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26 May 2020
 
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  Invisible injury

By: Sharon Adams
Article originally featured in Legion Magazine

VVi 29 Feb 2020

If a soldier’s moral conscience is damaged, the problem and the solution can both be hard to find.

January 30, 2019 — For almost a decade, Canadian Armed Forces reservist James (not his real name) has been haunted by memories from one of his three tours to Afghanistan—haunted by something he did not do.

An Afghan civilian reported to him that a member of the Taliban had set an improvised explosive device (IED) along a route travelled by patrols returning to base. The informant said he could see the terrorist lying in wait, ready to blow up the next military vehicle to come by.

Although he was in radio contact with a Canadian convoy using that road, James had been ordered to pass such information only up through the chain of command, where it would be verified and orders issued. He was warned that charges would be laid against anyone who passed along information otherwise. “They said, ‘We’re a unit, one organization…the information is going to come from us, not you as an individual.’”

So, that’s what James did. Sent the information up. “And waited, and waited, and waited.”
Then over the radio came words he dreaded to hear: “Contact IED.”

“I heard the second-by-second, minute-by-minute update.” Heard the reports as ammunition in the LAV started to cook off. Heard the desperate comments of comrades in failed rescue attempts.

“I’ve always questioned if that delay, because of people’s egos, because of following rules, if that cost lives…in situations like this, in situations of life and death, fuck all that, none of that matters.

“I have to live with that every day. Every time I see these guys’ pictures in the news, every time I remember that tour, it affects me.
Those guys would possibly be here and aren’t because I followed the rules. I obeyed the orders. I have that guilt.”

James is still serving and asked not to be identified in this article. Although he has been treated for post-traumatic stress disorder, those unextinguished feelings of guilt are a hint of a different kind of injury, one as old as armed conflict.

“Those unextinguished feelings of guilt are a hint of a different kind of injury, one as old as armed conflict.”

Moral injury. It’s an injury not to the body, not to the mind, but to the inner self, the conscience or moral compass—some say the soul or spirit.
Moral injury can coincide with a post-traumatic stress injury, but it can be altogether separate. Not everyone who has PTSD also has a moral injury and conversely, not everyone with a moral injury has PTSD. But some people suffer both.

Veterans with moral injury can be haunted by something they did not do, as in being unable to rescue someone or intervene in wrong-doing—or something they did do, such as having to choose which life to save, or accidentally killing an ally. It can be caused by witnessing or learning about an act that goes against deeply held beliefs, such as the killing of civilians or children, a massacre, or enemy execution of a helpful civilian.

And it can be caused by betrayal of deeply held beliefs—lives unnecessarily sacrificed; orders violating rules of engagement, military ethical codes or the Geneva Convention; a devastating lie from a source who should be entirely trust-worthy; dishonourable conduct.

“One of the most frequent causes of soul injury is betrayal,” said Vancouver psychologist Marv Westwood. Feeling abandoned by comrades or chain of command when ‘I’ve got your back’ is a mantra of service; being shamed and shunned by the very people they were willing unto death to serve.

Over the years, Legion Magazine has interviewed many veterans who have suffered moral injuries. A sniper in Croatia in 1993, who helplessly watched the massacre of an entire village, but was prevented by rules of engagement from intervening. A submariner who survived the fire on HMCS Chicoutimi in 2004, and felt sailors’ lives were held cheap by command and survivors’ health needlessly endangered.

One young soldier during the October Crisis in 1970 had his faith in the military and his own moral compass shaken by a warning that he could be ordered to shoot fellow citizens, leading him to question, even now, whether he would have pulled the trigger.

A female soldier in the early 2000s was shamed into feeling guilty and disloyal for reporting sexual assault by an officer in garrison, while also feeling violated by the assailant, whose duty it was to protect her, as well as the chain of command that belittled her.

Shame and guilt are hallmarks of the injury, negative emotions that become life’s background noise, an earworm of intrusive thoughts, a combination of memories and self-condemnation looping through the mind. They lead to self-medication with drugs and alcohol and other actions described in psychology literature as “parasuicidal behaviour.” People can become so demoralized they reject anything that might raise the spirits, so hopeless and suspicious they can trust no one. Shame and guilt lead to many attempted—and too many successful—suicides.

Moral injury violates core beliefs about what is right and wrong, good or evil, just and unjust. It goes far beyond hurt feelings, to the anguish of dark nights of the soul.

“The profession of arms is profoundly moral in nature,” said Megan M. Thompson, a research scientist with Defence Research and Development Canada. From a government’s decision to deploy to an army’s strategic plan to the actions of an individual soldier manning a gun—decisions at all levels involve justice, fairness and the right thing to do. “It involves high stakes, deeply held values and the well-being of others.”

Ethics separates combat and warfare from murder and slaughter—and demands a higher standard of behaviour from soldiers, sailors and air force members—on and off the job. Military professionals in Canada are guided by written rules and provided with ethics training. “Ethics is a fundamental principle of the culture of our men and women in uniform,” said Department of National Defence spokesperson Ashley Lemire.

