Deployed civilians face hurdles in getting medical treatment

WASHINGTON (AP) -- Civilians deployed to war zones often encounter problems receiving medical treatment and are hesitant to seek help for emotional stress caused by their deployment, a new congressional report finds.

Federal policies on the treatment of nonmilitary personnel - particularly medical screening before and after an individual deploys - are not clearly articulated or widely understood, prompting cases in which some civilians have had trouble receiving benefits or filing claims, the bipartisan report by the House Armed Services oversight and investigations subcommittee says.

Civilians also seem less likely receive help for post-traumatic stress syndrome. The Labor Department says only 11 mental health claims have been filed by federal personnel serving in Iraq or Afghanistan, despite a recent survey of foreign service officers that found more than 100 officers deployed in hardship posts may have symptoms of the stress syndrome, according to the report.

The findings shed light on the complexities of an emerging new phenomenon in federal government: the reliance on its civilian work force to aid a war effort. In recent months, the Bush administration has pushed hard to expand involvement by such agencies as the Agriculture Department and Health and Human Services in rebuilding Iraq and Afghanistan.

Deployment of civilians, however, has been difficult. Unlike the military, in which service members are required to deploy on command, civilian agencies have relied mostly on volunteers and encountered staffing shortages when not enough individuals stepped forward.

According to the Congressional Research Service, only 668 out of 729 posts were filled as of January at the U.S. embassy in Iraq and 294 out of 329 posts at the embassy in Afghanistan.

A recent cable by the State Department warned diplomats that they may be forced to serve in Iraq next year, as it started identifying candidates for jobs at the Baghdad embassy and outlying provinces. A similar call-up notice last year caused an uproar among foreign service officers, some of whom objected to compulsory work in a war zone, although in the end the State Department found enough volunteers to fill the jobs.

The House subcommittee warns in its report that the government must find a way to encourage civilians to serve in war zones on a voluntary basis. The report cites a recent survey that found extra pay and benefits was the No. 1 factor in enticing foreign service officers to volunteer, followed by a sense of patriotism and career development.

"As it is for the military, a motivated and qualified all-volunteer force must be preferred to one populated by reluctant draftees," the subcommittee wrote in its report. "Tomorrow's potential civilian volunteers will well-note how today's deployed members are supported and compensated for these risky assignments."

In his 2009 budget, President Bush requested $249 million to build a response corps that would comprise more than 2,000 federal civilian personnel from all 15 civilian agencies. His plan also would create a separate reserve corps filled with experts from state and local governments and the private sector.


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