In 2008, when he was only 29, Army Pfc. Russell Madden enlisted in the Army because he needed health insurance for his son, who was born with cystic fibrosis. While deployed to Afghanistan in 2010, he died after a rocket-propelled grenade hit his convoy. His son, Parker, was only six years old.

Madden is one of around 6,200 U.S. military personnel, contractors, humanitarian workers and journalists who have died in Afghanistan since the U.S. government invaded just over 18 years ago. An estimated 9,000 others have died in Iraq, Syria and at least 19 other countries where U.S. troops have fought since Oct. 7, 2001.

Hundreds of thousands have returned from these wars injured, both physically and mentally. Beyond the official casualty counts, there are the family members and friends of the dead and the wounded — those like Russell Madden’s loved ones, whose lives have been forever altered by the wars and yet are generally overlooked in the official costs of the post-2001 U.S. wars. Across the United States, millions have been affected — the collective damage is immeasurable.

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As horrible as the wars’ impacts are in this country, a new report released today by Brown University’s Costs of War project shows that the magnitude of death, injury and trauma in the countries where the United States has fought its wars is far worse. According to the report’s authors, Neta Crawford and Catherine Lutz, an estimated 755,000 to 786,000 civilians and combatants, on all sides, have died in Afghanistan, Iraq, Syria, Pakistan and Yemen since U.S. forces began fighting in those countries. That figure is around 50 times larger than the number of U.S. dead.

But this is only the direct death toll from combat. Indirect deaths, caused by war’s destruction of health, sanitation and other local infrastructures, are generally estimated to be four times higher. This means that total deaths during the post-2001 U.S. wars in Afghanistan, Iraq, Syria, Pakistan and Yemen is likely to reach 3.1 million or more — around 200 times the number of U.S. dead.

Sadly, the numbers are so large, they’re numbing. “Numbers have dehumanized us,” wrote novelist Dalton Trumbo in 1970, during the U.S. war in Southeast Asia. “Over breakfast coffee we read of 40,000 American dead in Vietnam. Instead of vomiting, we reach for the toast.”

We quickly lose any sense of how it would feel to have one’s life irreparably damaged by war, to have a loved one’s life taken or forever harmed. It becomes hard to focus on a single death, a single life lost, a single family shattered.

Meanwhile, entire neighborhoods, cities, societies have been shattered by war. The total number of injured and traumatized extends into the tens of millions. In Afghanistan, in 2002, 42 percent of the population showed symptoms of post-traumatic stress disorder, according to the U.S. Centers for Disease Control and Prevention. Almost 70 percent showed signs of major depression. Recent research in Iraq showed one in five suffering from mental illness, with 56 percent of young people exhibiting signs of PTSD. More than 12.5 million have been displaced from their homes in Afghanistan, Iraq, Pakistan and Yemen alone, according to UNHCR. Even more hidden have been the tens of thousands of dead and wounded in the other wars where U.S. troops have fought since 2001, including in Somalia, Libya and the Philippines.

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Don’t we have a responsibility to wrestle with our individual and collective responsibility for the destruction our government has inflicted? Our tax dollars and implied consent have made these wars possible. While the United States is obviously not the only actor responsible for the damage done in the post-2001 wars, U.S. leaders bear the bulk of responsibility for launching catastrophic wars that were never inevitable, that were wars of choice.

The appalling harm is worse when we consider that U.S. taxpayers will ultimately spend more than $6.4 trillion to wage war in Afghanistan and Iraq alone, according to a Costs of War estimate. Consider how we could have otherwise spent that incomprehensible sum — to feed the hungry, improve schools, confront global warming, improve our transportation infrastructure and provide health care to people like Russell Madden and his son.

At a time when everyone from Donald Trump Donald John TrumpFederal prosecutor speaks out, says Barr 'has brought shame' on Justice Dept. Former Pence aide: White House staffers discussed Trump refusing to leave office Progressive group buys domain name of Trump's No. 1 Supreme Court pick MORE to Democratic Party candidates for president is calling for an end to these endless wars, we must push our government to use diplomacy — rather than rash withdrawals, as in northern Syria — to end these wars responsibly. As the new Costs of War report and 3.1 million deaths should remind us, part of our responsibility must be to repair some of the immeasurable damage done and to ensure that wars like these never happen again.

David Vine is professor of anthropology at American University in Washington, D.C. He is the author of “Base Nation: How U.S. Military Bases Abroad Harm America and the World” (Metropolitan/Holt, 2015) and the forthcoming “The United States of War: A Global History of Endless American Conflict, from Columbus to the Islamic State” (University of California Press, 2020). Vine is a board member of Brown University’s Costs of War project.