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America’s combat veterans
美国的退伍老兵
The waiting wounded
等待的伤员
The government is failing to keep faith with ex-soldiers
美国政府失信于退伍老兵
Mar 23rd 2013 | WASHINGTON, DC |From the print edition
IN WAR, it is said, there are no unwounded soldiers. Bombs that shatter bones also batter brains. Even on the periphery, war afflicts men with aching joints, ringing ears and psychological damage. Imagine, then, the human damage wrought by over a decade of battle.
有人说，战无不伤。炸弹炸碎了骨头，也刺伤了心灵。战争周边地区的人们关节疼痛，耳朵轰鸣，心理遭受创伤，痛苦不堪。由此，十多年的战争造成的伤害可想而知。
America does not have to. Its wounded warriors are now seeking help in record numbers. Nearly half of its 1.6m soldiers who have served in Iraq and Afghanistan have asked for disability benefits from the government. (Just 21% filed similar claims after the first Gulf war, according to estimates.) With ageing veterans of earlier conflicts also seeking more help, America’s disabled-servicemen population has increased by almost 45% since 2000.
美国就不用想了。美国要求索赔的退伍士兵数量达到了最高点。有160万士兵参加了伊拉克和阿富汗战争，近半数的人都在向政府索要残疾抚恤金。（据估计，第一次海湾战争后仅有21%的人提出相似的诉求）。同时，前几次战争中的退伍老兵现已步入老年，他们也在不断要求理赔。这样，2000年以后，美国退伍残疾军人的数量增长了约45%。
Some of them may be reacting to a bad economy, perhaps growing shrewder in their pursuit of benefits. But disability claims are also up because of positive developments. Advances in battlefield medicine mean more wounded are surviving their wounds. Mental-health problems once dismissed are now treated seriously. And the Department of Veterans Affairs (VA) has expanded access to benefits for older servicemen who were exposed to Agent Orange in Vietnam or are suffering from Gulf-war syndrome, while easing the requirements for claiming post-traumatic stress disorder (PTSD).
由于经济不景气，他们一些人可能会有一些反应。在索赔过程中，可能会变得更精明。但伤残理赔进展积极，理赔数量也在上升。战地医学的进步挽救了大量伤员。心理健康问题的诉求曾经被驳回，现在已严肃对待。美国退伍老兵事务部（VA，以下简称事务部）在放宽了创伤后应激障碍(PTSD，以下简称障碍)理赔要求的同时，还降低受橘剂落叶剂毒害的越战老兵和患海湾战争综合症老兵提出的理赔门槛。
Having created, by virtue of war, and recognised, by virtue of policy, more wounded veterans, America’s government might have anticipated the challenges they pose. But the system responsible for helping these men and women as they find their ways back into civilian life has been overwhelmed. Ironically, it is Eric Shinseki who oversees this broken bureaucracy. Before becoming Barack Obama’s secretary of veterans’ affairs, the former general earned the ire of George W. Bush’s cabinet by testifying that “several hundred thousand soldiers” might be needed in Iraq.
战争使更多的士兵受伤，政策也使更多士兵的伤残得到认证，美国政府已经预料到了这些人带来的压力。负责帮助伤残士兵过上正常人生活的部门已经不堪重负了。具有讽刺意义的是，辛塞奇（Eric Shinseki）是这个烂摊子的负责人，是奥巴马政府退伍老兵事务部部长。辛塞奇以前当过将军，因为宣称需要“成百上千的士兵”参加伊拉克战争而引起布什（George W. Bush）内阁的不满。
Mr Shinseki was right, but now he heads an agency that is both understaffed and ill-equipped. The VA is crumpling under a growing pile of disability claims. In some cases literally: last year the department’s inspector-general said the mounds of paperwork at one regional office threatened the building’s structure. Bureaucrats are completing more claims than ever—over 1m a year in the past three years—and almost three times as many in 2012 as in 2001. But they cannot keep pace with the growing caseload (see chart).
虽然辛塞奇说对了，但眼下他的部门人手不够、条件简陋，伤残理赔文件堆积如山，部门快要崩溃了。部门总监说，去年某地区办事处呈送了大量的文件，部门的大楼都受到了威胁。现在，要完成的理赔案件比以前都要多――过去三年年均完成量为100万件之多――2012年几乎是2001的三倍。
Compound fractures
有创骨折
Nearly 1m veterans are now waiting. On average it takes the VA about nine months to complete a claim. In some big cities the average delay is over 600 days. Those who appeal against a refusal usually wait two years for a resolution. Mr Obama entered the White House with a promise to fix the system, but waiting-times have increased considerably on his watch. Even the navy SEAL who shot Osama bin Laden says he is waiting for his claim to be processed.
