NPR piece on prosthetic parity

The ACA has been working with Ann Hepperman at NPR on a Marketplace piece about the need for prosthetic parity and the disparity between military and civilian care.

You can hear the story, titled "Civilian amputees find it hard to get their C-legs", on the Marketplace website, at http://www.marketplace.org/shows/2006/04/25/PM200604256.html.

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Washington Post: "Limbs Lost to Enemy Fire, Women Forge a New Reality"

Limbs Lost to Enemy Fire, Women Forge a New Reality
By Donna St. George, Washington Post Staff Writer, 4/18/6

Her body had been maimed by war. Dawn Halfaker lay unconscious at Walter Reed Army Medical Center, her parents at her bedside and her future suddenly unsure. A rocket-propelled grenade had exploded in her Humvee, ravaging her arm and shoulder.
In June 2004, she became the newest soldier to start down a path almost unknown in the United States: woman as combat amputee.

It was a distinction she did not dwell on during days of intense pain and repeated surgeries or even as she struggled to eat on her own, write left-handed and use an artificial limb. But scattered among her experiences were moments when she was aware that few women before her had rethought their lives, their bodies, their choices, in this particular way.

She was part of a new generation of women who have lost pieces of themselves in war, experiencing the same physical trauma and psychological anguish as their male counterparts. But for female combat amputees has come something else: a quiet sense of wonder about how the public views them and how they will reconcile themselves.

Their numbers are small, 11 in three years of war, compared with more than 350 men. They are not quite a band of sisters, but more a chain of women linked by history and experience and fate -- one extending herself to another who then might offer something for the next.
They have discovered, at various points of their recovery, that gender has made a difference -- "not better or worse," as Halfaker put it, "just different."

For Halfaker, an athlete with a strong sense of her physical self, the world was transformed June 19, 2004, on a night patrol through Baqubah, Iraq. Out of nowhere had come the rocket-propelled grenade, exploding behind her head.

Another soldier's arm was sheared off. Blood was everywhere.

"Get us out of the kill zone!" she yelled to the Humvee driver. She was a 24-year-old first lieutenant, a platoon leader who two months earlier had led her unit in repulsing a six-hour attack on a police station in Diyala province. As medics worked to stabilize her, she warned: "You bastards better not cut my arm off."

In the hospital, there had been no other way to save her life.

At first, in the early days, she tried to ignore the burns on her face, her wounded right shoulder, the fact of her missing arm. She had been a basketball standout at West Point, a starting guard through four years of college. She was fit, young, energetic.

Suddenly, she was a disabled veteran of war.

"I didn't want to know what I looked like," she recalled recently. She asked her mother to get a towel and cover the mirror in her hospital room.

New Terrain, New Perils

The Iraq war is the first in which so many women have had so much exposure to combat -- working in a wide array of jobs, with long deployments, in a place where hostile fire has no bounds. In all, more than 370 women have been wounded in action and 34 have been killed by hostile fire.

The war has created what experts believe is the nation's first group of female combat amputees. "We're unaware of any female amputees from previous wars," said historian Judy Bellafaire of the Women in Military Service for America Memorial Foundation, which researches such issues.
Surprising many political observers, the fact of female casualties has produced little public reaction. Before Iraq, many assumed that the sight of women in body bags or with missing limbs would provoke a wave of public revulsion.

"On the whole, the country has not been concerned about female casualties," said Charles Moskos of Northwestern University, a leading military sociologist. Politically, Moskos said, it is a no-win issue. Conservatives fear they will undermine support for the war if they speak out about wounded women, and liberals worry they will jeopardize support for women serving in combat roles by raising the subject, he said.

In the hospital, female combat amputees face all the challenges men do -- with a few possible differences. Women, for example, seem to care more about appearance and be more expressive about their experiences, hospital staff members said. Among the women, there also was "a unique understanding or bond," said Capt. Katie Yancosek, an occupational therapist at Walter Reed.

