The Civil War General, William Sherman, is credited for the quote, “war is hell.” Indeed, many veterans, especially those who served in combat, will agree. A large number of veterans face challenges of physical illness or psychological issues stemming from their military service. Healthcare providers may gain a broader perspective and knowledge base of their patients by investigating health issues and unique needs commonly experienced by era of military service.

Unique health risks by era of service:

World War II

Cold injury

Exposure to nuclear weapons

Chemical warefare agent experiments

Korean War

Cold injury

Exposure to nuclear weapons

Chemical warfare agent experiments

Vietnam War

Malaria

Hepatitis C

Typhoid fever

Post-traumatic stress disorder (PTSD)

Chemical warfare agents, esp. agent orange

Desert Storm/Gulf War

Exposure to smoke, chemical or biological agents

Depleted uranium exposure

Amyotrophic lateral sclerosis (ALS)

PTSD

Iraq War

Infectious disease: Acinetobacter, leishmaniasis

Cold injury, environmental hazards

PTSD, polytrauma, depression

Traumatic brain/spinal cord injury

Vision loss, suicide, traumatic amputation

Depleted uranium (DU)

During military service, individuals may encounter threats to their well-being from biological, environmental, chemical or combat-related sources. While each of the health risks impact veterans, post-traumatic stress disorder (PTSD) typically has the greatest influence on veterans and their families during hospice care.

PTSD can be very complicated to the individual and their support system, as well as society in general. If the healthcare provider does not possess knowledge about PTSD, their delivery of hospice care and support may be significantly difficult. PTSD is defined as “an anxiety disorder that may develop after one is exposed to a traumatic event; military combat, rape, physical abuse and natural disasters” (Seahorn & Seahorn, 2010).

PTSD, often thought of as a new syndrome of mental illness, has most likely been present since the beginning of civilization. One of the first descriptions of PTSD, circa late 1500s, is thought to be contained in the lines of Shakespeare’s classic, “Henry IV.” Other sources suggest that “PTSD was documented in Greek (e.g., Iliad) and Roman (e.g., Aeneid) war literature” (Pitman, 2013). Perhaps the “fathers of PTSD” may be Jean-Marie Charcot and Pierre Janet. Charcot, in the 1880s, developed a new category named “traumatic hysteria.” Charcot proposed that a very intensive situation could cause physical symptoms. In other words, Charcot felt that the traumatic event, and how the mind processes and perceives it, could also cause physical ailments and symptoms. Additionally, Janet emphasized the mental effects of trauma on the individual, particularly when the mind isolates the event and causes the individual difficulty in adapting and separating the trauma from ordinary scenarios of life. Throughout time, PTSD was referred to by a number of terms, including:

  • Da Costa’s syndrome
  • Soldier’s heart
  • Stress syndrome
  • Shell shock
  • Combat fatigue

While many survivors of combat throughout history have been afflicted by PTSD, the modern examination and investigation into it began in the 1970s in response to the difficulties experienced by veterans of the Vietnam War. However, one must remember, combat is not the sole cause of PTSD. Any traumatic event in an individual’s life can cause PTSD: sexual trauma, severe automobile accidents, the death of a child, a fire or events caused by natural disasters. Characteristics of PTSD may vary as much as the individual who suffers from the illness.

Typically, characteristics/presentations may include the following:

  • Hyper arousal and abnormal startle responses
  • Hyper vigilance
  • Nightmares, insomnia and night sweats
  • Recurrent traumatic memories/flashbacks
  • Intrusive memories
  • Overwhelming waves of emotions
  • Survivor’s guilt
  • Detachment and/or emotional withdrawal
  • Fragmented sense of self and identity
  • Panic attacks
  • Shame
  • Despair
  • Sadness and hopelessness about the future
  • Control issues
  • Anger
  • Self-destruction

The healthcare provider should make every attempt to assist the veterans with his/her feelings. An important fact to remember is that as death nears, individuals feel the need to share life experiences with others. Reasons for this may vary. Perhaps the veterans are seeking to cope with unresolved grief, making an attempt to atone for their actions, or just coming to terms with the reality of their own approaching death.

The Maine Hospice-Veteran Partnership (n.d.) offers tips for healthcare providers. Tips to improve the hospice care of a veteran with PTSD are listed below.