有近100万的老兵正在等候赔偿。事务部平均需要9个月才能完成一宗赔偿，而某些大城市平均完成的期限则要600天之多。上诉失败的人通常要等上两年才能结果。奥巴马就职时说，要进行整顿，但他上台之后等待的时间又延长了，就连射杀本•拉登的前海豹突击队员还在等候结果。
Efforts to improve training and streamline processing have shown little in the way of results. The VA now says it hopes that by 2015 it will be able to process all claims within 125 days. Yet veterans of Iraq and Afghanistan have grown accustomed to rosy projections that come to naught.
虽然已经做出努力来改进培训并使理赔流程合理化，但收效甚微。事务部说，希望能在2015年前能够在125天之内完成理赔。但是，伊拉克和阿富汗战争的退伍老兵已经习惯了乐观的前景化为泡影。
A grim result of this bottleneck is that in the past fiscal year over $400m in retroactive benefits was paid to family members of veterans who died waiting. One such veteran was Scott Eiswert, a National Guardsman who returned from Iraq in 2005. Tortured by nightmares of roadside bombs and fallen comrades, Eiswert took to drink. When the doctors at the VA at last found time to see him they diagnosed him with PTSD. But the VA rejected his disability claims, on the ground that his condition could not be tied to specific incidents from his service. In 2008, after learning that his unit was going back to Iraq, he took his own life.
去年美国财政拔款400万美元，对等待无果而死的退役士兵家属追加赔偿，导致了瓶颈出现，由此产生的后果非常严重：斯科特（Scott Eiswert）便是一位。2005年，他从伊拉克战场返回家乡，但终日梦见路边炸弹和逝去的战友，为摆脱困扰他就借酒浇愁。最后，事务部的医生抽时间来看他，诊断他患有障碍。鉴于，他的状况可能和服役时执行任务无关，他的伤残索赔被驳回。2008年，他得知所在的部队又要返回伊拉克时，自杀了。
About 20% of Iraq and Afghanistan veterans are thought to suffer from PTSD, though many do not report their problems. Instead they try to dose themselves. A VA study found that veterans suffering from PTSD or depression were about four times more likely to have drug or drink problems. Too many end up in the same desperate place as Eiswert. The VA reported that, on average, 22 veterans committed suicide each day in 2010. Last year more active-duty soldiers took their own lives than were killed in combat.
约20%的伊拉克和阿富汗战争的老兵被认为患有障碍，但是很多人都没有说明自己的情况，他们就给自己注射针剂治疗。事务部研究发现，患有障碍或抑郁症的退役士兵是吸毒者或酗酒者的四倍多。很多人跟艾斯维特（Eiswert）一样绝望，都是自杀身亡。事务部有报道说，2010年每天平均有22人自杀。去年，自杀的现役士兵比在战斗中致死的还要多。
In 2010 the VA eased its requirements for PTSD claims so that, as Mr Obama put it, soldiers in war zones don’t have to “take notes to keep for a claims application”. (Eiswert’s family did receive benefits in the end.) But the preponderance of invisible ailments like PTSD makes today’s disability claims more complicated and harder to sort through. Those who were injured in earlier wars typically received compensation for at most a handful of problems; today’s veterans often report ten or more issues each.
2010年，事务部放宽了“障碍”理赔要求，奥巴马便说，战场的士兵不必“为索赔记日记了。”（艾斯维特的家人最终也获得了补偿。）但今天，像障碍这样无形的疾病使伤残理赔认证更复杂、更困难。早年在战争中受伤得到补偿的的士兵最多也申报不了多少问题，而现在的退役士兵每人都会申报十项或者更多的问题。
Many afflicted veterans feel isolated. “There’s just not a lot of people who understand what PTSD is like,” says Derek Coy, a former marine who waited 13 months for his claim to be approved. Volunteer groups have stepped in, organising disaster-relief missions, bike rides and protests against the VA. The camaraderie, at least, can be therapeutic.
很多受折磨的士兵感觉都被抛弃。“这没有多少人知道什么是障碍，”德里克•科依（Derek Coy）说。他曾是一名海军陆战队员，等了13年才得到理赔答复。有些退役士兵自发地组织起来，骑自行车进行宣传，抗议事务部。至少，兄弟手足情可以缓解痛苦。
Veterans already tormented by demons and tangled in red tape face further anxieties on the home front. Those recently returned from wars abroad have an unemployment rate 1.7 points higher than the national one. Encouraged by the first lady, Michelle Obama, some firms, including Walmart, IBM and GE, have created programmes to hire more veterans. But veterans’ advocates talk of an inability to translate war-related skills into civilian job qualifications. A soldier who drove a bulldozer in Iraq must get a certificate before doing the same job back home.