DND’s Statement of Defence Ethics requires military members “at all times and in all places” to respect the dignity of all persons, serve Canada before self, and obey and support the law, acting with integrity, loyalty, courage and stewardship. That’s backed up by the Defence Ethics Programme Code of Values and Ethics, which requires members to behave “in a manner that will bear the closest public scrutiny.”

The code gives many examples, but says “expected behaviours are not intended to cover every possible ethical situation or issue that might arise.” It also encourages members to seek advice and support from “other appropriate sources within their organization.”

“Moral injury violates core beliefs about what is right and wrong.”

For 26 years, retired chaplain Jim Short was one of those sources. Moral injury “has been around since the beginning of time, the beginning of warfare,” he said.

But the term was not in use in the 1990s, at the start of his career, when the military was dealing with fallout from a peacekeeping mission during which a Somali citizen was beaten to death by members of the subsequently disbanded Canadian Airborne Regiment. Nor in Bosnia, where Canadian soldiers witnessed massacres, genocide and other atrocities; nor Rwanda, where they dealt with child soldiers. The 1990s brought attention to the need for ethics training, said Short. Coincidentally, it also marked the evolution of diagnosis and treatment of post-traumatic stress and preventive training.

But “when I went to Afghanistan, people were distressed, and it wasn’t related to a particular incident of trauma,” as with post-traumatic stress. Among the troubled souls were soldiers with moral and ethical dilemmas related to killing the enemy or who felt guilt and shame from celebrating insurgents’ deaths.

Chaplains are non-combatants, but go on deployments, sometimes accompanying troops even to forward operating bases to support and help those who come under fire. “We don’t carry weapons,” said Short. “And we don’t have the power of command. We’re the one profession that has equal access to all ranks. A troubled private can’t just knock on the door of a major and say, ‘Hey, I want to talk to you.’ But they can do that to a chaplain. We’re approachable.” They help all troops, regardless of denomination or religion, or lack thereof.

Chaplains are experienced in determining the needs of those who’ve been through moral trauma, and are often the first step to wellness for the morally injured. “You cannot simply quote the ‘just-war’ theory to them. Sometimes they need to connect to their religious roots or they may need to talk about their concept of good and evil and God. They may need to be connected with other people who have gone through the same thing.” Short knows this from personal experience: he himself has suffered a moral injury and is being treated for post-traumatic stress.

Many chaplains have therapeutic training, work in mental-health clinics or as part of a mental-health team. “A really important function is to identify and refer.”

Confidentiality is key. “Troops know that if they go to the medical people, things are going to start to be written down.” Chaplains recognize that “they may be having a struggle, but are able to function fairly well, so we don’t want to make them a casualty,” either on deployment, or once they return home.

But what can and should be done to help those with moral injury? Clouding the issue are disagreements about what moral injury is, how it should be treated, whether it is preventable, whether it’s a leadership issue, a legal issue, or a spiritual issue best handled by chaplains, and what is the most effective method of ethics training. Research provides few answers, particularly in Canada, with its smaller military and pool of scientists.

Evidence-based methods of prevention and treatment are slow in coming, because there is, as yet, no diagnostic criteria for moral injury. Some argue there never should be, because it is not a medical condition.

“The problem is, what can you do to treat and prevent it when it hasn’t even been defined yet,” said CAF senior psychiatrist Colonel Rakesh Jetly. “There’s a risk of putting a medical model onto something that may not be an illness. That doesn’t mean people aren’t suffering. But it may be premature to call it an illness when it may just be a distressing part of the human condition.”

Some people believe moral injury is a disease unto itself, others that guilt and shame are a complicating factor of another disease or condition, such as PTSD. “Some believe it may explain why a lot of people don’t get better with traditional [PTSD] therapy,” said Jetly. Recent U.S. research documented that while most patients showed improvement of symptoms, two-thirds still met the criteria for PTSD diagnosis after treatment with the two most widely used therapies.

Some argue that PTSD treatments involving repeatedly recalling the trauma in order to normalize the fear reaction may actually worsen the shame and guilt of a moral injury. Others report success in adapting PTSD therapy for those with moral injury.

DND and CAF are heavily involved in international research to define military moral injury, establish a way to measure it, identify potentially morally injurious events and facilitate prevention and treatment. Research so far has established a relationship between ethics, morality and mental health, said Jetly. Having mental-health issues raises the risk of moral injury, and moral injury can cause mental-health problems.

As the international military debate goes on, as researchers try to make sense of it all, soldiers, sailors and air force personnel are dealing with the effects of moral injuries and the situations that give rise to them.

Data from the 2013 Canadian Forces Mental Health Survey shows 58 per cent of personnel deployed overseas between 2001 and 2013 were exposed to events that heighten risk of moral injury; 39 per cent were unable to help injured women or children; 32 per cent felt responsible for Canadian or allied personnel; six per cent had difficulty distinguishing civilians from combatants.

“We ask our soldiers to make ethical decisions under circumstances that can—but do not always—affect moral decision-making,” said Thompson. Aside from operational stressors—harsh weather, rough living conditions, sleep deprivation, hunger, thirst, fear—military personnel, including junior ranks, have to make quick decisions under great stress and often with insufficient information. The right thing to do may not immediately be clear. One set of values may violate another and a negative result will happen regardless of action taken, or inaction. The mission may have several competing and incompatible goals—combat, area stabilization, a humanitarian component.

