Washington State Secretary of Health Mary Selecky has announced plans to retire from state service and return to her longtime home in Colville.
Selecky has served three governors since first being appointed “acting secretary” in October 1998. Her nearly 15 years as Washington’s secretary of health make her one of the longest serving state health leaders in the country. Selecky had been the administrator for the Northeast Tri County Health District in our state for nearly 20 years before taking the state job. She marks 38 years in public service this year.
“Public health affects every person in our state. I’m especially proud of the great progress we’ve made lowering smoking rates and getting more kids vaccinated. We’ll have a healthier future because of it,” said Secretary Selecky. “It has truly been an honor to serve the people of Washington and to work with such dedicated state, local, and tribal public health professionals.”
Under Selecky’s leadership, Washington’s adult smoking rate has dropped 30 percent, and youth smoking rates are down by half; childhood vaccination rates are the highest in years.
“Thanks to Mary, Washington is a healthier place to live and raise a family,” said Gov. Jay Inslee. “I thank her for her valuable service to the people of our state and wish her all the best as she returns to the beautiful town of Colville.”
Secretary Selecky has committed to continuing to lead the Department of Health until a successor is found.
Good health is not shared equally in our state or the nation. Native American men in Washington die seven years before their white neighbors, and babies of black mothers are twice as likely to die before their first birthday compared to the babies of white mothers.
These are just two examples of health inequities faced by racial and ethnic minorities in our state. These so-called health disparities happen because different conditions and resources shape our health. Communities of color tend to have lower incomes and less education, for example. Lower income and less education lead to less access to health care, nutritious food, and safe and healthy environments. The unequal distribution of social and economic resources isn’t the only factor that contributes to health disparities – these inequities show up even when factors such as education and income are taken into account. The added stress of how society treats people of color also contributes to the many factors that lead to inequities in health.
For several years, the Governor’s Interagency Council on Health Disparities (a group of state agency leaders) has been working to address this issue. The council strives to make sure that programs and services offered through the state are culturally and racially appropriate, work to break down barriers, and improve the conditions facing our state’s many diverse ethnic and minority populations. You can learn more about the council’s work and its new top priorities on its website.
While some of the factors that influence health are out of the control of individual people, each of us can take important steps to be as healthy as we can be and to support the healthiness of the places we work, play, and live.
An outbreak of Salmonella illnesses linked to chicken in Washington and other states points out that all poultry products carry the risk of contamination. Thorough cooking and proper preparation and handling can make poultry safe to eat.
Since last June, at least 56 people in Washington got sick from a specific strain of bacteria known as Salmonella Heidelberg. The disease investigation linked that genetic pattern of Salmonella to Foster Farms plants in Washington and California. None of the Washington patients died; 15 were hospitalized.
Salmonella is a common cause of foodborne illness, accounting for 600-800 reported cases in Washington each year. Poultry is common among the many sources of Salmonella bacteria. Salmonella in raw chicken is not limited to any one brand. The U.S. Department of Agriculture allows the sale of raw poultry that contains Salmonella, so the bacteria may be in all brands. In most cases of Salmonella illness, a source is not identified.
Symptoms of Salmonella illness usually include diarrhea, fever and stomach cramps. The symptoms usually begin one to three days after exposure, and the illness usually lasts four to seven days.
Proper poultry handling, preparation, and cooking can help prevent foodborne illness. Raw poultry should be kept separate from other foods; it should always be thawed before cooking to avoid undercooking. Cook poultry to 165 degrees F. Always wash your hands after handling poultry and thoroughly clean utensils and surfaces after preparing poultry.
Pine Ridge Liberation Day Event Turns Into Alcohol-Related Showdown in Whiteclay Nebraska, Says Alcohol Justice
PINE RIDGE, S.D., March 1, 2013 /PRNewswire-USNewswire/ — Alcohol Justice is reporting that a serious confrontation over illegal alcohol activity occurred last night on the border between Whiteclay Nebraska and the Pine Ridge Native American Reservation in South Dakota.
“We have so many strong sober relatives that the only option is to continue to heal,” stated activist Olowan Martinez. “We no longer hide our spirituality, we no longer walk in shame of who we are. An escape from the slavery of alcohol is now occurring and soon the mind of the Oglala Lakota will also be liberated.”
