http://www.npr.org/templates/story/story.php?storyId=124500733
by Terry Gildea
March 21, 2010
According to recent VA statistics, PTSD and depression are the top
disability claims among America's female veterans many of whom
served in Iraq and Afghanistan. But many of them have trouble proving
that they saw combat a key to getting treatment for Post-Traumatic
Stress Disorder.
A decorated war veteran, Marti Ribeiro's return to America marked
by a divorce and bouts of anxiety highlights the struggles many
female veterans face. Ribeiro, 30, spent eight years in the Air
Force, achieving the rank of staff sergeant. She served tours in both
Iraq and Afghanistan. Sitting for an interview recently, Ribeiro
smoked a cigarette, looking both tired and nervous.
In 2006, she was embedded with the Army's 10th Mountain Division in
Afghanistan as a military journalist, covering the unit's
humanitarian mission. But on many occasions, Ribeiro, a slender woman
with hazel eyes and blond hair, had to drop her camera and pick up her rifle.
Of the attacks on her unit, Ribeiro said, "We were hit with mortars
and RPG [rocket-propelled grenades] and it ranges from IED's on our
convoys to a lot of small-arms fire."
A Troubled Return
Ribeiro was awarded the Army's Combat Action Ribbon, but the medal
did little to slow the mounting chaos in her life. She was getting
ready to separate from the Air Force and return to her husband and
young daughter in the United States when her husband filed for a divorce.
Shaken by the tension and grief of combat, Ribeiro came home to take
on her new role as a single parent. She recalls being overwhelmed by
stress and anxiety.
"It's like having a burning sensation in the pit of your stomach that
doesn't ever go away," she said. "You become very paranoid in that
sometimes you feel like people are out to get you."
Ribeiro was diagnosed with post-traumatic stress disorder by military
doctors at a hospital in San Antonio, where she was stationed. She
says doctors recommended she apply for benefits through the
Department of Veterans Affairs. More than 40 percent of America's
female veterans have enrolled in the agency's health care plan.
After being discharged, Ribeiro moved to Oklahoma City with her
daughter, and her symptoms got worse. According to her VA medical
records, her PTSD claim was approved but when she tried making an
appointment at the local clinic, another battle began.
"They kept saying 'Oh, well you've got to go get registered at the
clinic, and then you've got to go to your primary care physician, and
then we will set you up with a mental health appointment,'" Ribeiro
said. "And one day, I just walked into the mental health facility and
stood there and said, 'I'm not leaving until you help me.'"
High Demand For Help
She was finally evaluated by a physician and a psycho-therapist, but
Ribeiro claims she was over-medicated with drugs like Xanax, that
covered up her symptoms but didn't deal with the roots of her
anxiety. Eventually, she found a psychiatrist who helped her.
"He got me on the right medication, the exact medication I needed to
be on," Ribeiro said, "but there are two psychiatrists, that's it,
for the entire Oklahoma City VA Medical Center, and I'm only allowed
to see him once every six months."
Officials at the Oklahoma City VA say there are 14 psychiatrists on
staff but only one solely dedicated to PTSD issues from the wars in
Iraq and Afghanistan. Ribeiro says her counselors denied her access
to a group therapy program designed for combat veterans of those conflicts.
Speaking of the PTSD treatment options meant for veterans who served
in Iraq and Afghanistan, Ribeiro said, "They've got sleep therapy,
they've got a nightmare group therapy program but they are sticking
to their guns and they won't refer me."
When asked why that is, Ribeiro said, "You're asking the wrong
person. It seems to be the only thing that's excluding me is the fact
that I'm female."
Studies show that female veterans often have a hard time proving they
saw combat something that can help get a PTSD claim approved. But
in Ribeiro's case, she earned a combat medal.
Dr. Dan Jones is the director of the Post-Traumatic Stress Recovery
Program at the Oklahoma City VA Medical Center. He didn't comment
directly on Ribeiro's case, but Jones says there are national
policies that should prevent a female vet with an approved claim from
being denied access to a support group.
"I can't think of a reason that she would be denied for entrance into
most of these programs if she had those qualifications," Jones said.
Facing The Future
Marti Ribeiro says she's given up on the VA's ability to provide free
counseling. She's found a good therapist for herself and her
daughter, through private insurance.
"It's 30 bucks a week that's my co-pay for seeing a specialist,
basically. So it can get expensive, especially between that and my
daughter's counseling."
Today, Ribeiro has a full-time job, and she's found support from a
committed relationship. She wants to move on from the memories of
war, but she knows her life will never be the same.
"You don't want to forget. You feel guilty for wanting to forget,"
Ribeiro said.
"I served my country honorably for eight years. I should be proud,"
she says. "I've seen things and done things that a million other
people haven't, and I lived through it and I'm fine, and I'm on the
other side, and I'm going to get through it."
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