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  • By Bruce Lloyd

The endless battle for vet healthcare

U.S. military vets in the Pacific are angry about second class health care

treatment; Will a Washington oversight hearing make a difference?

It will be scheduled for next year.

By one count there are nearly 30,000 U.S. military veterans scattered across the Pacific. The population numbers range from 27,000 on Guam to six in the Marshall Islands. The CNMI, the Federated States and Palau also have resident vets, as do Majuro and Kosrae.

Every one of these people who rendered service to the United States are entitled to the same level of health care they would receive, had they chosen to reside in the U.S. mainland. But for many years, individual Pacific vets and organizations representing them have made increasingly loud complaints that Veterans Administration system is not only failing to do the job, but is stubbornly insisting that ailing vets travel across the international dateline to Honolulu for anything beyond the most basic of treatments.

Now three island legislators—Congresswomen Madeleine Z. Bordallo of Guam, Amata Coleman Radewagen of American Samoa and Congressman Gregorio ‘Kilili’ Sablan of the CNMI—are calling for a U.S. House of Representatives Veterans Affairs committee oversight hearing to look into the situation of the insular vets. A news release on the letter to the committee leadership requesting the hearing contained what many aware of the situation would view as a dry understatement: “The Representatives noted that these areas suffer from minimal involvement by the national Department of Veterans’ Affairs.”

How minimal? Honolulu VA representatives got an earful from Guam vets who packed a hotel conference room last April.

A clinic/dispensary facility to meet basic non-critical needs of Guam vets was for years housed at Navy Hospital, piggybacking on facilities for active duty personnel. But even before the opening of the VA Community Based Outpatient Clinic in a separate building a few years ago, local vets complained that its size and staffing appeared inadequate to serve thousands of local veterans. Vet Joseph Mendiola called the CBOC “that itty-bitty clinic up there” and said it was suffering turmoil with a lot of medical staff turnover. But Mendiola got loud clapping and applause from the crowd with this observation: “The one thing that really irks me is that there’s no one to return my phone call. It’s common decency.”

Worse than an unanswered phone call, services at the clinic have been cut back, patients are seen only by appointment and emergency cases are urged to go to the Navy Hospital emergency room.

Vietnam vet Barry Mead is among those who have urged a full-fledged VA hospital on Guam for years. As to Congresswoman Bordallo’s response, “You have no idea the resistance we got. And we got NOTHING from the Congresswoman, and I mean NOTHING!” And like other Guam vets, Mead has noted the effects of staff turnover and limited funding.

“The VA itself though SUCKS when it comes to the issues of our CBOC. Since Nov of 2013 I have now been seen by 7 different doctors as for whatever reason the VA just can’t staff the CBOC. As well the Honolulu District spends far less per vet on Guam than they do for vets in Hawaii.” From the Congressional letter: “Veterans in the Pacific must contend with much greater obstacles to access VA healthcare than veterans in the rest of the country. They must travel thousands of miles to reach the nearest full-service facility, the Spark M. Matsunaga VA Medical Center in Hawai’i.

American Samoan veterans must fly 5 hours north, a distance of about 2,650 miles, to receive the most basic of care, due to the rundown nature of both the local Veteran’s clinic and LBJ Hospital. Veterans in American Samoa also face the unique challenge of not having direct flights to and from Hawai’i every day, forcing veterans to spend a minimum of three days away from home, and often up to a week.”

And how do the vets fare, once they reach their healthcare destination? Many complain of botched appointments, hotel reservations and the hardships of travel while alone and in pain.

In April, vet Henry Leon Guerrero was among those with a travel complaint. After enduring a painful procedure in Hawaii, the VA booked him on the 17 hour ‘island hopper’ flight back to Guam, a tourist draw featuring frequent landings and take-offs, but not well suited to a recently treated patient. Others complained that they or their spouses were booted out of Honolulu hotels while still being treated.

And another vet contended that with all that distance comes insensitivity to local needs, which Retired Command Sergeant Major Franklin Artero attributed to the view of Guam—and by extension, the other insular areas—as “the red-headed stepchild of the U.S.A.” Artero said he told the VA after months of waiting that he expected his prescription would change before his new glasses arrived from Hawaii. “You can get glasses in one hour at the mall,” said Artero, noting that two women in Honolulu handle this entire program for Pacific vets.

William Duenas Sablan

A common complaint is that the VA has been slow to deal with long term injury due to exposure due to the herbicide Agent Orange. Drafted from Guam in 1964, William Duenas Sablan recalled watching B-52 bombing runs in Vietnam. “When we would go out to the area the next day, the foliage was all cleared.” Sablan said that the years old promise that the herbicide was safe reminded him of treaty promises given to Native Americans.

But by standards elsewhere, Guam has it better than others. From the Congressional letter: “Veterans living in the Northern Marianas do not have a VA medical facility, dedicated medical and mental health professionals or a Vet Center to serve them. VA health services are limited to two part-time contract physicians who are at capacity and unable to take additional veteran patients. Veterans in the Marianas must travel to Guam, or in many cases go directly to Hawai’i to receive VA care.

In addition, the Veterans Benefits Administration does not have staff in American Samoa or the Northern Marianas. Veterans there wanting to speak with VBA staff must wait for the occasional visits by staff from Hawai’i or Guam.”

CNMI Rep. Sablan used his newsletter to lay out his proposal to fix the situation for vets living on Saipan, Tinian and Rota. His goals include establishing a fully staffed, fully equipped VA clinic in the Marianas with medical and mental health professionals; a Center that provides transition assistance, counseling, outreach, and social service referrals for veterans and their families; a permanent VA benefits staff servicing veterans on all three islands; and more staffing and supervision for the VA health office.

Given a chaotic situation in Washington and a Congress that appears to have trouble accomplishing anything positive, what will an oversight hearing—when and if it occurs—accomplish?

[Update: The chairman of the House Veterans' Affairs Committee, Dr. David P. Roe, responded to the joint request from Guam Delegate Bordallo, Northern Marianas Delegate Gregorio "Kilili" Sablan and American Samoa Delegate Aumua Amata Coleman Radewagen for a congressional oversight hearing. On Oct. 24, just 13 days after Bordallo, Sablan and Radewagen made the request, Roe wrote to the three delegates that the congressional hearing will be held next year.]

Barry Mead, who has been listening to excuses for the state of Pacific care for years is skeptical but holds out some hope that he and his fellow vets will finally be heard. “All I can say to this is FINALLY.”


Guess who the VA left out of the suicide statistics?

For those who feel U.S. overseas territories, which send a disproportionate number of their citizens to serve in the military, get second class treatment from federal agencies, you don’t have to go much further than the latest suicide statistics from the Veterans Administration.

You won’t find numbers for Guam, the CNMI, Palau or any other U.S. territories, with the exception of Puerto Rico which reported 15 veteran suicides in 2014.

These are important statistics because, as the VA emphasized in a news release, “After adjusting for differences in age and sex, risk for suicide was 22 percent higher among Veterans when compared to U.S. non-Veteran adults.” The report says, “The 2017 version of the report excludes U.S. territories from all data points, due to variations in the availability of National Death Index data for the territories.”

There’s no question that suicide-by-vet is an issue. A call to the Guam vets clinic starts with a recorded message attempting to direct callers with suicidal thoughts to another number that offers counseling services.

According to the VA, “Analysis of this information will help VA’s Office of Mental Health and Suicide Prevention gain insight into high-risk populations and share that information with community-based health care providers and partners, continuing to expand the network of support for Veterans.

Vets can only hope that the territories will be included in future reports.


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