Female Veterans face employment challenges
It's a steep climb back to employment when they return from war
Wednesday, Feb. 15, 2012 Updated Wednesday, Feb. 15, 2012 1 Comment Print Reprints
By Kimberly Olson

Sara was living in her car in the parking lot of a local grocery store -- certainly not the place that this military veteran thought she would find herself after returning from two tours in Iraq. Unfortunately, hers is a story that unfolds for some women veterans.
If you met Sara today, you would scarcely believe that just four months ago her car was her home and that she was wondering where she would get her next meal. What happened during those four months was that Sara experienced outreach from a fellow veteran and found meaningful work.
Those of us at Grace After Fire who interact daily with veterans quickly discover a powerful truth: Work makes them well. After years of constant deployments and relocation, most veterans want work that sustains a family and is in a place where they can put down roots. Our veterans are smart, brave, tenacious and experienced men and women, and they don't want or need a handout. "Let me earn my way," or "I can do it myself" are common refrains.

Although most veterans are disciplined, loyal and hardworking, there is an alarming gap between the employment rates of veterans and civilians. One in 3 veterans between 18 and 24 was out of work last month, compared with only 1 in 6 of their civilian counterparts. And the gap is even larger for our women veterans, 22 percent of whom are unemployed, compared with 7.8 percent of civilian women.
These statistics are curious since veterans are often more experienced and better-educated: Their skills literally have been battle-trained and -tested, and over 70 percent have been to college.
Texans are returning after years of combat; the wars in Afghanistan and Iraq are winding down. Our state is at a pivotal moment in terms of how we treat our veterans. While there is widespread support, the path veterans face when they come home is a challenging one. Like many of our veterans, the civilian economy is trying to find sure footing.

Of the 2.2 million Americans who have deployed to Iraq and Afghanistan, nearly 300,000 are women -- young women, since 6 in 10 of them are under 30. Given that Texas has the second-largest population of female veterans, that means that more than 5,000 of the 25,000 women veterans in North Texas are looking for work.
So what accounts for this unemployment rate? Could it be that the news media report only on the heartbreak that is war? Are we missing an opportunity? It seems that these young men and women who come home from war must now battle the perception that all military personnel are suffering from physical or emotional trauma.

Yes, war changes you. Yes, war is a violent affair that brings out the worst of humanity. And yes, it is important to report on the terrible price some pay in defense of our nation. Some veterans do need help and time readjusting from the battlefield experience, and we have learned much from the preceding generations of veterans. Today, in the Fort Worth area, some 326 organizations are working with veterans.
But war also can bring out the best of humanity. Today only 1 percent of young Americans choose to defend this country. We believe that it's the responsibility of the remaining 99 percent of Americans to do everything in our power to help these warriors.

Here is our opportunity to do something.
First, celebrate Women Veterans Month this March. The Texas Legislature is only the fourth in the nation to make such a declaration, although others appear likely to follow our lead. Second, simply say thanks to a veteran in your family, at your workplace or in your community. Then, if you'd like to support our troops, please consider helping a local veterans organization.
Finally and most important, if you can, hire a veteran. We know that for most of our brave young veterans, perhaps more than anything else, warriors will work themselves well. Give them that chance today.
Retired Air Force Col. Kimberly Olson is president and CEO of Fort Worth-based Grace After Fire. www.graceafterfire.org

Read more here: http://www.star-telegram.com/2012/02/15/3738227/olson-female-veterans-face-steep.html#storylink=cpy

Female Stryker team making advances
in dealing with Afghan women, children
by Cheryle Hatch, For the News-Miner Fairbanks Daily News Miner
Jan 22, 2012

Pfc. Jamie Sterna, 21, left, of Mequon, Wis., and Valerie Cronkhite, 32, of Skipperville, Ala., speak with Afghan women and children at a compound during a dismounted patrol with the 3rd Platoon Bravo Company of the 1st Battalion 5th Infantry Regiment in Kandahar Province, Afghanistan. Sterna and Cronkhite are members of the Female Engagement Team, a group of women soldiers who connects with the Afghan women and children population. / JR Ancheta photo
slideshow

