Care after Combat

January 17, 2020

Doctor’s Log - Star Date 17012020

"Learning from the lessons of history"

January 1879

In 2011 the film "Zulu" was voted the British Army's favourite film of all time. It depicts the battle of Rorke's Drift in 1879: Eleven Victoria Crosses were awarded in action that saw approximately 140 defenders hold their position against a force of around 4,000.

The 11 Victoria Crosses awarded for valour at Rorke's Drift are still more than for any other military action in history. It was a tale of heroism that gave Victorian schoolboys their own version of the 300 Spartans at Thermopylae. But what what eventually happened to the recipients. It seems the curse of Rorke's Drift never left them.

Lt. John Chard VC

"...hopelessly slow and slack... With such a start as he got, he stuck to the company doing nothing…..he placidly smokes a pipe and does nothing.” (Company Commander, RE)

Lt. Gonville Bromhead VC

"...the height of his enjoyment seemed to be to sit all day on a stone on the ground smoking a most uninviting looking pipe. The only thing that seemed equal to moving him in any way was any allusion to the defence of Rorke’s Drift. This used to have a sort of electrical effect on him, for up he would jump and off he would go, and not a word could be got out of him."

Of the other nine VCs:

Sgnt John Williams, who won a VC after clawing through the hospital's walls to help its patients, had ruined his hands for life.

Pte Henry (Harry) Hook, stabbed above the right eye by a Zulu assegai weapon, grew an unsightly lump on his head. The government found him a job as a janitor at the British Museum, but he died from tuberculosis in 1905.

Pte Robert Jones shot himself 19yrs later - coroner’s verdict of “suicide whilst temporarily insane”, buried with headstone facing away from the church in Herefordshire.

When he was buried rules dictated that he could not even be placed in the consecrated ground because he took his own life. The authorities of the time are understood to have relented and agreed a compromise which meant his gravestone faced away from the church.

More recently, SAS veteran Pete Winner, who fought in the Falklands, the Middle East and helped end the 1980s Iranian Embassy had hoped to have Jones’ headstone reversed to face St Peter’s Church in Withington, Herefordshire.

But after learning of the campaign Pte Jones’ great-granddaughter Gillian Evans, intervened saying that the family would like his final resting place left the way it is. widow who asked for it to be placed the wrong way around so that it could be seen from the road.

Pte William Jones mind never recovered from that battle. He was found wandering around Manchester, destitute and penniless, having sold his VC for £6.00. He endured long periods of destitution, recurring nightmares of Zulu attack and in later life (1912) found wandering with his granddaughter in his arms, convinced Zulus were attacking his home in Manchester.

Pte John Manley was sentenced to 18 -months imprisonment with hard labour for assault in 1885.

Pte William Neville was sentenced to 12 -months imprisonment with hard labour for assault in 1885.

Pte John Wall was discharged as “insane as a result of intemperance” in 1881.

However, although records are far from complete the majority of defenders seem to have adapted successfully (although ill-health etc was fairly common).

Colour Sgt Frank Bourne (later Lt.Col., DCM, OBE) lived happily, actively and productively until the age of 91 years (in 1945). (But tragically, the actor who played him in the film died of an overdose...)

January 2020

Society has a moral obligation and duty of care to service personnel and their families, as enshrined within the Armed Forces Covenant.

Some facts:

  • Ex-service personnel account for 5% of the custodial population with > 84% former Army personnel.
  • There is compelling evidence that indicates a higher prevalence of health issues among service personnel compared to the general public.
  • Regulars who leave the service early and reservists have a higher risk of developing mental health problems than their peers.
  • Whilst PTSD accounts for a small number (6-8%), combat troops and reservists are at a greater risk of developing it.
  • Outcomes for early service leavers are likely to relate to pre-enlistment risk factors.
  • Drinking to excess levels is widespread in the Armed Forces - Prevalence rates of substance misuse in veterans appear to be higher for both rates of smoking (26% versus 19%) and alcohol misuse (39% versus 25%).
  • Self-harming is thought to be associated with pre-enlistment factors.
  • Rates of self-harming behaviour range from 1% to 5.6% in serving personnel, this compared to 4.9% rate in the general population and 10.5% for veterans.
  • Self‐harm has increased over time in the UK serving and veteran community.
  • Lifetime self‐harm increased significantly from 1.8% among serving personnel and 3.8% among veterans in 2004/06 to 1.9% and 4.5% in 2007/09 and to 4.2% and 6.6% in 2014/16 in the two groups, respectively.
  • Veterans were consistently significantly more likely to report lifetime self‐harm than serving personnel. Significant determinants of lifetime self‐harm included current mental disorder symptoms, stigmatization, poor social support, suicidal ideation, and seeking help from formal medical sources.
  • Help-seeking veterans present with complex mental health difficulties in conjunction with frequent comorbidities, high rates of pre-enlistment vulnerabilities, and social and physical problems.

"Our work is never done"