Eyewitness reports state a Round Dance celebration for Liberation Day 2013 (in recognition of the 1973 Wounded Knee Occupation) turned into a showdown between Nebraska state troopers and Native Oglala Lakota activists working to end destructive alcohol use when Nebraska State troopers walked onto Pine Ridge sovereign land. They warned Bryan Brewer Sr. , Oglala Sioux Tribal President, that if he stepped into Nebraska he would be charged with trespassing.
A state trooper performed an alcohol Breathalyzer test on Whiteclay Nebraska Sheriff Terry Robbins due to his behavior and results were not made public. Over a hundred Oglala Lakota marched into the town of Whiteclay forcing the state troopers to withdraw from the area. Tribal President Bryan Brewer Sr. stated that “…on Friday March 1st, activists will return with five times as many people to shut down Whiteclay.”
25% of Pine Ridge Reservation youth suffer from Fetal Alcohol Spectrum Disorder.
2/3 of Pine Ridge Reservation adults suffer from alcoholism.
What: Liberation Day 2013 Rally to end illegal alcohol activity in Whiteclay Nebraska
When: Friday, March 1, 2013
Where: Border of Pine Ridge South Dakota and Whiteclay Nebraska
Who: Representatives from:
Oglala Lakota Nation
Deep Green Resistance
Community Supporters
Why: To stop the illegal alcohol activity at Whiteclay, Nebraska such as:
Retailer participation in alcohol smuggling into the Pine Ridge Reservation
Trade of alcohol for sex
Loitering at the premises of alcohol retailers with open containers
The inability of Nebraska Liquor Commission to stop illegal retailer activity
Apple Health for Kids offers Native American families a quality, free or low-cost insurance option
More kids and teens in Washington State qualify for health insurance through Apple Health for Kids than ever before. Apple Health for Kids, a free or low-cost health insurance program for kids and teens in Washington State, seeks to provide an affordable health insurance option to families across the state. Today marks the launch of a statewide campaign to enroll uninsured kids and teens in the Apple Health for Kids program.
With Apple Health for Kids, kids and teens under the age of 19 receive quality medical, dental, vision and prescription coverage. In addition to having access to a network of doctors, hospitals and clinics, families will have no copays or deductibles. New federal guidelines mean most families that make up to 300% of the federal poverty level qualify. Premiums range from free to $30 per child, depending upon a family’s household income. No family will pay more than two premiums. For example, a family of four that makes $5,700 per month likely qualifies for $30 per child, per month health insurance premiums.
About one third of the 83,000 uninsured children in Washington live in Pierce, King, Yakima, and Clark counties. While the Apple Health for Kids campaign will include statewide outreach, specifically reaching target audiences in those four counties will be a priority. Special attention will be given to American Indian/Alaska Native, Asian/Pacific Islander, and Hispanic/Latino populations that currently have lower levels of enrollment. Several partners are assisting with outreach efforts, including Community-Minded Enterprises, Catholic Charities of the Diocese of Yakima, Kauffman and Associates, Inc. and Desautel Hege Communications.
“More families than ever are looking for ways to save money, but still provide quality health care to their children, and Apple Health for Kids is the perfect solution,” said Jo Ann Kauffman, MPH, President and CEO of Kauffman and Associates, Inc. “Families, including those who use Indian Health Services, can easily enroll to have access to things like x-rays, immunizations, well-child checks and maternity care.”
The campaign is using an innovative, research-based model to promote easy enrollment and offer one-to-one support for people going through the enrollment process. A new website,myapplehealth.org, has been developed which simplifies the application and links enrollees with representatives who can help them fill out the forms and answer questions they may have. Phone interpreting is available in 240 languages.
Now through June, Apple Health for Kids will be promoted at special enrollment events as well as existing community events like Hoopfest. Employers and childcare providers will also receive information and materials to educate employees and parents about the program. It is important that all families in Washington State know about this quality, free or low-cost health insurance option, so advertising is part of the outreach plan as well.
Families with kids and teens should visit myapplehealth.org or call 1-855-900-3066 to learn more and see if they qualify.
