The true scale of American casualties in Iraq is revealed today by new figures obtained by The Observer, which show that more than 6,000 American servicemen have been evacuated for medical reasons since the beginning of the war, including more than 1,500 American soldiers who have been wounded, many seriously.
The figures will shock many Americans, who believe that casualties in the war in Iraq have been relatively light. Recent polls show that support for President George Bush and his administration's policy in Iraq has been slipping.
It is believed many of the American casualties evacuated from Iraq are seriously injured.
The number of casualties will also increase pressure on Bush to share the burden of occupying Iraq with more nations. Attempts to broker an international alliance to pour more men and money into Iraq foundered yesterday when Colin Powell, the US Secretary of State, brusquely rejected a French proposal as 'totally unrealistic'.
Three US soldiers were killed last week, bringing the number of combat dead since hostilities in Iraq were declared officially over on 1 May to 68. A similar number have died in accidents. It is military police policy to announce that a soldier has been wounded only if they were involved in an incident that involved a death.
Critics of the policy say it hides the true extent of the casualties. The new figures reveal that 1,178 American soldiers have been wounded in combat operations since the war began on 20 March.
It is believed many of the American casualties evacuated from Iraq are seriously injured. Modern body armour, worn by almost all American troops, means wounds that would normally kill a man are avoided. However vulnerable arms and legs are affected badly. This has boosted the proportion of maimed among the injured.
There are also concerns that many men serving in Iraq will suffer psychological trauma. Experts at the National Army Museum in London said studies of soldiers in the First and Second World Wars showed that it was prolonged exposure to combat environments that was most damaging. Some American units, such as the Fourth Infantry Division, have been involved in frontline operations for more than six months.
Andrew Robertshaw, an expert at the museum, said wars also claimed casualties after they were over. 'Soldiers were dying from injuries sustained during World War I well into the 1920s,' he said.
British soldiers are rotated more frequently than their American counterparts. The Ministry of Defense has recently consulted the National Army Museum about psychological disorders suffered by combatants in previous wars in a bid to avoid problems.
The wounded return to the USA with little publicity. Giant C-17 transport jets on medical evacuation missions land at Andrews Air Force Base, near Washington, every night.
Battlefield casualties are first treated at Army field hospitals in Iraq then sent to Landstuhl Regional Medical Center in Germany, where they are stabilized.
Andrews is the first stop back home. As the planes taxi to a halt, gangplanks are lowered and the wounded are carried or walk out. A fleet of ambulances and buses meet the C-17s most nights to take off the most seriously wounded. Those requiring urgent operations and amputations are ferried to America's two best military hospitals, the Walter Reed Army Medical Center, near Washington, and the National Naval Medical Center, Bethesda.
The hospitals are busy. Sometimes all 40 of Walter Reed's intensive care beds are full.
Dealing with the aftermath of amputations and blast injuries is common. Mines, home-made bombs and rocket-propelled grenades are the weapons of choice of the Iraqi resistance fighters. They cause the sort of wounds that will cost a soldier a limb.
The less badly wounded stay overnight at the air base, where an indoor tennis club and a community Center have been turned into a medical staging facility. Many have little but the ragged uniforms on their backs. A local volunteer group, called America's Heroes of Freedom, has set up on the base to provide them with fresh clothes, food packages and toiletries. 'This is our way of saying, "We have not forgotten you,"' said group founder Susan Brewer.
© Guardian Newspapers Limited 2003