The advent of female combat amputees has left an enduring impression on many hospital staff members. "We have learned not to underestimate or be overly skeptical about how these women will do," said Amanda Magee, a physician's assistant in the amputee care program. "Sometimes they arrive in really bad shape, and people are really worried. . . . But we've learned they can move on from a devastating injury as well as any man."

Motherhood Redefined

Two months after Dawn Halfaker was wounded, Juanita Wilson arrived on a stretcher at Walter Reed, her left arm in bandages, her hand gone. It was August 25, 2004, just days after a roadside bomb went off under Wilson's Humvee. She came to the hospital as the Iraq war's fourth female combat amputee -- the first who was a mother.

From the beginning, Wilson decided she did not want her only child to see her so wounded. She talked to the 6-year-old by phone. "Mommy's okay," she assured the girl. "What are you doing at school now?"

It was only after four weeks that Wilson allowed her husband and child to travel from Hawaii, where the family had been stationed, for a visit. By then, Wilson was more mobile. She asked a nurse put makeup on her face, stowed her IV medications into a backpack she could wear and planned an outing to Chuck E. Cheese's.

"Mommy, I'm sorry you got hurt," her daughter, Kenyah, said when she arrived, hugging her. And then: "Mommy, I thought you died."

The sort of mother who mailed her daughter penmanship exercises and math problems from the war zone, Wilson wanted Kenyah to stay focused on school and the ordinary concerns of being 6. "I wanted it to be like I was going to be okay when she saw me," said Wilson, 32.
Changes revealed themselves one at a time.

Wilson remembered that her daughter eyed a plate of croissants in the hotel-like room where the family stayed at Walter Reed that first time they were together again. The child asked her mother for a sandwich.

"I realized, 'Oh, I can't even make a sandwich,' " she said. "It was a hurting feeling, your kid asking you to make her a sandwich and you're saying, 'You'll have to make your own sandwich' to a 6-year-old."

In November 2004, she heard that a female pilot had just been shot down in her Black Hawk helicopter in Iraq. Within days, Tammy Duckworth arrived at the hospital missing both legs, her right arm in jeopardy. She lay in a coma, her husband and parents at her bedside. "You care about everybody, but somehow amputees connect to amputees," Wilson said, especially if they are women. "It was a big deal to me," she said.

Wilson headed to the pilot's room to sit with her family. She found herself returning to Duckworth's bedside again and again -- arranging her get-well cards, decorating her room, kissing the top of her head. One day, when Duckworth, now 37, was conscious, Wilson rolled up her sleeve to reveal her own amputated arm.

In a soft voice, Wilson said, she reassured her that another soldier was with her now. Wilson told her she could not imagine exactly how she felt but that she cared deeply.

She could not hold the pilot's hand because Duckworth was too injured. Instead, Wilson stroked her hair.

'The Sky Is the Limit'
By mid-2005, Juanita Wilson was back to the rhythms of daily life with her husband and daughter. The couple bought a house in the suburbs of Baltimore. She took a new job with the Army, is a staff sergeant and is up for a promotion.

At 6:30 one winter morning, Wilson was cooking Cream of Wheat on her stovetop -- taking great care to pour with her prosthetic and stir with her other arm. In her life as a woman, a mother and a wife, there are limits she once didn't face and could not even imagine.
"Kenyah," Wilson called.

When the child came down the stairs in bright pink pajamas, she saw her mother's trouble: Wilson was in uniform, almost ready for work, but she needed help with her hair.
Wilson sat on a chair as Kenyah brushed gently, and then brought her mother's hair up in a bun. She is "a happy helper," Wilson said.

