Historically, non-combat injuries and illnesses have had a significant impact on military missions. We conducted an anonymous cross-sectional survey to assess the prevalence and impact of common ailments among U.S. military personnel deployed to Iraq or Afghanistan during 2003-2004. Among 15,459 persons surveyed, diarrhea (76.8% in Iraq and 54.4% in Afghanistan), respiratory illness (69.1%), non-combat injuries (34.7%), and leishmaniasis (2.1%) were commonly reported. For all causes, 25.2% reported that they required intravenous fluids, 10.4% required hospitalization, and 5.2% required medical evacuation. Among ground units, 12.7% reported that they missed a patrol because of illness, and among air units, 11.7% were grounded because of illness. The incidence of diarrhea and respiratory infections doubled from the pre-combat to combat phases, and the perceived adverse impact of these illnesses on the unit increased significantly during the combat phase. Despite technologic advances in warfare and preventive medicine, illness and non-combat injuries have been common during operations in Iraq and Afghanistan, resulting in frequent transient decreases in operational efficiency.

From Am. J. Trop. Med. Hyg., 73(4), 2005, pp. 713-719

Troops largely surviving wounds of Iraq war

By Dave Moniz
USA Today

U.S. troops are more than twice as likely to survive combat wounds in Iraq than they have been in most wars over the last century, an analysis of the numbers of wounded and killed there shows.

During all major wars in the 20th century, one American service member died for every two to four wounded in combat. But factors such as better protective gear and aggressive new medical techniques now mean that many troops who might have died are now surviving — though some come away with grievous wounds.

The numbers are dramatic: Since the Iraq war began in March, one American service member has been killed for every seven injured in combat. That’s nearly four times better than World War II, when one service member died for about every two wounded.

"This is a good news story. We have been able to save many more wounded service members," says Col. Ron Maul, a physician who is the senior medical adviser at U.S. Central Command in Tampa.

Maul and other medical experts cite several reasons for the sharp increase in the survival rate:

• Wounded troops see surgeons and trauma specialists much more quickly. In Iraq, mobile surgical teams travel with combat units and can begin operating on severely wounded troops in minutes.

• Most troops in Iraq have protective Kevlar body armor that covers vital organs and can repel shrapnel and small-caliber bullets.

• Medics and other first-aid specialists carry blood supplies with them into battle so they can immediately stabilize patients who in previous wars might have bled to death before reaching a field hospital.

• The war in Iraq has been characterized by guerrilla attacks and not by traditional battles involving tanks, aerial bombs and heavy artillery fire.

The ratio of wounded-to-killed has improved even more since May 1, when President Bush declared major combat over. As of Thursday, 1,058 U.S. troops had been wounded and 104 killed by enemy fire since May 1, more than 10 wounded to every one killed.

John Greenwood, chief of the office of medical history at the U.S. Army Medical Command, says body armor has played a critical role. The bulky armor protects the heart, lungs and other areas where injuries are often fatal. "We’re seeing a lot fewer thoracic (chest) wounds than you would normally," Greenwood says.

Since the war began in March, 218 U.S. troops have been killed in action and 1,609 wounded by enemy fire, a ratio of 7.38 to one. Many of the wounded would likely have died before the advent of body armor and the new medical practices, experts say.

Because of the way guerrilla fighters are attacking American forces — with rocket-propelled grenades and land mines — some of the injuries have resulted in amputations or other serious injuries, but not death.