Female soldiers (from center left) Spc. Melicia James, 25, Pvt. Liliana Nunez, 20, (from top right) Valerie Cronkhite, 32, and Pfc. Jamie Sterna, 21, attend a debriefing after a mission with soldiers from the 3rd Platoon Bravo Company of the 1st Battalion 5th Infantry Regiment in combat outpost Sperwan Ghar located in Kandahar Province, Afghanistan. James and Nunez were attached as Female Engagement Team members during a dismounted patrol. They were able to speak with several women on the mission. Editors Note: This photo was digitally altered to blur potentially classified information on the wall. / JR Ancheta photo
slideshow

Spc. Valerie Cronkhite, 32, of Skipperville, Alabama holds a Purple Heart and wears a Combat Medic Award she received Dec. 30, 2011. Cronkhite is the only FET member who is awarded a Purple Heart. / JR Ancheta photo
slideshow

Pfc. Jamie Sterna, 21, of Mequon, Wis., waits to begin a patrol with 3rd Platoon Bravo Company of the 1st Battalion 5th Infantry Regiment, Jan. 4, 2012, in Kandahar Province, Afghanistan. Sterna is a member of the Female Engagement Team, a group of women soldiers who connects with the Afghan women and children population. / JR Ancheta photo
slideshow KANDAHAR PROVINCE, Afghanistan On patrol with infantry soldiers, Spc. Valerie Cronkhite carries her weight.

At 5 feet 3 inches and 110 pounds, Cronkhite carries at least 110 pounds in gear. Her body armor and ammo weigh about 50 pounds. As a medic, she carries a rucksack packed with 70 pounds of supplies.

I have to carry enough to sustain four to six people in case of casualties, she says.

Cronkhite also is a member and veteran of a new program, the Female Engagement Team and the Female Search and Seizure Team.

The FET/FSST is inspired by the Marine Corps Lioness program, a team of female soldiers trained to search Muslim and Iraqi women. The Army took the program and expanded and adapted it to meet its needs.

Our ideal mission is to inform and influence, says Maj. Maria Rodriguez, 37, from the Bronx, N.Y. Rodriguez is the brigade provost marshal and brigade Female Engagement Team officer in charge.

We also do searches, she said.

The women accompany the male soldiers on missions with the intention of meeting with the Afghan women and learning about their concerns. On a mission, the male soldiers ask a male head of the household, a malek, if he would allow the FET soldiers to speak with the women of the house.

Sometimes we get told yes. Sometimes we get told no, Rodriguez says.

If theyre accepted, they often offer lotions, shampoo, diapers and feminine hygiene products.

Well sit there for two hours and have tea and have girl talk. And that builds relationships, Rodriguez says. It is a slow, slow process.

Seven women form the FET team attached to the 1st Battalion, 5th Infantry Regiment of the 1st Stryker Brigade Combat Team, 25th Infantry Division. Cronkhite, 32, from Skipperville, Ala., and Spc. Melicia James, 25, from Jamaica, N.Y., have been with the team since its initial training at Fort Wainwright in late 2010. Pfc. Jamie Sterna, 21, from Mequion, Wis., and Pvt. Liliana Nunez, 20, from Brownsville, Texas, are recent additions.

Nunez and Sterna, theyre fresh-eyed, says Cronkhite, who guides their training.

Sgt. 1st Class Miriam Lopez, 45, from Salina, Puerto Rico, joined the team at the start of 2012. Another, Mary, who cannot be identified for security reasons, serves as the teams female linguist. Capt. Stephanie Boatman, 30, from Augusta, Ga., completes the team.

Each of the women has an assigned job, separate from her FET duties. Cronkhite and Nunez are medics. James is a mechanic. Lopez is a cook. Sterna is an ammo specialist, truck driver and mail clerk. Boatman is a signal officer.

In early January, Cronkhite, Sterna and Lopez prepare for a mounted patrol with 4th Platoon, Bravo Company, based at strongpoint Sperwan Ghar in Kandahar Province. They join two interpreters, eight Afghan National Army personnel and 23 American soldiers for the three-mile drive to the village of Big Reggai.

They arrive at a dusty, walled compound. Before starting on foot, the soldiers are advised to stay to the left of the red spray-painted lines; the area to the left indicates its been swept for mines. The women are told to hang back. As they wait, a muffled boom-boom catches the soldiers attention.

You can tell by how the blast sounds, Cronkhite says, describing how she can judge distance. You can feel it in your feet or you feel it in your stomach.

