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In addition to loss of life and equipment, fratricide incidents take a toll on all those involved, said Maj. Ellen Ballerene, a psychiatrist with the 48th Medical Operations Squadron at RAF Lakenheath.

“It affects morale of the troops if they’re attacked [by friendly forces],” she said. “Also, guilt goes along with it if they injure their comrades or those they’re fighting with.”

The effects of friendly fire don’t end once the casualties are cleared and the battle moves on.

“The more trauma people are exposed to in war, the more likely they are to develop post-traumatic stress disorder or other long-term effects,” she said.

Because of the long-lasting impact of such incidents, they’re always in the minds of troops, even long after major combat operations are done.

“Stability and support operations [such as operations in Iraq and Afghanistan] can turn quickly to high-intensity conflict and we sometimes become our own worst enemy,” said Capt. Roger Wang, Scout Platoon leader with A Troop. “‘Blue on blue’ is still a real concern on the modern battlefield.”

And it’s not just a concern for U.S. troops, as other coalition forces also have been on the receiving end of American fire in Iraq and Afghanistan.

Of the nine nations participating in a recent exercise to help minimize friendly fire incidents using new force identification systems, three — Britain, Canada and Italy — have lost people to American fire in either Afghanistan or Iraq.

The other participating nations in exercise Urgent Quest were the United States, Australia, Denmark, France, Germany and Sweden.

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