿富汗戰爭的老兵被認為患有障礙，但是很多人都沒有說明自己的情況，他們就給自己注射針劑治療。事務部研究發現，患有障礙或抑鬱症的退役士兵是吸毒者或酗酒者的四倍多。很多人跟艾斯維特（Eiswert）一樣絕望，都是自殺身亡。事務部有報道說，2010年每天平均有22人自殺。去年，自殺的現役士兵比在戰鬥中致死的還要多。
In 2010 the VA eased its requirements for PTSD claims so that, as Mr Obama put it, soldiers in war zones don』t have to 「take notes to keep for a claims application」. (Eiswert』s family did receive benefits in the end.) But the preponderance of invisible ailments like PTSD makes today』s disability claims more complicated and harder to sort through. Those who were injured in earlier wars typically received compensation for at most a handful of problems; today』s veterans often report ten or more issues each.
2010年，事務部放寬了「障礙」理賠要求，奧巴馬便說，戰場的士兵不必「為索賠記日記了。」（艾斯維特的家人最終也獲得了補償。）但今天，像障礙這樣無形的疾病使傷殘理賠認證更複雜、更困難。早年在戰爭中受傷得到補償的的士兵最多也申報不了多少問題，而現在的退役士兵每人都會申報十項或者更多的問題。
Many afflicted veterans feel isolated. 「There』s just not a lot of people who understand what PTSD is like,」 says Derek Coy, a former marine who waited 13 months for his claim to be approved. Volunteer groups have stepped in, organising disaster-relief missions, bike rides and protests against the VA. The camaraderie, at least, can be therapeutic.
很多受折磨的士兵感覺都被拋棄。「這沒有多少人知道什麼是障礙，」德里克•科依（Derek Coy）說。他曾是一名海軍陸戰隊員，等了13年才得到理賠答覆。有些退役士兵自發地組織起來，騎自行車進行宣傳，抗議事務部。至少，兄弟手足情可以緩解痛苦。
Veterans already tormented by demons and tangled in red tape face further anxieties on the home front. Those recently returned from wars abroad have an unemployment rate 1.7 points higher than the national one. Encouraged by the first lady, Michelle Obama, some firms, including Walmart, IBM and GE, have created programmes to hire more veterans. But veterans』 advocates talk of an inability to translate war-related skills into civilian job qualifications. A soldier who drove a bulldozer in Iraq must get a certificate before doing the same job back home.
這些退役士兵受魔鬼的折磨，還受到繁瑣程序的糾纏，在國內還面臨著更多的焦慮。最近從戰爭返家士兵的失業率比國內高1.7百分點。一些公司，比如沃爾瑪（Walmart），國際商用機器公司（IBM）和通用公司（GE），應第一夫人米歇爾•奧巴馬的號召，已經決定招聘更多的退役士兵。但有些退役士兵說不能把戰時技能運用到日常生活中，因為戰時會開推土機的士兵要想在國內工作必須取得相應的資格證書。
Washington』s budget-cutting is unlikely to help. Flag-waving politicians are loth to slash the VA』s funding. But overall cuts in spending will disproportionately hurt veterans, who made up 28.3% of the federal government』s new hires in 2011. The numbers had been increasing, thanks in part to an administration effort to take on ex-soldiers. Naturally, many of them joined the Pentagon, which has suffered the largest cuts of any department.
華盛頓財政削減計劃也幫不上多大忙。有些政治家愛國主義狂熱，都不願意削減事務部的資金。因為政府支出的削減會不同的傷害退役士兵，2011年他們占政府新僱員的28.3%。某種程度上還要感謝政府吸納退役士兵的努力，就業士兵的數量還在上升。通常他們會到五角大樓工作，補充到人員流失最多的部門。
As America draws down its remaining troops in Afghanistan, the challenges facing veterans may become larger still. A bureaucratic wall separates America』s ex-soldiers from the benefits they have earned, and it is growing higher as more veterans confront it. Many of those still serving in Afghanistan will come home seeking compassion, only to find new battles in store.
雖然美國還要吸納從阿富汗返回的士兵，但退役士兵還會面臨更大的挑戰：行政管制，這樣就得不到應有的補償。而且還會有更多的士兵受到管制，管制還會加強。那些仍在阿富汗服役的士兵本想回家找些安慰，到頭來卻發現面前仍是新的戰鬥。
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