Friday, 16 August 2013

2002 - The 1982 South Atlantic Conflict`s Aftermath


- Eduardo C. Gerding  -

International Review of the Armed Forces Medical Services- Vol. 75/2, 2002, p 84-94


Argentine Navy
 

The 1982 Malvinas war had 74 days of duration and 33 fighting days. It had a code name Operación Rosario for the Argentines and Operation Corporate for the British. It took 746 Argentine lives, 255 British and 3 inhabitants of the islands (9) It was certainly no picnic. The total amount of deaths produced by the sinking of the cruiser ARA ‘General Belgrano’ represents 50 per cent of all the Argentine casualties in the conflict. Thirty per cent were 18 years old conscripts (14,37,38) . Tables 1,2,3,4,5.6,7.8.9,10. The Royal Navy paid a terrible price. Five British ships were sunk and at least twenty others hit. Eighty per  cent of the British losses were due to the Argentine Air Naval Task Force (8). Mount Longdon, Mount Tumbledown and Goose Green were bloody ground battles which ended with fixed bayonets and hand-to-hand fighting (5,6,10,11,39) Fourteen per cent of casualties were due to trench foot (15).

About 73% of the patients assisted at the Puerto Argentino Military Hospital presented gunshot wounds in their limbs (6). About 53,3% of the British with combat wounds were due to high velocity bullets (6). About 40 % of the surgery made by the British was done in Argentine soldiers (6). Since 1982 there has been 264 Argentine veterans and more than 100 British veterans committing suicide. A research made in 1995 with Argentine war veterans showed that 58% experienced depression episodes related with the conflict ,and 28% had ideas of suicide (33) .


Between 1990 and 1998, 150 people were discharged from the British forces for Post traumatic stress 43 . An update is being presented.

Historical Vignette
 

The Argentinian government had claimed the Islas Malvinas since Argentina achieved independence from the Spanish in the early 19th century. Argentina had a settlement on the islands in 1826. Most of the settlers were expelled by the USS Lexington in 1831 and a British expedition took control of the territory in 1832. British sovereignity was declared in 1833. There were 150 years of arguments and protest.

Dr Scheina wrote in 1983 ´ The most persistent error concerning the Malvinas dispute is the belief that the problem had its origin in the recent past. Some have suggested that the Argentine Government was trying to divert attention from the country monetary inflation. And the commonly hold notion is that the invasion to the Malvinas was intended as a mean of forestalling a nationwide labor strike. Simplistic misconception such as these can lead to erroneous conclusions that the status quo has been restored and the problem solved. In fact neither is true´ ´ The war was caused by an unanticipated series of events heaped upon years of frustration´ ´ Few wars can be scheduled, most must be fought with what is already on hand or immediately available´ (37) More than a 100 books have been written, medical articles, poems, films, a military march, T-shirts, decals and even a video war game called Malvinas 2032 (22). The Chilean Armed Forces aid to the British was well depicted by former tory Rupert Allason ( Nigel West ) in his book ´The secret war for the Falklands´ ( Clarín, October 23rd,1998 ).
 

The conflict had a profound effect on the lives of ordinary men and women, particularly the service personnel involved in the conflict and the families they left behind. Even those who were not wounded physically found that they had changed on their return home .

Jus ad bellum ( the justice of the war ) and jus in bello ( justice in the war) (13)
 

Just ad bellum: Although the British invoked Art 51 of the United Nations Charter ( “ inherent right of individual and collective self-defense if armed attack occurs ” ), such attack would have to imply lives threatened. According to Fotion the British attack was unjustified because the lives and well-being of the islanders were not apparently at immediate threat from the presence of the occupying Argentine troops (12)
Just in bello: According to Ron Smith, British moral position was compromised by the extent to which it unwittingly drew Argentina towards the initiation of conflict and by the inevitable disproportion between the value of the interests being defended and the cost of that (40)
 

The sinking of the ARA ‘General Belgrano’ 
(14, 27, 28, 37, 41)
 