About Apple Health for Kids
Apple Health for Kids (AHFK) was created in 2007 as part of the Cover All Kids law signed by Governor Gregoire in order to expand existing health care programs for children by making it affordable to all families. Since its creation, the program has made innovative changes to application and renewal processes to offer families a single, streamlined enrollment process and comprehensive benefits to all eligible applicants. AHFK has also undergone changes to expand eligibility to more of Washington State’s 83,000 uninsured children, now covering families making up to 300% of the federal poverty limit, regardless of immigration status.
I’m wandering the aisles of Central Co-op, a natural foods market on Capitol Hill, checking its shelves for genetically engineered foods. Once you know what to look for, it turns out those ingredients are everywhere—even here, among the fake meats and packages covered in leafy art, smiling animals, and hand-lettering. They’re in the whole-grain bread, in the veggie burgers, in the peanut-free soy nut butter. You can’t always tell from friendly labels—”100% natural,” “multi-grain,” “fair trade.” But you may be able to tell soon.
Washington State will be voting in November on Initiative 522, which would require food made with genetically engineered ingredients (also known as genetically modified organisms, or GMOs) to be labeled as such at the retail level.
When I set out to research the initiative, I thought I’d end up with a clear and obvious answer about how I felt about it—and what the science says. I was wrong.
I was raised on organic produce, bulk-bin grains, and peanut butter you had to crank by hand; these food-labeling people are my people. But I still wanted to see hard science that backs up the squick factor of vegetables birthed in a petri dish. I wanted studies I could point to, something I could wave around and say, “Here! Here is incontrovertible proof that GMOs are evil! Their curse will last for generations and our grandkids will have four noses, and here, have some organic hummus.” But the smoking gun just isn’t there. Not that the anti-labeling side is all that convincing, either.
Genetically engineered food crops have been around since the 1990s, and they took off rapidly across the United States. Now certain American crops are almost universally GMO: more than 90 percent of soy and sugar beets, and 88 percent of corn, according to the US Department of Agriculture. Modifications are done at the genetic level (mainly by corporations that don’t exactly inspire trust, like Monsanto and Dow Chemical), often to make a crop resistant to a particular pest or herbicide. The FDA regularly approves new GMO plants—and soon, an animal: GMO salmon are on their way.
GMOs aren’t just in the processed food you grab in a stoned midnight run to Safeway. And while a 100 percent organic product can’t contain GMOs, lots of foods we think of as “natural” can and do.
For example, Gardenburger’s package is stamped with a cartoon cow and chicken embracing, and the message “There are no unimportant ingredients. If it’s in here, then it’s got a role to play.” That includes corn- and soy-based ingredients (and remember that nearly all US corn and soy is GMO), and when we e-mailed their parent company, the automated response we got back said that some of their products “do contain biotech ingredients.” In a form letter, the company explained: “It has become increasingly difficult to maintain non-biotech sourcing of the soy proteins.”
Franz Family Bakeries offers a “100% Natural, 100% Whole Grain” loaf of bread, touting its “premium Northwest grown & milled ingredients” and lack of high-fructose corn syrup. We asked Franz about GMOs in their bread, and they “do use cornmeal, soybean oil and canola oil in our products, and most of the corn, soybeans, and sources of canola oil are GMO, so most certainly these ingredients would be genetically modified.”
Even the crazily named I.M. Healthy Chunky SoyNut Butter, which announces on the label that it contains non-GMO soybeans, doesn’t guarantee that other ingredients in the same jar, such as corn-derived maltodextrin, aren’t genetically engineered. And the boxed gluten-free cake mix from Cherrybrook Kitchen contains some ingredients that “are not GMO-free,” the company says.
This isn’t to pick on these companies at all, or the groovy grocers that carry them; it’s just to point out how ubiquitous GMO ingredients are. And if I-522 passes this fall, we’ll be reminded wherever we shop how common they’ve become. Or, on the other hand, the measure could prompt more food producers to eradicate GMOs from their ingredients to avoid the GMO label altogether.
