GOVERNOR CALVO: We are the most patriotic Americans that you'll see anywhere.

HINOJOSA: They serve in the military in surprising numbers.

MAGGIE AGUON: Boom, you're going to war.

But when we come back, what happens to us?

HINOJOSA: A population of unsung American warriors in the Pacific.

What is it gonna take for them to know that we're here?

I don't know.

You're in pain every day?

Yes.

HINOJOSA: Are they forsaken by the country they swore to defend?

ROLAND ADA: I can't get the help that I need, and I need the help now.

This is the new America-- black, brown, Asian, LGBT, immigrants.

The country is going through a major demographic shift, and the numbers show it.

The face of the U.S. has changed.

CHRISTINA IBANEZ: We're American.

We care about the same things.

But yet we also want to preserve our culture.

I just see it destroying what we had planned to happen here.

HINOJOSA: By 2043, we will be a majority non-white nation.

NORM GISSEL: We are making, as we speak, a new America.

And it's a marvelous moment in American history.

Everybody's voice is important to this debate.

HINOJOSA: America by the Numbers.

I'm Maria Hinojosa.

This program was made possible in part by: The Corporation for Public Broadcasting.

And by contributions to your PBS station from: Welcome to America by the Numbers.

I'm Maria Hinojosa.

Behind every number, there's a story, and today's numbers tell a dramatic one.

2.7 million Americans have been deployed in the wars in Iraq and Afghanistan since 9/11.

Half struggle with physical or mental health problems stemming from their service.

As many as one in five suffer from post-traumatic stress disorder.

It's known as the tip of the U.S. spear in the Pacific.

A tiny island smaller than New York City with fewer than 200,000 people.

Guam is an unincorporated U.S. territory 6,000 miles away.

I have never seen anything like this.

An entire series of photographs in the airport dedicated to fallen soldiers.

VICTOR ROGERS: K57 Vet Talk listeners, we have the honorable governor Eddie Baza Calvo.

Thank you, sir, for coming aboard.

GOVERNOR CALVO: It's a pleasure and an honor to be here, especially as we lead up to the Liberation Day festivities.

VICTOR ROGERS: Coming here from outside, I don't think people realize how much Guam's community revolves around the service to the country, the family members that have served, the aunts and the uncles and the brothers, and it's just amazing.

(drill sergeant shouting) HINOJOSA: The men and women of Guam are U.S. citizens and serve in the American military at a rate that's three times higher than the rest of the country.

And in the wars in Iraq and Afghanistan, Pacific Islanders have the highest rate per capita of casualties and deaths-- the ultimate sacrifice.

GOVERNOR CALVO: We are living in paradise, and all this is just as a result of some folks that have signed up to put on a uniform and sacrificing everything.

Everything for what we are enjoying today.

HINOJOSA: I came here to find out why so many of Guam's people have chosen to become warriors for a country half a world away, and some say get too little in return.

According to Guam's office of veterans affairs, at least one in eight adult Guamanians is a veteran, among the highest percentages of all U.S. states and territories.

But in 2015, Guam ranked third-to-last in per capita spending on medical care by the U.S. Department of Veterans Affairs, or the V.A.

This, at a time when many men and women from Guam are returning from war with mental and physical health challenges.

36-year-old Roland Ada served two tours of duty in Iraq as a combat medic.

HINOJOSA: He was discharged in 2013, and returned to Guam with a diagnosis of post-traumatic stress disorder, or PTSD, which affects as many as one in five Iraq War veterans.

HINOJOSA: The symptoms of PTSD include flashbacks, angry outbursts, intense emotion, avoidance, and withdrawal.

Following active duty, Roland moved back to his family's small, four-bedroom house behind their food market.

Many of his relatives, including his cousin, uncle, and father, are also vets.

Because of PTSD and, you know, what's going through his head, in my opinion, my brother's self-confidence, has, you know, been so damaged.

You know, my brother would always say, "Hey bro, what are you doing?"

"Nothing, just staying here at the house."

"Oh, let's go watch a movie, you know, go do this or that."

"Nah, I'm all right, I'm gonna stay home."

KEN JOE ADA: I would joke with him and tell him, you know, "If you want a girlfriend, man, "you gotta go out there and get her.

She ain't gonna walk into your bedroom and find you."

(laughing) Why did you decide to enlist?

My godmother.

She came into our store one day, she was wearing the army green uniform.

To me, she looked like somebody I wanted to be.

I wanted to wear that nice, starched uniform.

I wanted to to look good and people to notice that, "Hey, there's that guy who's helping serve our country."

