Our Obligations
Military service members were exposed to toxic fumes in Afghanistan, now that they're home some are getting sick.
It’s Thursday, June 3rd.
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Since we last spoke, two interesting developments internationally.
First, the border with our neighbors to the north is coming under increasing scrutiny as representatives of the U.S. and Canadian governments push for their respective countries to reconsider standing policy which has largely halted travel between the two countries. Canada’s vaccination totals trail the U.S. but both countries are making serious progress when placed in a global context (map here shows the differences). I wouldn’t book that “Amoosing Memories” cabin near Lake Louise just yet but expect to see progress here in the coming weeks.
Second, Israeli leader Yair Lapid has successfully formed a coalition government with fellow lawmaker and party leader Naftali Bennett and thus, current Prime Minister Benjamin Netanyahu is in the final weeks of his term. The new governing coalition includes parties from across the ideological spectrum and is likely quite fragile. Time will tell how the new government and Prime Minister (Bennett will initially assume the post) will impact any number of issues (primarily the crisis in Palestine).
On the heels of Memorial Day earlier this week, today let’s look at an issue that’s seriously impacted a large number of American Veterans and what policy might be an appropriate response.
Exposure
When Air Force veteran Dan Jentik was serving 10 years in Iraq and Afghanistan, there was likely an endless list of potential dangers that he was actively considering. I find it hard to imagine that when he first deployed, trash was somewhere on that list.
During the U.S. war efforts in both Iraq and Afghanistan, the ways in which the military elected to dispose of trash might not have seemed like a particularly important choice. As military leadership shaped policy, the choices they made now seem to be highly questionable.
Below, let’s briefly describe what a burn pit is and why they were used, how this situation has some relevant historical parallels, and what the critical question is that intersects our values system and policy.
What are burn pits?
Burn pits are large piles of trash gathered directly outside of a U.S. military base which are then set on fire to destroy their contents. The use of burn pits was not, and is not, standard Department of Defense policy. Of course the reason that is true is that there are serious questions about the potential health risks associated with long-term exposure of the smoke and fumes coming off of these pits. This is especially concerning when burning trash such as plastics, batteries, and other sensitive material.
Of course, there are other ways to dispose of garbage. Critically, a 2014 report from the Special Inspector General for Afghanistan Reconstruction speaks specifically to the situation at Shindand Airbase.
At the Airbase in Western Afghanistan, the military awarded multiple contracts for the construction of trash incinerators to be used by both U.S. and Afghan forces. These incinerators cost between $4.4M and $11M each (more on why this matters later).
However, even with the newly constructed incinerators (which were built and delivered in proper working order), the Airbase was only directing 35% of their total waste to the incinerators due to unspecified mechanical problems. That means that despite the theoretical incinerator capacity, ~65% of total Airbase waste was burned in pits in extremely close proximity to the base.
While the exact number of burn pits in-use is unclear, Shindand Airbase was certainly not the only military outpost relying on the crude method of trash destruction. In Afghanistan alone between 2002 and 2015, at least 21 burn pits were used with 10 of them being labeled as high risk for causing at least short-term health risks.
2 parallels
For Americans with military or first responser experience, this basic idea, living/working in an environment that is materially unsafe (outside of the combat or responding scenario), may lead to long-term health problems that go unrecognized or unvalidated.
Two very similar situations stand out:
Vietnam War & Agent Orange: Agent Orange was a powerful (and toxic) herbicide used by the U.S. military during the war to destroy forest cover and crops that Viet Cong forces relied on to stay undetected and feed themselves. While not known at the time, the chemical was later found to cause serious health problems including cancer, rashes, and neurological problems (among others). After returning home, and as some veterans got sick, it then became a drawn out battle with the Veterans Administration to get them to recognize the effects of Agent Orange and to receive full care and compensation.
9/11 & Exposure: When responding to the September 11th attacks on the World Trade Center & The Pentagon, firefighters, police officers, and paramedics were exposed to ash, smoke, and chemical fumes from the plane crashes and subsequent building collapses that took place. Now almost 20 years removed from the attacks, hundreds of first responders have gotten sick or died with illnesses that are potentially related to that prolonged exposure (many first responders were on the scene for days or weeks). It was only in 2019 (and after a prolonged process) that Congress approved a 9/11 victim’s bill to ensure that a compensation fund will never run out of money.
A question & a policy
There is a critical question that runs through the heart of the situation with burn pits, Agent Orange, and 9/11 exposure:
When there is a lack of clear scientific evidence to prove a causal link between exposure to a toxin during service and a resulting illness, what obligation does the government have to provide proactive/comprehensive medical care and compensation to affected individuals?
That is obviously a difficult question and yet from a public policy perspective may not have a particularly challenging or controversial answer.
Remember how those trash incinerators cost between 4.4 and 11 million dollars each? The key point (at least in the context of burn pits) is that negligent military leadership, not the exorbitant expense of an alternative (11 million dollars is a rounding error to the U.S. military) is likely to blame.
Especially in that case, where the military failed service members or first responders, it seems that providing additional resources even ahead of conclusive scientific links may be the best policy. Restricting aid until the evidence is in, risks that service members who are most quickly or severly impacted won’t have the help they need, when they need it.
To that end, both the House and Senate will soon see bills designed to create a fast track system at the VA to direct benefits to veterans who served since 1990 and then developed a respiratory condition or cancer. The bill, if passed, would expand the group of veterans eligible for “presumptive status” for VA benefits which includes comprehensive care and disability compensation.
The question of what individuals who served are “owed” is no doubt complicated, but its a question which unquestionably deserves appropriate factual, historical, and values-based context.
Wonk Wrap
What you could read
A 4 minute article from ProPublica which describes a Tulane University Law School study showing how Immigration and Customs Enforcement (ICE) is significantly more likely to quietly release detainees who challenge their indefinite detentions in court.
What you could think about
South Sudan has administered ~.1 doses of COVID vaccine per 100 people. Using some relatively generous assumptions (i.e., assuming every single dose administered is a single-shot program like J&J or Astra-Zeneca vs. a two-shot program like Pfizer or Moderna), it will take the country, 166 years to vaccinate the entire population. Obviously there are plenty of reasons to believe that in the mid-term (at least compared to 166 years from now), vaccination pace will increase in South Sudan and elsewhere but it’s still striking to see how COVID is still very much a threat in most parts of the world.
With Gratitude,
- Sam