Women in combat: Education, leadership keys to success

Story by Jacqueline M. Hames, Soldiers Live
Staff Sgt. Nikita Zarelli, right, a member of the Female Engagement Team, with Charlie Troop, 5th Squadron, 1st Cavalry Regiment, 1st Stryker Brigade Combat Team, 25th Infantry Division, talks with a group of local Afghan children on their way to school in Dand district, Kandahar province, Afghanistan, Feb. 9, 2012. While women have served in austere environments alongside their male counterparts for years, they do face unique medical and environmental challenges. The Department of Defense and the U.S. Army are working to educate women and mitigate those challenges. (U.S. Army photo by Sgt. Thomas Duval)

Staff Sgt. Nikita Zarelli, right, a member of the Female Engagement Team, with Charlie Troop, 5th Squadron, 1st Cavalry Regiment, 1st Stryker Brigade Combat Team, 25th Infantry Division, talks with a group of local Afghan children on their way to school in Dand district, Kandahar province, Afghanistan, Feb. 9, 2012. While women have served in austere environments alongside their male counterparts for years, they do face unique medical and environmental challenges. The Department of Defense and the U.S. Army are working to educate women and mitigate those challenges. (U.S. Army photo by Sgt. Thomas Duval)

When former Secretary of Defense Leon Panetta announced an end to the Direct Ground Combat Exclusion Rule for female Soldiers in January, it solicited a flood of questions and concerns about how the Army will open military occupational specialties previously closed to women.

“In order to open any position that is closed, whether it is due to the military occupational specialty or the unit’s mission, all the services have to submit a detailed request outlining the MOS, the unit, the numbers, and also a legal analysis, that has to go through the Army leadership to the Secretary of Defense,” said Col. Linda Sheimo, chief of the Command Programs and Policy Division at the Human Resources Policy Directorate, Army G-1.

The Secretary of Defense would then notify Congress of the intent to open those positions, and Congress would have a finite amount of time to consider the issue before anything changes, she added.

“The Army is pursuing a very careful and deliberate approach. As we move forward we will open units and/or MOSs as we complete the appropriate assessments, and we will submit those requests to Congress to open those positions,” Sheimo said.

Direct combat roles for women raise certain health concerns, both physical and psychological, but the Department of Defense and the Army are actively researching how to integrate women into those positions.

The Women’s Health Task Force, established in 2011 by the Army’s Surgeon General Lt. Gen. Patricia Horoho, is focused on the gender-specific health needs of women in the military, helping to make sure the military is meeting the health needs of women and men equally. The task force developed from the Health Services Support Assessment Team, Col. Anne Naclerio, WHTF chairperson, explained.

“The result of that work culminated into a white paper (titled) ‘The Concerns of Women Currently Serving in the Afghanistan Theater of Operations,’” she said. The paper is a compilation of interviews, town halls and group discussions from about 150 service women and the challenges they faced downrange.

One of the biggest things the task force noticed was under-education, Naclerio said. Sometimes, the Army’s curricula on hygiene and health are more male-focused because the service is made of a majority of male Soldiers. The WHTF believed there were ways to add to the curriculum to help women serving in an austere environment.

“We found that many of the women downrange didn’t know about urinary diversion devices — they called them FUDDs, female urinary diversion devices — and so instead of being able to urinate standing up just like the guys off the side of the truck or into a bottle, they would withhold urine, try not to drink as much, try not to have to go to the bathroom. And by doing so, maybe they predisposed themselves to poor health,” Naclerio said.

The women the task force spoke with were also not aware of the option to regulate their menstrual cycle, which includes choosing to have a lighter menstrual cycle or suppressing it entirely while deployed.

“If you are going to be out on a mission for a while, to have that in your bag of tricks is something I think we need to empower our women with,” she said.

The WHTF is also helping to develop self-diagnosing kits for common vaginal infections, so women who don’t want to take time away from their mission or are uncomfortable with going to their unit’s medical staff will be able to diagnose and treat any issues.

While the physical health needs for male and female Soldiers will differ, Dr. Kate McGraw, associate director of Specialty Care for the Deployment Health Clinical Center, doesn’t believe psychological health needs based on gender alone are any different in combat.

“There are some studies that have examined gender-based differences and the impact of combat on psychological health, and these studies pose the question if you’re in a combat situation and you’re male or female, is your psychological health better or worse based on your gender? And there have been no significant differences found,” McGraw said. “So we know that gender alone in combat situations is not going to be the factor that causes a difference in impact of combat on psychological health.”

McGraw, who is also the co-lead of a joint working group between the Department of Defense and the Department of Veterans Affairs studying mental health needs of female service members and veterans, said the most common psychological challenge for servicemembers, male and female, is being able to stay flexible and resilient in a stressful environment.

“I would say that women have been in combat now for quite a while unofficially, and in some positions officially, and I don’t believe their experience now is going to be any different (in) how they actually experience combat itself,” she added.

An added challenge female warriors may experience being integrated into previously all male MOSs is facing peers and being accepted by them. McGraw explained that when a person is ostracized from a peer or social group there is a powerful negative influence on the individual.

A person with peer or social support is more likely to have better outcomes with a psychological health condition, or even a shorter length of the duration of that condition, McGraw said.

“It’s basic, simple, human respect. If you welcome any new member to your unit with the same level of enthusiasm and acceptance, then you’re building your team and esprit de corps,” she said. McGraw believes this effect can be enhanced if women are not treated any differently than their male counterparts in the MOS, and said it is imperative that the leadership maintain an upbeat attitude.

“Without that strong leadership, being sensitive to both viewpoints, and being willing to shift the culture to support and encourage females to be welcome members of the unit, then it is not as likely to be successful,” she said.

Naclerio also thinks that being accepted in the peer group is important for women’s health.

“I think as we expand roles the other thing that is probably important is how we put women in these units. What we heard from women is unlike their male colleagues,” Naclerio said, “At least, this was their perception. One of the ways they dealt with some of the events and some of the stresses was talking to other women.”

“We can ensure that we have senior NCO females there to mentor junior female enlisted and officers,” and not just have one woman in an otherwise male MOS, but rather, always have a female peer, she explained.

The Army will focus on recruiting women to newly opened MOSs not only from the outside, but also from within its ranks in order to fill important enlisted and officer leadership roles, Sheimo said.

“Leadership is a key element of success in this effort, Sheimo said. “It’s very important to have a leadership cadre in place.”

Any changes the Army makes will not take effect until, at the earliest, the summer of 2013, after careful consideration of the MOSs, she said. Every position should be open by January 1, 2016, regardless of gender.

Editor’s Note: C. Todd Lopez from the Army News Service contributed to this article.