KANDAHAR, Afghanistan - Vimy Ridge. Dieppe. Normandy.
Rwanda. Bosnia. Afghanistan.
Canadian troops have witnessed some of the most tragic events of our times, as peacekeepers and as soldiers at war.
Those experiences can haunt them for years after they leave the battlefield, and the Canadian Forces is trying to battle the post-traumatic stress disorder among its ranks.
"Our guys see incredible, terrible things," one soldier at a Canadian base in one of the most violent districts in Kandahar province said in a recent interview.
Soldiers of the base had come under heavy fire from insurgents. Mortar attacks were so regular for a period of time that soldiers were wearing their flak jackets and helmets to eat dinner and walk to the showers.
Several times they carried the caskets of dead friends down the tarmac, draped in the Canadian flag, for one final flight home.
At the tiny trauma centre at the base in the restive Zhari district, Dr. Linda Rodger said dealing with "stress injuries" starts well before soldiers touch the ground in Kandahar.
The pre-deployment training includes courses in coping with stress and trauma. There is also mental health screening for soldiers before they are ever deployed.
Social workers and padres come to the base, offering spiritual guidance or just a compassionate ear. But most importantly, each member of the unit is looking out for the other, she said.
"We all live together. You can't help but know when something happens," she said.
Rodger, who's been in the military since 1990, said soldiers will seek her out to talk - "in the shower, in the gym, in the kitchen lineup."
One veteran of the peacekeeping mission in Croatia said the Balkan conflict was the beginning of the end of the old way of thinking.
"Back then, if a guy had trouble, he was kind of peeled off the herd. It's not the same any more."
The soldier said steps have been taken to deal with the emotional scars of war.
"I don't think anybody who watches a soldier disappear on an IED (roadside bomb) can not be affected," the soldier said. "But we can talk about it now. No one's going to look at you and call you a wimp."
For veterans of the world wars the return home was much different.
Bryan Quinlan, 87, a combat pilot for three years in the Second World War, still has memories that send shivers up his spine.
He flew a torpedo bomber in the Mediterranean, then hunted German submarines from the air. His brother was killed and is buried in Denmark.
But the feelings to those experiences could never be revealed.
"In those days if somebody lost his nerve, and there were many who did and didn't want to fly anymore, they were actually listed as LMF - 'lack of moral fibre.' In other words, they were a coward."
In the First World War, soldiers who turned and ran, even from certain death, were shot by commanders, he said.
It was the startling and high-profile breakdown of former general, now Sen. Romeo Dallaire, that focused attention on stress injury in the armed forces.
Dallaire, who witnessed the 1994 genocide in Rwanda as head of a UN peacekeeping mission, was found in 2000 half-conscious and curled in a fetal position in a Quebec park. In his autobiography, the former soldier admitted he twice tried to kill himself.
"I think he embarrassed the military and the Canadian government to start allocating funding," said Dr. Greg Passey, a soldier turned psychiatrist and one of the country's leading experts on "operational stress injury."
Passey, who spent 22 years in the forces and now heads a new operational stress injury clinic in Vancouver for the Canadian Forces, conducted a sweeping study in the 90s but little came of it.
Since then there's been a huge change, he said.
About five per cent of soldiers returning from Afghanistan show signs of depression or post-traumatic stress, he said, compared with one out of every five soldiers who came back from the former Yugoslavia.
From 2001 to 2006, there was a 40 per cent increase in the number of soldiers being treated for traumatic stress due to greater awareness, he said.
For veterans of the world wars and early peacekeeping missions, "it was not appropriate to talk about it," Maj. Annie Bouchard, commanding officer of Role 1, the Canadian medical clinics throughout Kandahar.
Many came back scarred emotionally, as well as physically, and never recovered. But for today's soldiers, mental health is as important as physical health, she said.
"They know that if they want to be the best soldier, they have to do it," Bouchard said.
There are trained medics, social workers and psychiatrists in theatre to try to deal with stress before it becomes a post-deployment disorder.
A social worker went to a base in the restive Zhari district a couple of days after two soldiers from their unit were killed in a double IED blast. The company commander had requested the visit and 20 to 25 soldiers went to speak to her.
Post-traumatic stress disorder doesn't happen in one day, Bouchard said, and it doesn't happen to everyone.
"The guys we've seen, it's all different events, different reactions," she said. "We're all human. Reactions are variable. For one person it can be an IED blast; for another just going outside the wire at all is triggering a reaction.
"Some people can pick up the pieces of their friend to put in a body bag and it won't bother them after; others can't deal with it."
Admitting traumatic stress doesn't have the stigma it once did in the Canadian Forces, said Bouchard.
Of the 2,800 troops in theatre, there have been five medical repatriations for people who weren't coping well with being in Afghanistan. That low figure suggests to Bouchard that pre-deployment preparation and followups after the tour ends is working.
Yet earlier this year, the Military Police Complaints Commission sounded the alarm about PTSD in its annual report. The report said that of more than 8,000 Afghan veterans who filled out a post-deployment questionnaire last year, about six per cent had symptoms of post-traumatic stress disorder and/or major depression.
The commission said civilian social agencies that care for soldiers and their families noted a growing number of domestic violence cases. Last year, Ottawa committed $98 million to hire another 218 military mental health specialists, but the military was struggling to fill the positions and the time frame has been extended to 2010.
In June, the House of Commons defence committee released the results of a year-long study of PTSD among Canadian Forces.
The committee heard expert testimony that of some 27,000 soldiers and aircrew who have rotated through Afghanistan, approximately 3,640 members are expected to exhibit some sort of mental health concern. Of those, roughly 1,120 could exhibit symptoms of PTSD, based upon a mathematical model.
Last summer, the Canadian Forces officially launched a mental-health awareness campaign and by this fall, hoped to have 10 operation stress injury clinics like Passey's up and running across the country.
Commodore Hans Jung, commander of the Canadian Forces Health Services Group, said soldiers who have served in Afghanistan are subject to a post-deployment screening between three and six months after their return for mental health and lifestyle issues.
The forces has done about 13,000 such assessments now and "the vast majority from Afghanistan come back well."
Jung said studies have found that about 6.5 per cent develop operational stress injury - a military term, not a medical one. But some also come back and experience "post-traumatic growth," he said.
"You go to Afghanistan, you see the devastation there and a lot of our, especially younger, soldiers come back with a much greater appreciation of Canada as a whole, our role in the world, and they feel a tremendous sense of satisfaction for themselves and what they've been able to contribute."
For those who do suffer a disorder, about a third recover completely, another third function normally but continue to suffer highs and lows, and another third will not recover, he said.
Jung said soldiers are getting better at seeking help but it doesn't mean the stigma has gone away.
Stigma among the rank-and-file is worse than organizational stigma, he said.
"The whole culture of the organization of the military is to be self-sufficient, be gung ho, be out there.... we drive that sense of independence, confidence into individuals," Jung said.
"That's our next challenge, is really breaking down self-stigma."
KANDAHAR, Afghanistan - Vimy Ridge. Dieppe. Normandy.
- March 01, 2010 - 14:39
My heart goes out to all of the soldiers who are fighting for our country. I do not think that they get the recognition that they deserve for all the hardship, mentally and physically, that they endure.
We need to do more to support our soldiers and veterans. A lot of these men and women spend the better part of their lives fighting for us and our freedom.
- Crack in the sidewalk
- March 01, 2010 - 14:39
I think its great the govt has stepped up and finally recognized these problems as major issues within all ranks of the canadian forces. I hope all troops get the necessary emotional support they need. Keep up the good work and god bless.