  1. Make sure the veteran’s story has been heard.
  2. Assist the veteran with putting the traumatic events into some sort of perspective in their lives.
  3. Assist the veteran with dealing with the effects that PTSD has had on their lives, such as mending relationships, giving and accepting closeness and affection, and getting affairs in order.

Overview of Military History

World War II

The First World War, also known as the “war to end all wars,” ended in 1918. Little did the world realize that another world war would erupt in a mere twenty years. This war would be even more devastating than the last war. The time for an uprising was right. The country of Germany was severely punished for their major role in World War I. The once proud and financially stable country of Germany was reduced to a shadow of its former self. The mood in Germany was dismal; Germany was void of not only food and infrastructure, but also lacking patriotism and national pride. During these dark days, a new leader entered into the political scene. Adolf Hitler and his Nazi party rose to power with lightning speed. In an attempt to strengthen the nation, Hitler formed partnerships in an attempt to strengthen his attempt to dominate the world.

The first move began in the early fall of 1939 as Hitler’s troops invaded Poland. As a result of this act, Great Britain and France declared war on Germany; this declaration began World War II. “Over the next six years, the conflict would take more lives and destroy more land and property around the globe than any previous war” (History.com Staff, 2009). Among the millions who lost their lives, six million Jews were systematically murdered in Nazi concentration camps across Europe.

The Beginnings of World War II

World War I left Europe, especially Germany, in shambles. Hitler seized the opportunity and rose to power very quickly. Along his journey to the leadership of Germany, Hitler placed sole blame on the Jewish population for the German defeat in World War I, as well as the economic and low morale in Germany. In his memoir, “Mein Kampf (My Struggle),” Hitler predicted another war engulfing Europe that would result in the extermination of the Jews.

Reich Chancellor Hitler moved quickly and appointed himself “Führer” (supreme leader) in 1934. “Part of Hitler’s master plan was the creation of a master race made up of ‘pure’ Germans; called ‘Aryans’” (History.com Staff, 2009). In the mid-1930s, he secretly began to build up the military force in Germany. In 1938, Hitler sent troops to occupy Austria, and in 1939 he added Czechoslovakia to his list of conquered countries.

The War Begins

On September 1, 1939, Hitler invaded Poland, and two days later France and Britain declared war on Germany. World War II had begun. On September 17, Soviet Union troops invaded Poland from the east. The weakened and grossly under-armed and under-manned Polish army could not match the military superiority of the Nazi war machine. Within a few days, Poland surrendered. Early in 1940, Germany and the Soviet Union controlled Poland. Over the next six months, the seas around Britain were filled with German submarines. The mission of these submarines was to sink merchant ships headed for Britain.

War in Western Europe

In the spring of 1940, Germany invaded Norway and occupied Denmark. These actions caused the war to come into full swing. “On May 10, 1940, German forces swept through Belgium and the Netherlands in what became known as ‘blitzkrieg,’ or ‘lightning war’” (History.com Staff, 2009). Three days later, Hitler’s troops attacked French forces. With France on the verge of collapse, Mussolini, the leader of Italy, joined Hitler and declared war against France and Britain on June 10.

On June 14, 1940, German military forces entered Paris. The next country on Hitler’s agenda was Britain. “In an attempt to weaken the people and military of Britain, German planes bombed Britain extensively throughout the summer of 1940, including night raids on London and other industrial centers that caused heavy civilian casualties and damage”( History.com Staff, 2009). The Royal Air Force (RAF) eventually defeated the Luftwaffe (German Air Force). With Britain’s ability to protect and defend itself, Prime Minister Winston Churchill requested and received aid from the U.S. In an attempt to assist Britain in defending their country, the U.S. sent pilots to fly missions with the RAF.

War in the Pacific Theater

“On December 7, 1941, 360 Japanese aircraft attacked the major U.S. naval base at Pearl Harbor in Hawaii, taking the Americans completely by surprise and claiming the lives of more than 2,300 troops” (History.com Staff, 2009). The attack on Pearl Harbor pushed America into World War II. On December 8, Congress declared war on Japan. Germany, Italy and Japan soon declared war on the United States.