Modern conflict presents unique challenges, said Thompson. Insurgents don’t wear uniforms. They have moral codes quite different from western forces and play on those differences to provoke a disproportionate response or retaliation.

Those responses, and other ethical infractions and misconduct which lead to moral injury, can be curbed, reducing dishonourable behaviour and long-term mental-health problems, including suicide, said U.S. Army Colonel Christopher Warner at a NATO seminar on moral injury.

A decade ago, research found less than half of U.S. troops serving in Iraq and Afghanistan believed non-combatants should be treated with dignity and respect. A third described local populations in derogatory terms. One in 10 had damaged civilian property and five per cent had hit or kicked civilians. A third believed torture is acceptable to save a comrade. Less than half would report a team member’s unethical behaviour. “A reduction in nearly all levels of behaviour” followed the institution of ethics training, which included teaching leaders how to maintain ethics on the battlefield, said Warner.

Canada invests in career-long ethics training, said Lemire, including an ethics module for new recruits, annual ethics training, leader-led dialogue, briefings, awareness activities and scenarios. Its Road to Mental Readiness training is also geared to improve performance in the short term, and long-term mental health.

But nothing prepared Tim Garthside for the moral and ethical situations he faced in Afghanistan.

“The defining piece of soul injury is the depth of injury,” says Garthside, a signals operator during a day-long firefight in Panjwaii on Aug.

3, 2006, which took out an estimated 90 Taliban at the cost of four Canadians killed and at least 10 wounded.

Garthside’s job that long, long day was to relay messages to and from infantry in Panjwaii and CAF headquarters. His shift started with an IED incident.

“There’s people injured and one dead, but they’re taking fire,” he recounted. “Medevac will not fly in if they’re taking fire; they need a clear landing zone. I have in one ear the infantry asking for medevacs and in the other ear, HQ telling me that no one’s coming.”

Elsewhere in the battle, Taliban were being rooted out and eliminated in airstrikes directed by an onsite Afghan counterintelligence source. A pilot reported a man on a roof armed with a rocket-propelled grenade gun. Garthside asked command what to do, and relayed the kill order. “They cut him in half, and within five seconds, intelligence says their phone went dead. So, in effect, I killed a guy that was enabling us to save Canadian lives.”

At the end of his shift, an officer asked if he was OK. “I said I was fine,” Garthside said, something he continued to say for years. But he wasn’t.

Back home, he had trouble sleeping. “I wasn’t in the infantry and I wasn’t on the front line. I thought there’s no way there could be anything wrong with me because I didn’t get shot at or blown up.” Insomnia morphed into depression, physical and psychological pain, isolation from friends and family, self-medication with alcohol and drugs.

“It took six years for me to want to kill myself,” said Garthside. He received immediate support at a branch of The Royal Canadian Legion, where he met a veteran who referred him to a psychologist and the Veterans Transition Program, a peer group program which has helped hundreds of veterans with PTSD over the past 20 years.

“It 100 per cent saved my life at the time,” he said. So much so that he volunteered for the program, eventually participating in training videos involving therapeutic enactment. During one session, “I realized I blamed myself for the death of that Afghan man.” He calls it a soul injury. “The psychological pain was like that of being cut in half. And it ran to the very core of who I am.”

“The degree of pain they experience is tied to the degree of goodness,” said Westwood, co-founder of the program, which has been altered to accommodate those with moral injury. “Although the morally injured often see themselves as a failed person, their anguish actually proves how honourable they are.”

This program helped Garthside wrestle his demons, but there havebeen few randomized control trials comparing effectiveness of different treatments, no handy list of evidence-based therapies.

“In the end, it may be that there is no one right treatment that will be effective for all situations,” Thompson wrote in a CAF report. Since moral injury knows no borders, ideally a multinational, randomized control trial could identify best practices for the care of moral injury, which could be tailored for differences in national and cultural practices and individual clients’ needs.

Individualized support has helped Garthside turn his life around. He is working toward a degree in social work, and at press time was looking forward to becoming a father. He still sees a therapist weekly for PTSD, and is still coping with his moral injuries.

“There was literally nothing I could do but tell those guys no one was coming. In a way, I was betraying those guys. Even if it was headquarters that made the decision, I’m the talking head. And saying I did my job and I did my job well or whether it was a mistake, the reality is that Afghan man is dead. That’s the piece that beats your insides out, that still does.”

Still, he has a better perspective on it today. “I was acting for the greater good. I’m not healed, but I have so many more tools to cope. I have more depth of character to draw on. That shift in perspective allows me to re-engage with life. Instead of being in a live production, I’m looking at a picture.”

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More veterans are getting cancer, and some suspect it's due to burn pits in Iraq and Afghanistan

Lisa Gutierrez, The Kansas City Star
November 01, 2019 at 07:21 PM

VVi 03 Feb 2020 db

Lloyd Blair joined the Marine Corps as an 18-year-old itching for a fight after hijacked planes rocketed into the World Trade Center towers and set the world on fire. He pulled two tours in Iraq. The first landed him in the hell of Fallujah where some of the bloodiest fighting took place.