这些退役士兵受魔鬼的折磨，还受到繁琐程序的纠缠，在国内还面临着更多的焦虑。最近从战争返家士兵的失业率比国内高1.7百分点。一些公司，比如沃尔玛（Walmart），国际商用机器公司（IBM）和通用公司（GE），应第一夫人米歇尔•奥巴马的号召，已经决定招聘更多的退役士兵。但有些退役士兵说不能把战时技能运用到日常生活中，因为战时会开推土机的士兵要想在国内工作必须取得相应的资格证书。
Washington’s budget-cutting is unlikely to help. Flag-waving politicians are loth to slash the VA’s funding. But overall cuts in spending will disproportionately hurt veterans, who made up 28.3% of the federal government’s new hires in 2011. The numbers had been increasing, thanks in part to an administration effort to take on ex-soldiers. Naturally, many of them joined the Pentagon, which has suffered the largest cuts of any department.
华盛顿财政削减计划也帮不上多大忙。有些政治家爱国主义狂热，都不愿意削减事务部的资金。因为政府支出的削减会不同的伤害退役士兵，2011年他们占政府新雇员的28.3%。某种程度上还要感谢政府吸纳退役士兵的努力，就业士兵的数量还在上升。通常他们会到五角大楼工作，补充到人员流失最多的部门。
As America draws down its remaining troops in Afghanistan, the challenges facing veterans may become larger still. A bureaucratic wall separates America’s ex-soldiers from the benefits they have earned, and it is growing higher as more veterans confront it. Many of those still serving in Afghanistan will come home seeking compassion, only to find new battles in store.
虽然美国还要吸纳从阿富汗返回的士兵，但退役士兵还会面临更大的挑战：行政管制，这样就得不到应有的补偿。而且还会有更多的士兵受到管制，管制还会加强。那些仍在阿富汗服役的士兵本想回家找些安慰，到头来却发现面前仍是新的战斗。
From the print edition: United States
美国的退伍老兵
The waiting wounded
等待的伤员
The government is failing to keep faith with ex-soldiers
美国政府失信于退伍老兵
Mar 23rd 2013 | WASHINGTON, DC |From the print edition
IN WAR, it is said, there are no unwounded soldiers. Bombs that shatter bones also batter brains. Even on the periphery, war afflicts men with aching joints, ringing ears and psychological damage. Imagine, then, the human damage wrought by over a decade of battle.
有人说，战无不伤。炸弹炸碎了骨头，也刺伤了心灵。战争周边地区的人们关节疼痛，耳朵轰鸣，心理遭受创伤，痛苦不堪。由此，十多年的战争造成的伤害可想而知。
America does not have to. Its wounded warriors are now seeking help in record numbers. Nearly half of its 1.6m soldiers who have served in Iraq and Afghanistan have asked for disability benefits from the government. (Just 21% filed similar claims after the first Gulf war, according to estimates.) With ageing veterans of earlier conflicts also seeking more help, America’s disabled-servicemen population has increased by almost 45% since 2000.
美国就不用想了。美国要求索赔的退伍士兵数量达到了最高点。有160万士兵参加了伊拉克和阿富汗战争，近半数的人都在向政府索要残疾抚恤金。（据估计，第一次海湾战争后仅有21%的人提出相似的诉求）。同时，前几次战争中的退伍老兵现已步入老年，他们也在不断要求理赔。这样，2000年以后，美国退伍残疾军人的数量增长了约45%。
Some of them may be reacting to a bad economy, perhaps growing shrewder in their pursuit of benefits. But disability claims are also up because of positive developments. Advances in battlefield medicine mean more wounded are surviving their wounds. Mental-health problems once dismissed are now treated seriously. And the Department of Veterans Affairs (VA) has expanded access to benefits for older servicemen who were exposed to Agent Orange in Vietnam or are suffering from Gulf-war syndrome, while easing the requirements for claiming post-traumatic stress disorder (PTSD).