After many Japanese victories, the U.S. Navy and Marines won a major victory at the Battle of Midway in June 1942. This victory was a turning point in the war. On Guadalcanal, one of the southern Solomon Islands, the Allies had success against Japanese forces in a series of battles from August 1942 to February 1943. These victories helped turn the war in favor of the Allies. By mid-1943, Allied navies began an aggressive attack against Japan, focusing on a series of battles on Japanese-occupied islands in the Pacific. This plan proved successful, and Allied forces moved even closer to an invasion of Japan.

Onward to Victory

In North Africa, British and American forces had defeated the Italians and Germans by 1943. An Allied invasion of Sicily and Italy followed, and Mussolini’s Italian government fell apart in July 1943. Allies fighting against the Germans in Italy would continue until 1945.

On June 6, 1944, Allied forces launched a huge invasion of Europe. “56,000 British, Canadian and American soldiers on landed on the beaches of Normandy, France” (History.com Staff, 2009). The Allied troops moved through Europe on their way to Berlin. In December 1944 – January 1945, the Battle of the Bulge occurred. Many American troops died and were injured during this battle. “Troops were forced to spend days in foxholes, which are holes dug in the ground and covered with tree branches to disguise their position, in freezing conditions with little food. For the Germans, this battle was their last major offensive of the war” History.com Staff, 2009).

An intensive aerial bombardment in February 1945 began as the Allies planned a land invasion of Germany. On May 8, 1945, Germany formally surrendered only after their leader successfully committed suicide on April 30 in his underground Berlin bunker.

World War II Ends

In April of 1945, Americans mourned the death of their leader, President Franklin D. Roosevelt, as the war with Japan raged on. In July – August 1945, U.S. President Harry S. Truman, Churchill and Stalin agreed to divide Germany into four areas. These areas would be controlled by the Soviet Union, Britain, the United States and France.

Meanwhile, heavy casualties piled up in Iwo Jima (February 1945) and Okinawa (April – June 1945). Truman feared more lives would be lost if the U.S. and her Allies invaded Japan. Because of this, President Truman gave the okay to use a new and powerful weapon, the atomic bomb, on the Japanese cities of Hiroshima (August 6, 1945) and Nagasaki (August 9, 1945). As a result of the dropping of the atomic bomb, thousands of individuals died. The survivors and their children suffered serious medical issues due to their exposure to the high levels of radiation. On August 10, the Japanese government issued a statement declaring they would surrender. September 2, 1945, Japan formally surrendered aboard the USS Missouri in Tokyo Bay.

“World War II proved to be the most devastating international conflict in history, taking the lives of some 35 to 60 million people, including six million Jews who died at the hands of the Nazis” (History.com Staff, 2009). Millions more people were injured, while countless others lost their homes and property. Unfortunately, peace did not last.

Korean War

On June 25, 1950, the Korean War began when soldiers from the North Korean People’s Army invaded South Korea by crossing the 38th parallel, a boundary separating the Soviet-supported Democratic People’s Republic of Korea from the pro-Western Republic of Korea in the south. This invasion is considered by many as the first military engagement of the Cold War. By July, American committed troops to assist South Korea in their struggle.

Many American officials held the opinion the war was not over land in Korea but rather a war to stop the spread of communism. After some early back-and-forth across the 38th parallel, the fighting stalled and casualties mounted with nothing to show for them. Meanwhile, American officials worked anxiously to fashion some sort of armistice with the North Koreans. The alternative, they feared, would be a wider war with Russia and China — or even, as some warned, World War III. Finally, in July 1953, the Korean War came to an end. Upon the war’s end, “over 5 million soldiers and civilians lost their lives” (History.com Staff, 2009b). Today, the country remains divided.

How Korea Became Divided

Korea was a part of the Japanese empire until after World War II. During that time, the country became the center of a possession and control debate. In August 1945, the Korean peninsula was divided in half with the 38th parallel acting as the division point. The Russians occupied the area north of the line and the United States occupied the area to its south.

The divided country was led by two individuals with differing political philosophies. In the south, Syngman Rhee (1875–1965) embraced the political mindset readily embraced by the U.S. Rhee’s counterpart, Kim II Sung (1912–1994), patterned his government after the Soviet Union. Unfortunately, neither leader was content to stay on his side of the 38th parallel. Intermittent border skirmishes occurred. “Nearly 10,000 North and South Korean soldiers were killed in battle before the war even began” (History.com Staff, 2009b).

