Ovenny Jermeto was on a combat tour 7,000 miles away from his Pacific island home when a bomb blew up his vehicle in the Hindu Kush mountains of Afghanistan. He survived and completed his deployment, but later lost feeling in his right foot and battled anxiety and depression.
He returned to the United States to finish his enlistment and was eventually released on medical grounds. So he had to make a difficult decision: stay in the United States for free medical care or return home to the Marshall Islands in the middle of the Pacific Ocean and spend thousands of dollars a year traveling to US military hospitals to receive treatment. .
This is a difficult situation for hundreds of people from the Marshall Islands, Palau and the Federated States of Micronesia, all former US Pacific colonies of Micronesia, who served in the US military as foreign nationals. Thousands of foreign nationals enlist in the US military each year; hundreds of them are from Micronesia, a result of the country’s close ties to the United States. According to the State Department, the regional enlistment rate is twice the rate in the United States, with nearly 1 percent of Micronesians serving.
The Department of Veterans Affairs, which oversees veterans’ benefits, is largely paralyzed. Federal law prohibits it from providing medical services directly to veterans in foreign countries other than the Philippines, a department spokesperson said. Most veterans are not eligible to use the Military Health System, which is overseen by the Department of Defense and is responsible for active duty soldiers, retirees, and their families.
Jermeto, 44, chose to return to Majuro, the capital of the Marshall Islands, in 2019, almost a decade after the episode in Afghanistan. Since then, he has sought three trips to the nearest US military hospital, a five-hour flight away in Hawaii, and has gone years without medication. To cope, he said, he regularly drinks with other vets. He tries to limit himself to 12 beers per session. The alcohol encourages him to share memories of Afghanistan, which in turn allows him to cry.
“The only option is to drink,” he said. “Drinks are my medicines.”
Hospitals in the Marshall Islands should, in theory, be an option. A VA spokesman, John Santos, said that while the department can’t provide care directly outside the United States, it reimburses veterans if they get it. All veterans are eligible for subsidized care, and those with service-connected conditions get it free of charge. But the health systems in Micronesia are so under-resourced that getting care locally is virtually impossible.
Traveling to VA hospitals is also not easy. Federal law allows the VA to compensate veterans for health-related travel, but regulations restrict it to movement within the United States and its territories. Micronesian officials estimate that hundreds of veterans live there, but do not have a precise number.
The United States has expanded its support for Micronesia in recent years, largely driven by concern over China’s efforts to gain influence in the region. The Marshall Islands, Palau and the Federated States of Micronesia are independent but remain closely affiliated with the United States, which controls their defense policy and funds much of their government spending under agreements known as compacts of free association.
Another Marshallese veteran, Misao Masao, 40, served two terms in Iraq. In the second, a friend took his place in a patrol that was attacked by two suicide bombers. Mr. Masao’s friend was killed.
“It could have been me,” said Masao, who has since struggled with anxiety and depression. He was prescribed a six-drug cocktail, but the difficulty of traveling to the VA hospital in Honolulu means “I run out of medication all the time.”
The United States, Masao said, “forgot” about him. “If you treat my fellow soldier in California right, then treat your fellow soldier in the Marshall Islands the same,” he added. The VA declined to comment.
There has been a bipartisan push in Congress to address the problem.
“This is a matter of basic fairness,” Sen. Brian Schatz, D-Hawaii, said in an interview. “If someone dons the uniform to serve our nation, they should receive the same benefits our service members receive, no matter where they live.”
In 2019, Mr. Schatz proposed legislation that would require the VA to experiment with serving veterans in Micronesia through telehealth and opening small clinics there. The bill remains stalled.
Mr. Jermeto enlisted in 2006. He was fresh out of college with a young son to support and few job prospects. He soon wrapped up a tour of Iraq. In 2011, he was posted to the Pech River Valley in Afghanistan, where he patrolled narrow mountain roads.
One day his vehicle hit an explosive device. When he regained consciousness, he said, he saw that shrapnel had pierced his right leg, ripped open his gunner’s belly and severed his commander’s left arm.
The treatment helped him complete the journey. But he eventually lost feeling in his leg and was crippled by anxiety and depression.
When he was discharged in 2018, he couldn’t tolerate crowded areas, so he sought refuge in the Marshall Islands. But even there, his condition, he said, forces him to isolate himself from the family.
Traveling to the “mainland,” as many Marshallese refer to the United States, to renew your prescriptions can be prohibitively expensive. Jermeto, whose main source of income is a disability benefit, can take a free military flight from a nearby US base to Honolulu, but a round-trip flight from his home to the base costs about $500. The military flight is also usually full, and. Hotels and food in Hawaii can cost hundreds more.
In April, Mr. Jermeto traveled to Honolulu for his third VA appointment since discharge. But a programming error forced him to wait three more weeks to see a doctor in person and refill his prescription.
Kalani Kaneko, a Marshallese senator and former health minister, has repeatedly called on VA officials to treat people like Jermeto like other hard-to-reach veterans.
“We’re not trying to invent new ways to operate in VA because it’s the same things that they’re doing now for those isolated places in the United States,” Mr. Kaneko said.
Mr. Kaneko, 47, is a two-decade veteran of the US Army. He suffered traumatic brain injuries while training as a tank driver at Fort Irwin, California, taking various medications and making frequent trips to the hospital. VA in Portland, Oregon for care.
But their main motivation to drive the change is a feeling of guilt. Toward the end of Mr. Kaneko’s military career, he worked as a recruiter for the Army. He persuaded Mr. Jermeto and many other Marshallese men to enlist.
“I lose sleep over it,” Mr. Kaneko said. “They might have been better off doing something else, but I went after them.”