Argentina

Decades After Falklands War, Argentina Strives to Help Veterans Overcome PTSD

Today marks the 33rd anniversary of the Falklands War. In Argentina, more than 20,000 Falklands War veterans cope with the after effects of the nation’s only war of the 20th century, but only 600 of them have received therapeutic assistance from the Health Center of the Armed Forces' Veterans of the Malvinas unit in Buenos Aires, a government institution created to prevent suicides among veterans.

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Decades After Falklands War, Argentina Strives to Help Veterans Overcome PTSD

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BUENOS AIRES, ARGENTINA – Manuel Ricardo Daer, 52, adjusts his broad back in the seat, intertwines his fingers and mentally returns to the battlefield of three decades past, when he fought the British in the Falklands War, a bloody struggle for control of an archipelago off the Argentine coast.

Daer’s countenance remains serene as he talks about the bombings and air raids, and then of the death of his best friend. But when his gaze falls on his upturned left arm, where he has had a tattoo of the Falkland Islands inked, his voice cracks and his eyes moisten.

He got the tattoo – featuring the light blue and white of the Argentine flag – a few months ago to mark on his body the experience that forever changed his life.

“Look at how I improved that I can say it to you without crying,” he says. “Not because I am a rock, but rather because I have cried myself out.”

When the war began in 1982, the armed forces ordered all 18-year-olds serving a year of compulsory military service confined to their barracks so they could be sent to the islands, which Argentines call the Malvinas.

Daer, the only son of a widow, was a few weeks away from completing his year of service when the order was issued. He had to say goodbye to his mother from the wired fence at his barracks.

During the war, Daer worked in communications, away from the front line. For Daer, trauma came in the form of his comrades’ wounds and deaths.

Today, Daer works eight to 10 hours a day as the administrative deputy director of the Chamber of Deputies, one of the nation’s two legislative chambers. He also serves on the legislative staff of the Combatants of Malvinas Subcommittee.

But, the emotional scars of the war remain.

For years, Daer remained quiet about the war. Panic attacks compelled him to ask for help. He began receiving treatment in 2007 at the Center of Post-traumatic Stress Malvinas Argentinas, the army’s center for treatment of PTSD. He continues to engage in therapy because it helps him endure his mood swings.

Three decades after the war, Argentina’s armed forces began providing medical care for veterans with chronic symptoms of combat stress, including depression and substance abuse. Health centers in different parts of the country provide these services to veterans cost-free.

The government aims to extend such treatment to more war veterans by opening more such centers this year.

The Falklands War was fought from April 2 to June 14, 1982. The military government that then ruled Argentina had fallen into disfavor with the public for implementing unpopular economic measures that led to increased unemployment and a drop in wages, University of Buenos Aires history professor Raúl Isman says.

Argentina claimed sovereignty of the Falkland Islands, a territory on its continental shelf, after winning its independence from Spain in 1816. In 1833, the United Kingdom forcefully occupied the islands. Argentina made diplomatic entreaties to Britain over the years.

The Argentine government set out to reclaim the Falklands territory – after almost 150 years of British occupation – in 1982 in the hope that a victory would win it popular support and political strength, Isman says.

Many Argentines resented war veterans for the nation’s defeat, aggravating the stress of combat trauma.

In recent decades, Argentina has filed complaints regarding sovereignty over the islands with the United Nations, Isman says. Most recently, it registered a complaint with the U.N. Special Committee on Decolonization in December 2014.

Last Tuesday, British Defense Secretary Michael Fallon announced that Britain was increasing its military presence in the islands and spending 280 million pounds ($415 million) to prevent any hostile actions.

During the 10-week Falkland Islands War, 22,857 Argentine troops fought 25,948 British forces, according to the respective nations. Argentina lost about 650 troops while Britain lost 237.

After failing for decades to address the PTSD of war veterans, the Argentine army opened the Center of Post-traumatic Stress Malvinas Argentinas in 2004 to provide cost-free services to veterans of the war.

In 2012, this service was extended to members of the Argentine navy and air force at Veterans of the Malvinas, a program at the Health Center of the Armed Forces, says Col. Augusto Esteban Vilgré La Madrid, the center’s general director.

The government is now creating a national network to extend mental health services to 20,000 combat veterans. Already it has opened similar centers in Córdoba and Curuzú Cuatiá in the Corrientes province.

Although the war lasted just two and a half months, it was a grave ordeal for Argentine forces. Veterans of the war say they suffered from insufficient training, winter clothing, food and weaponry.

Daer says he had only shot a gun once before going to war.

Jorge Luis Toledo Chiqui, another veteran of the war, says he ate rotten onions and raw lamb meat to survive.

And after the war, Toledo Chiqui faced the stigma of having served in an unpopular war, predisposing him to mental health challenges.

“I returned from the Falklands the 26th of June, and the 29th I got sick in bed with a liver illness,” Toledo Chiqui says. “I was bedridden three months without moving, and that was terrifying because I could not reintegrate, return to my social life. When I got out, I could not find work because of my veteran status. And from there, my depression was increasing.”