Mission: Stop Communism

The invasion of South Korea by their North Korean enemies was viewed by many as the start of a worldwide effort to spread Communism. Because of this, immediate action from the U.S. was necessary. President Truman said, “If we let Korea down, the Soviet[s] will keep right on going and swallow up one [place] after another” (History.com Staff, 2009b).

At first, the war went badly for the Allies. The North Korean army was well-disciplined, well-trained and well-equipped; Rhee’s forces, by contrast, were frightened, confused and seemed inclined to flee the battlefield at any provocation” (History.com Staff, 2009b). The difference in the armies was not the only issue. “Korea was experiencing one of the hottest and driest summers on record and desperately thirsty American soldiers were often forced to drink water from rice paddies that had been fertilized with human waste” (History.com Staff, 2009b). As a result, life threatening diseases adversely affected troops.

By the end of the summer, President Truman and General Douglas MacArthur, the commander of the Asian theater, had decided on a new trajectory for the war, to free the North Koreans from war aims. Now, for the Allies, the Korean War was an offensive one: It was a war to “liberate” the North from communism.

Early on in the war, the new strategy was a success. An amphibious assault at Inchon pushed the North Koreans out of Seoul and back to their side of the 38th parallel. American troops crossed the boundary and headed north toward the Yalu River. Now communist China began to worry about their security. Chinese leader Mao Zedong strongly warned the United States to keep away from the Yalu boundary.

The relationship of Truman and MacArthur soon ended due to philosophical differences. April 11, 1951, the president fired the general for insubordination.

Peace on the Horizon

In July 1951, President Truman and his new military commanders began peace talks. After more than two years of failed peace talks, an armistice was signed on July 27, 1953. As part of the agreement, the 38th parallel was extended; this act gave South Korea an extra 1,500 square miles of territory. Additionally, a two-mile-wide “demilitarized zone” was created and still exists today.

Casualties of the Korean War

When compared to prior wars, The Korean War was short but casualties and deaths were high. “Nearly 5 million people died. More than half of these — about 10 percent of Korea’s prewar population — were civilians. (This rate of civilian casualties was higher than World War II’s and Vietnam’s.) Almost 40,000 Americans died in action in Korea, and more than 100,000 were wounded” (History.com Staff, 2009b).

Vietnam War

The Vietnam War was long and costly. The war’s opposing forces involved the communist forces of North Vietnam (commonly known as the Viet Cong), and South Vietnam with its primary ally, the United States. The war began in 1954 after Ho Chi Minh came to power in North Vietnam. This served as yet another stronghold for what seemed to be an attempt to spread communism worldwide. “More than three million people, including 58,000 Americans, were killed in the Vietnam War; more than half were Vietnamese civilians. By 1969, at the peak of U.S. involvement in the war, more than 500,000 U.S. military personnel were involved in the Vietnam conflict” (History.com Staff, 2009c).

Following the Tet Offensive of 1968, support for the war dwindled. The U.S. was sharply divided in support of the war. This lack of support negatively impacted the returning troops. The impact of this negativity is still felt among many veterans even today. In 1975, communist forces seized and controlled Saigon, thusly ending the Vietnam War.

Why the War Began

Vietnam, located in the Indochina Peninsula, was under French rule since the 19th century. During World War II, Japan invaded Vietnam, a nation on the eastern edge of Southeast Asia that had been under French administration since the late 19th century. Ho Chi Minh, a true follower of communism, formed the Viet Minh and fought for independence from Japan and France. Japan withdrew their military in 1945 but the French remained. Almost immediately, Viet Minh forces rose up and seized the city of Hanoi, thereby declaring a new republic, the Democratic Republic of Vietnam (DRV). Ho Chi Minh was president.

Seeking to regain control of the region, France set up the state of Vietnam (South Vietnam) in July 1949 with Saigon as its capital and Bao as its president. Armed conflict continued until a decisive battle at Dien Bien Phu in May 1954 ended in a loss for France. The Geneva Accord split Vietnam along the latitude known as the 17th parallel (Ho controlled the North and Bao the South).

