by women, regardless of their military occupation and background (Wolfe et al. 1993a). The rate of reported sexual assault was about 70 per 100,000 uniformed service members in 2002-2003 for all duty stations; 9% of the victims were men (DoD 2004). Reported rates of sexual harassment of women in the military were about 46% and 24% in 1995 and 2002, respectively, and of men 8% and 3%. The female-to-male ratio for being a victim of sexual assault in the Gulf War was 16.5:1 and for sexual harassment 25:1 (Kang et al. 2005).

The 1995 National Health Survey of Gulf War Era Veterans and Their Families, conducted by the Department of Veterans Affairs (VA), found that of the 11,441 Gulf War veterans who responded (4202 women and 7239 men), 24% of the women reported having been subject to sexual harassment, and 3.3% reported sexual assault; only 0.6% of the men reported experiencing sexual harassment, and even fewer (0.2%) reported a sexual assault (Kang et al. 2005). Wolfe et al. (1998) interviewed 160 Army women on their return from the Gulf War and 18-24 months later; the women reported rates of sexual assault of 7.3%, physical sexual harassment 33.1%, and verbal sexual harassment 66.2%—all higher rates than those found in peacetime military and civilian population. Goldzweig et al. (2006) reported rates of sexual harassment in veterans and active-duty military that ranged from 55% to 79%, with sexual assault ranging from 4.2 to 7.3% in active-duty women and 11 to 48% in female veterans.

LIVING CONDITIONS

During the buildup to the 1991 Gulf War, combat troops were crowded into warehouses and tents on arrival in the Persian Gulf region and then often moved to isolated desert locations. Most troops lived in tents and slept on cots lined up side-by-side, affording virtually no privacy or quiet. Sanitation was often primitive, with communal washing facilities and shortages of latrines. Hot showers were infrequent, the interval between launderings of uniforms was sometimes long, and desert flies, scorpions, and snakes were a constant nuisance. Military personnel worked long hours and had narrowly restricted outlets for relaxation. Troops were ordered not to fraternize with local people, and alcoholic drinks were prohibited in deference to religious beliefs in the host countries. The diet of most of the military units consisted mostly of packaged foods and bottled water. In a 2006 survey of 1767 soldiers and Marines stationed in Iraq for OIF, over one-third reported the lack of privacy and personal space to be a stressor (MHAT 2006b).

Temperature extremes are also a source of stress. In the first 2 months of troop deployment (August and September 1990) to the Persian Gulf region, the weather was extremely hot and humid, with air temperatures as high as 115°F and sand temperatures reaching 150°F. Troops had to drink large quantities of water to prevent dehydration. In some of the areas of Iraq that U.S. troops patrol in OIF, the temperature can reach 140°F.

Although the summers in the Middle East are hot and dry, temperatures in winter (December-March) are low, and wind-chill temperatures at night can drop to well below freezing. Wind and blowing sand make protection of skin and eyes imperative. Goggles and sunglasses help somewhat, but visibility is often poor, and contact lenses were prohibited in the Gulf War (Ursano and Norwood 1996).

In a survey of 1576 Gulf War veterans, 62-85% experienced the chronic stressors associated with living and working in the gulf, including crowding, lack of privacy, working in the desert, long hours, and boredom; 35-61% of the veterans found the conditions to be at least moderately stressful (Stretch et al. 1996a).



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