The sinking of the cruiser marked a turning point as it stopped the peace plan proposed by the President of Peru. Kevin Myers of The Irish Times summarized the action ´the sinking of the Belgrano seems a shocking, dreadful act and the loss of life perfectly inexcusable´ and ´in my mind the sinking remains unjustifiable and unnecessary´ According to Norton-Taylor ´It took two years to force Margaret Thatcher to admit the damaging truth about when the Belgrano (4) was first sighted.´ On July 2000, relatives of the service personnel filled a human rights action against the British Government to the European Court of Human Rights in Strasbourg claiming that that the attack violated war conventions set out in The Hague Agreement of 1907. The human rights convention stipulates that applications must be made within six months after all available remedies have been pursued in the domestic courts. Strasbourg rejected the case ruling that in this case the relatives were expected to file a complaint in the British courts ( while the country was still at war ! ) within such period. The knowledge that Britain was receiving satellite and aircraft reconnaissance information from the USA led to the decision to retire the fleet to secure coastal waters. Thus the Navy remained intact in spite of confronting the 3rd most powerful fleet in the world. Figure 1

 
Figure 1 - The sinking of the ARA ´General Belgrano´

(Cruiser ARA ‘General Belgrano ‘-Photograph taken by the author at the Puerto Belgrano Naval Base)
On May 3rd, 1982, the cruiser ARA ´General Belgrano´( former USS Phoenix ) was sunk 360 miles away from the British task force and steaming away from it. It was hit by two British Mark 8 torpedoes from the HMS Conqueror (Commander Chris Wreford-Brown). The first torpedo (the death blow) hit under the aft of 5-inch gun director, and the second hit on the port side forward of number one turret. Evacuation was made in absolute darkness. The total amount of casualties (30% of a 1,091-man crew) represents 50% of all the Argentine casualties in the South Atlantic. Thirty per cent of the casualties corresponded to 18 years old conscripts. Eighty four percent of casualties died as a direct result of the torpedoes. Sixty nine survivors suffered from hypothermia and 18 died from this condition (14) .The cruiser was navigating at 35 knots, the water temperature was 2ºC there were gales of 100 km/h, a wind chill factor of –20ºC and waves were 9 meters high. The ship sank 15 minutes later at 55º18´South, 61º47´West. On September 2000, Narendra Sethia, a junior officer on board the HMS Conqueror in 1982, had a moving meeting in Buenos Aires with Commander Bonzo , Captain Nestor Cenci ( third in charge ) of the Belgrano, and Captain Washington Barcena captain of the destroyer Hipolito Bouchard (38)

The Argentine pilots 
Five Skyhawks and nineteen Mirages were destroyed by the American-made air-to-air Sidewinder missile AIM-9L (45). Approximately 109 argentine aircrafts were lost during the entire war. SAMs accounted for shooting down about 38 percent of them; the Harrier´s kill ratio was 28 percent. More than half of SAM kills were attributed to land-based Rapier and shoulder-fire supersonic Blowpipe missile (19) The courageous Argentine pilots demonstrated their aerial skill by flowing a low-altitude, terrain-hugging profile over West Falkland islands to use the rolling hills as a shield against British radar detection (9) RFA Sir Galahad and RFA Sir Tristam were hit by air strike at Fitzroy. The Sir Galahad was burnt out. Fifty men died of which 32 were from the 1st Battalion Welsh Guards aboard Sir Tristram (29). Forty Welsh Guardsmen who were trapped in the burning shell of the warship Sir Galahad later sue the Defense Ministry. Many of the survivors say they have since been unable to work and some claim not to have had a full night´s sleep since the attack (43) The Type 21 frigates used aluminium in their superstructure which gave significant raisings in the weight of the ship above the water line but the metal loses strenghth in the fire (29). Seven Type 21 ships served in the Falklands conflict, with HMS Ardent and HMS Antelope being sunk by Argentine bombs.  A case of friendly fire was registered among British forces (31) Six Sea Harriers were destroyed, of which 2 were lost to enemy fire, one to small-arms fire and one to a Roland surface-to-air missile (29).  On June 22, 1998
General Sir Richard Johns of the Royal Air Force honored the Argentine pilots who died in Malvinas and in November 2001, Alan West, Chief of the Royal Navy, who was the former commander of the HMS Arden sunk by Argentine planes honored our dead in the Puerto Belgrano Naval Base. (Clarín November 28th, 2001)