U.S. Presence Begins

In 1955, President Dwight D. Eisenhower pledged support to President Diem and South Vietnam by supplying training and equipment from the American military. Diem’s security forces cracked down on Viet Minh sympathizers in the south. Many people were tortured and executed. By 1957, the Viet Cong and other opponents of Diem’s regime began fighting back and even engaging South Vietnamese Army forces in the fights. In 1961, President Kennedy sent in a team of advisors to report on the conditions in South Vietnam. The team suggested an American military buildup in the region, as well as further aid to combat the Viet Cong. Kennedy increased U.S. aid but stopped at a large-scale military intervention. “By 1962, the U.S. military presence in South Vietnam had reached some 9,000 troops, compared with fewer than 800 during the 1950s” (History. com Staff, 2009c).

Vietnam War Intensifies

Diem and his brother, Ngo Dinh Nhu, were killed by their own military leaders in November 1963. South Vietnam became unstable yet again. Because of this, Lyndon B. Johnson and Secretary of Defense Robert McNamara increased U.S. military and economic support. In August 1964, two U.S. destroyers were torpedoed in the Gulf of Tonkin. In response to the action, Johnson ordered bombings of military targets in North Vietnam. Shortly afterward, Congress passed the Gulf of Tonkin Resolution, giving Johnson more power, and U.S. planes began regular bombing raids in February 1965.

In March 1965, Johnson made the decision to send U.S. combat forces into battle in Vietnam. “By June, 82,000 combat troops were stationed in Vietnam, and the call came for 175,000 more by the end of 1965 to shore up the struggling South Vietnamese army” (History.com Staff, 2009c ). “Despite the concerns of some of his advisers, Johnson authorized the immediate dispatch of 100,000 troops at the end of July 1965 and another 100,000 in 1966” (History.com Staff, 2009c ). In addition to the United States, South Korea, Thailand, Australia and New Zealand also committed troops to fight in South Vietnam but in much smaller numbers.

Strategy of Attrition in Vietnam

The majority of U.S.-South Vietnamese war effort in the south was fought on the ground. The general mission of the U.S. military forces in the region was to kill as many enemy troops as possible. “By 1966, large areas of South Vietnam had been designated as ‘free-fire zones,’ from which all innocent civilians were supposed to have evacuated and only enemy remained” (History.com Staff, 2009c). Heavy bombing made these zones uninhabitable. Even as the body count increased, the DRV and Viet Cong troops refused to stop fighting. Meanwhile, aid from China and the Soviet Union flooded in as North Vietnam strengthened its air defenses.

By November 1967, the number of American troops in Vietnam was approaching 500,000, and U.S. casualties had reached 15,058 killed and 109,527 wounded” (History. com Staff, 2009c). As the war went on, some soldiers came to mistrust the U.S. government’s reasons for keeping them there, and Washington’s claims that the war was being won. “The later years of the war saw increased physical and psychological deterioration among American soldiers, including drug use, mutinies and attacks by soldiers against officers and noncommissioned officers” (History.com Staff, 2009c).

Bombarded by horrific images of the war on their televisions, Americans on the home front turned against the war as well. “In October 1967, some 35,000 demonstrators staged a mass anti-war protest outside the Pentagon” (History.com Staff, 2009c ).

The Tet Offensive

By the end of 1967, Hanoi’s communist leadership carried out a major attack on the U.S. and South Vietnamese troops. “On January 31, 1968, some 70,000 DRV forces launched the Tet Offensive, a coordinated series of fierce attacks on more than 100 cities and towns in South Vietnam” (History.com Staff, 2009c ). U.S. and South Vietnamese forces struck back quickly and held the communists at bay. Reports of the attacks stunned the U.S. public, however, especially after news broke that Westmoreland had requested a large number of additional troops. With his approval ratings dropping in an election year, Johnson called a halt to bombing in much of North Vietnam in March and committed himself to seeking peace.

Johnson’s new strategy, relayed in March of 1968, met with a positive response from Hanoi, and peace talks between the U.S. and North Vietnam opened in Paris that May. Despite the later inclusion of the South Vietnamese and the National Liberation Front (the political arm of the Viet Cong), the peace talks failed. Johnson, who did not seek re-election, was replaced by Richard M. Nixon as president.

