OCEANSIDE, Calif. - Kristine Wise remembers driving from San Diego to Victorville, Calif., to visit her brother and seeing haunting messages on the freeway signs. Instead of the speed limit or the miles to the next town, she envisioned: Beware of Snipers. Watch Out for Bombs. 40 miles to Baghdad. Death Ahead.
"It was horrible'' said Wise, who served in Iraq with the Army in 2003 and 2004.
The disturbing images are part of the anxiety and panic attacks she has suffered since serving as a supply clerk just as the insurgency was becoming proficient at killing Americans with roadside bombs and suicide attacks.
In Iraq, her depression ran so deep that she wrote a suicide poem: "The pressure is too great / I'm going to crack and fall apart / ... My casket is now fully covered, it looks nice.'' Sent back to Germany, Wise received psychiatric and medical treatment before she was honorably discharged in 2004, two years early.
Now 40 and a student at Cal State San Marcos, she is part of a growing phenomenon: large numbers of women who have been traumatized by military service.
The number of female veterans being treated by the Department of Veterans Affairs has doubled in recent years and is expected to double again within a decade. The swift demographic change has prompted some veterans' advocates to assert that the VA has not responded adequately to women's mental and physical health care needs.
Moves are under way in both houses of Congress to prod the VA, a massive organization that has historically been dedicated to the treatment of men, to improve service to female veterans. VA officials say they have gotten the message.
More than 240,000 female soldiers, Marines, sailors and airmen - about 11 percent of the overall force - have been deployed to Iraq or Afghanistan.
Through Oct. 1, 11,713 female veterans had been diagnosed by the VA with post-traumatic stress disorder, a number that does not include thousands who are still on active duty and received a similar diagnosis from military health specialists.
Through mid-2009, 5,100 female veterans were receiving disability benefits for stress, compared with 57,732 men.
There have yet to be comprehensive studies about how women are affected differently than men in war zones in Iraq and Afghanistan.
U.S. Sen. Patty Murray, D-Wash., a leading VA critic, has called for a study to determine whether a bias toward men makes it more difficult for women to receive disability payments.
Some preliminary statistics and anecdotal evidence collected by clinicians suggests that women are experiencing physical and emotional problems at a higher rate than their male counterparts, although firm numbers are not available.
By one study, about 40 percent of female veterans from Iraq and Afghanistan are seeking care at the VA, compared with 22 percent of male veterans.
In San Diego County, which has a large military population, female veterans are more likely to have a mix of physical and emotional problems than men. The divorce rate among enlisted women is three times that of enlisted men.
Rep. Bob Filner, D-Calif., chairman of the House Committee on Veterans Affairs, said the VA's response to women's needs has been "too slow and not comprehensive enough. It's not just a money thing, it's a major culture shift.''
A bill passed in November by the Senate would authorize a comprehensive study of the VA's treatment of women by outside researchers. A companion bill is pending in the House. Filner wants a Women's Veterans Bill of Rights.
Patricia Hayes, chief consultant for the Women's Veterans Health Strategic Health care Group at the VA, said four-day seminars are being held nationwide with the goal of training 1,200 employees to become specialists in women's health issues.
At a hearing held last spring by Filner's committee, Anuradha K. Bhagwati, executive director of Service Women's Action Network, told lawmakers that many women continue to receive inferior care at VA hospitals.
"Attending a VA medical appointment as a woman veteran can be a traumatic experience,'' she said. "VA employees sometimes fail to acknowledge the prevalence of servicewomen throughout the armed forces, forcing women to 'prove' their veteran status.''
Filner said the VA needs to make sure its employees, starting with its doctors, realize that women are serving in combat.
"We had a woman who lost her arm in Fallujah, but the doctor couldn't recognize that women are in combat and figured it must have been cancer,'' he said. "If a woman feels disrespected like that, she's not going to seek the care she deserves.''
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