由于经济不景气，他们一些人可能会有一些反应。在索赔过程中，可能会变得更精明。但伤残理赔进展积极，理赔数量也在上升。战地医学的进步挽救了大量伤员。心理健康问题的诉求曾经被驳回，现在已严肃对待。美国退伍老兵事务部（VA，以下简称事务部）在放宽了创伤后应激障碍(PTSD，以下简称障碍)理赔要求的同时，还降低受橘剂落叶剂毒害的越战老兵和患海湾战争综合症老兵提出的理赔门槛。
Having created, by virtue of war, and recognised, by virtue of policy, more wounded veterans, America’s government might have anticipated the challenges they pose. But the system responsible for helping these men and women as they find their ways back into civilian life has been overwhelmed. Ironically, it is Eric Shinseki who oversees this broken bureaucracy. Before becoming Barack Obama’s secretary of veterans’ affairs, the former general earned the ire of George W. Bush’s cabinet by testifying that “several hundred thousand soldiers” might be needed in Iraq.
战争使更多的士兵受伤，政策也使更多士兵的伤残得到认证，美国政府已经预料到了这些人带来的压力。负责帮助伤残士兵过上正常人生活的部门已经不堪重负了。具有讽刺意义的是，辛塞奇（Eric Shinseki）是这个烂摊子的负责人，是奥巴马政府退伍老兵事务部部长。辛塞奇以前当过将军，因为宣称需要“成百上千的士兵”参加伊拉克战争而引起布什（George W. Bush）内阁的不满。
Mr Shinseki was right, but now he heads an agency that is both understaffed and ill-equipped. The VA is crumpling under a growing pile of disability claims. In some cases literally: last year the department’s inspector-general said the mounds of paperwork at one regional office threatened the building’s structure. Bureaucrats are completing more claims than ever—over 1m a year in the past three years—and almost three times as many in 2012 as in 2001. But they cannot keep pace with the growing caseload (see chart).
虽然辛塞奇说对了，但眼下他的部门人手不够、条件简陋，伤残理赔文件堆积如山，部门快要崩溃了。部门总监说，去年某地区办事处呈送了大量的文件，部门的大楼都受到了威胁。现在，要完成的理赔案件比以前都要多――过去三年年均完成量为100万件之多――2012年几乎是2001的三倍。
Compound fractures
有创骨折
Nearly 1m veterans are now waiting. On average it takes the VA about nine months to complete a claim. In some big cities the average delay is over 600 days. Those who appeal against a refusal usually wait two years for a resolution. Mr Obama entered the White House with a promise to fix the system, but waiting-times have increased considerably on his watch. Even the navy SEAL who shot Osama bin Laden says he is waiting for his claim to be processed.
有近100万的老兵正在等候赔偿。事务部平均需要9个月才能完成一宗赔偿，而某些大城市平均完成的期限则要600天之多。上诉失败的人通常要等上两年才能结果。奥巴马就职时说，要进行整顿，但他上台之后等待的时间又延长了，就连射杀本•拉登的前海豹突击队员还在等候结果。
Efforts to improve training and streamline processing have shown little in the way of results. The VA now says it hopes that by 2015 it will be able to process all claims within 125 days. Yet veterans of Iraq and Afghanistan have grown accustomed to rosy projections that come to naught.
虽然已经做出努力来改进培训并使理赔流程合理化，但收效甚微。事务部说，希望能在2015年前能够在125天之内完成理赔。但是，伊拉克和阿富汗战争的退伍老兵已经习惯了乐观的前景化为泡影。
A grim result of this bottleneck is that in the past fiscal year over $400m in retroactive benefits was paid to family members of veterans who died waiting. One such veteran was Scott Eiswert, a National Guardsman who returned from Iraq in 2005. Tortured by nightmares of roadside bombs and fallen comrades, Eiswert took to drink. When the doctors at the VA at last found time to see him they diagnosed him with PTSD. But the VA rejected his disability claims, on the ground that his condition could not be tied to specific incidents from his service. In 2008, after learning that his unit was going back to Iraq, he took his own life.
去年美国财政拔款400万美元，对等待无果而死的退役士兵家属追加赔偿，导致了瓶颈出现，由此产生的后果非常严重：斯科特（Scott Eiswert）便是一位。2005年，他从伊拉克战场返回家乡，但终日梦见路边炸弹和逝去的战友，为摆脱困扰他就借酒浇愁。最后，事务部的医生抽时间来看他，诊断他患有障碍。鉴于，他的状况可能和服役时执行任务无关，他的伤残索赔被驳回。2008年，他得知所在的部队又要返回伊拉克时，自杀了。
About 20% of Iraq and Afghanistan veterans are thought to suffer from PTSD, though many do not report their problems. Instead they try to dose themselves. A VA study found that veterans suffering from PTSD or depression were about four times more likely to have drug or drink problems. Too many end up in the same desperate place as Eiswert. The VA reported that, on average, 22 veterans committed suicide each day in 2010. Last year more active-duty soldiers took their own lives than were killed in combat.