Vietnam War Ends

Nixon deflated the anti-war movement by appealing to a “silent majority” of Americans whom he believed supported the war effort. In an attempt to decrease American casualties, Nixon announced a program of troop withdrawal, but also increased aerial and artillery bombardment while giving the South Vietnamese control over the ground war. Nixon continued public peace talks in Paris. During these negotiations, the North Vietnamese demanded a complete U.S. withdrawal as a condition of peace. The next few years would witness more casualties. Anti-war sentiment was fueled by the allegations that U.S. soldiers had massacred more than 400 unarmed civilians in the village of My Lai in March 1968.

Anti-war protests continued as the conflict wore on. “On November 15, 1969, the largest anti-war protest in American history took place in Washington, D.C., as over 250,000 Americans gathered peacefully, calling for withdrawal of American troops from Vietnam” (History.com Staff, 2009c). The anti-war movement, which was particularly strong on college campuses, split American thoughts and attitudes significantly. For some young Americans, the war became a form of authority they resented bitterly. For others, opposing the government was unpatriotic and a treasonous action.

As the U.S. troop withdrawal began, many of those remaining “in country” quickly became angry and frustrated, leading to increased problems with low morale and poor leadership. “Tens of thousands of soldiers received dishonorable discharges for desertion, and about 500,000 American men from 1965–73 became ‘draft dodgers,’ with many fleeing to Canada to evade conscription” (History.com Staff, 2009c). Nixon ended the military draft in 1972, and began an all-volunteer military the following year.

Joint U.S-South Vietnamese forces invaded Cambodia in 1970 while hoping to wipe out North Vietnam’s chain of supply. Additionally, South Vietnam spearheaded an invasion of Laos, which was unsuccessful. The invasion of these countries sparked unrest on college campuses across America. In Kent State University, four students died during an exchange with National Guardsmen during an anti-war protest. Kissinger and North Vietnamese representatives drafted a peace agreement by early fall, but leaders in Saigon rejected it, and in December, Nixon authorized a number of bombing raids against targets in Hanoi and Haiphong. These bombing were known as the “Christmas Bombings,” and were met with great negativity from the international community.

Legacy of the Vietnam War

In January 1973, the United States and North Vietnam finalized a peace agreement but war between North and South Vietnam continued until April 30, 1975. On this date, North Vietnamese forces captured Saigon and renamed it Ho Chi Minh City. The long war negatively affected Vietnam.

The last U.S. troops returned home in 1975. For the United States, the effects of the Vietnam War would last for many years. “The nation spent more than $120 billion on the conflict in Vietnam from 1965–73; this massive spending led to widespread inflation, exacerbated by a worldwide oil crisis in 1973 and skyrocketing fuel prices” (History.com Staff, 2009c). The psychological toll of this war was immense. The Vietnam War shattered the American invincibility mindset while bitterly dividing the country. Many returning veterans faced unspeakable persecution from both factions. The opponents of the war called them unspeakable names, potential employers refused to offer work to a Vietnam veteran, many of the returning Vietnam troops had human and animal feces thrown at them. From those who supported the war, the returning troops were viewed as a force that lost the war. Many Vietnam veterans and their children suffer from the physical ailments due to exposure to the harmful chemical herbicide, as well as the sustaining and life altering effects of post-traumatic stress disorder. In 1982, the Vietnam Veterans Memorial was unveiled in Washington, D.C. The memorial contains the names of 58,200 American military members who were killed or missing during the war.

Persian Gulf War

Iraqi leader Saddam Hussein ordered the invasion and occupation of Kuwait in early August 1990. Concerned by these actions, Arab nations asked the U.S. and other nations for help. Hussein, in defiance of the U.N. demands, refused to withdraw troops. His refusal caused the beginning of the Persian Gulf War. A massive and intensive air campaign led by the U.S., commonly known as Operation Desert Storm, commenced.

After 42 days of relentless allied air and ground attacks, President George H. W. Bush declared a cease-fire on February 28, 1991. Though the Persian Gulf War was at first considered a success, it only proved to be a starting point for conflict in this region.