The Air Naval Task Force

During the South Atlantic conflict five British ships were sunk and at least twenty others hit. British losses numbered 256 for the entire war but almost 80 percent of these came at the hands of the Argentine Air Naval Task Force. (8)
Five warships and one civilian ship sunk, Eleven warships damaged in varying degrees. The campaign had cost the British 255 men killed (113 of the Royal Navy) and 777 wounded (436 of the Army ) The Argentine Super Etendards
carrying the French-built Exocet AM39 missiles (range,45 miles) advertised as the “fire and forget missile” sank the destroyer HMS Sheffield (twenty Britons are killed. Sixteen, were from south east Hampshire). Captain James Salt recalled ´We could feel the heat of the deck through our shoes, the superstructure was steaming. Paint on the ship´s side was peeling off. The area where the missile penetrated the hull was white hot´ Three weeks later another missile slammed into the side of the MV Atlantic Conveyor (19 Britons are killed and Captain Ian North sinks with his ship). On June 12th the ´County´ class cruiser HMS Glamorgan was hit as it bombards on shore by a shore-launched MM-38 Exocet missile from a range of 30 Km (thirteen Britons are killed) (37) .They did not sink the Glamorgan, but the ship was very badly damaged and 13 men killed. Figures 2, 3 and 4
 
Figure 2-The sinking of the HMS Sheffield
The Argentine Super Etendards carrying the French-built Exocet AM39 missiles (range,45 miles) advertised as the “fire and forget missile” sank the Type 42 destroyer HMS Sheffield (twenty Britons are killed. Sixteen, were from south east Hampshire) One of the missiles penetrated the ‘Shiny Sheff.’ Into the electronic fire control room. It ignited everything around it, flames fueled by the missiles own propellant. It came in low, about six feet above water level and exploded outward and upward. The whole working area of the ship was in flame and poisonous smoke quickly engulfed the ship. (Gross,David-The Sinking of the Shiny Sheff-Yorkshire Online Magazine-HMS Sheffield and the Falklands)
 
Figure 3 The Air Naval Task Force
The anchorage area became known fittingly as ´Bomb Alley´. An A4 Skyhawk of the Third Naval Attack Squadron flows at low level to attack and sink HMS Ardent .
HMS Argonaut and HMS Brilliant were badly damaged. Argentines lost two planes.
R.G.Smith had a special affection for the little A4 Skyhawk. The superb painting was the front cover of the Proceedings-May 1983 - It was kindly authorized by Sharlyn Marsh, daughter of late artist R.G.Smith, and Carol Mason Director of Member and Customer Services - US Naval Institute.


 
Figure 4 The first Argentine air naval combat
Coastguard PNA GC-83 ´Rio´Iguazu´ in Puerto Argentino (1982)
( Built by Blohm + Voss GMBH, Germany ) 

( Kindly submitted by the Prefectura Naval Argentina) 
Upper left corner CSEN Oscar Guzmán.Upper right corner CSEN Roberto Daniel Borello.


On May 22, at 08.00 AM the small Z-28 class coastguard PNA GC-83 ´Rio´Iguazu´ was transporting up to Darwin port two 105 mm OTO Melara Pack Howitzers from the Nº 4 Airtransport Artillery who were reinforcing the Nº 12 Infantry Regiment in Goose Greeen. There were as well 20 Army men under the orders of a Second Lieutenant. The Rio Iguazu had only two 12.7 Browning machine guns in stern. The crew was composed by 15 members of the Coast Guard, and Guzman, a Corporal male nurse of the Navy which belonged to the Azopardo Naval Arsenal.
They were attacked by two Sea Harriers who fired their 30 mm guns and unsuccesfully bombed them. Cabo Segundo Ametralladorista Julio Omar Benitez died while firing the planes. Cabo Segundo Maquinista José Raúl Ibañez took his place in the machine gun . (La Prensa, May 19th, 1992) (24) . Foreman Juan José Baccaro was hit by shrapnel in his spine, lungs and left leg (he still keeps 61 fragments in his body). Cabo Segundo Alberto Bengoechea received a grapeshot in his left thigh. An Army soldier received a hit which lodged few millimeters from the thoracic aorta.
The Cabo Segundo Enfermero Oscar Guzman had to treat seriously wounded people. Another coastguard, ‘Islas Malvinas’ was attacked as well by a British Sea King. 
The Cabo Segundo Maquinista Antonio Ramón Grigoletto received a hit in his abdomen. He was treated by Cabo Segundo Enfermero Roberto Daniel Borello. In 2000, by resolution EMGD Nº 240/00 Guzman and Borello were both awarded the Medal for Courage in Combat. (‘Prefectura en Malvinas’-Círculo de Suboficiales de la PNA- ISBN 987-96455-0-2)


Ground Battles (10,11,13,24,29,35,37,39)
 