There he was, not long out of high school, fighting in the desert, ducking bullets while carrying 40, 50 pounds of full battle rattle on his back.

The stench of human feces flowing out of Fallujah in shallow creeks suffocated the air. There was smoke everywhere. "I mean, there was stuff burning all the time in Fallujah," says Blair, who is 35.

He didn't give a second thought to the smoke billowing from the burn pits where the military torched its own trash, not until he was diagnosed with testicular cancer after he came home.

Cancer doesn't run in his family, said Blair, who lives in Lee's Summit. So he was confused about why the cancer that befell Lance Armstrong had found him. Looking for answers online, he came across hundreds of other worried veterans with the same diagnosis.

A McClatchy investigation of cancer among veterans during nearly two decades of war shows a significant increase in cancer cases —like Blair's — treated by the Department of Veterans Affairs health care system.

The review, based on VA health care data obtained through Freedom of Information Act requests, found the rate of treatments for urinary cancers — which include bladder, kidney and ureter cancers — increased 61 percent from fiscal year 2000 to fiscal year 2018.

The rate of treatments for blood cancers — lymphoma, myeloma and leukemia — rose 18 percent in the same period. For liver and pancreatic cancer treatments the increase was 96 percent, and for prostate cancer it was 23 percent.

The VA has disagreed with McClatchy's findings, however data from its own cancer registry provided to McClatchy also shows a significant rise during a similar time frame.

McClatchy chose to look at the rate of veteran cancer treatments beginning in fiscal year 2000 to see what happened in the years following the September 11, 2001, terrorist attacks when U.S. forces were involved in wars in Afghanistan and Iraq.

The rate of cancer treatments for veterans at VA health care centers peaked earlier this decade and has declined over the past several years, but is significantly higher than before 9/11.

The barber vet: 'An eye for an eye'

The word is out that the Corner Barber Shop in Northmoor, Missouri, is friendly to those who serve and have served in uniform, be they police officers or veterans. There's usually a veteran sitting in Blair's chair.

At his work station, Blair's barbering supplies sit on a thick black rubber mat advertising Jack Daniel's Tennessee Honey whiskey with the slogan, "Fly Straight Drink Responsibly."

The shop is a big open room spare of furnishings except for guest seating, a pool table and two barber chairs — owner Rich Dedrick's is closest to the door.

Jabberjawing about LC's Hamburgers and football — both barbers are Raiders fans, their customers are not — and the beef jerky from the bar next door ping-pongs off the walls over the buzzing of razors. Conversations turn polite when a woman is in the room. "Somehow we got a five-star rating," Dedrick joked one recent morning. "We're trying not to screw it up."

Blair was a client here before he joined the Marines as a teenager. When he came home from Iraq, the shop owner made him an offer he didn't refuse.

Dedrick worried about his friend, concerned that working on cars was too solitary a gig for someone who came home from war a different man, one with Post Traumatic Stress Disorder. Dedrick knew Blair to be a "self-motivated" man "who goes for it when he sets his mind for something."

Blair needed to be around people, Dedrick thought. Drinking wasn't helping. So the long-time barber threw his friend a lifeline.

"He's like 'Man I don't want you sitting at home. Why don't you go get your barber's license and I'll let you cut in that chair right there?' And that's what I did," said Blair, who displays his barber licenses from Kansas and Missouri at his work station.

The barber shop sits in Blair's neck of the woods north of the river. He was 5 when he and his father moved to the Kansas City area from Los Angeles. Some of the tattoos that cover his arms pay homage to his birthplace — the words "California Life" are inked on his upper right arm along with a buxom Latina woman in a hat.

Blair, a member of the Class of 2003 at Park Hill South, was in classes on Sept. 11, 2001.

"As soon as 9/11 happened, it was kind of the jump for all of the kids of my time," said Blair. "We watched it happen. We were getting ready to be out of high school, and it kind of just ruffled my feathers.

"My grandfather was in the Navy through Korea and Vietnam. A lot of my other family were in the Marine Corps, Army, Air Corps. … I just kind of felt the need to do that as well, to serve my country."

His dad, a mechanical engineer, had pushed him toward college, he said. But, "I wasn't as good in school as my dad, you know what I mean? Math and stuff like that," said Blair. "I was more of a hands-on type of kid." So he waited until his dad went out of town on business to meet with recruiters.

"I was supposed to go into the Army and I went into the recruiting station to turn in my paperwork and there were a couple of (Marines) who had just got back from the first push through Iraq and they were in their dress blues," he recalled. "And they were kind of talking crap about the Army.

"They were like, 'only sissies go in the Army.' So they kind of got me hook, line and sinker."

Days later, in February 2003, he headed to Marine Corps Recruit Depot, MCRD, in San Diego. He went to Iraq with 1st Battalion, 5th Marines, Weapons Company.