Prelude to the Persian Gulf War

A long war between Iran and Iraq ended in cease-fire, orchestrated by the U.N., in August 1988. By the mid-1990s, no permanent and binding peace agreement existed. A treaty seemed close until Saddam Hussein accused Kuwait of siphoning crude oil from the Ar-Rumaylah oil fields. His accusation derailed any plans for a formal peace agreement. To complicate matters even more, Iraq gathered troops and positioned them on Kuwait’s border. Concern for the stability of the region caused Egyptian president Hosni Mubarak to initiate negotiations between Iraq and Kuwait. Hussein walked out after a few hours. On August 2, 1990, Hussein ordered the invasion of Kuwait. Hussein felt his fellow Arab countries would support the war; his assumption was incorrect. “Two-thirds of the 21 members of the Arab League condemned Iraq’s act of aggression, and Saudi Arabia’s King Fahd, along with Kuwait’s government-in-exile, turned to the United States and other members of the North Atlantic Treaty Organization (NATO) for support” (History.com Staff. 2009d).

Iraqi Invades Kuwait and the Allies Respond

President George H. W. Bush condemned the invasion, along with Britain and the Soviet Union. On August 3, 1990, the United Nations Security Council called for Iraq to withdraw from Kuwait; three days later, King Fahd met with U.S. Secretary of Defense Richard Cheney to request U.S. military assistance. On August 8, the first U.S. Air Force fighter planes began arriving in Saudi Arabia as part of a military buildup, commonly known as Operation Desert Shield. The planes were accompanied by troops sent by NATO allies to guard against an Iraqi attack on Saudi Arabia.

“In Kuwait, Iraq increased its occupation forces to some 300,000 troops” (History.com Staff, 2009d). In an effort to garner support from the Muslim world, Hussein declared a jihad (holy war) against the coalition forces. Hussein’s plans failed.

The Gulf War Begins with “Shock and Awe”

On November 29, 1990, the U.N. Security Council authorized the use of force against Iraq if it did not withdraw from Kuwait by January 15, 1991. Preparations were on their way for an all-out military engagement.

U.S.-led air offensive hit Iraq’s air defenses with swiftness and pinpoint accuracy as they destroyed major infrastructure elements. Coalition forces utilized modern military technology to accomplish their collective goals, delivering quick and decisive attacks and decreasing the need for an extensive ground war. The result was the near destruction of the Iraqi air force.

War on the Ground

By mid-February of 1991, the coalition forces focused on the Iraqi ground forces in Kuwait and southern Iraq. A massive allied ground offensive, Operation Desert Sabre, was launched on February 24. Over the next four days, coalition forces defeated the Iraqis and freed the country of Kuwait. At the same time, U.S. forces stormed into Iraq to attack Iraq’s armored reserves from the rear position. The elite Iraqi Republican Guard mounted a defense south of Al-Basrah in southeastern Iraq, but most were resoundingly defeated in three days. With Iraqi resistance nearing collapse, Bush declared a cease-fire on February 28, ending the Persian Gulf War. “In all, an estimated 8,000 to 10,000 Iraqi forces were killed, in comparison with only 300 coalition troops” (History.com Staff, 2009d).

The war is over… But is it?

The Gulf War was viewed as a victory for the coalition; Kuwait and Iraq suffered great damage. Saddam Hussein was not forced from power; an issue that will come back to haunt the coalition forces. Hussein was “knocked down but not knocked out.”

In the years that followed, U.S. and British aircrafts continued to patrol skies and maintain a no-fly zone over Iraq, much to the Iraqis’ dislike. A brief period of violence occurred in 1998 due to Iraq’s refusal to admit U.N. weapons inspectors, and Iraqi military forces exchanged fire with U.S. and British aircrafts over the no-fly zone.

In 2002, the United States, led by President George W. Bush, advocated for the return of weapons inspectors to Iraq. The request was honored and U.N. inspectors re-entered Iraq in November. Differences in the interpretation in the degree of Iraq’s compliance with the inspectors caused the U.S. and Britain to assemble forces on Iraq’s border. Bush issued an ultimatum on March 17, 2003, demanding Hussein step down and leave Iraq within 48 hours and failure to do so would result in a threat of war. Hussein refused the ultimatum and the second Persian Gulf War, commonly known as the Iraq War, began three days later.