When they enter the compound, a Sufi mystic the soldiers call the Pope is sitting with a gathering of men. Many are awaiting a blessing.

Boom-boom. Boom-boom. A couple more shudders, apparently not close enough to deter the patrol.

If you guys want, you can move up a little bit, do your thing, a soldier tells the FET women.

The male head of the household escorts the women to the compound. A sergeant arranges security for the women and gets them a radio. The man will not allow the male interpreter inside with the women. The interpreter stands outside the door. They play a sort of telephone game as the questions are passed from the FET soldiers to the man to the interpreter back to the man then back to the women.

Eight women four of them cradling infants quickly gather around the soldiers.

What were doing now is to start to get to know them. Were asking all these questions so we can help them, Cronkhite says, asking the interpreter to explain their intentions to the male head of household.

Is everybody OK with us being here? Cronkhite says. They dont mind, the interpreter relays. Thats awesome.

Cronkhite directs the conversation. She asks about the children, their ages, any illnesses. One woman is nine months pregnant. Cronkhite asks if theres someone who delivers babies in the village. A 70-year-old woman with hennaed hands responds that she is their midwife.

Cronkhite asks to hold one of the babies. The infant girl begins to cry as Cronkhite shushes her. She asks if they can take photographs of the babies and the women agree to be photographed, too, which is unexpected and delights the FET women.

Over the radio, the women are told to wrap it up. The whole mission takes two hours. Forty minutes after they return to base, the soldiers gather for a debrief. The men run through security issues. The FET members offer their assessment.

They were very receptive to us being there, Lopez says. We felt very comfortable.

The FET women are not assigned to the infantry. The FET soldiers are attached to the 1-5 Bobcats. Its an important distinction in the Army.

Technically, I dont have any females assigned to this unit, says Command Sgt. Maj. Ernest Bowen of the 1-5.

And though they are not officially assigned to the infantry, they are in combat.

When you put boots on the ground on patrol female, male, working dog, youre as susceptible as anybody to contact with the enemy or stepping on a mine, Bowen says. Theyre doing a great job out there with the guys. The FET has been value added. They go to interact and touch part of the population that male soldiers cant.

In Dand district, the 1-5 FET helped local women create water filtration systems using layers of sand in barrels with simple spigots. The FET soldiers also taught midwifery, well-baby, well-woman and basic hygiene classes. As a military police officer, Rodriguez is particularly proud of the small, new womens unit in the Afghan Uniform Police in Qalat in Zabul District, where the women went from wearing burkhas to wearing uniforms.

Now the FET soldiers attached to the 1-5 are working in Panjawai District, hoping to create similar opportunities for Afghan women.

The FET requires a soldier with good people and social skills. And the soldiers get language and cultural awareness training, plus a week of field exercises. Of the approximately 4,000 soldiers deployed with the 1/25 Stryker Brigade Combat Team, 226 soldiers are women. Of those 226, only 22 are FET soldiers, with an additional 15 in reserve, according to Rodriguez. The women have conducted 57 missions as of early January 2012.

I joined FET because I thought it was a great opportunity to reach out to Afghan women and children, Sterna says. It makes me feel like Im doing something good, huge in life.

All of us were secretly hoping to get it, Cronkhite says. Not a lot of females get to go out on the line and do the things we get to do.

In the morning, Sterna is among the first of the team to rise for the next mission. Before Cronkhite rolls out of bed and puts a dip of chewing tobacco in her mouth, Sterna has already showered and put on make-up.

I put on make-up every day no matter what, she says. It makes me feel like Im still a woman. Her breakfast consists of the five Ps: two cinnamon Pop-Tarts, two cans of Pit Bull and a powered-sugar donut, followed by a Newport menthol cigarette.

The women will accompany 3rd Platoon Bravo Company on a clearing operation in Sekecha, a town the soldiers nicknamed Sketchy.

If you come out with Bravo Company, youre guaranteed to get in a firefight, a soldier says.

Before the patrol begins, the soldiers give Sterna grief. Shes wearing her insulating poly-pro garments under her uniform and the guys repeatedly tell her she should remove it. They think shell overheat on patrol. A blonde with the broad shoulders and straight back of an athlete, Sterna holds her ground.

I grew up with an older brother always picking on me and beating me up, so it doesnt bother me much when the other guys here pick on me, she says later. Im used to it. I just try to pick on them back.