The majority of the Argentine casualties resulted from ground actions supported by artillery and naval gun fire. It should be said that Mount Longdon, Mount Tumbledown and Goose Green were bloody battles which ended with fixed bayonets and hand-to-hand fighting. Mount Longdon was organized on company “B” of the Army´s 7th Regiment `Coronel Conde´, well known as the regiment which liberated Chile from the Spaniards. It was reinforced with mortars, a section of engineers and another of Marine Corps.
They faced the British 3 Parachute Regiment. The Argentines had 36 deaths and 84 wounded. At one point during the attack, an entire British company was held up for hours by a single Argentine sniper. After 10 hours Mount Longdon was in British hands but after paying a high price. When the day broke 18 Paras and an attached Royal Engineer were killed and 47 were injured. Three more Paras and a REME craftsman were killed in the subsequent shelling.
Brigadier Julian Thompson said `I was on the point of withdrawing my Paras from Longdon. We couldn`t believe that these teenagers disguised as soldiers were causing us to suffer so many losses´ The 7th Regiment could manage to expatriate their war flag. The 2nd Scots Guards seized Mount Tumbledown after a fierce battle against the 5th Marine Corps Battalion ( BIM5 ) (707 men) considered by the British as probably the best Argentine unit. The Marines received 1000 rounds per hour from 54 firearms placed West, fire from 3-5 ships placed North and South and air attacks from planes and helicopters. Argentines suffered 16 deaths and 64 wounded. Mount Tumbledown was captured at the cost of 9 British lives and 32 wounded .
Notwithstanding, Captain Robacio considered that , at least where the BIM 5 fought, 359 British died. (24)
Major Gen Nick Vaux had praise, but regrets for the performance of the Argentine Marine Corps Battalion who fought bravely and well at Mount Tumbledown on the outskirts of Port Stanley´ (42). An Argentine Marine Corps
was made up of 70% conscripts, 25% non commissioned officers and 5% commissioned officers. Goose Green was a hard slog for the Paras as they found the Argentineans well dug in and waiting for them. The battle lasted more than 40 hours. The 2 Para lost 17 killed and over 30 wounded In Sapper Hill the Marine Corps didn´t allow either that the flag of the Company Mar could fall in the enemy´s hands. During the conflict 40 argentine gendarmes participated and suffered 7 deaths which was the biggest casualty proportion in regard to the men who participated. (24) . Most military operations took place between April and June with strong winds ( 26 Km/h average ). Fourteen percent of casualties during the Conflict of Malvinas were due to trench foot. (15)
Argentine troops presented 290 cases of trench foot (164 were from the Army ) after an exposure of 65 average days to adverse conditions. The BIM 5 presented only one case of  trench foot ( it required the amputation of his right big toe ) after an exposure of 71 average days. The British presented 70 cases of trench foot after an exposure of 24 average days. The Argentine Army had 14 cases of malnutrition and the Marine Corps one. There were some cases of diarrhoea among the 3 Commando Brigade Royal Marines who fought in Mount Harriet. In Two Sisters. the 45 British Commando suffered a friendly fire clash between their mortars and a patrol mistaken as Argentine.


According to Major José Yofre (Argentine Army ) in Puerto Argentino there were 195 deaths : 1 Officer every 2 Petty Officers and every 9 conscripts. Of the 9,804 soldiers in Puerto Argentino died 1,99% of the total ( In Vietnam 1,11% ).
Human Rights The South Atlantic Conflict was “fought with remarkable respect for decency on both sides” (18). Notwithstanding there were issues to be considered as 

a) The employment of cluster bombs against Puerto Argentino, 
b) The use of phosphorous munitions (both by British forces). 
Both cases “clearly contradicting the principle of proportionality” (5). 
c) According to the book Green - Eyed Boys by Adrian Weale and Christian Jennings (Harper Collins) there was
the murder of an unidentified Argentine conscript after the Battle of Mount Longdon by retired British Army corporal Gary Sturge. An near-arrest was made in Buenos Aires of British veteran Ken Lukowiac who promoted his book Soldier´s Song in which he confesses to killing an Argentine soldier after the surrender at Mount Tumbledown.(17

d) The RFA Argus was a unit capable of transporting helicopters and not a hospital ship in the strict sense (International Defense Review 2/1991)

Demalvinization
 

The term desmalvinización was coined by the french politician Alain Rouquié and was to be used in different symposium since june 1982 (7).
The word allegedly implied a process followed by military, civilian governments and relevant groups of the society backboned by the media. It meant many things :

a) To act as if the Malvinas war never took place, 
b) To consider the soldiers as inept `children of the war` (even a film depicted them this way) ,
c) Consider a foolish thing to have fought against the British power and
d) Mixing the involvement in the South Atlantic conflict with the political and social upheaval the country was experiencing at that time.