Iraq War

Operation Enduring Freedom

September 11, 2001 is the day the world will never forget. Terrorists, attached to the al-Qaida network, hijacked four airplanes. Two of the planes hit the World Trade Centers in New York City. The third plane hit the Pentagon building in Washington, D.C., while a fourth plane crashed in Shanksville, PA. In all, over 3,000 individuals were killed.

On October 7, 2001, a U.S.-led coalition began attacking Taliban-controlled Afghanistan with an intense bombing campaign in response to the 9/11 attacks. Many nations offered support for this far reaching military operation. This action was the opening round in the “war on terrorism.”

Dubbed Operation Enduring Freedom (OEF), the mission behind the invasion of Afghanistan was to destroy the al-Qaida organization, the Taliban government and its leader, Osama bin Laden. The Taliban, a group of fundamentalist Muslim militants, caused despair and hardship on countless individuals living in the region and on the entire country. It also perpetrated countless human rights abuses against its people, especially women, girls and ethnic Hazaras.

In the weeks prior to the invasion, the United States and the U.N. Security Council demanded the Taliban turn over Osama bin Laden for prosecution. Failed negotiations led to the invasion of Taliban and al-Qaida bases in Kabul, Kandahar, Jalalabad, Konduz and Mazar-e-Sharif. In response for the bombardments, The Taliban deemed this as “an attack on Islam,” and bin Laden called for a war against the entire non-Muslim world.

With the success of the bombardments, the coalition forces began a ground attack. On November 12, Taliban officials and their forces retreated from the capital of Kabul. By early December, the last Taliban stronghold had fallen and Taliban leader Mullah Mohammed Omar went into hiding. Al-Qaida fighters continued to hide out in the mountain region, specifically Tora Bora, where they fought anti-Taliban Afghan forces supported by U.S. Special Forces troops. Soon, al-Qaeda initiated a truce but many believe this act was a trick to permit Osama bin Laden and other key al-Qaida leaders to escape to Pakistan.

After Tora Bora, Afghan tribal leaders and others met in an attempt to carve out a peaceful end as al-Qaida and Taliban forces began to regroup. They still continue to engage U.S. and Afghan troops in guerilla-style warfare. Hundreds of American and coalition soldiers and thousands of Afghans have been killed and wounded in the fighting.

Operation Iraqi Freedom

On March 19, 2003, President George W. Bush informed the nation that Operation Iraqi Freedom (OIF) has begun. The new mission’s focus is twofold; remove Saddam Hussein from power and eliminate Iraq’s ability to develop weapons of mass destruction (WMD).

While not directly involved in the terrorist attacks of September 11, 2001, Bush designated Iraq as a “rogue nation” that supported terrorists. Additionally, intelligence suggested that Iraq was working to negotiate a deal to acquire large amounts of uranium in order to develop WMD.

Between 2002 and early 2003, U.N. weapons inspectors attempted to find WMD. Hussein did not cooperate with the inspectors to see if he had violated U.N. resolutions against manufacturing biological and chemical weapons; Hussein stalled in complying with the inspections. Frustrated due to the lack of U.N. support, Bush announced that the U.S. was prepared to launch military action against Iraq alone. Additionally, Bush gave Hussein and his sons 48 hours to leave Iraq or face war. Hussein and his sons ignored the offer. OIF began on March 19.

Bush received a great deal of criticism from many fronts for the war. Critics questioned if Bush’s desire was to control Iraq’s vast oil supplies. Many others felt the U.S. military action was in retaliation for an attempt on former President George H. W. Bush’s life ordered by Hussein in 1990. Allegations of intelligence cover-up or manipulation surfaced. Bush denied the accusations. U.S. forces captured Hussein, who had gone into hiding shortly after the start of on December 15, 2003. Losses in this war were great. “In the first four years of the war, American casualties stood at more than 3,000 with more than 23,000 wounded, while Iraqi civilian casualties were estimated at more than 50,000” (History.com, 2014).

Operation New Dawn

On August 31, 2010, President Barack Obama announced that the U.S. combat mission in Iraq (OIF) had ended. A transitional force of U.S. troops remained in Iraq under Operation New Dawn (OND), which ended on December 15, 2011. Several thousand U.S. civilian personnel, contract personnel and a limited number of U.S. military personnel remain in Iraq carrying out U.S. government business and cooperative programs under the auspices of agreements with the Iraqi government.