Psychiatrist Daniel Mosca, coordinator of the Area of Traumatic Stress and Anxiety at the Hospital of Psychiatric Emergencies Torcuato de Alvear in Buenos Aires, says negative stimuli such as bloodshed, cold and hunger aggravated the fighters’ sense of helplessness, of having no escape from life-threatening danger. Upon returning, their inability to reconnect with people deepened the guilt and terror that combat induced.

“When I returned from the Falklands, I left my job and my studies,” Daer says. “I spent six months locked up in my house, isolated, not wanting to talk to anyone. I could not rid myself of that feeling of having left people that I loved for dead over there. Without the help of my friends and family, I don’t know if I could have continued going forward.”

Social support is one of the pillars that enables people to endure and overcome trauma, Mosca says.

However, the soldiers who returned home from the Falklands War defeated were not received with recognition and honor, he says.

“If the lack of immediate psychological assistance is added to this, the result was, unfortunately, deadly for many,” he says.

As of 2013, 589 Argentine Falklands War veterans had died, according to the Ministry of Defense. Their causes of death are not matters of record. Suicide is suspected in hundreds of cases.

State health agencies were poorly equipped to treat traumatized war veterans, Mosca says. PTSD was poorly understood, and treatment of the disorder was in its infancy.

In 2003, the Argentine army sent Col. Vilgré La Madrid and psychiatrist Martín Bourdieu to the United States to study the work of its Department of Veterans Affairs.

Upon return, Vilgré La Madrid and Bourdieu began operating an army health center specializing in PTSD. Since then, about 600 veterans of the Falklands War have received cost-free psychiatric and psychological care at the center, Vilgré La Madrid says.

The Veterans of Malvinas team comprises 18 physicians, psychologists, psychiatrists, occupational therapists and nutritionists, Bourdieu says. The team provides weekly psychological care, including individual and group therapy, and biweekly psychiatric care.

Trauma occurs when one’s life is at risk, whether in fact or according to one’s perception, Bourdieu says. If trauma is not treated immediately, symptoms such as anxiety and insomnia can become chronic and increase in severity.

Daer says his experience confirms Bourdieu’s prediction.

“I am a person with many ups and downs, very anxious,” he says. “At one moment I am very happy, and other moments very sad. If I do not take the pills that the psychiatrist prescribes me, I do not sleep well; I sleep as if I am dreaming – and they are almost always nightmares. Although sometimes I do not remember, I realize that it is not a pleasant dream because I wake up startled or with anguish.”

Daer visits a psychologist once a week and sees a psychiatrist every 15 days. The treatment enables him to direct his thoughts in a more positive way and increase his self-esteem.

Before the armed forces began to provide mental health care for veterans, 20 years after the war, some veterans sought out professional care on their own.

One such veteran is Toledo Chiqui.

Toledo Chiqui has had periods of depression since returning from the war. But unlike Daer, he obtained therapy on his own. At first, counseling and psychiatric care cost him a lot of money, he said. Eventually he was able to obtain health coverage through employers. When he learned of the aid offered by the center, he decided not to go.

“I set a goal that I do not have to resort to therapy every time I feel bad,” Toledo Chiqui says. “After much experience, I have to learn to handle myself with my own means.”

Veteranos of the Malvinas provided an unprecedented 3,500 consultations in 2014, says Dr. Enrique Stein, a psychiatrist and president of the Armed Force’s mental health team. A consultation does not always mean that treatment began.

The center expects demand to continue as more veterans become aware of the availability of care, he says.

One of the significant challenges facing veterans today is the lack of mental health professionals who specialize in PTSD in veterans, forcing the center to launch training programs that will only bring results over the long term. The lack of trained professionals has delayed the opening of the new centers up to now.

“The veterans’ problem in Argentina is a subject of the present, and not of the past,” Stein says, “because they have suffered the abandonment from the state, once the war ended. And we still must settle that debt as a society.”

The Health Center of the Armed Forces also serves active military personnel who are participating in peacekeeping missions in Haiti, Cyprus and the Middle East, Bourdieu says.

For Vilgré La Madrid, the PTSD program is an important evolution in the Armed Forces. It signifies a paradigm shift in the military’s approach to mental health. The military must maintain a high quality of service and strive to reach combat veterans throughout the country, he says.

He hopes to see the program expand in 2015.

“We no longer have a passive attitude, of waiting, but rather proactive,” he says. “We are consolidating a network of primary care at the national level so that the veteran who comes to a consultation for physical ailments, for example, can understand that what he suffers from is PTSD, and may be referred to receive the appropriate treatment.”

Toledo Chiqui and Daer also stress the importance of avoiding a slide into isolation. Veterans must talk about their war experiences, transmitting them to future generations.

“This not only helps preserve the memory and reclaim what belongs to us, but it is also repairing,” Daer says.

 

 

Natalia Aldana, GPJ, translated this article from Spanish.