Post Traumatic Stress Syndrome (PTSD) (46)
 

1. The traumatic events
 

People who are exposed to traumatic events are at increased risk for PTSD as well as for major depression, panic disorder, generalized anxiety disorder and substance abuse. They may also have somatic symptoms and physical illness particularly hypertension, asthma and chronic pain syndromes. Medical
Officer Barry Elsby published an interesting observation on high rate of male breast cancer in Malvinas. (British Journal of Hospital Medicine, 1993, Vol 49, Nº 11). Acute stress disorder is not always followed by PTSD.


2. PTSD diagnosis
 

To be given a diagnosis of PTSD a person has to have been exposed to an extreme stressor or traumatic event to which he or she responded with fear, helplesness or horror and to have three distinct types of symptoms consisting of 
  1. Reexperiencing of the event,
  2. Avoidance of reminders of the event and
  3. Hyperarousal for at least one month. Symptoms of hyperarousal refer to physiological manifestations such as insomnia, irritability, impairedconcentration, hypervigilance and increased startle reactions. The diagnosis iseasily missed as sometimes there is an overlap with depression or other anxiety disorders.
TSD may appear between 3 weeks and 30 years after the traumatic episode (Davidson JRT in Sinopsis de Psiquiatría-Kaplan H., Sadock B-Edit.Intermédica Bs As 1995). PTSD can become a chronic psychiatric disorder that can persist for decades and sometimes for a lifetime marked by remissions and relapses.
The immediate precipitant is a situation that resembles the original trauma in a significant way (a war veteran whose child is deployed to a war zone). (Friedman, Matthew-Post-Traumatic Stress Disorder: An Overview, Darmouth Medical School ).
 

2.1-The flashbacks
 

John, a British who fought in the Malvinas says “When we got back there were no offers of help”. The flashbacks were triggered by a variety of things including news items and war films but we got no psychological help. It was OK being with my mates, but I had real problems with other people. People thought they could pick your brains for a pint of lager. Then the first question was the most insensitive you can ask anyone who´s just back from combat : If you killed anyone. That puts you in places you don´t want to be. It can instantly set off a flashback. John was violent and depressed. His behavior even led to a three-month spell in prison for GBH “I had no fear of anything. I wasn´t scared of the police, of authority. Nothing. And of course I was suffering from awful nightmares and flashbacks” (Ebner, Sarah -War´s mind field-The Guardian May 2, 2001)


2.2-PTSD Measurements

 

PTSD can be measured through the Mississipi Scale for PTSD (combat and civilian version), Clinician Administered PTSD Scale for DSM IV and portions of the Minnesota Multiphasic Personality Inventory.

3. PTSD researchs
 

The US National Institute of Mental Health considers that 30 percent of men and women who have spent time in war zones experience PTSD (1,000,000 war veterans in Vietnam). A group of 64 British war veterans who were still serving in the British Army were studied by O’Brien et al and compared with a group of matched controls. Half the veterans reported some symptoms of PTSD and 2% were rated as having the complete PTSD. Presence of the symptoms was associated with intensity of combat experience and the retrospective report of emotional difficulties in the initial period of return from the war. Tables 11 and 12 (30). There were no Royal Army Medical Corps psychiatrists in the Malvinas war (Price HH-J R Army Med Corps 1984;130:109-113). Interpersonal violence gives rise to PTSD more often than natural disasters. The unexpected death of a loved one makes this event the single more frequent traumatic event to occur in both men and women accounting for 39 percent of cases of PTSD in men and 27 percent of cases in women. According to the US National Center for PTSD, 25-75% of survivors of abusive or violent trauma report problematic alcohol use. this is associated with a chaotic lifestyle, which reduces family emotional closeness, increases family conflict and reduces parenting abilities. Table 13. A direct link between a particular traumatic stressor and a specific crime can be evidenced.

Crimes at times literally or symbolically recreate important aspects of trauma. Environmental conditions may be similar and finally life events immediately preceding the offense can realistically or symbolically force the individual to face unresolved conflicts related to the trauma.