A vast majority of the American public supports labeling foods with GMO ingredients. A 2010 NPR/Thomson Reuters poll found that 93 percent of Americans were on board. Worldwide, more than 60 countries already label foods with GMO ingredients, including members of the European Union, China, Japan, and India.
Still, the opposition to labeling is fierce. In November, Proposition 37, which would’ve mandated labeling of GMO foods, lost on the California ballot after the opposition dumped more than $45 million into a campaign arguing that labeling GMOs would be deceptive, pointless, and expensive. The donor list looked like exactly what you’d expect: Monsanto, Dow AgroSciences, BASF Plant Science, Kraft Foods Global, Nestlé USA, ConAgra Foods.
Here in Washington, there’s already opposition to I-522. The Seattle Times came out strongly against it, saying that “there is no reliable evidence crops containing genetically modified organisms… pose any risks.” The Washington Association of Wheat Growers is opposed as well, saying that mandatory labeling of GMO foods “that are indistinguishable from foods produced through traditional methods would mislead consumers by falsely implying differences where none exist.”
When it comes to the science, people on each side promise they can debunk anything the other side claims to prove. Biotech researcher Dr. Martina Newell-McGloughlin gave compelling testimony at an I-522 hearing in Olympia, saying, “There is practically no domesticated plant or animal today that has not been genetically engineered over the last 10,000 years,” since we’ve been selectively breeding, grafting, and even irradiating foods forever. Today’s precise genetic engineering has been found by all major science and health organizations to be “as safe or safer than” conventional methods, she said. Further, she argued, GMO foods are actually “more thoroughly tested than any in the history of food,” subjected to years of research before they make it to market.
But George Kimbrell of the Center for Food Safety, who helped draft I-522, says, “We’re essentially taking the science from the industry for safety,” because the FDA doesn’t do its own pre-market testing, instead signing off on testing done by Monsanto and other companies developing the biotech foods. Dr. Michael Hansen testified in favor of I-522 in Olympia; he works for Consumers Union, the public policy arm of Consumer Reports, and he points to his organization’s long-standing position in favor of mandatory pre-market testing as opposed to the current system of “voluntary safety consultations,” as Consumers Union describes it. In place of that, Hansen says, they support labeling so consumers can at least make informed choices.
Another commonly heard argument is that labeling would burden manufacturers and grocery stores. But initiative spokeswoman Trudy Bialic, who works for PCC Natural Markets, which is running the I-522 campaign, says that’s bogus. GMO labeling would be “no different from any of the other things we keep track of already,” she says. “It did not cost us to add country of origin labeling, it did not make food unaffordable when we added nutrition panels, [and] it did not create a lot of extra costs when we started labeling trans fats.”
I-522 is also written differently than Prop 37. It specifies who’s required to do the labeling—the manufacturers—whereas Prop 37 didn’t. And Prop 37 was roundly criticized as being catnip for tort lawyers, who could claim damages from companies that didn’t properly label. In Washington, I-522 doesn’t allow awards for damages, just a reimbursement of attorney’s fees. Kimbrell says it was “deliberately drafted narrowly” to disincentivize costly lawsuits.
In the end, a lot of this comes down to how hard the food-industry opposition is willing to fight I-522. And weirdly, it turns out that buying some of the hippie products at the co-op may still be supporting the GMO industry. In California, big food companies poured money into the anti-labeling campaign, leaving labeling supporters furious. Angry green websites called for boycotts of GMO-free Silk soy milk (owned by Dean Foods), Kashi cereals (owned by Kellogg’s), Odwalla juice (owned by Coca-Cola), and tons more, since all those larger parent companies wrote checks to fight labeling. Here, as of yet, no counter-campaign to I-522 has filed with the state.
This pear crisp is easy enough to make on a weeknight and doesn’t require fully ripe pears. Photo: Matthew Mead / Associated Press
By Sara Moulton, Associated Press
Sometimes, even on a weeknight, you really crave a little dessert. But making dessert takes time, and you already are spending time cooking up the main event, namely dinner.
That’s where this recipe comes to the rescue. It’s a quick, easy and delicious pear crisp that calls for just five ingredients: pears, granola, lemon juice, apricot jam and a pinch of salt.
