Viewpoint

The VA woman problem

Army Sgt. LaQuisha Gallmon, shown with her three children in their Greenville, S.C., home in June 2014, was authorized by her local VA office to see a private physician during her pregnancy. The VA later refused to pay her emergency room bill.
Army Sgt. LaQuisha Gallmon, shown with her three children in their Greenville, S.C., home in June 2014, was authorized by her local VA office to see a private physician during her pregnancy. The VA later refused to pay her emergency room bill. AP

On Sept. 11, 2001, Desma Brooks was a single mother of three in her mid-20s who served part-time in the Indiana Army National Guard. Watching the attack, she wondered if she might be assigned to a support role on the home front. Instead, she served two yearlong deployments – one in Afghanistan and one in Iraq. During the second, while driving a military vehicle, she hit a roadside bomb. Brooks returned home with a mild case of traumatic brain injury and a serious case of post-traumatic stress disorder.

Of the almost 22 million veterans in the United States today, more than 2 million are women, and of those, more than 635,000 are enrolled in the Department of Veterans Affairs system – double the number before 9/11. Women are the fastest growing group of veterans treated by the VA, and projections show that women will make up more than 16 percent of the country’s veterans by midcentury.

Like Brooks, many female veterans are returning home with PTSD – the No. 1 complaint among women at VA health facilities. Hypertension and depression are the next largest diagnostic categories. And 1 in 5 female veterans treated reported experiencing military sexual trauma.

Unfortunately, these veterans aren’t always getting the care they require from a system designed to serve men. Women have different health care needs than men, and particular expertise is required for women in their childbearing years.

Women’s clinics at VA facilities still don’t offer prenatal care, obstetrics or mammograms, and many are located in basements or obscure corners of the buildings.

Disabled American Veterans, an advocacy and assistance group, recently issued a report called “Women Veterans: The Long Journey Home,” which includes a list of recommended changes. Among them are establishing a culture of respect for women, requiring a gynecologist on staff and adding gender-sensitive mental health programs.

“One of the most perplexing problems is a culture in VA that is not perceived by women as welcoming,” Joy J. Ilem, the group’s deputy national legislative director, said at this year’s Senate hearing.

Part of the solution is simply explaining that female veterans exist. “We are invisible,” says Kathryn Wirkus, founder of Women Veterans of Colorado. “Women vets come home and ... go back to being mothers, wives, schoolteachers, nurses, whatever ... We don’t wear funny hats that say ‘World War II vet.’ If I walked into a room, nobody would think I was a veteran.”

Once, when Wirkus sought treatment at a VA facility in Colorado, a male veteran asked what she was doing there. “They don’t think you’re a veteran,” she said. “They think you’re someone’s spouse.”

Either because they do not believe the VA can offer them care or because they do not understand that they qualify for benefits, eligible women have been 30 percent less likely to enroll in the system than eligible men.

Veterans Affairs has responded by hiring providers with expertise in women’s health, relocating space to make room for women’s clinics and offering training on administering breast exams, gynecological exams and Pap smears.

The problem is not will – it’s money. The VA has to care for all living veterans and demand has increased on every front.

Desma Brooks eventually got the help she needed through regular therapy. And when, like Brooks, the veteran is a mother, the well-being of her children is deeply affected by whether she is able to heal from trauma.

As we put more women in peril, we have to get better at welcoming all veterans back home.

Helen Thorpe is the author of “Soldier Girls: The Battles of Three Women at Home and at War.”

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