约20%的伊拉克和阿富汗战争的老兵被认为患有障碍，但是很多人都没有说明自己的情况，他们就给自己注射针剂治疗。事务部研究发现，患有障碍或抑郁症的退役士兵是吸毒者或酗酒者的四倍多。很多人跟艾斯维特（Eiswert）一样绝望，都是自杀身亡。事务部有报道说，2010年每天平均有22人自杀。去年，自杀的现役士兵比在战斗中致死的还要多。
In 2010 the VA eased its requirements for PTSD claims so that, as Mr Obama put it, soldiers in war zones don’t have to “take notes to keep for a claims application”. (Eiswert’s family did receive benefits in the end.) But the preponderance of invisible ailments like PTSD makes today’s disability claims more complicated and harder to sort through. Those who were injured in earlier wars typically received compensation for at most a handful of problems; today’s veterans often report ten or more issues each.
2010年，事务部放宽了“障碍”理赔要求，奥巴马便说，战场的士兵不必“为索赔记日记了。”（艾斯维特的家人最终也获得了补偿。）但今天，像障碍这样无形的疾病使伤残理赔认证更复杂、更困难。早年在战争中受伤得到补偿的的士兵最多也申报不了多少问题，而现在的退役士兵每人都会申报十项或者更多的问题。
Many afflicted veterans feel isolated. “There’s just not a lot of people who understand what PTSD is like,” says Derek Coy, a former marine who waited 13 months for his claim to be approved. Volunteer groups have stepped in, organising disaster-relief missions, bike rides and protests against the VA. The camaraderie, at least, can be therapeutic.
很多受折磨的士兵感觉都被抛弃。“这没有多少人知道什么是障碍，”德里克•科依（Derek Coy）说。他曾是一名海军陆战队员，等了13年才得到理赔答复。有些退役士兵自发地组织起来，骑自行车进行宣传，抗议事务部。至少，兄弟手足情可以缓解痛苦。
Veterans already tormented by demons and tangled in red tape face further anxieties on the home front. Those recently returned from wars abroad have an unemployment rate 1.7 points higher than the national one. Encouraged by the first lady, Michelle Obama, some firms, including Walmart, IBM and GE, have created programmes to hire more veterans. But veterans’ advocates talk of an inability to translate war-related skills into civilian job qualifications. A soldier who drove a bulldozer in Iraq must get a certificate before doing the same job back home.
这些退役士兵受魔鬼的折磨，还受到繁琐程序的纠缠，在国内还面临着更多的焦虑。最近从战争返家士兵的失业率比国内高1.7百分点。一些公司，比如沃尔玛（Walmart），国际商用机器公司（IBM）和通用公司（GE），应第一夫人米歇尔•奥巴马的号召，已经决定招聘更多的退役士兵。但有些退役士兵说不能把战时技能运用到日常生活中，因为战时会开推土机的士兵要想在国内工作必须取得相应的资格证书。
Washington’s budget-cutting is unlikely to help. Flag-waving politicians are loth to slash the VA’s funding. But overall cuts in spending will disproportionately hurt veterans, who made up 28.3% of the federal government’s new hires in 2011. The numbers had been increasing, thanks in part to an administration effort to take on ex-soldiers. Naturally, many of them joined the Pentagon, which has suffered the largest cuts of any department.
华盛顿财政削减计划也帮不上多大忙。有些政治家爱国主义狂热，都不愿意削减事务部的资金。因为政府支出的削减会不同的伤害退役士兵，2011年他们占政府新雇员的28.3%。某种程度上还要感谢政府吸纳退役士兵的努力，就业士兵的数量还在上升。通常他们会到五角大楼工作，补充到人员流失最多的部门。
As America draws down its remaining troops in Afghanistan, the challenges facing veterans may become larger still. A bureaucratic wall separates America’s ex-soldiers from the benefits they have earned, and it is growing higher as more veterans confront it. Many of those still serving in Afghanistan will come home seeking compassion, only to find new battles in store.
虽然美国还要吸纳从阿富汗返回的士兵，但退役士兵还会面临更大的挑战：行政管制，这样就得不到应有的补偿。而且还会有更多的士兵受到管制，管制还会加强。那些仍在阿富汗服役的士兵本想回家找些安慰，到头来却发现面前仍是新的战斗。
From the print edition: United States