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Iraq war's human toll could be felt for decades

Beyond fatalities, an average of eight American soldiers a day are wounded.

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Politicians and the press tend to tally the human costs of going to war by counting those killed. So far, that's 311 Americans in Iraq and 88 more as part of "Operation Enduring Freedom" in Afghanistan. If one dates this newly defined "war on terror" back to the 1983 car bomb attack on the US Marine barracks in Lebanon, another 300 or so American lives have been lost.

But the number of those wounded in action (or injured in combat-zone accidents) is far higher. And while combat deaths have been relatively low since the Vietnam War, the ratio of these nonfatal casualties to war fatalities is increasing - from 3 to 1 in World War II to more than 5 to 1 in Iraq (1,691 to date).

With no end in sight to a substantial US presence in Iraq, the number of nonfatal casualties (now averaging more than eight per day) is likely to keep increasing, experts say. And beyond the human dimension, the costs of such casualties, which tend to be overlooked as part of the cost of national security and foreign policy, will continue for decades as well. Among those costs: rehabilitation, retraining, postcombat counseling, long-term medical treatment, and assisted-living care.

Seen positively, the higher ratio of wounded to killed means more soldiers are surviving their battle injuries. Kevlar helmets, body armor with ceramic plates, and top-notch medical facilities nearby all help.

Attacks more severe

But what this also results in is "a large number of survivors with permanent physical and emotional scars, not to mention profound disabilities," says Loren Thompson, head of security studies at the Lexington Institute in Alexandria, Va. "Not only are some wartime wounds uncommonly complex to treat, but the range of treatments provided - including counseling, assisted living, disability benefits, and so on - can be quite extensive."

One reason: the nature of the attacks on US troops in Iraq these days - rocket- propelled grenades and roadside bombs instead of rifle fire - means that injuries often tend to be more traumatic, including loss of limbs.

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