The girl, now 7, tells all her friends about "handie," as she has nicknamed Wilson's artificial limb. "My daughter is definitely not bashful about telling anybody," Wilson said. "She tells other kids at school. Kids don't judge you. They think it's the coolest thing that I have a robotic arm."
But Wilson continues to shield her daughter from the discomfort and anguish of her injury. "I didn't want to take her childhood away. That's my focus -- that she is happy and enjoying life and not thinking about me. She'll ask me questions, and I'll say, 'Oh that's not for children to worry about.' "

On that winter morning, Wilson had already tied her combat boots, her right hand doing most of the work and her prosthetic holding the loop before it is tied. "I want it to be known that just because you're a female injured in combat, you don't have to give up your career and you don't have to look at yourself as disabled," she said.

She added: "I haven't met any female soldier yet who feels she shouldn't have been there."
How the world sees war-wounded women like her, she said, is a little harder to pinpoint.

"When you're in Walter Reed, you're in a bubble. I could walk around with my arm off. It's acceptable. Everyone there knows. . . . But when you walk out that gate, it's a whole different world. No one knows what I've been through, no one probably cares, and to avoid all of that, I never come outside without my [prosthetic] arm. Never."

Wilson added, "I have noticed that when you're a female walking around as an amputee, everybody's mouth drops."

Lately, she has set new career goals, aiming high, perhaps even for the Army's top enlisted job. She listened with glee to the news that Tammy Duckworth -- at whose bedside she had prayed -- had decided to run for Congress in Illinois.

Soon after, she learned about her friend's new political life, she called Duckworth, joked that she would serve as her assistant in Congress, and then reflected: "It definitely says the sky is the limit."

Scars Farther From the Surface

Long out of Walter Reed, Dawn Halfaker is also deeply into a life remade. It has been 17 months since she was wounded, and her favorite yoga tape is playing on a small VCR in an apartment in Adams Morgan. Halfaker barely seems to notice her image, which once was difficult to bear and is now reflected back at her from a large mirror: red hair and trim, athletic build, one arm extended perfectly above her head.

In place of her missing limb is a T-shirt sleeve, empty, hanging. Following along with the yoga tape, Halfaker visualizes that she still has a right arm; it helps her balance.

She retired from the Army as a captain -- a tough choice only four years out of West Point, but one she made as she tried to imagine fitting back into military culture. Without her arm, she could no longer do push-ups, tie her combat boots, tuck her hair neatly under a beret.

She still has friends in Iraq, although one was killed in December. But the Bronze Star that she was awarded last year for her role at the Diyala police station is tucked away in a box. That day, she was in charge of 32 soldiers during the sustained firefight, taking a position on the roof with a grenade launcher, then quelling a jail riot.

Lately, she works at an office in Arlington, mostly as a consultant to the Defense Advanced Research Projects Agency. She has applied to graduate school in security studies, bought a condo in Adams Morgan and co-wrote a book proposal about postwar recovery.

To get to this new place, Halfaker has made all sorts of adjustments. She types on a computer one-handed. Drives a car with a push-button ignition. Uses her knees to hold steady a peanut butter jar she wants to open. To write a note or a letter, she learned to use her left hand, practicing nightly at Walter Reed as she penned her thoughts in a journal.

"You don't think about how many times you have a lot of things in your hands, like for me just carrying my coffee from the cafe downstairs up to my office on the seventh floor is a total battle every day," she said. She has to hold the coffee cup, scan her identification badge, open doors, press elevator buttons. Sometimes she spills. Sometimes the coffee burns her.

In her apartment, Halfaker bends and stretches into yoga poses, her artificial arm lying beside the mirror. More functional prosthetics did little good for her type of injury, she found. So she persuaded prosthetic artists at Walter Reed to make this one -- lightweight and natural-looking, easier on her body, allowing her to blend in with the outside world.

Halfaker goes without a prosthetic when she is exercising, jogging through the streets of Washington or snowboarding in Colorado or lobbing tennis balls around a court.

"I never really wanted to hide the fact that I was an amputee," she said, "but I never wanted it to be the central focus of my life." For some men, she said, it seems a badge of honor that they do not mind showing. "For a woman, at least for me, it's not at all. . . . The fact that I only have one arm, I'm okay with that, but I want to be able to walk around and look like everyone else and not attract attention to myself."

