In a sense, the wars in Afghanistan and Iraq began with a burn pit. When the Twin Towers collapsed on September 11, the bombing incinerated hundreds of thousands of tons of cement, steel, drywall, window glass, computers, and electrical cables. A toxic plume arose from the site, and the dust that settled over the city included the remains of the 2,753 people killed in the attack. It was, in more ways than one, a foreshadowing of what was to come.

For veterans exposed to the burn pits, every delay by the government means

less treatment, higher medical costs, and a greater risk of death.

In the weeks following the attacks, the Environmental Protection Agency assured New Yorkers that the dust and smoke from Ground Zero did not pose a health risk. But by the time the United States invaded Iraq in 2003, it had become clear that those assurances were a lie driven not by science, but by politics: The Bush administration, it turned out, had pressured the EPA to downplay the risk posed by Ground Zero exposure. As 9/11 first responders began to develop cancer and die, the government fell into the pattern of evasion that continues to this day: deny the problem exists, delay taking action for as long as possible, create a registry of those who complain, order a study, spin the findings, and then order another study.

In June 2015, the VA finally published findings drawn from the burn-pit registry, based on questionnaires completed by 27,000 veterans who said they had been exposed to burn pits. (Nearly all of the vets also reported being exposed to dust storms at some point during their deployment.) Those exposed to burn pits suffered from higher rates of asthma, emphysema, and rare lung disorders. Thirty percent had been diagnosed with respiratory diseases, including serious disorders like chronic obstructive pulmonary disease and chronic bronchitis. Three hundred and sixty five veterans said they had been diagnosed with constrictive bronchiolitis or idiopathic pulmonary fibrosis, another incurable lung disease, typically not found in young, fit populations.

Such numbers almost certainly underestimate the scope and severity of the health crisis among veterans of America’s wars in Iraq and Afghanistan. Many cancers don’t reveal themselves for a decade or more, and many serious respiratory symptoms tend to be misdiagnosed as asthma. When veterans develop respiratory disorders after they return home, doctors may fail to make a connection between their symptoms and their military service. The truth is, we may never have a full scientific understanding of the pain and suffering that the burn pits inflicted on U.S. soldiers. And the VA is taking advantage of that fact to withhold medical treatment and disability benefits from those who were injured overseas. For veterans exposed to the burn pits, the equation is simple: Every delay by the government means less treatment, higher medical costs, and a greater risk of death.

In February 2015, Jessey and Maria Baca traveled to New York City. They had put together a “bucket list” of things Jessey wanted to do before he died, and visiting the city was on it. When I meet them in the lobby of a Holiday Inn on Wall Street, not far from the World Trade Center site, Jessey shows me a red welt on his cheek.

“No idea why,” he says. “Weird new things all the time.”

“This is him on a good day,” Maria adds.

“It feels like a cactus growing in my lungs,” Jessey says. “I can breathe in, but not always out.”

Maria tells me that another of the veterans who worked to create the burn-pit registry had died. Bill McKenna didn’t live to see the registry open: He died of a cancerous mass on his heart in 2010. He was 42 years old and had never smoked.

Baca knows he has been treated unfairly. But he is glad that he managed to receive a diagnosis before he dies, and that he forced the government to acknowledge he was injured in service to his country. “I’m one of the lucky ones,” he says.

I ask why he thinks that.

“The worst part was the unknown,” he says. “I didn’t want to die of the unknown.”