Pears are just now at the tail end of their season. Yes, I know we can find pears all year these days. But believe me, those specimens are going to be nowhere near as electrifying as a fully ripened, in-season local pear.
The problem is the relative rareness of such pears. Ralph Waldo Emerson was onto something when he wrote, “There are only 10 minutes in the life of a pear when it is perfect to eat.”
In other words, most of the time, no matter where it comes from, our pears aren’t at the peak of perfection. And for those times, when pears are unripe and you don’t have time to let them ripen, this recipe comes in mighty handy. Baking an unripe pear not only makes it tender, it also crystallizes and magnifies the fruit’s flavor.
Happily, any kind of pear — and there are many varieties — will work in this recipe, as will a mix of varieties.
Pears also have a lot to offer in terms of health. They’re a good source of vitamin C and a great source of fiber.
As for granola, there are a zillion brands in the cereal aisle of the supermarket. The problem is that many of them are laden with fat and sugar even as they masquerade under a healthy halo.
That’s why the recommended portion on the back of most granola boxes is just 1/4 cup. Pour yourself a normal, adult-sized portion and you might as well be tucking into a breakfast of waffles and sausage.
So when you shop for granola, look for a brand that’s lower in fat, sugar and calories than the competition and which also contains lots of nuts, seeds and dried fruit. And if you want to bump up the nutritional value of this recipe even more, you also could add 1/4 cup of ground flaxseed.
With all of that said, I wouldn’t worry too much about the amount of granola in this recipe. Per serving, it’s about what the granola box recommends, and mostly serves to put the crisp on this pear crisp.
Heck, you’d be much better off serving this dessert for breakfast than dogging a big bowl of nothing but granola.
Speedy pear crisp
1/2 cup plus 1 tablespoon apricot preserves or sweetened fruit spread
4 pears (about 2 pounds), peeled, cored and thinly sliced
2 tablespoons lemon juice
Table salt
2 cups purchased granola
Heat the oven to 350 degrees. Lightly coat a shallow 6-cup baking dish with cooking spray.
In a small saucepan over medium-low, heat the preserves until melted and easily stirred.
Set the sliced pears in a large bowl, then drizzle the preserves over them. Add the lemon juice and salt, then toss well. Spread the pears evenly in the prepared baking dish.
Sprinkle the granola evenly over the pears, then cover the dish loosely with foil and bake 30 minutes. Remove the foil and bake another 15 minutes, or until the pears are tender. Serve hot or cold.
Makes 8 servings. Per serving: 210 calories; 25 calories from fat (12 percent of total calories); 2.5 g fat (0.5 g saturated; 0 g trans fats); 0 mg cholesterol; 50 g carbohydrate; 5 g fiber; 27 g sugar; 3 g protein; 55 mg sodium.
The alarm in Europe over the discovery of horse meat in beef products escalated again Monday, when the Swedish furniture giant Ikea withdrew an estimated 1,670 pounds of meatballs from sale in 14 European countries.
Ikea acted after authorities in the Czech Republic detected horse meat in its meatballs. The company said it had made the decision even though its tests two weeks ago did not detect horse DNA.
Horse meat mixed with beef was first found last month in Ireland, then Britain, and has now expanded steadily across the Continent. The situation in Europe has created unease among American consumers over whether horse meat might also find its way into the food supply in the United States. Here are answers to commonly asked questions on the subject.
Has horse meat been found in any meatballs sold in Ikea stores in the United States?
Ikea says there is no horse meat in the meatballs it sells in the United States. The company issued a statement on Monday saying meatballs sold in its 38 stores in the United States were bought from an American supplier and contained beef and pork from animals raised in the United States and Canada.
“We do not tolerate any other ingredients than the ones stipulated in our recipes or specifications, secured through set standards, certifications and product analysis by accredited laboratories,” Ikea said in its statement.
Mona Liss, a spokeswoman for Ikea, said by e-mail that all of the businesses that supply meat to its meatball maker issue letters guaranteeing that they will not misbrand or adulterate their products. “Additionally, as an abundance of caution, we are in the process of DNA-testing our meatballs,” Ms. Liss wrote. “Results should be concluded in 30 days.”