As a medic and veteran of many patrols, Cronkhite is put at the front of the first group, near the soldier on point with the Valon metal detector. Still in training, Sterna marches near the back of the second group. The terrain is challenging. The land around Sperwan Ghar is a maze of vineyards. The vines lean against tall mud supports and the soldiers must repeatedly climb over the 6-foot walls.

They reach a compound with only an older woman and several children living in it. Once the ANA and American soldiers have cleared the structure, Cronkhite and Sterna approach the woman with a translator. They remove their helmets and set aside their rifles. They sit on the dirt floor and face the woman. Cronkhite talks and Sterna takes notes.

We are poor people. We have nothing to eat, the woman says. We make money by our farm.

The soldiers discover two rooms half-filled with processed marijuana (their unconfirmed estimate: 5,000 pounds).

What does she think about the women being here? Cronkhite says.

Yes, were happy the women are here.

Not for long. The soldiers return and tell Cronkhite to tell the woman theyre going to burn her crop. Its illegal to raise marijuana in Afghanistan.

Thats the only way we have to make money, the woman says. If you want to destroy it, you must give us money.

This turn of events puts Sterna and Cronkhite in a tough position. They came to discuss the womans concerns and needs. Now theyre telling her the soldiers will burn her cash crop.

This is the first time we hear this is illegal, the woman says. If you destroy this, I wont have food for my kids. Just forgive us this time. We wont grow it again.

Tell them to stick to wheat and grapes, Staff Sgt. Matt Huck says.

The American soldiers spend the next three and a half hours shoveling the marijuana into bags, which the ANA soldiers drag outside and dump into two piles for burning.

The Americans want to use the womans straw as a fire-starter. Again the woman protests. This is for heating the house and making bread.

The soldiers take some of the straw. The woman goes inside a room and does not return.

The Americans give the ANA soldiers the materials to set the blaze. As they burn the marijuana, they may also be burning the bridges that Sterna and Cronkhite intended to build.

Each woman has different rituals that surround departure for and return from a mission. A self-described troublemaker, Nunez listens to country music to relax. She often plays If Youre Going Through Hell by Rodney Atkins. At night, she and Sterna might join some of the male soldiers around a bonfire on the edge of their home base, Shoja. Theyll smoke cigarettes, laugh, call each other out and drink the non-alcoholic beer the soldiers call near beer.

James starts her day and missions with prayer.

I wake up, listen to gospel, read my Bible and pray, James says. On Mondays, I fast. I only read the New Testament when Im in the field cuz I cant carry that big Bible. I believe in God and I pray to God and I can see him pulling me through.

James is a single mother of two young boys, Dario, 10, and AJ, 6. She loves the Army and the FET and the chances both have given her.

I still could do good for myself, my kids and my country.

As a mother, James understands the challenges of the Afghan women she meets. She recalls an encounter on a recent mission near Khenjakak.

I empathize with that older lady cuz her husband died and shes struggling to make ends meet. That really touched me, James says. Were there to help and at that particular moment, I couldnt help. I am pushing to go back to that area. Out of the kindness even of their heart, they have no land to grow their food, they couldnt provide for their family, they still gave us tea and bread. That shows their generosity and kindness.

James has her after-mission rituals, too.

Actually, I go to the shower first, then I go to the MWR (Morale Welfare Recreation center). I talk to my kids and my sister.

Cronkhite calls her husband, Robert, who is a retired Army first sergeant.

I called him after I got blown up, Cronkhite says. She was returning from leave Oct. 21, 2011 when the Stryker vehicle she was traveling in hit an IED.

It destroyed the mine roller. There were eight in that Stryker. James was in the gunners hatch, Cronkhite says. I got knocked out. I remember hearing it. It wasnt loud. All that moon dust. We were all strapped down. It was a big boom and Im a little girl.

On Dec. 30, 2011, Battalion Commander Lt. Col. Brian Payne pinned a Purple Heart on Cronkhite. She is the only FET soldier to receive a Purple Heart and is one of only two women in the 1/25 Brigade to receive it. She also earned the Combat Medic Award for rendering medical aid while under fire.

She has mixed emotions about the Purple Heart.

Theres guys who arent coming back who get that. I dont know if Im worthy of that. It kind of gets to me in the head when people congratulate me for it.