Last year, a guy she met on the Metro asked her out, saying that he thought she was pretty. She agreed to meet him for lunch but felt nervous about mentioning her missing limb. It turned out that he was no less interested, she said. In the fall, she started dating an Army anesthesiologist, to whom she has become close. He is deployed in Iraq.

As a woman in her twenties, "I want to look as good as I can look," she acknowledged. "I think that's very much a female perspective, based on the roles that society has put men and women in."

Even more, she said, "I don't want to be known for being one-armed. I want to be known for whatever it is I do in my life."

http://www.washingtonpost.com/wp-dyn/content/article/2006/04/17/AR2006041701618_pf.html

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JOB: Action Campaign Assistant

The Amputee Coalition of America (ACA) is a national, non-profit organization working to reach out to people with limb loss and to empower them through education, support and advocacy.

Americans living with the absence or loss of a limb are facing discouraging obstacles when trying to obtain appropriate prosthetic care. Some third-party payers place annual or lifetime caps on prosthetic devices; others eliminate coverage for them altogether.

The Amputee Coalition of America (ACA) assumed the challenge to address and improve prosthetic access for all amputees in the U.S. at both state and federal levels through the launch of the Action Plan for People with Limb Loss (APPLL). The campaign is looking to expand its operation and program goals. The Acton Campaign Assistant will play a crucial role in meeting our campaign goals.

Summary: The Amputee Coalition of America is looking for a responsible, dedicated professional to fill the position of Action Campaign Assistant. The Assistant will help to educate activists and elected officials on the importance of the issues and take other actions to further the goals of the APPLL campaign.

Reports to: National Campaign Director

Responsibilities: The assistant will assist in all aspects of the Action Plan, including: administration, fundraising, communications and organizing

· Administration:
o Provide administrative support to the National Campaign Director;
o Process requests for information and materials;
o Organize files and manage the database;
o Assist legislative efforts by helping arrange meetings;
o Collect and compile information;
o Track legislation; and
o Prepare project reports and updates as directed.

· Fundraising:
o Provide administrative support to assist in the planning, logistics and preparation for major donor meetings and special events;
o Help coordinate mailings and appeals to members; and
o Support grant solicitation.

· Communications:
o Develop, draft and edit materials as needed;
o Update content on the state parity blog; and
o Distribute alerts to educate members, generate action, and increase event turnout.

· Organizing
o Assist with outreach strategies;
o Maintain accurate volunteer records;
o Monitor, analyze and report on state parity efforts;
o Develop and maintain positive relationships with local organizations to maximize potential for collaboration; and
o Maintain administrative systems as necessary to track and count activist participation.

· Other:
o Participate in office strategy meetings; and
o Perform other duties and assist with additional projects as they arise.

Qualifications:
· Minimum 6 months effective grassroots organizing experience or activism experience;
· Some knowledge of the legislative process;
· A strong commitment to the ACA’s mission and goals;
· Ability to prioritize and handle a variety of projects simultaneously;
· Ability to produce concrete results with minimal supervision;
· Excellent written and verbal communications skills;
· Ability to work effectively both individually and as part of a team; and
· Attention to detail.

Salary: Commensurate with experience. Standard ACA benefits package includes paid time off (PTO); health, dental, disability and life insurance; 401K; and paid holidays.

Details: While the ACA is headquartered in Knoxville, TN, we are in the process of opening an office in the Washington, DC area. This position will be based out of the Washington, DC area office. The position requires some flexibility in terms of schedule basis. You may be required to travel or to work alternate hours based on project deadlines and events.

Submitting applications: Applications will be accepted on a rolling basis. The search will close when a hire is made. Please submit a resume and cover letter with a salary range to Morgan Sheets, National Campaign Director either through email, msheets@amputee-coalition.org or fax 866.599.8994.

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