"I joined infantry off the cuff," said Blair. "I knew what I was signing up for. From the get-go, I knew I wanted to be infantry and I wanted to go to Iraq and make right what was wrong to us. An eye for an eye. That's the way it should be."

'A common way to get rid of waste'

The fighting was close-up.

"Nowadays when you go to the Middle East it's house-to-house fighting," said Blair. "It's not going out into the field and there's 10 million guys lined up in a line and they just watch each other. That's not what it is. They hide in the houses and they shoot from the windows, the tops of the buildings."

His mission took him into an industrial part of the city to search buildings for weapons caches. "So on a day-to-day basis that's what we were doing, going through and finding where they were storing all their guns and ammunition and RPGs (rocket-propelled grenades), finding them before they could use them on us."

In Fallujah he lived on an FOB — Forward Operating Base — and that's where he saw his first burn pit.

The VA's website describes burn pits as "a common way to get rid of waste at military sites in Iraq and Afghanistan."

"Waste products in burn pits include, but are not limited to: chemicals, paint, medical and human waste, metal/aluminum cans, munitions and other unexploded ordnance, petroleum and lubricant products, plastics, rubber, wood, and discarded food," the website says.

"Basically, it's just a big trash pile," said Blair. "So if you've ever been to, like, a city dump, that's all it is. It's where we threw all our trash.

Basically everything. Bloody camis. Old batteries. Everything. Old food. And then they would set it on fire with diesel fuel and let it burn."

The pit that Blair lived near in Fallujah sent smoke pouring into their sleeping quarters and showers, he said. "I didn't even think anything about it. It wasn't one of our priorities. That was for the guys that were in charge of the base. We just went in there and slept," he said.

"I think the reason a lot of us didn't smell anything weird was because our noses were so dead to smell because of how it smelled everywhere around there. So when they're doing the burn pits it didn't smell any different from the rest of the city."

At the time, he was more focused on staying alive.

The kind of cancer Lance Armstrong had

Blair came home with medical problems he didn't have before — PTSD and a traumatic brain injury sustained in a Humvee explosion, he said. Two weeks after he was discharged in 2007 he collapsed in pain at his father's house in Kansas City and wound up having emergency gall bladder surgery.

He got sick again in 2013 with pain in his lower abdomen. "So I went to the VA and they said I had an infection and sent me home with some antibiotics," he said.

Two years later in 2015 he was on his way to the VA hospital in Kansas City. He worked there as a service officer for the VFW, helping other vets secure their veterans' benefits. He was riding his motorcycle when he felt excruciating pain below the belt.

He went straight to the hospital's emergency room and that became the day he learned he had Stage 3, advanced, testicular cancer.

"The doctor came in the room and he didn't really say anything, and then he's like, "Hey, you know who Lance Armstrong is? Well, he beat it, so can you.' And then he walked out of the room," Blair said.

Doctors that day removed one of his testicles "that was basically coated in cancer," he said. But things got much worse.

More tests over the next few days showed the cancer had spread. "That's when they told me 'We're sorry, you have lymphatic cancer as well." He spent the next month getting chemotherapy treatments and today is in remission. He's been told the cancer could come back "three days or 30 years from now."

Because he knew cancer did not run in his family Blair started researching, typing into Google phrases such as: "How many Iraq veterans are coming down with testicular cancer?"

He quickly found one online forum that alone had nearly 400 "guys who all came back and got testicular cancer," he said.

The American Cancer Society says on its website that testicular cancer "is largely a disease of young and middle-aged men" and "is not common: about 1 of every 250 males will develop testicular cancer at some point during their lifetime."

Blair already knew, through his work with the VFW, that some veterans suspected that being exposed to burn pits in Iraq and Afghanistan made them sick, some critically. It became his concern, too.

Veterans groups and members of Congress are working on ways to make it easier for veterans to get their illnesses connected to their service. The Airborne Hazards and Open Burn Pit Registry, run by the VA, has collected health information about more than 170,000 Iraq and Afghanistan veterans, Stars and Stripes reported earlier this year.

The VA denies a direct connection, stating on its website: "At this time, research does not show evidence of long-term health problems from exposure to burn pits. VA continues to study the health of deployed Veterans."

Like Vietnam and Agent Orange

Blair is not angry that he got cancer. He talks about it like most people would discuss a hangnail. Yeah, I had it. I don't anymore.

"You just keep on going. You can't let it get to you. It is what it is," he said. "I went in during a time of combat and I volunteered.

"I wasn't 'volun-told' like most of the Vietnam guys. I had a decision and I made that decision, and so that's why I don't bag on any of the government agencies or anything. I love my country, I love my government. Some of it's stupid right now, but I would never cross my government."

He holds no animosity toward the VA, either, "because they've kept me alive on just about everything I've been through."

But he still wants to know, more so for his fellow veterans, if his cancer was somehow caused by his service to country.

"Obviously none of us knew the burn pits had bad stuff in them," he said. "We didn't realize, just like (Vietnam vets) didn't realize that Agent Orange was going to give them diabetes and different cancers and a lot of them were going to pass away before their 50th birthdays. They didn't know any of that."