She notes that both awards mean that someone got hurt. And shes seen a lot of hurt.

Shes been a medic at the scene of multiple mass casualties.

The aftermath of one IED explosion sticks with her.

It was rather graphic. Get the clothes off. Rinse off some of the stuff, Cronkhite says. We were all a little shell-shocked.

Some soldiers survived, one with a double-amputation of his legs; one soldier died.

And she carries that weight with her, too.

Cheryl Hatch was a recent Snedden chair in the University of Alaska Fairbanks journalism department. She and photographer JR Ancheta, a UAF student, were embedded with a Fort Wainwright Stryker brigade unit in Afghanistan.

Read more: Fairbanks Daily News-Miner - Female Stryker team making advances in dealing with Afghan women children

New Members Appointed to VA Committee on Women Veterans
WASHINGTON Six new members have been appointed to the Department of Veterans Affairs (VA) Advisory Committee on Women Veterans, an expert panel that advises VA on issues and programs affecting women Veterans.

The Advisory Committee on Women Veterans significantly guides VAs efforts to identify and address the ever changing needs of women Veterans, said Secretary of Veterans Affairs Eric K. Shinseki. VA welcomes the newest members.

Established in 1983, the advisory committee makes recommendations to the Secretary for administrative and legislative changes. The new committee members, who are appointed to two-year terms, are: Sherri Brown, Alexandria, Va.; Latoya Lucas, Rocky Mount, N.C.; Sara J. McVicker, Washington, D.C.; Delphine Metcalf-Foster, Vallejo, Calif.; Robin Patrick, Virginia Beach, Va.; and Felipe Torres, Helotes, Texas.

Women serving in the military are essential components of our Nations success, Shinseki added. In honor of their service, VAs is committed to providing women Veterans with quality care and preparing for their evolving needs.

Women Veterans are one of the fastest growing segments of the Veterans population. There are 23.4 million Veterans; approximately 1.8 million are women Veterans. They comprise nearly 8 percent of the total Veterans population and nearly 5 percent of all Veterans who use VA health care services.

VA estimates that by 2020 women Veterans will comprise 10 percent of the Veteran population. VA has women Veterans program managers at VA medical centers and women Veterans coordinators at VA regional offices to assist women Veterans with health and benefits issues.

New Members
VA Advisory Committee on Women Veterans
Sherri Brown, Alexandria, Va. A Veteran of the Coast Guard Reserves; currently serves as Senior Vice President for Service to the Armed Forces for the American Red Cross.
Latoya Lucas, Rocky Mount, N.C. A retired Army specialist, with combat service in Iraq; currently works as a motivational speaker.
Sara J. McVicker, Washington, D.C. A former Army Corps nurse, with service in Vietnam; currently serves as a member of Vietnam Veterans of Americas National Women Veterans Committee.
Delphine Metcalf-Foster, Vallejo, Calif. A retired Army first sergeant, with service in Desert Storm/Desert Shield; currently serves as a member of Disabled American Veterans Department of California Womens Committee.
Robin Patrick, Virginia Beach, Va. A Veteran of the U.S. Navy and Army National Guard; currently serves as a Veterans advocate for women Veterans, homeless Veterans, disabled adults, and families.
Felipe Torres, Helotes, Texas. A retired Marine Corps colonel, with service in Vietnam; currently serves as a women Veterans advocate.