HINOJOSA: Last decade, when the wars in Iraq and Afghanistan were at their peak, four of the U.S. Army's top recruiters were from Guam.

Enlistment in the Pacific Islands doubled while it was plummeting nearly everywhere else in the U.S.

Sergeant Gonzalo Fernandez was a top producer for the National Guard, winning Recruiter of the Year three times in a row.

In every village on Guam, you're gonna find a big amount of people who served in the military.

It's a family tradition to do it.

So that must mean that your job is a lot easier than in other places.

The success I have here I probably couldn't duplicate anywhere else because I'm not sure that the people of those places are as patriotic as the people on this island.

HINOJOSA: Michael Bevacqua, a history professor at the University of Guam, thinks the numbers tell a different story.

A lot of it has to do with the shininess and the niceness of the military.

HINOJOSA: Guam's poverty level is about 50% higher than the national average.

as is the island's unemployment rate.

That's in stark contrast to the well-resourced U.S. military, which occupies almost 30% of the island.

MICHAEL BEVACQUA: Guam is one of the most militarized places in the world, and it seems like there's this excess of resources.

And so, for me, that's why a lot of them join, because they see it as this clean green place that offers all these economic possibilities and opportunity.

HINOJOSA: Historically, the armed forces have always played a critical role in Guam's relationship with the U.S. Michael took me to Asan Overlook, where the defining moment in Guam's modern history occurred.

BEVACQUA: In terms of remembering World War II, this is sort of the central location.

Here, if you look over there, you have the main point of invasion for U.S. forces in 1944.

HINOJOSA: The Japanese occupation of Guam in World War II was particularly brutal.

Many Guamanians or Chamorros, as the indigenous people are called, were confined in concentration camps.

Some died en route, others were tortured, raped, beheaded, or starved to death.

By the time the U.S. Marines arrived, it's estimated that nearly 10% of the population had been killed.

Chamorros would meet American soldiers for the first time after they had pushed the Japanese north.

And the Chamorros would say, "Thank you for saving us!"

And the Americans would say, "We didn't know anyone lived on this island.

People live here?"

HINOJOSA: Guam became a U.S. territory in 1950, and, like Puerto Rico, its residents have U.S. citizenship.

They can enlist in the military, but they can't vote for the president who will send them to war.

Guamanians elect a delegate who serves in the House of Representatives, but that delegate can't vote.

And despite its connection to the U.S., Bevacqua says Americans are still largely ignorant about Guam.

Some people say, "Oh, Guam, wow, Central America."

"Guam, wow, South America."

"Guam, really?

You look so light for an African."

HINOJOSA: I met with a group of veterans to find out what service in the U.S. military means to them.

Being a Chamorro, joining the military, I represent my island.

And I want to put it on the map.

What is it gonna take for them to know that we're here?

I don't know.

My two sons, "Dad, I want to go military."

I tell them, "Don't."

"But I want to follow in your footsteps."

I said, "How, son?

I got p-- severe PTSD."

It took me 12 years to finally get a settlement.

12 years.

Why so long?

I'm going on, what, seven, eight years.

I've not yet talked about what I've known, what I've saw, what I went through.

HINOJOSA: Maggie Aguon was the first woman from Guam to volunteer after 9/11.

During a tour in Iraq, she suffered a head injury when her vehicle was struck by an IED.

Would you say that you have PTSD?

I'll be honest with you.

Sometimes I get emotional, and when I see things on TV, I start breaking down.

Um...

When these two guys came back from... you know, every time they come back, you know... You get that... ...flashback.

And, I mean, even me, I almost didn't make it home, but knock on wood that I had an angel on my side that made me come home.

Why has it taken this long for me to talk to somebody?

I don't know.

I think that's pretty typical of what we experience here on Guam, about not being recognized for who we are and what we contribute.

HINOJOSA: So what happens when a congressional delegation comes to Guam?

You talk to them, you try to give them the right information.

But you get this stare.

And they always come up with, you know, "We don't have the money."

It's always like that-- they don't have the money.

They don't have the money.

HINOJOSA: These veterans say the lack of awareness and the lack of money translate into a lack of services.

Specialized programs for PTSD can be inaccessible for many.

It's called the PTSD program locator.

So it tells me to enter my address.

Five options here.

But the closest one so far looks like Hawaii.

It's 3,803 miles-- .22 miles.

And then you got... Alaska, which is the next one.

That's ridiculous for me.

That's why I just stay home.