Does the United States import any beef from countries where horse meat has been found?
No. According to the Department of Agriculture, the United States imports no beef from any of the European countries involved in the scandal. Brian K. Mabry, a spokesman for the department’s Food Safety and Inspection Service, said: “Following a decision by Congress in November 2011 to lift the ban on horse slaughter, two establishments, one located in New Mexico and one in Missouri, have applied for a grant of inspection exclusively for equine slaughter. The Food Safety and Inspection Service (F.S.I.S.) is currently reviewing those applications.”
Has horse meat been found in ground meat products sold in the United States?
No. Meat products sold in the United States must pass Department of Agriculture inspections, whether produced domestically or imported. No government financing has been available for inspection of horse meat for human consumption in the United States since 2005, when the Humane Society of the United States got a rider forbidding financing for inspection of horse meat inserted in the annual appropriations bill for the Agriculture Department. Without inspection, such plants may not operate legally.
The rider was attached to every subsequent agriculture appropriations bill until 2011, when it was left out of an omnibus spending bill signed by President Obama on Nov. 18. The U.S.D.A. has not committed any money for the inspection of horse meat.
“We’re real close to getting some processing plants up and running, but there are no inspectors because the U.S.D.A. is working on protocols,” said Dave Duquette, a horse trader in Oregon and president of United Horsemen, a small group that works to retrain and rehabilitate unwanted horses and advocates the slaughter of horses for meat. “We believe very strongly that the U.S.D.A. is going to bring inspectors online directly.”
Are horses slaughtered for meat for human consumption in the United States?
Not currently, although live horses from the United States are exported to slaughterhouses in Canada and Mexico. The lack of inspection effectively ended the slaughter of horse meat for human consumption in the United States; 2007 was the last year horses were slaughtered in the United States. At the time financing of inspections was banned, a Belgian company operated three horse meat processing plants — in Fort Worth and Kaufman, Tex., and DeKalb, Ill. — but exported the meat it produced in them.
Since 2011, efforts have been made to re-establish the processing of horse meat for human consumption in the United States. A small plant in Roswell, N.M., which used to process beef cattle into meat has been retooled to slaughter 20 to 25 horses a day. But legal challenges have prevented it from opening, Mr. Duquette said. Gov. Susana Martinez of New Mexico opposes opening the plant and has asked the U.S.D.A. to block it.
Last month, the two houses of the Oklahoma Legislature passed separate bills to override a law against the slaughter of horses for meat but kept the law’s ban on consumption of such meat by state residents. California, Illinois, New Jersey, Tennessee and Texas prohibit horse slaughter for human consumption.
Is there a market for horse meat in the United States?
Mr. Duquette said horse meat was popular among several growing demographic groups in the United States, including Tongans, Mongolians and various Hispanic populations. He said he knew of at least 10 restaurants that wanted to buy horse meat. “People are very polarized on this issue,” he said. Wayne Pacelle, chief executive of the Humane Society of the United States, disagreed, saying demand in the United States was limited. Italy is the largest consumer of horse meat, he said, followed by France and Belgium.
Is horse meat safe to eat?
That is a matter of much debate between proponents and opponents of horse meat consumption. Mr. Duquette said that horse meat, some derived from American animals processed abroad, was eaten widely around the world without health problems. “It’s high in protein, low in fat and has a whole lot of omega 3s,” he said.
The Humane Society says that because horse meat is not consumed in the United States, the animals’ flesh is likely to contain residues of many drugs that are unsafe for humans to eat. The organization’s list of drugs given to horses runs to 29 pages.
“We’ve been warning the Europeans about this for years,” Mr. Pacelle said. “You have all these food safety standards in Europe — they do not import chicken carcasses from the U.S. because they are bathed in chlorine, and won’t take pork because of the use of ractopamine in our industry — but you’ve thrown out the book when it comes to importing horse meat from North America.”
The society has filed petitions with the Department of Agriculture and Food and Drug Administration, arguing that they should test horse meat before allowing it to be marketed in the United States for humans to eat.
This article has been revised to reflect the following correction:
Correction: February 25, 2013
An earlier version of this article misstated how many pounds of meatballs Ikea was withdrawing from sale in 14 European countries. It is 1,670 pounds, not 1.67 billion pounds.