RelatedBy Drew Brooks
Staff writer

For a week in July, Mariel Marrero and her two children visited the Cumberland County Headquarters Library every day.
Between 7:45 a.m. and 4:30 p.m., Marrero, 30, and her children - ages 10 and 12 - sought out the library not for its books, but for its air conditioning. Their only alternative, Marrero said, was to stay in parks in nearly 100-degree heat.
At night, Marrero and her children slept at the Salvation Army shelter on Alexander Street.
"You always hear about the men," Marrero said of homeless veterans. "But we're out there, too. People just don't see us."
Marrero is one of about 90 female veterans who are homeless in the Fayetteville area, according to the Department of Veterans Affairs.
She's also part of a growing trend.
Each year, the percentage of female veterans increases. Rising, too, is the percentage of women in the homeless veteran population.
Years ago, homeless veterans were almost exclusively men. But with new wars and a changing Army, young women in their mid-20s to early 30s are encompassing a larger part of the homeless population, especially in Fayetteville.
While other VA offices say women account for about 6 percent of their homeless veteran populations, that number triples to 18 percent in Fayetteville, said Stephanie Felder, the Fayetteville VA's homeless program coordinator.
"The problem is extensive," Felder said. "It's a national problem."
Felder said the Fayetteville VA serves about 504 homeless veterans - about 90 of those being women - although she concedes that the VA's numbers don't show the whole problem.
Some homeless veterans, for whatever reason, do not seek help, she said, and those veterans go uncounted.
"Our numbers are not a true representation," Felder said. "It's hard to get a good read."
The count is further exacerbated by the fact that not all homeless veterans end up living on the streets or in shelters.
Andrea Ray, who served more than eight years in the Navy, did not have a steady home for nearly five years before receiving a VA voucher for subsidized housing.
As Ray, then battling alcoholism, bounced from job to job, she and her son also bounced from home to home, staying with her mother for a year and with various friends for weeks at a time.

"I was giving up. Jobwise, housewise. I'd lose my job, then I'd have nowhere to go," Ray said.

Nationally, the number of homeless female veterans has doubled in the last decade, yet resources for them have failed to keep pace.

"The resources are limited," said Felder, who has organized several summits in Fayetteville to address homelessness. "They are growing, but they are limited."

Jubilee House
The lack of resources is what led Barbara Marshall, a Navy veteran who was once homeless herself, to open the Steps n Stages Jubilee House - a transitional house for homeless female veterans - in August 2010.

Marshall says lack of space limited the success of the home, which could serve only five homeless women and their families for up to 90 days.

But space has become much less of an issue.

Last month, the Jubilee House was expanded and renovated through the reality show "Extreme Makeover: Home Edition."

Marshall said the house now has space for mentoring and counseling, as well as additional amenities.

The Jubilee House, which receives about 90 percent of its referrals from the VA, can now house up to seven families.

Marshall said she hopes the Jubilee House's recent fame will help raise awareness of homeless female veterans.

"Fayetteville is a bastion of military persons," Marshall said. "They retire here, and, unfortunately, some encounter times of trouble."

Marshall said she would gladly put herself out of business if it meant eliminating homelessness among female veterans.

She said the VA's summit on homelessness, which she has participated in, was a good step toward planning real-life, tangible ways to make homelessness a non-issue.

"I want to see these women with keys in hand, joy in heart," Marshall said.

Since the "Extreme Makeover" publicity, Marshall has seen an increase in donations and more willingness from people to volunteer as life coaches.

Felder and her supervisor at the VA, Doris Moore-Russell, hope the Jubilee House's fame will also translate into more community groups becoming involved in the battle against homelessness in and around Fayetteville.

"The community is more aware," Felder said. "But there just isn't enough beds, especially for women and children."

Veterans Affairs is taking the lead on homelessness among its veteran population in part because of an agencywide push that began in 2009, when VA Secretary Eric Shinseki declared that the VA would seek to end homelessness among veterans by 2015.

Moore-Russell said the Fayetteville VA has been ahead of the game when it comes to combating homelessness.

She was Fayetteville's first homeless program coordinator in 1997, when the program had two employees. Now, a dozen workers are dedicated to finding housing, jobs and other resources for homeless veterans.

The VA partnered with the Department of Housing and Urban Development in February 2010 to provide housing to 45 veterans in Fayetteville, with Ray being one of them, Felder said. Another 25 HUD houses became available for homeless veterans at the end of July.

Ray, who now lives on Edwards Street, said the home has been a blessing that has helped bring stability to her 8-year-old son and 18-month-old daughter.

"Yes, I have to clean my kitchen. But at least it's my kitchen," she said. "It makes me think that things can be different. That things will get better."

The VA summits, which bring together nonprofit organizations, employment agencies and city, state and federal agencies, are aimed at filling in the remaining gaps of service providers. The next summit is scheduled for Tuesday.

Some of the items to be addressed will likely come from a recent guide on providing care for homeless female veterans.

The guide was released in July by the Department of Labor's Women's Bureau and is based on a nationwide listening tour. It is meant to educate service providers and calls for specialized care for some of the unique challenges facing female veterans. The guide's introduction says female veterans are four times more likely to be unemployed than women who did not serve their country.

