Rape Within the Ranks



Former Marine Officer Ariana Klay (right) addresses rape
in the military in The Invisible War.

The eye-opening documentary The Invisible War exposes an ugly truth: Rape by colleagues is an occupational hazard for women in our armed forces. Statistics in The Invisible War assert that military women serving in Iraq or Afghanistan are more likely to be raped by fellow military personnel than to be killed in the line of fire.

Sexual assault is the most under-reported crime in the nation, so the precise number of cases within military ranks is uncertain. A 2011 report from the U.S. Department of Defense itself estimates 19,000 cases in fiscal year 2010 alone.

And men are far from immune. According to the Department of Defense, the percentage of male victims of sexual assault within the military increased from 8 percent in FY 2010 to 13 percent in FY 2011.

Further, victims of rape within the military report facing disbelief and threats of retribution.

Rape and PTSD

Rape, like war, is a trigger for post-traumatic stress disorder. A precursor to the identification of PTSD in rape victims known as “rape trauma syndrome” was first articulated in 1974 by Penn Nursing Professor Emerita Dr. Ann Burgess and sociologist Lynda Lytle Holmstrom. Today, the term “military sexual trauma” describes what too many of our service women and service men are facing.

As nurses, we vowed to identify, treat, and conduct research on the specific health needs of our veterans and service members through Joining Forces, the national initiative launched by First Lady Michelle Obama and Dr. Jill Biden. Understanding and addressing the prevalence of rape perpetrated against members of our military by members of our military must be part of this mission.

What Nurses Can Do

I urge nurses to stress awareness of rape when caring for members of the armed forces and U.S. veterans. Nurses, who always have the opportunity to hear about patients’ lived experiences, are in the best position to uncover stories of trauma and stories of rape, even when their patients seem reluctant to reveal them.

We must intervene wherever and whenever we can through careful, sensitive health assessments, education, and research on military sexual trauma. It is a critical way for us to join forces with those harmed and betrayed during their service to our country.

First Lady Michelle Obama Joins Forces with Penn Nursing

I am thrilled and honored that on Wednesday, April 11, First Lady Michelle Obama and Dr. Jill Biden will come to Penn Nursing to announce a major initiative on the education and the role of nurses in meeting the unique health needs of service members, veterans, and their families. Mrs. Obama and Dr. Biden are turning to nurses to identify, treat, and conduct research on post-traumatic stress disorder (PTSD) as part of their national initiative Joining Forces, which champions wellness, education, and employment among military service members and their families.

Of course the best possible care comes from the best research and our Penn Nursing scientists are established investigators in PTSD and injury science. We have here a critical mass of ongoing research projects related to PTSD and trauma, led by faculty who partner with the U.S. Department of Veterans Affairs and the military.

• Dr. Rosemary Polomano, an expert in pain management, conducts innovative research on the perceptions of pain among military personnel and on battlefield analgesia. Her findings showed that regional nerve blocks and epidurals shortly after injury led to a statistically significant decrease in pain intensity and have the potential to reduce chronic pain, a crucial finding given the high correlation between chronic pain and PTSD. 
• Dr. Therese Richmond, a leader in injury science, conducts pioneering research on the psychological effects of injury and how to address those effects. In a National Institutes of Health-funded study, she found that even among patients who had relatively minor injuries, a substantial number had PTSD and depression, which is a precursor to PTSD, a year or more after the injury.
• Dr. Marilyn Stringer, a champion of women’s health, is expanding the understanding of the care of female service people and families in a nation at war. As associate editor of the Journalof Obstetric, Gynecologic, & Neonatal Nursing, Dr. Stringer published a special section on the leadership of military nurses in advancing science and practice in women's health, including gender differences in the area of PTSD.
• Dr. Mary Ersek specializes in pain and palliative care in older adults. Her work with the NIH’s Patient Reported OutcomesMeasurement Information System (PROMISE) program and her leadership in the End-of-LifeNursing Education Consortium are improving end-of-life care for U.S. veterans.
• Dr. Salimah Meghani is working to address pain management in low-income and minority patients. Her focus on racial and ethnic disparities in pain treatment can benefit active military personnel, veterans, and civilians.

The role of nursing in bringing research to the battlefield and the bedside is imperative to serving our military and their families. The number of service people returning from two major wars requires healthcare professionals prepared to recognize the signs and symptoms of visible and invisible injuries -- consequences of physical and mental trauma -- and to develop and implement best care practices to help them and their families cope.