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The report examines the devastating toll of war on human health, whoever the combatant, whatever the compounding factor, in the most violent conflicts in which the U.S. government has been engaged in the name of counterterrorism since September 11, 2001. Rather than teasing apart who, what, or when is to blame, this report shows that the post-9/11 wars are implicated in many kinds of deaths, making clear that the impacts of war's ongoing violence are so vast and complex that they are unquantifiable.

Nearly 18 years since the start of the war in Afghanistan and 16 years since the U.S. invasion of Iraq, majorities of U.S. military veterans say those wars were not worth fighting, according to a new Pew Research Center survey of veterans. A parallel survey of American adults finds that the public shares those sentiments.

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Views do differ significantly by party, however. Republican and Republican-leaning veterans are much more likely than veterans who identify with or lean toward the Democratic Party to say the wars in Iraq and Afghanistan were worth fighting: 45% of Republican veterans vs. 15% of Democratic veterans say the war in Iraq was worth fighting, while 46% of Republican veterans and 26% of Democratic veterans say the same about Afghanistan. The party gaps are nearly identical among the public.

The Indian Wars began the moment English colonists arrived in Jamestown, Virginia, in 1607, when the settlers started an uneasy relationship with the Native Americans (or Indians) who had thrived on the land for thousands of years. At that time, millions of indigenous people had settled across North America in hundreds of different tribes. But between 1622 and the late 19th century, a series of wars and skirmishes known as the Indian Wars took place between American Indians and European settlers, mainly over land control.

In April, I made the decision to end this war. As part of that decision, we set the date of August 31st for American troops to withdraw. The assumption was that more than 300,000 Afghan National Security Forces that we had trained over the past two decades and equipped would be a strong adversary in their civil wars with the Taliban.

Wars have had an important part in psychiatric history in a number of ways.It was the psychological impact of the world wars in the form of shell shockthat supported the effectiveness of psychological interventions during thefirst half of the 20th century. It was the recognition of a proportion ofthe population not suitable for army recruitment during the Second World Warthat spurred the setting up of the National Institute of Mental Health inUSA. The differences in the presentation of the psychological symptoms amongthe officers and the soldiers opened up new ways of understanding the psychiatricreactions to stress.

Though there have not been any world wars since the Second World War, therehave been wars and conflicts throughout the last 60 years. For example, inthe 22 countries of the Eastern Mediterranean region of the World Health Organization(WHO), over 80% of the population either is in a conflict situation or hasexperienced such a situation in the last quarter of century (7).

War has a catastrophic effect on the health and well being of nations.Studies have shown that conflict situations cause more mortality and disabilitythan any major disease. War destroys communities and families and often disruptsthe development of the social and economic fabric of nations. The effectsof war include long-term physical and psychological harm to children and adults,as well as reduction in material and human capital. Death as a result of warsis simply the "tip of the iceberg". Other consequences, besides death, arenot well documented. They include endemic poverty, malnutrition, disability,economic/ social decline and psychosocial illness, to mention only a few.Only through a greater understanding of conflicts and the myriad of mentalhealth problems that arise from them, coherent and effective strategies fordealing with such problems can be developed. ff782bc1db