Often, female veterans have had to come to terms with trauma faced at home and while working in war zones in Afghanistan and Iraq, the guide says.

One in five female veterans experiences sexual trauma, according to the guide. One in three is sexually assaulted - compared with one in six civilians.

President Obama also has weighed in on some of the circumstances that lead to homelessness among veterans.

While not mentioning the problem specifically, Obama announced this month new initiatives aimed at increasing employment among veterans and easing their transition into the civilian world.

"If you can save a life in Afghanistan, you can save a life in an ambulance in Wyoming. If you can oversee millions of dollars in assets in Iraq, you can help a business balance its books here at home," Obama said in remarks at the Washington Navy Yard. "Our incredible servicemen and women need to know that America values them not simply for what they can do in uniform, but for what they can do when they come home. We need them to keep making America stronger."

In addition to a "reverse boot camp" aimed at preparing veterans for life after the military, Obama announced tax credits for companies that hire unemployed veterans and challenged the private sector to hire or train 100,000 veterans who joined the service after Sept. 11, 2001. Obama wants the veterans, or their spouses, hired by the end of 2013.

Asking for help
During her five-year hitch with the Army, Mariel Marrero worked as a respiratory therapist at a hospital at Fort Sam Houston in San Antonio. Four years later, she and her two children became homeless.

Marrero said she had fallen behind on her rent because her disability payments were lowered.

"It was harder for me because of my children," said Marrero, who hasn't been able to find a job because of child care concerns and her disabilities, which include fibromyalgia and herniated discs. "Everything happened so fast that it was just like a shock."

The Marreros lived at the Salvation Army shelter for a week, sharing a multipurpose room with one other family.

A spokeswoman for the shelter said Marrero is one of 10 female veterans to have lived in the shelter since the beginning of the year. The women had a total of four children, the spokeswoman said.

From the Salvation Army, Marrero was referred to the Jubilee House and moved in just three days after the reality television crews left. She has since relocated, and it's unknown where she is living today.

Shortly after moving in, Marrero called living in the Jubilee House a surreal experience.

Weeks after the "Extreme Makeover: Home Edition" taping, gawkers still slowly passed the grandiose house, which stands out in its neighborhood between Murchison Road and Ramsey Street.

At the time, Marrero said she was happy for the opportunity that the Jubilee House had given her, but she would rather not live there.

"It's a beautiful house. But I don't have keys to this house. It's not my house," she said. "In a perfect world I'll be out of here tomorrow, come back and volunteer."

Marrero said she doesn't want to have to rely on the kindness of strangers. She doesn't want to have to ask for help.

"I want to go to school," said Marrero, who has plans to eventually attend Fayetteville Technical Community College and study social work. "I want to get everything together and maybe help others like myself."

Her first piece of advice for others who have fallen on hard times:

"I would say to pray a lot. A lot. And to have patience and to always try to get a step ahead and not get complacent. It is so easy to get frustrated and just give up."

Staff writer Drew Brooks can be reached at brooksd@fayobserver.com or 486-3567.

VA docs rusty on women's care learn new skills
August 12, 2011
By KIMBERLY HEFLING, Associated Press

KISSIMMEE, Fla. (AP) - The "show and tell" table at this gathering of doctors featured contraceptive sponges and female condoms. Life-size rubber pelvises and female breasts covered several other tables at the back of a windowless convention center ballroom. The lectures focused on topics like how to help a rape victim feel comfortable in an exam room.

Not unusual for a doctors' meeting, but these were doctors and nurse practitioners with the Veterans Affairs Department, a cohort of medical professionals who in the past might have gone years without seeing a female patient.

But avoiding topics like gynecology and breast exams is no longer possible because of an influx of thousands of female veterans of Iraq and Afghanistan into the VA's system of hospitals and clinics.

Used to treating the men who served in Vietnam or World War II, many of the VA's practitioners are rusty on skills like performing pelvic exams on women and talking about birth control. Some are downright nervous over treating women.

The result has been very limited availability at some VA clinics for gender-specific health appointments for women. Female veterans often had to drive hours to get to another facility, or the VA had to pick up the tab for them to go to a nearby private doctor -- if they opted to go at all.

The VA is working toward having a trained, designated women's provider in every facility. So far, officials have achieved the goal in its approximately 150 medical centers and in at least 60 to 65 percent of its 900 community-based clinics, according to the VA.

