Post deployment medicals a must

Canadian Forces Army News ^ | 2007-05-11 | Sgt Mike Van Den Broek

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EDMONTON, Alberta — The majority of Task Force 1-08's 2500 troops came from Land Force Western Area's Regular Force brigade, 1 Canadian Mechanized Brigade Group.

Did you know that, upon their return to Canada, soldiers of a task force are required to conduct a post deployment medical screening within 180 days?

The process is fairly simple. The first step is to book a time at the base medical clinic for an enhanced post deployment screening. Next, a soldier must complete a questionnaire pertaining to health issues, updating of injuries and general well being.

This is followed by a tuberculosis (TB) skin test. TB is a serious disease that usually attacks the lungs, but can also affect other parts of the body, including the lymph nodes, kidneys and urinary tract and bones. Although it is completely curable, the disease remains, according to Health Canada, a major health problem that kills almost two million people worldwide annually.

In a TB test, a thin needle is injected into the skin and a very minute amount of noninfectious TB protein is deposited. Within 48 to 72 hours, a hard swelling usually develops at the site of the injection if the patient is infected with TB. If TB has been contracted, a physician may recommend antibiotic therapy to cure the infection before it develops into a disease. A TB sufferer must take antibiotics for a minimum of six months.

"This process is important for many reasons," indicated Lieutenant-Colonel Henry Flaman Senior Medical Advisor for 1 Health Services Group headquarters at Edmonton Garrison. "The screening is designed to detect or bring out any changes in the soldiers health since his or her redeployment back to Canada. The TB test is very important for soldiers returning from Afghanistan were tuberculosis is rampant in the population. Wouldn't you want to know if you are exposing your family to such a disease?"

Another important aspect of postdeployment screening is the mental health of a soldier. This is done by a series of tests and an interview that bring to light any problems in the readjustment to family life and Canadian society.

"We equate importance of the mental health portion of the postdeployment screening to that of the medical portion," stated Lieutenant-Commander Mercy Yeboah-Ampadu, a social worker with the mental health unit of 1 Field Ambulance.

"We recognise war or combat has a mental health component to it and there is a psychological effect that some or many of our soldiers may be experiencing. We look at overall mental health and signs like depression, anxiety, panic disorders and signs, and symptoms of posttraumatic stress disorder, as well as substance abuse. The reason for screening is for early identification and early intervention to bring normalcy back into the soldiers life."

The screening also provides a database for Canadian Forces Health Services to identify trends and health issues and take preventive measure in regard to future deployments. In brief, postdeployment screening is vital for the well being of soldiers and those around them.

For an article on the enhanced post deployment medical screening process for Operation Apollo, please click on http://www.forces.gc.ca/health/information/op_health/op_apollo/pdf/engraph/screening_process_e.pdf

Article by Sergeant Mike Van Den Broek Photos by Dennis J. Mah and Master Corporal Peter Simpson

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Box quote:

The screening is designed to detect or bring out any changes in the soldiers health since his or her redeployment back to Canada.

— Lieutenant-Colonel Henry Flaman

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[Candor7]

Some soldiers who suffer from post combat mental trauma need the support of familiar structure.

That means that their process of demilitarization needs to be more gradual. Prompt release into the covilian world is part of the problem. They need the support and structure of military life and camaraderie, for their very lives depended on that for long periods of time.

So they should stay in military service with family visits home for a period until established guidelines for re-entry into civilian life at home can be handled by them.Until then they should stay on base, go through a gentle resocialization process, visit family, but stay on base until their survival instincts and fight or flight issues are stabilized.

Some men are more easily understood by "imprinting" psychology theory. Fighting and killing is the antithesis of family life. The adjustment for some men is so staggering that they cannot reconcile the two in the same world. For others , it is relatively simple. It has to do with the ability to cultivate a peaceful mind and heart in extreme circumstances, and we have many Canadians who can teach that, but it takes time, and an environment of gradual change.

The military should be cognizant of this fact, and act accordingly.

[Candor7]

One thing I forgot to mention , in my previous post, that an examination of how the PTS issue has been handled by other cultures reveals some very interesting things.

In old Japan, samurai had the same issues that modern combat veterans do. Some could not handle being around their families and friends, and became stone cold killing machines, inhuman. Those men in old times were asked to go into a Zen meditation retreat, to repair their " Kokoro" ( mind/hearts) , and reestablish the ability to generate compassion. It was a painful , process of gentle discipline, and al;most always successful. The famed swordsman, Miyamoto Mushashi had to go through this process in order to become complete as a human being. He did so thanks to a little courageous monk known as Takuan, but could not repair himself enough to trust himself to enter into a relationship with the love of his life. The story is well known in Japan, and by some Canadians who are versed in Asian history.

I mention this, because the process of adjusting to post combat environment is not something to be ashamed of. Extinguishing human life as if it means nothing, and then going to an environment where preserving human life is paramount, is very difficult, and raises spiritual issues, not just medical ones. The Japanese had a particular way of handling it in olden times, unfortunately lost by the time WWII came along, and thus the inhumane tragedies committed by the Japanese military in China and elsewhere.

In the best of worlds, soldiers who suffer from PCTS would receive the mental/meditation practices which could easily save them, but we are too deeply suspicious of them because of the cultural gap.

In any case, those individuals I have known as friends and acquaintances, who suffered from it, have often successfully received instruction in Zen, or practiced one of the Zen Arts, to transcend their mental suffering. One of the greatest warriors I know teaches this way, and has saved many in this ancient way, mostly Vietnam and Gulf War I veterans. He himself was taken prisoner in Mongolia by the Russians, spent WWII in a coal mine in Afghanistan, where the survival rate was 1 out of 60, and was not repatriated to Japan until 1953. He adjusted to civilian life using the old methods handed down to him, and now teaches them in the USA. I wish that some of our soldiers could engage these teachings for it would mean their salvation. His name is Shibata Sensei, 20th in his samurai family line, kyudo master, and bow maker to the imperial court of japan. I often joke that he is a modern day "Yoda." The force is definitely with him ( LOL). I have been his student for 21 years:

http://www.ryukokyudojo.org/

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Agreed.

Soldiers returning from combat zones need time to decompress in a structured environment.

Witness the episode in Edmonton last Friday:

Stressed-out soldier involved in standoff

I do see a problem with the post-deployment psych evaluation. How many soldiers will be willing to disclose emotional issues to a military shrink for fear of screwing up their careeers. Also, some issues take time to become manifest.