Dedrick joked that Blair is so patriotic that "I'm not sure he doesn't p**s red, white and blue."

Two years ago while he was at Headlines Barber Academy in KCK learning his way around a set of clippers, Blair and a couple of veteran buddies took on a new mission. They founded a nonprofit called Veteran Barbers for Veterans as a hand-up for any vet in a hard place.

They began raising money to fund scholarships for veterans who want to go to barber school. And, they turned a 24-foot trailer into a mobile barber shop to take on the road and give free haircuts and shaves to veterans, active duty military and first responders.

They want to take the shop-on-wheels across the country to veterans' events, VA hospitals, anywhere they can meet a vet. They've been to Columbia, Missouri, and Las Vegas already. But they've been sidelined by red tape, some requirement about needing a bathroom onboard, Blair said.

For now he counsels his fellow brothers in arms from his work station, where the conversations aren't always about barbecue and football.

"There's nobody that knows more about a person than his own barber," said Dedrick.

When McClatchy presented initial findings to the VA, the agency said it disagreed with McClatchy's approach. The VA said an analysis of billing data would create an overcount, and that its internal cancer registry system did not show a significant rise.

"According to the latest official VA cancer data, the annual total number of cancer cases among enrolled veterans peaked in 2010 and has been declining since," the VA said in a statement. "Colorectal and prostate cancer have been declining, while hepatocellular and skin (melanoma) cancer have been increasing. These trends largely mirror national cancer trends."

There are multiple ways to track cancer rates, and each has limitations.

Studies have found that the billing data used in McClatchy's analysis, which covered all treatments provided by the VA coded as cancer according to the International Classification of Diseases (ICD), has a tendency to overcount, while data from cancer registries such as the one used by the VA has a tendency to undercount.

McClatchy asked the VA through a Freedom of Information Act request for the internal data that the VA referenced in the statement above.

FOIA Response

In its response to that FOIA request, the Veterans Health Administration said parts of the cancer registry system were not being maintained.

"[The VA Central Cancer Registry] is not a viable source of VA cancer registry data at this time," the Veterans Health Administration wrote in a response to our open records request. "There are no staff working on [the VA Central Cancer Registry] so it is not functioning to any standard."

The VA then sent McClatchy raw data from its cancer registry that could not be adjusted for population and did not include a breakdown by service.

While the VA in its statement noted a decrease in cancers from 2010, viewing the raw cancer registry data over a longer period, from 2000 to 2017, showed an increase in some cancers. It was a similar trend to McClatchy's analysis of billing data over fiscal years 2000 to 2018.

The VA's cancer registry data shows the number of blood cancers increased 41 percent, while bladder, kidney and ureter cancers increased 70 percent. Skin cancers have increased 48 percent, brain cancers are up 20 percent. Liver and pancreatic cancers are up 151 percent — although they represent only a small number of actual cases. Prostate cancers are up 9 percent.

McClatchy's analysis of billing data showed decreases in treatments for brain, respiratory and testicular cancers. VA's cancer registry system showed increases in brain, respiratory and testicular cancers. The differing results are due to differences in methods of calculation and the makeup of the two datasets.

"Don't let anyone convince you that the information you're pulling is wrong. It's not wrong. It's just different from what VA has used," said Susan Lukas, a former VA official who now advocates for military reservists and veterans through the Reserve Officers Association.

"One of the outcomes of your research comparing ICD codes to identify veterans with cancer is that it may be time for VA to use this international system instead of their internal cancer register."


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More veterans are getting cancer, and some suspect it's due to burn pits in Iraq and Afghanistan

Lisa Gutierrez, The Kansas City Star
November 01, 2019 at 07:21 PM

VVi 17 Jan 2020 db

Lloyd Blair joined the Marine Corps as an 18-year-old itching for a fight after hijacked planes rocketed into the World Trade Center towers and set the world on fire. He pulled two tours in Iraq. The first landed him in the hell of Fallujah where some of the bloodiest fighting took place.

There he was, not long out of high school, fighting in the desert, ducking bullets while carrying 40, 50 pounds of full battle rattle on his back.
The stench of human feces flowing out of Fallujah in shallow creeks suffocated the air. There was smoke everywhere. "I mean, there was stuff burning all the time in Fallujah," says Blair, who is 35.

He didn't give a second thought to the smoke billowing from the burn pits where the military torched its own trash, not until he was diagnosed with testicular cancer after he came home.

Cancer doesn't run in his family, said Blair, who lives in Lee's Summit. So he was confused about why the cancer that befell Lance Armstrong had found him. Looking for answers online, he came across hundreds of other worried veterans with the same diagnosis.
A McClatchy investigation of cancer among veterans during nearly two decades of war shows a significant increase in cancer cases —like Blair's — treated by the Department of Veterans Affairs health care system.

The review, based on VA health care data obtained through Freedom of Information Act requests, found the rate of treatments for urinary cancers — which include bladder, kidney and ureter cancers — increased 61 percent from fiscal year 2000 to fiscal year 2018.

The rate of treatments for blood cancers — lymphoma, myeloma and leukemia — rose 18 percent in the same period. For liver and pancreatic cancer treatments the increase was 96 percent, and for prostate cancer it was 23 percent.