This article has been revised to reflect the following correction:
Correction: February 25, 2013
An earlier version of this article misstated the last year that horses were slaughtered in the United States. It is 2007, not 2006.
EVERETT — In honor of National Women and Girls HIV Awareness Day, all women ages 14 years and older who have had any risk for HIV transmission qualify for free, rapid HIV testing on March 12. The test involves a simple pinprick to the finger, resulting in a tiny drop of blood, and only takes 30 minutes, including results.
No appointment is necessary. Just stop by between 9 a.m. and 7 p.m. on Tuesday, March 12, at Snohomish Health District Suite 106, located at 3020 Rucker Ave. in Everett. For more information, call 425-339-5298 or visit www.womenshealth.gov.
Former Marine Capt. Timothy Kudo walks among civilians carrying a burden of guilt most Americans don’t want to share. A veteran of the wars in Iraq and Afghanistan, Kudo thinks of himself as a killer. “I can’t forgive myself … and the people who can forgive me are dead,” he says. Photo: JOHN MINCHILLO / AP
A veteran of the wars in Iraq and Afghanistan, former Marine Capt. Timothy Kudo thinks of himself as a killer – and he carries the guilt every day.
By Pauline Jelinek, Associated Press
WASHINGTON — A veteran of the wars in Iraq and Afghanistan, former Marine Capt. Timothy Kudo thinks of himself as a killer – and he carries the guilt every day.
“I can’t forgive myself,” he says. “And the people who can forgive me are dead.”
With American troops at war for more than a decade, there’s been an unprecedented number of studies into war zone psychology and an evolving understanding of post-traumatic stress disorder. Clinicians suspect some troops are suffering from what they call “moral injuries” – wounds from having done something, or failed to stop something, that violates their moral code.
Though there may be some overlap in symptoms, moral injuries aren’t what most people think of as PTSD, the nightmares and flashbacks of terrifying, life-threatening combat events. A moral injury tortures the conscience; symptoms include deep shame, guilt and rage. It’s not a medical problem, and it’s unclear how to treat it, says retired Col. Elspeth Ritchie, former psychiatry consultant to the Army surgeon general.
“The concept … is more an existentialist one,” she says.
The Marines, who prefer to call moral injuries “inner conflict,” started a few years ago teaching unit leaders to identify the problem. And the Defense Department has approved funding for a study among Marines at California’s Camp Pendleton to test a therapy that doctors hope will ease guilt.
But a solution could be a long time off.
“PTSD is a complex issue,” says Navy Cmdr. Leslie Hull-Ryde, a Pentagon spokeswoman.
Killing in war is the issue for some troops who believe they have a moral injury, but Ritchie says it also can come from a range of experiences, such as guarding prisoners or watching Iraqis kill Iraqis as they did during the sectarian violence in 2006-07.
“You may not have actually done something wrong by the law of war, but by your own humanity you feel that it’s wrong,” says Ritchie, now chief clinical officer at the District of Columbia’s Department of Mental Health.
Kudo’s remorse stems in part from the 2010 accidental killing of two Afghan teenagers on a motorcycle. His unit was fighting insurgents when the pair approached from a distance and appeared to be shooting as well.
Kudo says what Marines mistook for guns were actually “sticks and bindles, like you’d seen in old cartoons with hobos.” What Marines thought were muzzle flashes were likely glints of light bouncing off the motorcycle’s chrome.
“There’s no day – whether it’s in the shower or whether it’s walking down the street … that I don’t think about things that happened over there,” says Kudo, now a graduate student at New York University.
“Human beings aren’t just turn-on, turn-off switches,” Veterans of Foreign Wars spokesman Joe Davis says, noting that moral injury is just a different name for a familiar military problem. “You’re raised `Thou shalt not kill,’ but you do it for self-preservation or for your buddies.”
Kudo never personally shot anyone. But he feels responsible for the deaths of the teens on the motorcycle. Like other officers who’ve spoken about moral injuries, he also feels responsible for deaths that resulted from orders he gave in other missions.