4. PTSD Biologic responses (46)
 

The body´s biologic responses in the aftermath of a traumatic event may perpetuate a state of fear that interferes with the restoration of feelings of safety particularly if the result leads to further events such as war. Figure 5
  • Increased circulating levels of norepinephrine.
  • Increased reactivity of adrenergic receptors.
  • Increased levels of thyroid hormone.
  • Increased reactivity of the amygdala and anterior paralimibic region to trauma related stimuli.
  • Decrease activity of anterior cingulate and orbitofrontal areas.
  • Differences in hippocampal funcion and memory processes dependent of the hippocampus.
  

Figure 5
5. PTSD treatment (46)
 

Clinicians can provide a non critical ear and emphasize that patients are not alone. There are possible differences between Western and non-Western societies. Research has demonstrated the effectiveness of such techniques as exposure therapy (helping patients confront painful memories and feelings), cognitive therapy (helping patients process their thoughts and beliefs), anxiety management and interpersonal therapies helping patients understand the ways in which the traumatic event continues to affect relationships and other aspects of their lives. The best therapeutic option for mild-to- moderately affected PTSD patients is group therapy. It helps to reduce isolation and stigma. In any future conflicts it would appear essential to provide an acute counseling service as did Stőfsel in The Netherlands after passengers were held hostage in a train (Stőfsel W. Psychological sequelae in hostages and their aftercare-Dan Med Bull 1980;27:239-246)
 

5.1- Medication for PTSD
 

Serotonin-reuptake inhibitors are a first-line medication because they are safer and better tolerated. Sertraline (Zoloft®) and paroxetine (Paxil®) are the only agents that have been approved by the Food and Drug Administration for the treatment of PTSD. If there´s no response to an 8 week trial of serotonin-reuptake inhibitors it should be switched to nefazone (Serzone®) or venlafaxine (Effexor®). If there is a partial response, divalproex (Depakote®) should be added. Benzodiazepines should be avoided in PTSD. Alprazolam and clonazepam are no better than placebo immediately after a traumatic event. Foa EB et al have published thorough guidelines for PTSD treatment (Expert Concensus Guideline Series- J. Clin Psychiiatry 1999; 60 Sept 16)

Suicide Statistics of War Veterans
 

1. The Vietnam case
 

According to a study by Tim A.Bullman and Han K.Yang in the Federal Practitioner (12) (3):9-13 (March 1995) “no more than 20,000 Vietnam Veterans died of suicide from the time of discharge through the end of 1993”.
Notwithstanding, in Chuck Deans´book Nam Vet the author states that “Fiftyeight thousand plus died in the Vietnam War. Over 150,000 have committed suicide since the war ended”. Mr. Dean was the executive director of Point Man International a Seattle based, non-profit support organization dedicated to healing the war wounds of Vietnam Veterans. According to a VA doctor the number of suicides was 200,000 men and the reason the official suicide statistics were so much lower was that in many cases suicides were documented as accidents, primarily single-car drunk driven accidents and self inflicted gunshot wounds that were not accompanied by a suicide note or statement. In the end was a primarily an act of kindness to the surviving relatives. The Suicide Wall web site is an attempt to determine how many Vietnam Veterans have actually taken their own lives, as well as a place to memorialize and honor those who served their country, and finally a place which may serve to help prevent suicides in the future.



2. The Malvinas case
 

2.1-Argentine suicides
 

According to Héctor Beiroa President of the Argentine Federation of Malvinas War Veterans there have been 264 veterans committing suicide since 1982. There are no official data of suicides neither from the Argentine Federation of War Veterans nor from the Province of Buenos Aires Federation of War Veterans. According to Ruben Rada, President of a Malvinas War Veterans Centre, in 1995 they´ve got in contact with an statistics from the Campo de Mayo Army Hospital informing about 236 cases. They´ve been updating such figure ever since. In the city of Buenos Aires, according to the National Institute of Statitics and Census (INDEC), between 1986-1990 there was a 30% increase of suicides. An update research using the judicial morgue showed 333 cases in 1991 and 499 cases in 1994 (near a 50% increase) (Rodriguez Garin, Eduardo Dr et al-Suicidios consumados por pacientes psiquiatricos-Alcmeon- Año VIII-Vol 6- Nº1, Junio 1997).

In Argentina in 1992 there was a peak of 12 suicides per day in people 20-24 years old. In 1996, Argentina had a males suicide rate of 9.9 per 100,000 . Each suicide directly affects ten people and indirectly affects a further 50.