The VA has disagreed with McClatchy's findings, however data from its own cancer registry provided to McClatchy also shows a significant rise during a similar time frame.

McClatchy chose to look at the rate of veteran cancer treatments beginning in fiscal year 2000 to see what happened in the years following the September 11, 2001, terrorist attacks when U.S. forces were involved in wars in Afghanistan and Iraq.

The rate of cancer treatments for veterans at VA health care centers peaked earlier this decade and has declined over the past several years, but is significantly higher than before 9/11.

The barber vet: 'An eye for an eye'

The word is out that the Corner Barber Shop in Northmoor, Missouri, is friendly to those who serve and have served in uniform, be they police officers or veterans. There's usually a veteran sitting in Blair's chair.

At his work station, Blair's barbering supplies sit on a thick black rubber mat advertising Jack Daniel's Tennessee Honey whiskey with the slogan, "Fly Straight Drink Responsibly."

The shop is a big open room spare of furnishings except for guest seating, a pool table and two barber chairs — owner Rich Dedrick's is closest to the door.

Jabberjawing about LC's Hamburgers and football — both barbers are Raiders fans, their customers are not — and the beef jerky from the bar next door ping-pongs off the walls over the buzzing of razors. Conversations turn polite when a woman is in the room. "Somehow we got a five-star rating," Dedrick joked one recent morning. "We're trying not to screw it up."

Blair was a client here before he joined the Marines as a teenager. When he came home from Iraq, the shop owner made him an offer he didn't refuse.

Dedrick worried about his friend, concerned that working on cars was too solitary a gig for someone who came home from war a different man, one with Post Traumatic Stress Disorder. Dedrick knew Blair to be a "self-motivated" man "who goes for it when he sets his mind for something."

Blair needed to be around people, Dedrick thought. Drinking wasn't helping. So the long-time barber threw his friend a lifeline.

"He's like 'Man I don't want you sitting at home. Why don't you go get your barber's license and I'll let you cut in that chair right there?'

And that's what I did," said Blair, who displays his barber licenses from Kansas and Missouri at his work station.

The barber shop sits in Blair's neck of the woods north of the river. He was 5 when he and his father moved to the Kansas City area from Los Angeles. Some of the tattoos that cover his arms pay homage to his birthplace — the words "California Life" are inked on his upper right arm along with a buxom Latina woman in a hat.

Blair, a member of the Class of 2003 at Park Hill South, was in classes on Sept. 11, 2001.

"As soon as 9/11 happened, it was kind of the jump for all of the kids of my time," said Blair. "We watched it happen. We were getting ready to be out of high school, and it kind of just ruffled my feathers.

"My grandfather was in the Navy through Korea and Vietnam. A lot of my other family were in the Marine Corps, Army, Air Corps. … I just kind of felt the need to do that as well, to serve my country."

His dad, a mechanical engineer, had pushed him toward college, he said. But, "I wasn't as good in school as my dad, you know what I mean? Math and stuff like that," said Blair. "I was more of a hands-on type of kid." So he waited until his dad went out of town on business to meet with recruiters.

"I was supposed to go into the Army and I went into the recruiting station to turn in my paperwork and there were a couple of (Marines) who had just got back from the first push through Iraq and they were in their dress blues," he recalled. "And they were kind of talking crap about the Army.

"They were like, 'only sissies go in the Army.' So they kind of got me hook, line and sinker."

Days later, in February 2003, he headed to Marine Corps Recruit Depot, MCRD, in San Diego. He went to Iraq with 1st Battalion, 5th Marines, Weapons Company.

"I joined infantry off the cuff," said Blair. "I knew what I was signing up for. From the get-go, I knew I wanted to be infantry and I wanted to go to Iraq and make right what was wrong to us. An eye for an eye. That's the way it should be."

'A common way to get rid of waste'

The fighting was close-up.

"Nowadays when you go to the Middle East it's house-to-house fighting," said Blair. "It's not going out into the field and there's 10 million guys lined up in a line and they just watch each other. That's not what it is. They hide in the houses and they shoot from the windows, the tops of the buildings."

His mission took him into an industrial part of the city to search buildings for weapons caches. "So on a day-to-day basis that's what we were doing, going through and finding where they were storing all their guns and ammunition and RPGs (rocket-propelled grenades), finding them before they could use them on us."

In Fallujah he lived on an FOB — Forward Operating Base — and that's where he saw his first burn pit.

The VA's website describes burn pits as "a common way to get rid of waste at military sites in Iraq and Afghanistan."

"Waste products in burn pits include, but are not limited to: chemicals, paint, medical and human waste, metal/aluminum cans, munitions and other unexploded ordnance, petroleum and lubricant products, plastics, rubber, wood, and discarded food," the website says.

"Basically, it's just a big trash pile," said Blair. "So if you've ever been to, like, a city dump, that's all it is. It's where we threw all our trash.

Basically everything. Bloody camis. Old batteries. Everything. Old food. And then they would set it on fire with diesel fuel and let it burn."

