In a recent survey of Ukrainian residents concerning mental health during the ongoing war, 31.2% of respondents met the criteria for post-traumatic stress disorder (PTSD). Physical violence, displacement, and the loss of loved ones produced by the Russo-Ukrainian War have intrusively echoed throughout all different walks of life. War leaves lasting wounds, and for some places and people, it does get the last word. We can look to history and examine cases such as the Vietnam War and the War on Terror, which still have chokeholds on those involved.

Those that returned home from the horrors of Vietnam found themselves still haunted by their experiences despite the distance. The National Vietnam Veterans Longitudinal Study found that nearly 271,000 veterans continued to have full or below-the-threshold PTSD for 40 years after the war ended. To have such mental conditions for such a long duration, it is no question that it has affected their lives on all levels: social, familial, professional, and many others. Secondary traumatization among the wives and children was found to be linked to veterans’ PTSD in addition to demoralization in their wives/partners and alcoholism. For work after the war, veterans with a lifetime diagnosis of PTSD were less likely to be working, and for those that were employed, they received lower hourly wages. Conversely, among servicemembers who were not deployed to Vietnam, “self-reports of PTSD symptoms during 25 years are low and stable.” Veterans were not the only ones affected, as the physical battlefield on which they fought was also devastated. Agent Orange, an herbicide used across 4.5 million acres of Vietnamese vegetation, caused health issues like cancer, birth defects, and neurological problems. To rub salt in the wound, a 2004 class action lawsuit against more than 30 chemical companies alleging that the use of Agent Orange was against international law was dismissed, creating outrage among both the affected Vietnamese civilians and US service members alike. With all the misery and destruction it wrought, one might think that the Vietnam War got the last word.

In more recent conflicts, the Global War on Terror (GWOT) also produced additional lasting effects on current generations. The Costs of War project at Brown University estimates that total costs of care for veterans of post-9/11 conflicts are to reach $2.2–2.5 trillion by 2050. Over 40% of veterans from GWOT conflicts are entitled to lifetime disability payments and are expected to increase to 54% over the next 30 years. Other estimates by the same project found that the number of post-9/11 veterans that died by suicide was four times higher than those who died in combat. Additionally, over 38 million civilians were estimated to be displaced from wars in Afghanistan, Pakistan, Iraq, Syria, Libya, Yemen, Somalia, and the Philippines. To this day, long-term US military engagement across the world continues to produce disastrous effects across the spectrum of human well-being.

US counterterrorism in the Middle East and the rest of the world has produced long-lasting consequences for everyone involved, and its nature continues to influence current conflicts in the region. While not a part of the GWOT conflicts, the conflict in Gaza finds its conduct similar to previous conflicts, and its effects are still not fully pronounced. Since October 2023, significant increases in PTSD, anxiety, depression, psychosomatic problems, and substance abuse have been observed in Palestinian civilians by humanitarian responders. War continues to have a word in for those that have engaged with it, and will do so in ongoing conflicts.

In spite of all the tragedy and pain that war brings, it only gets the first and loudest word. What is not heard nor seen is what comes once rebuilding starts. The United States Institute of Peace report on US-Vietnam reconciliation found that key turning points in stabilizing such a dark history between the two countries came from ordinary US and Vietnamese citizens who took initiative to repair relations. Stories such as Chuck Searcy’s, who returned to Vietnam 20 years later to contribute to rebuilding, demonstrate that people, not war, can dictate the future when they take action.

For those that fought in conflicts during the Global War on Terror, various organizations and communities exist to take on mental health and other issues stemming from military service. Groups such as the Wounded Warrior Project, Headstrong Project, American Legion, and local organizations provide support services to fill gaps in veteran care where the federal government falls short. Similarly important, the US legislature passed the PACT Act in 2022, which expanded VA healthcare to those exposed to toxins in Vietnam, the Gulf War, and post-9/11 conflicts.

There are also organizations that provide services to civilians affected by conflict, such as the International Rescue Committee, Doctors Without Borders, International Committee of the Red Cross, Project HOPE, and Oxfam International. These were born during and after conflict to fill the gaps in care and support for society at large. The work they perform still carry on through more recent and modern conflicts, whether it be humanitarian aid, medical care (emergency medicine, disease response, and maternal/neonatal care), public health measures, policy advancement, legal support for displaced civilians, and many others. War’s effects don’t last forever, and its attempts to stay are constantly challenged by those seeking to find light at the end of the dark tunnel.

So, against all the horrors that we find in the conduct and aftermath of warfare, we find ways to pull ourselves out of these hells. We have each other to help us get back on the road when lost. We have more than what war says at its end.

So, does war get the last word? No, it doesn’t. We do.