2.2- British suicides
 

Seven men who served in the Falklands killed themselves in 2001. One Falkland Military Association official said that the figure of suicides was half of that for the number who went to war. Post-war suicides put the figure of more than 100 (South Atlantic Medal Association –SAMA).

In 1996, the UK had a males suicide rate of 11.7 per 100,000. A guardsman who survived the Bluff Cove Sir Galahad Disaster was forced to sell his cooker only days before he hanged himself. Another Welsh guardsman hanged himself in his father´s home last Sunday symbolically (16).
Charles Nish Bruce a professional parachute dropped himself from his plane (1400 meters height) while flying with his girlfriend. (La Prensa , January 14th,2002)
 

2.3-Possible causes of the Malvinas
        war veterans suicides
 

  • The lack of a job, 
  • The discrimination. 
  • The lack of social recognition
  • The impossibility of overcoming the stressful situations experienced during the war, 
  • Problems with their wives, 
  • Alcohol and drugs addiction and
  • Paranoia. 
According to Denzil Connick (one of SAMA founders), the cause would be in part the tendency of the soldiers of hiding their feelings and the lack as well of means to face the post traumatic depression of war veterans.

What is being done for the Malvinas war veterans
 

Table 14 shows the steps that have been taken since 2001 at the INSSJP Medical Area by the author’ s team. The only way to ascertain the true prevalence of psychiatric casualties of the war among serving soldiers and their relatives is by epidemiological studies (Jones GH- J R Coll of Gen Pract, Jan 1987). Notwithstanding two elements conspire against this last: the soldier’s reluctance and inaccuracies.

One of the few clinics in the UK that specialize in treating traumatised ex- service men and women is Ty Gwyn nursing home in Colwyn Bay, north Wales. Dr Dafydd Alan Jones has treated in the past 10 years more than 2,000 ex-servicemen suffering from post traumatic stress disorder (PTSD), many of whom have fallen into dire straits because of the lack of specialized care.

` The welfare of ex-servicemen is a major social problem, many end up homeless, unemployed, divorced and develop drug or alcohol problems ` says Dr Jones. `These men do not regard themselves as being ill, they`ve been psychologically injured. Many feel out of place in psychiatric units or day centers and drop out of drug or alcohol treatment programs because they believe staff cannot understand the traumas they have been through. Nor do they mix well with other service users who often find
them intimidating
` (1,2)


Malvinas War Veterans ad honorem works for the community Malvinas war veterans have helped the victims of floods in the Provinces of Chaco, Corrientes, Entre Ríos and Santa Fe. They’ve helped to extinguish fires in the Amazonas (Roraima state in Brazil) and participated in the reconstruction of two damps (Campo Gallo in Santiago del Estero). The war veterans assisted in the patagonic reforestation and in the struggle against cholera, Chaga’s disease and HIV infections. They’ve served dining rooms for old people under extreme poverty in Corrientes and Chubut.


War Veteran’s Associations
 

The Argentine Republic Malvinas War Veterans Federation was founded in 1990 and gathers 135 veteran`s centers. It works very closely with the Veteran’s INSSJP Managership . The National Coordinator of Former Malvinas Combatant`s Centers controls the organizations of Great Buenos Aires (4709 Veterans), La Plata, Mar del Plata and the provinces of Corrientes and Chaco.

The National War Veteran`s Commission was created in 1994 and is the official link with the government authorities. The War Veteran`s Day ( April 2nd ) was granted as a result of the veterans’ struggle and established in 2000 by Law 25.370. In Britain, Dr Rick Jolly, who was in charge of a field hospital in Ajax Bay founded the South Atlantic Medal Association (SAMA). In 1999 Prince Charles and Dr Jolly honored the dead soldiers at San Martin square (Buenos
Aires) . The same thing was done a year before by President Menem at Saint Paul’s crypt in London. Figure 6



Figure 6 The Malvinas War Veterans: a brotherhood in fatigue duty fighting for their rights 33
(Photograph kindly submitted by Veteran Miguel Giorgio - Federación Argentina de Veteranos de Guerra de la República Argentina - Piedras 930-Piso:1º-Buenos Aires)