The hardest part, Kudo says, is that “nobody talks about it.”
As executive officer of a Marine company, Kudo also felt inadequate when he had to comfort a subordinate grieving over the death of another Marine.
Dr. Brett Litz, a clinical psychologist with the Department of Veterans Affairs in Boston, sees moral injury, the loss of comrades and the terror associated with PTSD as a “three-legged stool” of troop suffering. Though there’s little data on moral injury, he says a study asked soldiers seeking counseling for PTSD in Texas what their main problem was; it broke down to “roughly a third, a third and a third” among those with fear, those with loss issues and those with moral injury.
The raw number of people who have moral injuries also isn’t known. It’s not an official diagnosis for purposes of getting veteran benefits, though it’s believed by some doctors that many vets with moral injuries are getting care on a diagnosis of PTSD – care that wouldn’t specifically fit their problem.
Like PTSD, which could affect an estimated 20 percent of troops who served in Iraq and Afghanistan, moral injury is not experienced by all troops.
“It’s in the eye of the beholder,” says retired Navy Capt. William Nash, a psychiatrist who headed Marine Corps combat stress programs and has partnered with Litz on research. The vast majority of ground combat fighters may be able to pull the trigger without feeling they did something wrong, he says.
As the military has focused on fear-based PTSD, it hasn’t paid enough attention to loss and moral injury, Litz and others believe. And that has hampered the development of strategies to help troops with those other problems and train them to avoid the problems in the first place, he says.
Lumping people into the PTSD category “renders soldiers automatically into mental patients instead of wounded souls,” writes Iraq vet Tyler Boudreau, a former Marine captain and assistant operations officer to an infantry battalion.
Boudreau resigned his commission after having questions of conscience. He wrote in the Massachusetts Review, a literary magazine, that being diagnosed with PTSD doesn’t account for nontraumatic events that are morally troubling: “It’s far too easy for people at home, particularly those not directly affected by war … to shed a disingenuous tear for the veterans, donate a few bucks and whisk them off to the closest shrink … out of sight and out of mind” and leaving “no incentive in the community or in the household to engage them.”
So what should be done?
“I don’t think we know,” Ritchie says.
Troops who express ethical or spiritual problems have long been told to see the chaplain. Chaplains see troops struggling with moral injury “at the micro level, down in the trenches,” says Lt. Col. Jeffrey L. Voyles, licensed counselor and supervisor at the Army chaplain training program in Fort Benning, Ga. A soldier wrestling with the right or wrong of a particular war zone event might ask: “Do I need to confess this?” Or, Voyles says, a soldier will say he’s “gone past the point of being redeemed, (the point where) God could forgive him” – and he uses language like this:
“I’m a monster.”
“I let somebody down.”
“I didn’t do as much as I could do.”
Some chaplains and civilian church organizations have been organizing community events where troops tell their stories, hoping that will help them re-integrate into society.
Some soldiers report being helped by Army programs like yoga or art therapy. The Army also has a program to promote resilience and another called Comprehensive Soldier Fitness to promote mental as well as physical wellness; some clinicians say the latter program may help reduce risk of moral injury but doesn’t help troops recognize when they or a buddy have the problem.
Nash says the Marines are using “psychological first aid techniques” to help service members deal with moral injury, loss and other traumatic events. But it’s a young program, not uniformly implemented and just now undergoing outside evaluation for its effectiveness, he says.
At Camp Pendleton, the therapy trial will be tailored to each Marine’s war experiences; troops with fear-based problems might use a standard PTSD approach; those with moral injury may have an imaginary conversation with the lost person.
Forgiveness, more than anything, is key to helping troops who feel they have transgressed, Nash says.
But the issue is so much more complicated that wholesale solutions across the military, if there are any, will likely be some time coming.
Many in the armed forces view PTSD as weakness. Similarly, they feel the term “moral injury” is insulting, implying an ethical failing in a force whose motto stresses honor, duty and country.
At the same time, lawyers don’t like the idea of someone asking troops to incriminate themselves in war crimes – real or imagined.
That leaves a question for troops, doctors, chaplains, lawyers and the military brass: How do you help someone if they don’t feel they can say what’s bothering them?