HINOJOSA: Roland is still battling traumatic memories of his service in Iraq.

We're at the site of a (bleep) IED.

It went off.

It's a pretty big bomb that went off.

Fire over there, and there's another fire over there.

We heard this bomb go off from.... That's me right there.

HINOJOSA: What are you doing there?

ADA: This, there's an older gentleman in here, and I was working on him because he was actually alive.

And the IED that went off was kind of right over here in the corner.

The kids were standing right around here, and they were, you know, waving at us as we were driving by, but we didn't expect them to try and blow us up.

They were trying to kill you?

Yeah.

This is a piece of one of the children's head.

There was three.

That's all we found, and another foot.

I think of things, like, when I'm driving, just driving on the road, and you're like... those fleeting thoughts of, "I could just let the steering wheel go," or "Why don't I just run my truck into the wall?"

Every day?

Once a week?

At least... ...two or three times a day.

Hello, how are you?

HINOJOSA: The island's V .A.-run vet center caters to the psychological needs of combat veterans.

Its leader, Dr. Edward Santos, says demand for services is high.

So do you feel that you're living up to giving as much as you can to the vets here on Guam?

Oh, no.

I'm doing my best, but I don't think we ever can do enough.

Because...?

Well, if we were...

I mean, you know, if I had the resources, I'd probably feel a lot prouder about it.

So you guys are lacking in resources?

A lot of the programs that are available, like in Hawaii, are not necessarily available here.

For the other resources, we have CBOC, Community Based Out Clinic.

I, in my opinion, I feel it's small for the amount of veterans we have.

HINOJOSA: In the states, there are about twice as many V.A.

mental health professionals per capita than in Guam.

HINOJOSA: Victor Duncga, the office manager here, also doubles as a peer counselor to veterans.

Victor served as an infantryman in Afghanistan and now has PTSD.

Can you tell me a little bit about the kinds of things that you did when you were serving in Afghanistan?

Oh...

I'm sorry.

It's okay.

Stay, stay, stay, stay.

What I've gone through, what I've seen...

Stepping on body parts, the smell of exploded flesh... Those type of things.

After Afghanistan, I came back home.

I isolated myself for a whole year.

I stayed in my house a whole year.

My wife and my kids, they went everywhere without me.

HINOJOSA: Victor decided to make the 3,800 mile trip to Hawaii for intensive PTSD treatment, leaving his wife and two young children for two months.

The treatment helped, and Victor is now able to give guidance to other veterans.

DUNGCA: With these guys, with all the issues that they have, I guess you could say it comes to resources.

They would need to have more people who understand the type of pain that we feel every single day.

You served in Afghanistan in 2010?

Yes.

And yet you're in pain every day?

Yes.

HINOJOSA: Now?

HINOJOSA: With so many veterans like Maggie, Roland, and Victor, why are Guam services and resources in V.A.

care lacking?

The answer may be in the numbers.

Guamanian advocates and politicians believe the V.A.

is using inaccurate census data, which records roughly 9,000 vets on Guam, when the actual number could be nearly double.

Carmelita Calvo, Roland's godmother, works for West Care Pacific Islands, a health advocacy group.

She is going door-to-door to establish an accurate count of how many veterans live on Guam.

Hafa adai, Hafa adai.

Carmelita Calvo from West Care Pacific Islands.

And your name?

Henry Mangniolia.

Henry, are you willing to participate in this census?

Of course.

Okay.

Are you a veteran?

Yes.

Great, can we come in?

HINOJOSA: How important is it for you to be trying to get an accurate count of the veterans on the island?

I think it's very important because there's conflicting numbers, and I hear the lawmakers saying that they need to know more, how many veterans are there, in order to act on anything.

Okay, Mr. Flores, thank you very much.

HINOJOSA: If their estimate of up to 16,000 is accurate, they believe the numbers will make the case for critical resources on the island, like a veterans' hospital.

But the facility planner for the V.A.

Pacific Islands thinks that's unlikely.

Do you wish that there was a veteran's hospital on the island of Guam?

Uh... no, no.

The number of veterans that we hospitalize, truthfully, quite small, quite small in numbers.

HINOJOSA: Because there were no official V.A.

representatives in Guam to answer our questions, the V.A.

flew in Craig Oswald from Hawaii to meet with me.

He took me on a tour of the outpatient clinic, opened in 2011.

So what we're seeing along the first part of the corridor are some of the physicians' offices.

So psychiatry?

That's correct, uh-huh.

We've got a board-certified, full-time psychiatrist, two of them here on island-- Is that enough?