The 1995 research over 145 war veterans showed that 36.6% had disintegrated families with abandon of one or two parents. A great amount (35%) of their fathers died immediately after the Malvinas war thus increasing the veteran’s sense of guilt. About 64% belonged to a low income class. According to a 1997 research 25 to 39% suffered of PTSD and 88% of them never attended a health center (4) . 74 % suffered discrimination when searching a job (20). Only 12 % owned a property and 35% lived in precarious situations. They felt shame and rejection (‘Only the good guys didn’t return’) (25). Today war veterans have a 70% unemployment rate (Argentina has a 22% unemployment rate). Since 1998 about 11,680 war veterans have joined the benefits of the INSSJP health and social network. Their medical assistance is considered in National Laws 24.736/96 and 25.210/99. The hospital fee exemption is considered in the Buenos Aires Municipal Decree 4475/82. They have obtained the following benefits between 1982 and 1999: 13 National Laws and 3 Decrees, 4 Laws and 2 Decrees in the Province of Buenos Aires and 7 statutes in the Capital city. About 13,800 have a National Life Pension and a Provincial Life Pension whose amount varies according to the Province. Besides there are 70 of them working nationwide at the INSSJP. The rest remain in active duty, are liable to receive retirements and have the social benefits of their Armed Forces. There have been some very successful veterans as the well known tenor Dario Volonte, a survivor of the General Belgrano, and Osvaldo Omar De Felippe a soccer player of Huracan team and veteran of the Army 3rd Regiment of La Tablada. (Clarín 7/2/98 and 11/5/99).



Argentine and British joined forces  
During the South Atlantic conflict, an Argentine Air Force helicopters squadron composed by two Bell 212 and two Chinooks played an important rol as they rescued seven pilots (one British), the 25 survivors of the Rio Iguazú Coast Guard and an observers’ patrol. This pilots were later assigned to Cyprus with the UN blue helmets and they shared missions with the British forces they once had as foes. (23) Since November 1993, at UNFICYP Argentine and UK forces operate together in Cyprus controlling 3% of the island territory. In Cyprus 18 the Mobile Force Reserve (MFR) is under a British Major command while an argentine second in charge operates a section (CFIM Luis Patoco - UNFICYP Personal communication)












 







Table 13
How may families react at home to the war veteran with PTSD

  1. Emotional Reactions: Family members feel hurt, frustrated etc.
  2. Isolation from other people
  3. Difficult communication with the war veteran.
  4. Overinvolvment with their children´s lives: The war veteran suffering from PTSD may become overinvolved with their children´s lives due to feeling lonely and in need of some positive emotional feedback or feeling that the partner can´ t be counted on as a reliable and responsible parent.
  5. Sleep disruption as a result of the war veteran´s sleep problems (reluctance to sleep at night, restlessness, nightmares or violent sleepwalking)
  6. The relative may be abused, frightened and betrayed.
  7. The war veteran´s addiction may give rise to domestic violence problems.
  8. Suicide: PTSD are more prone to contemplate and attempt suicide than similar people who have not experienced trauma. This places an unavoidable stress on families.
 Table 14
Steps that were taken since 2001 at the INSSJP War Veteran’s Health Area 
Organization
 
  • The Mission, Objectives and personal responsability of the War Veteran’s areas placed in every INSSJP delegation were submitted to the central authorities.
  • The nationwide war veteran’s medical profile requirements were presented to the central authorities who deal with different clinics and Hospitals.
Instruction
 
  • The few war veterans who work at the area attended an intensive course of Health Promoters at the Buenos Aires University thus multiplying the prevention and assistance of their own comrades.
  • Besides the author, a Licentiate in Psychology ( wife of a war veteran retired Navy Officer ) and war veterans Health Promoters dictate courses in the different provinces to professionals, war veterans and their families on PTSD etc which involves a feed-back process.

Assistance
 
  • Once a week a Self-knowledge Workshop directed by Licentiates in Psychology Elisabet Wagemans and Alberto H. Dupén ( a retired Navy officer ) is being held at the area for veterans and their relatives to increase their self-esteem and cope with different situations. The veterans are somehow reluctant to recur to other mental health institutions 25
  • An agreement has been submitted for a free psychological assistance to War veterans by the ‘John Fitzgerald Kennedy ‘ University ( Buenos Aires ). 
  • A free phone call line for psychiatric emergencies is already working organized by the Province of Buenos Aires War Veterans Association. The INSSJP Health Area is organizing such facility nationwide through the FACAP ( Argentine Federation of Psychiatric Chambers and Associations).
Research
 
  • A centralized painstaking national monthly follow-up is being made of  all the office hours medical assistance and surgical procedures to which war veterans and their families have been submitted. 

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