New book details health issues facing female service members

By Paul Bello, National Museum of Health and Medicine

SILVER SPRING, Md. - What female service members endure while in combat and their overall health while deployed are two of many topics covered in a recently released book entitled Women at War, a collaboration between co-editors Dr. Elspeth C. Ritchie and Dr. (Col.) Anne Naclerio. The topic headlined the July Science Café at the National Museum of Health and Medicine (NMHM) in Silver Spring, Maryland.

Ritchie retired as a colonel from the U.S. Army in 2010 following a 28-year career as a forensic psychiatrist with expertise in military and veteran's issues. As someone who has spent much time in the field, it's disheartening that very little attention is paid to women's health issues, Ritchie told the audience. It's that lack of attention that served as a catalyst for the book, which she hopes is an inspiration to civilians and unit leaders, who are predominantly men, to better understand women's issues in the military. She issued a challenge for future research on health issues faced by women on the frontlines, including better personal protective equipment, preventive care, and combat-related injury treatment.

"Females account for 15 percent of the entire military. We're an essential part of the military going forward," Ritchie said.

During their research, both Ritchie and Naclerio discovered a lack of data on not just one, but several topics of concern. Women who have suffered a traumatic brain injury (TBI), for example, have different responses than men. While not much is known presently about those types of responses, Ritchie said part of it is due to a woman's pituitary gland, which helps regulate their level of hormones. Another topic is how female veterans reintegrate into communities when returning stateside following a deployment. In the extreme cases of those who are homeless and in need of assistance, traditional veteran shelters are not set up for women who have children. Presently, most shelters are tailored to the needs of single, male veterans, which is why Ritchie believes it's time for a major push for attention.

In her book, some female service members report purposely avoiding liquids as a way to compensate for not using a bathroom, in response to challenging physical conditions in theater. That type of behavior, however, leads to dehydration and could lead to a painful urinary tract infection, Ritchie said.

Other facts discussed in the book and mentioned by Ritchie in her presentation are that, since the terrorist attacks in 2001, women have deployed just as frequently as men and for the same length of time. Women have also suffered slightly more psychological problems and approximately 15 percent of those medically evacuated out of combat zones were female.

Joining Ritchie at NMHM were fellow authors Dr. Remington Nevin, a doctoral candidate at the John Hopkins Bloomberg School of Public Health; Dr. Kate McGraw, associate director for psychological health clinical care at the Deployment Health Clinical Center (DHCC); Dr. Jackie Garrick, social worker with the Department of Defense (DoD), and retired U.S. Army Col. David Niebuhr. Each contributed a chapter to Women at War and discussed the prevention of malaria in women; ostracism and the impact of social groups; suicide and female disability, in addition to deployment length and medical evacuation, respectively.

"We hope this discussion on women in war will broaden a much larger discussion to women deploying in all types of settings," Ritchie said.

NMHM's Medical Museum Science Cafés are a regular series of informal talks that connect the mission of the Department of Defense museum with the public. NMHM was founded as the Army Medical Museum in 1862 and moved to its new location in Silver Spring, Md. in 2012. For information on upcoming programs, visit www.medicalmuseum.mil.

	Caption: Dr. Elspeth C. Ritchie, a retired U.S. Army psychiatrist, speaks about her book, Women at War, during a Medical Museum Science Café at the National Museum of Health and Medicine, July 28, 2015. (Disclosure: This image has been cropped to emphasize the subject.) (National Museum of Health and Medicine photo by Matthew Breitbart / Released)
	Caption: Dr. Elspeth C. Ritchie, a retired U.S. Army psychiatrist, speaks about her book, Women at War, during a Medical Museum Science Café at the National Museum of Health and Medicine, July 28, 2015. (Disclosure: This image has been cropped to emphasize the subject.) (National Museum of Health and Medicine photo by Matthew Breitbart / Released)