Who's Responsible?

Former Army major Tammy Duckworth lost both her legs in Iraq. The helicopter pilot--a major in the Illinois Army National Guard--was flying a Black Hawk over hostile territory when a rocket-propelled grenade hit her aircraft. Duckworth spent the next 13 months in hospitals and rehab centers, in a wheelchair or on prosthetic limbs, trying to relearn the skills she'd once taken for granted. "It's the very little things," that can be the hardest, she says. "It's something as mundane as trying to do your laundry. For me, it was changing the sheets on my bed. How do you do that if you have no legs?"

Duckworth is now running for Congress as a Democrat, hoping to win Henry Hyde's seat representing Chicago's western suburbs. But she's the exception: most of the more than 8,000 American soldiers severely injured in Iraq and Afghanistan aren't doing nearly so well. With record numbers of soldiers surviving injuries that would have killed them in earlier wars, veterans' organizations are questioning whether the federal government is able--or is willing--to cope with the demand for health-care benefits, rehabilitation services and ongoing treatment. And if Washington can't do it, then who should?

Enter the Intrepid Fallen Heroes Fund. Since last July, the nonprofit group has raised more than $25 million in private funds for the construction of a training and rehabilitation center for soldiers returning from battle with catastrophic injuries and amputations. To be built on site at the Brooke Army Medical Center in San Antonio, Texas, the 60,000-foot marble and granite Intrepid Center needs $10 million more before it can be completed. Once it's finished--tentatively in January 2007--the Veterans Administration and the military will take over. The facility will be able to work with as many as 100 returning soldiers and veterans at any given time.

But should such an institution really be funded by private sources? Inevitably, organizations like Intrepid have raised questions about whether the Bush administration--committed to two wars--is too stretched to properly take care of returning veterans. "It's surprising to us that there needs to be a facility that's privately funded, and we hope that the Congress and the Bush administration will recognize that we need to meet these goals of the severely injured," says Peter Gayton, director of veterans affairs and rehabilitation at the American Legion. "The fact that the Intrepid Center needs to exist shows that the VA is not receiving enough funding."

The debate is being fueled by syndicated radio host Don Imus, who has donated $250,000 and has made raising money for the fund a regular feature on his morning show. On Friday he told listeners he doesn't know why "the government wouldn't just simply pay for [the center], considering the extraordinary amount of money they spend on ... this idiotic war." And later said "We have a tradition in this country, well, going back to the Civil War, in which we send off young people to fight these wars. Stuff happens to them. They lose their arms and legs. And we just discard them. You know, like they are iPods of old telephones or something."

One issue may be the number of wounded returning from America's two ongoing wars. "I don't think anybody in the world expected the numbers of wounded coming back [from Afghanistan and Iraq]," says Bill White, the Intrepid Fund's president. "In Vietnam, they would have died. And it's wonderful that they're alive, but they've survived catastrophic injuries that require them to get special help to rehabilitate." According to U.S Senate research, the amputation rate has doubled from previous wars to 6 percent of those injured. Since 2000, the demand for prosthetic services has increased more than 30 percent, and is now funded at $1 billion annually by the Department of Veterans Affairs.

The Intrepid Fund aims to help bridge the gap between the services the VA is currently providing and what's needed by soldiers on the ground. "Understanding that these men and women need our utmost gratitude and respect for the sacrifices they've made, we decided not to wait for the debate," says White. "We decided to work with the military and say, 'How can we help you?'"

In 2004, Pentagon officials, including former deputy secretary of Defense Paul Wolfowitz, unveiled plans for a multimillion-dollar amputee-training center to be built at the Walter Reed Army Medical Center in Washington. At the time, Maj. Gen. Kenneth Farmer, commanding general of the North Atlantic Regional Medical Command and the Walter Reed staff praised "the record time" at which the project had gone "from concept to reality." But that plan was put on hold in August when Walter Reed was put on a closure list as part of the federal base-closing process. It is slated to shut down in 2011.

More recently, the Bush administration faced harsh criticism for its 2005 VA budget. After the $29.5 billion health-care-spending proposal was called "a disgrace and a sham" by the former head of the Veterans of Foreign Wars, Congress responded by putting through a $1.5 billion emergency increase.

Nonetheless, the VA system is still plagued by long backlogs, with some veterans waiting months to be accepted into the system. At one VA hospital, says Cathy Wiblemo, deputy director for health care at the American Legion, there is a seven-year backlog to receive dental care. At another, a surgery ward was closed because there wasn't sufficient staff to operate it.

"[Increased funding] is an obligation that the nation has, and needs to pick up," Wiblemo says. "You can't send [soldiers] over there and bring them back here and say, 'Oh, sorry, you're on your own!' ... The recognition needs to be there, and the bill needs to be paid."

The VA, which runs 157 hospitals and four poly-trauma centers nationwide, says it remains "a world leader" in prosthetics and health care. "What we're seeing from Afghanistan and Iraq that's really new to us is the blast injuries: the people who get hit by one of these homemade bombs, and because of body armor, have survived," said VA spokesman Phil Budahn. "They've lost limbs, they have burns, they'll have head and brain injuries, and other medical problems. But we've created four poly-trauma centers to deal with these injuries." Budahn said the VA expects to serve more than 5 million people this year.

At the Fallen Heroes Fund, the debate over how the Intrepid Center gets built seems beside the point. "The way we are going to deliver this facility is to finish fundraising," says White. "These are young, vibrant lives that have been robbed of body parts... We're not going to break our promise to them."

Editor's Note: The original text of this article misstated the number of amputees among veterans of the wars in Afghanistan and Iraq as 13,000. According to the Department of Defense, 8, 025 American soldiers have been severely wounded (not to return to duty within 72 hours) in those two conflicts.