--to treat veterans.

You feel like having two psychiatrists on the island to treat veterans, is that enough?

Do you wish there was more?

I think right now, we're doing well because we have some additional mental health staff that we have added to the clinic, namely social workers and nurses.

HINOJOSA: I pressed him on what I'd been hearing from veterans about a lack of services, and specifically what Roland said about the treatment he needs for his PTSD.

So, everything seems to look great-- I mean, great facility-- but the stories that we're hearing from this particular veteran don't jive with...

Right, doesn't line up with what one would expect.

Yeah, with what you're saying, frankly.

It doesn't line up with what I would expect either.

We do have some specialized types of PTSD care available in Honolulu.

But he says, "I'm from Guam, this is my home."

Right, right.

"I'm an American citizen.

I deserve to get the treatment that I need here on Guam."

Right, and we agree, and we agree, and so...

So, where's the snafu?

Is it that the federal government in Washington just doesn't see these veterans?

Guam is so far away?

No, no, I don't think so.

No, I think Guam is very well known, you know, to big V.A., to Washington, D.C. And so our particular health care system has actually received several million dollars-- several million dollars-- that's being spent directly on veterans in the Pacific.

HINOJOSA: But the highest elected official on the island, Governor Eddie Calvo, said that the Senate cut mental health care funds for Guam two years in a row.

And I advised them-- I said, "Folks, "these are statistics of all our veteran population, some of the statistics on the suicides that we've had."

But since we don't have a vote in the Senate, uh, you know, that would mean that they would have to have the heart of Mother Theresa, because it does not affect their home state.

Is the United States right now living up to its... its commitment to Guam in terms of what it's doing for the veterans?

The federal government has not done their part to assist a very patriotic group of American citizens fighting in so many distant lands, in areas that have never tasted democracy, yet these American citizens of Guam really have not felt what true democracy is all about.

What do you call a people... that cannot vote for their representatives that make the laws?

What do you call a people that can't vote in an electoral college to elect a chief executive that will send us to war?

To not offend anyone, I guess I'll keep it as a non-self-governing territory.

But I guess in a 19th-century sense, you could call it a colony.

HINOJOSA: Back at home, Roland fills his days by caring for his mother, who has Lou Gehrig's Disease.

ROLAND ADA: I worry about my mom.

I try and take care of her a lot.

So that's kind of what keeps my mind off of stuff.

Recently, I actually had an episode where I exploded-- you know, lost my temper-- had some very bad thoughts about doing very bad things to people or myself, so... HINOJOSA: Roland had a few appointments at the V.A.

clinic but decided to stop seeing his psychiatrist.

ROLAND ADA: I've already done it, and it didn't help.

It actually made me more frustrated.

Then I just put it to the side and say, "Screw this."

I ended up going back to alcohol.

It always just numbed everything.

But then it's like... soda.

You shake it too much, and you open it, and it explodes.

That's kinda how I am.

Is you can only shake me so many times before I explode.

HINOJOSA: Victor feels like he's stabilizing and on the road to recovery and thinks he might be a bridge for other veterans in need of help.

I wanted to go back to combat, but my doctor says no.

You still want to go back to combat?

I have a different mission now.

What's that mission?

Helping veterans.

That's my mission.

And there are a lot of them on Guam.

Yes, a lot.

A lot.

HINOJOSA: And despite what she's endured, Maggie's patriotism hasn't dimmed.

If you were asked to re-enlist and serve today...

If they were to say... "Pack your bags," I would go again.

In a heartbeat.

And become a soldier.

And become a soldier.

For your country.

For my country, for my island.

And I'm not trying to prove anything.

It's called pride.

God bless you.

Happy Liberation Day.

HINOJOSA: The V.A.

clinic now has three doctors on staff who can treat PTSD and plans to expand its facilities.

Victor is training to become a social worker for the vet center.

Roland's mother passed away.

And the Navy plans to construct a new base on Guam and relocate 5,000 Marines and their families to the island.

HINOJOSA: Next time: Long Beach, California.

where an alarming number of Cambodian-American students are not graduating high school.

Attending class is difficult for me.

Our families physically have been fractured.

If you don't pass, there's no graduation at the end of this rainbow.

HINOJOSA: To learn more about this and other episodes of America by the Numbers with Maria Hinojosa, please visit pbs.org.

♪ ...proud to be an American♪ ♪ Where at least I know...♪ America by the Numbers with Maria Hinojosa is available on DVD.

To order, visit shopPBS.org or call 1-800-PLAY-PBS.

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