Health Benefits Are Hard to Get in War Zone

They called him Homeboy.

He was an Iraqi, hired by U.S. defense contractor Titan Corp. as an interpreter for soldiers with the 82nd Airborne Division. He talked for them, prayed for them and even fought for them.

But a year after his leg was blown off during a skirmish, Hayder Kharalla hops around his house in Baghdad, unable to walk more than a few hundred yards or carry his young son.

Kharalla still believes in the America that said it wanted to free his country. But he doesn’t understand why Titan, one of the U.S. government’s biggest contractors, has failed to deliver on its promise to provide a prosthetic leg or rehabilitation therapy to help him walk again.

“I feel inside a little sorry for myself,” said Kharalla, 30, who was being paid $10 a day by the company. “I worked so much. And this hurts me so much.”

With perhaps as many as 150,000 people -- U.S. citizens, Iraqis and other foreign nationals -- employed under reconstruction programs, U.S. officials and contracting experts increasingly worry that companies are not providing required health benefits and insurance.

There have been at least 134 reported deaths and 858 reports of injuries involving workers from the United States and other countries since the U.S.-led invasion of March 2003, according to government figures. By comparison, more than 1,030 U.S. military personnel have been killed and more than 7,000 wounded.

With experts believing that the contractor statistics may fall short of reality, there is growing concern that some companies may be unaware of their responsibilities, especially in regard to Iraqi workers. Also, logistical difficulties in a war zone, such as inadequate communications, have made it difficult for companies to know when workers are injured.

The Labor Department, which monitors compliance, has had a number of meetings with companies and insurance providers to determine how best to increase awareness of the relevant law, the Defense Base Act.

But so far, Iraq’s chaotic situation has stymied efforts to improve matters. The country has no banking system able to process insurance payments, no legal system to enforce compliance and no tradition of litigation to file complaints. Also, the department has no personnel in Iraq.

“There are problematic issues coming up that you don’t normally see,” a department official said.

One U.S. Army Reserve judge advocate who has dealt with such cases criticized the department for not doing more for injured workers in Iraq.

“Most executive branches have offices at the U.S. Embassy. Why not the Department of Labor?” the judge advocate asked. “It’s possible to have more outreach.”

Titan declined to comment on the record, citing privacy concerns. One spokesman said the company was trying to help Kharalla and other injured translators obtain treatment outside Iraq. Titan has given Kharalla a raise and continues paying his salary, now $600 a month.

“Our insurance company and Titan personnel have been coordinating the movement of this action, but due to the lack of a stable Iraqi government structure, we have not been able to obtain the required travel requirements and logistics yet needed to make this ongoing effort possible,” the spokesman said.

A slight man with dark eyes and a quick wit, Kharalla watched the bombing of Baghdad in the opening days of the war with fear and relief.

The repressive regime that had once threatened to kill his father, a government lawyer, was on its way out. He had high hopes for a new, free Iraq.

When U.S. troops came knocking on his door a few days later in a search for unexploded bombs, Kharalla impressed them with his English, acquired during a childhood spent in England. They offered him a job as an interpreter.

Kharalla became the voice for the troops. He explained U.S. intentions to rebuild Iraq at neighborhood meetings. He calmed angry crowds of people who swarmed troops. He was at the front door during raids, asking permission to enter.

“He got along great with the guys,” said Lt. Matt Adamczyk, a commander with the 2nd Battalion, 325th Airborne Infantry Regiment, 82nd Airborne Division. “He was very pro-America, and it showed to us. He was interested in a better Iraq. He believed, like we did, in what we were doing.”

Kharalla became their voice, but U.S. troops became his window on a life he had seen only on television. They talked to him about freedom. They played rap music while driving around Baghdad in Humvees. They gave him his nickname, Homeboy.

“It was a dream, honestly,” Kharalla said as he sat in his family home in a middle-class neighborhood in Baghdad. “I loved the people I worked with. I became exactly like them.”

In the summer of 2003, the military began to consolidate its interpreters with Titan, which provides translators through a contract originally awarded in 1999. The contract is now the company’s largest source of revenue, worth up to $657 million. Last year, Titan reported $1.9 billion in revenue.

Airborne soldiers personally took Kharalla to Titan’s Baghdad office to make sure he was hired and assigned to their unit. A few days later, on Aug. 6, Kharalla was with a platoon conducting a patrol to enforce a curfew in south Baghdad.

It was after midnight when they stopped to talk with a man in the road. Kharalla had just begun asking questions when the first shots rang out.

Kharalla ducked down, lying against the wheel of an SUV. He barely felt the bullet that severed his right leg. There was a small sting, and suddenly, it was lying next to him in the road, still attached by skin. Another bullet punctured his left calf.

Around him, the firefight raged. Bullets whined past his head, thunking into the SUV. Men shouted. Blood poured from his leg. A sergeant fell next to him. Kharalla reached to pull him to safety behind the patrol vehicle, but the man was dead.

Another soldier threw Kharalla over his shoulder and staggered backward firing his rifle. Kharalla wound up in a Humvee, headed for a field hospital. Two soldiers were killed and 16 people were wounded in the incident, including Kharalla.

“What he did was probably what many would classify as heroic,” Adamczyk said.

The next month was spent in U.S. Army facilities in a failing effort to reattach his leg. After doctors had put a cast on the leg to prepare for amputation, Kharalla had one physician inscribe a message on it.

“It was my honor to work with the Americans. I want to dedicate this leg to all the Americans who died to make Iraq free,” he had the doctor write. A nurse started crying.

For Titan, Kharalla’s release a month later was the beginning of a logistical and bureaucratic nightmare. U.S. military hospital services in Iraq do not include treatment for amputees. Soldiers with such problems are normally taken to Walter Reed Medical Center in Washington, but as a private contractor, Kharalla was not eligible.

Titan’s main problem was getting Kharalla out of Iraq for treatment. No commercial flights were flying. Kharalla had no passport. He had to obtain a visa to enter other countries, but there were few functioning embassies in Baghdad.

As the months progressed, Kharalla’s case passed from one company official to another as Titan rotated personnel through Iraq. Several times, company officials called Kharalla to tell him his paperwork had been lost. Kharalla said he sent more than 20 photos and three different complete sets of medical records to Titan, which was working with AIG, its insurance carrier, to help Kharalla.

The airborne soldiers mounted their own effort to shred the bureaucracy, contacting higher-ups to win permission for Kharalla to leave.

By May, Lt. Col. Kevin King, then the chief operating officer of the Coalition Provisional Authority, wrote an e-mail to Titan demanding to know “why this happened in Aug. 03 and is still kicking around. I want to keep this off of [CPA head L. Paul] Bremer’s plate if at all possible.”

It is unclear why Titan had such trouble. Several companies and nongovernmental groups have transported wounded employees abroad for rehabilitation therapy.

Kharalla and the soldiers said they asked repeatedly for treatment in the United States, which could grant travel documents. Each time, they said, Titan told them they could transport Kharalla only to the closest possible country with adequate facilities for an amputee, such as Qatar and Germany.

A Titan official said Kharalla could not be sent to the U.S. because his case was not considered life-threatening.

An injured worker has the right to appeal to the Labor Department for a review of the treatment provided by a company’s insurance carrier. But Kharalla said he never received the letter that the department sent him in care of Titan that explained the process.

Kharalla is still hopeful that he will receive treatment. A Titan representative called him last month to tell him they were planning to take him to Jordan. Most recently, a company representative told him in an e-mail that Titan’s insurance carrier needed still more paperwork.

“I’m sorry this has taken so long,” the Titan official wrote.

Kharalla is still waiting.