The VA has been bringing doctors and nurse practitioners by the hundreds to mini-residency programs like this one outside Orlando, Fla., focused on women's health. A key component of the training is performing pelvic exams on live models -- typically volunteer nurses -- who critique them.

"What we heard time and time again from providers that have been there so long is, 'I have forgotten since medical school how to do a lot of the women's specific care,'" said Dr. Robert Dorr, chief of staff at the VA medical center in Saginaw, Mich. Providers who will be treating women in smaller VA clinics in Northern Michigan went with him to the seminar in Kissimmee.

"There was anxiety," Dorr said. "There was a lot of nervousness. There was even some fear: 'Would I be able to take care of a female appropriately?'"

In addition to exams on live models, the providers practiced breast and pelvis exams on large, lifelike rubber simulators with abnormalities that doctors need to be familiar with.

One topic was care for patients who have been sexually assaulted. An estimated 22 percent of female users experienced what the VA calls "military sexual trauma," meaning they endured unwanted sexual harassment, assault or rape in a military setting.

The providers learn tips like washing their hands in front of a patient to help ease the patient's comfort level, and to always have a chaperone during a pelvic exam. They also learn about what the women might have experienced in combat.

Women have been heavily involved in the fight in Iraq and Afghanistan in roles such as medics, truck drivers, pilots and military police officers, even though military policies prohibit women from serving in many combat positions. About 15 percent of the military is comprised of women, compared with 11 percent in the 1991 Persian Gulf War and 3 percent in the Vietnam War.

After the 2001 start of the war in Afghanistan and the 2003 U.S. invasion of Iraq, female veterans began coming in large numbers to VA hospitals and clinics. Most of the women from the recent conflicts were under age 40.

They frequently found facilities without private changing areas or women's clinics, staff members who did not believe they'd been in combat, and doctors unfamiliar with their health needs.

In 2009, the Government Accountability Office said the VA wasn't doing enough to ensure female patients had complete privacy, noting that it had found in some facilities gynecological exam tables facing the door.

The VA began the mini-residency program in women's health in 2008 and 1,100 providers have now completed it. The agency has also added more women's clinics with separate waiting areas within its facilities and made other improvements, such as creating private areas for women to change and bathe.

Recently, VA Secretary Eric Shinseki announced that pilot childcare centers were being rolled out in Northport and Buffalo, N.Y., and Tacoma, Wash.

Joy Ilem, deputy national legislative director at Disabled American Veterans, said the VA is headed in the right direction in providing care for women but has yet to implement all the changes needed systemwide. She said having providers trained in women's health is probably the most critical of all improvements that are needed.

"They've made progress and they should keep going and finish it," Ilem said.

Once VA officials started more closely tracking women's issues, they discovered that older women were seeking VA care as well. More than half of the VA's female patient population is 45 or older, said Dr. Patty Hayes, the VA's chief consultant for women's health.

As the economy has worsened and as word has spread about the improved quality of care for women, some of the older women are walking into VA facilities for the first time. The VA has responded by educating providers on menopause and heart disease as well as issues faced by younger women.

"It's not that the women aren't there. It's that we didn't invest soon enough in having women's health providers," Hayes said.

Hayes said that today about 22 percent of men eligible for VA health care use it, compared with 16 percent of eligible women, up from 10 percent before the changes were implemented.

Before leaving the mini-residency programs, which typically last a few days, the providers are asked to identify one thing they want to change at their home hospital or clinic to improve care for women.

Some of the things changed from early workshops include the purchase of gynecological tables and the acquisition of a rapid test for gynecological infections, said Dr. Laure Veet, director of women's health education in the VA's Women Veterans Health Strategic Care Group.

Dr. Aimee Sanders, a physician with the VA in Columbus, Ohio, who was one of the facilitators at the recent mini-residency session, recalled going into the Ohio facility where she now works when she was a medical student about a decade ago. Back then, she found it "not a female-friendly place."

Today, she is one of a few doctors who work in a separate women's clinic within the facility, providing comprehensive care for women. She treats only women, with patients ages 19 to 91.

The female vets who walk in the door say they would've come in sooner if they'd known how nice it was, Sanders said.

"Demand is much greater than the supply of physicians that we have," she said.