The pit that Blair lived near in Fallujah sent smoke pouring into their sleeping quarters and showers, he said. "I didn't even think anything about it. It wasn't one of our priorities. That was for the guys that were in charge of the base. We just went in there and slept," he said.

"I think the reason a lot of us didn't smell anything weird was because our noses were so dead to smell because of how it smelled everywhere around there. So when they're doing the burn pits it didn't smell any different from the rest of the city."

At the time, he was more focused on staying alive.

The kind of cancer Lance Armstrong had

Blair came home with medical problems he didn't have before — PTSD and a traumatic brain injury sustained in a Humvee explosion, he said. Two weeks after he was discharged in 2007 he collapsed in pain at his father's house in Kansas City and wound up having emergency gall bladder surgery.

He got sick again in 2013 with pain in his lower abdomen. "So I went to the VA and they said I had an infection and sent me home with some antibiotics," he said.

Two years later in 2015 he was on his way to the VA hospital in Kansas City. He worked there as a service officer for the VFW, helping other vets secure their veterans' benefits. He was riding his motorcycle when he felt excruciating pain below the belt.

He went straight to the hospital's emergency room and that became the day he learned he had Stage 3, advanced, testicular cancer.
"The doctor came in the room and he didn't really say anything, and then he's like, "Hey, you know who Lance Armstrong is? Well, he beat it, so can you.' And then he walked out of the room," Blair said.

Doctors that day removed one of his testicles "that was basically coated in cancer," he said. But things got much worse.

More tests over the next few days showed the cancer had spread. "That's when they told me 'We're sorry, you have lymphatic cancer as well." He spent the next month getting chemotherapy treatments and today is in remission. He's been told the cancer could come back "three days or 30 years from now."

Because he knew cancer did not run in his family Blair started researching, typing into Google phrases such as: "How many Iraq veterans are coming down with testicular cancer?"

He quickly found one online forum that alone had nearly 400 "guys who all came back and got testicular cancer," he said.

The American Cancer Society says on its website that testicular cancer "is largely a disease of young and middle-aged men" and "is not common: about 1 of every 250 males will develop testicular cancer at some point during their lifetime."

Blair already knew, through his work with the VFW, that some veterans suspected that being exposed to burn pits in Iraq and Afghanistan made them sick, some critically. It became his concern, too.

Veterans groups and members of Congress are working on ways to make it easier for veterans to get their illnesses connected to their service. The Airborne Hazards and Open Burn Pit Registry, run by the VA, has collected health information about more than 170,000 Iraq and Afghanistan veterans, Stars and Stripes reported earlier this year.

The VA denies a direct connection, stating on its website: "At this time, research does not show evidence of long-term health problems from exposure to burn pits. VA continues to study the health of deployed Veterans."

Like Vietnam and Agent Orange

Blair is not angry that he got cancer. He talks about it like most people would discuss a hangnail. Yeah, I had it. I don't anymore.

"You just keep on going. You can't let it get to you. It is what it is," he said. "I went in during a time of combat and I volunteered.

"I wasn't 'volun-told' like most of the Vietnam guys. I had a decision and I made that decision, and so that's why I don't bag on any of the government agencies or anything. I love my country, I love my government. Some of it's stupid right now, but I would never cross my government."

He holds no animosity toward the VA, either, "because they've kept me alive on just about everything I've been through."

But he still wants to know, more so for his fellow veterans, if his cancer was somehow caused by his service to country.

"Obviously none of us knew the burn pits had bad stuff in them," he said. "We didn't realize, just like (Vietnam vets) didn't realize that Agent Orange was going to give them diabetes and different cancers and a lot of them were going to pass away before their 50th birthdays. They didn't know any of that."

Dedrick joked that Blair is so patriotic that "I'm not sure he doesn't p**s red, white and blue."

Two years ago while he was at Headlines Barber Academy in KCK learning his way around a set of clippers, Blair and a couple of veteran buddies took on a new mission. They founded a nonprofit called Veteran Barbers for Veterans as a hand-up for any vet in a hard place.

They began raising money to fund scholarships for veterans who want to go to barber school. And, they turned a 24-foot trailer into a mobile barber shop to take on the road and give free haircuts and shaves to veterans, active duty military and first responders.

They want to take the shop-on-wheels across the country to veterans' events, VA hospitals, anywhere they can meet a vet. They've been to Columbia, Missouri, and Las Vegas already. But they've been sidelined by red tape, some requirement about needing a bathroom onboard, Blair said.

For now he counsels his fellow brothers in arms from his work station, where the conversations aren't always about barbecue and football.

"There's nobody that knows more about a person than his own barber," said Dedrick.

When McClatchy presented initial findings to the VA, the agency said it disagreed with McClatchy's approach. The VA said an analysis of billing data would create an overcount, and that its internal cancer registry system did not show a significant rise.

"According to the latest official VA cancer data, the annual total number of cancer cases among enrolled veterans peaked in 2010 and has been declining since," the VA said in a statement. "Colorectal and prostate cancer have been declining, while hepatocellular and skin (melanoma) cancer have been increasing. These trends largely mirror national cancer trends."

There are multiple ways to track cancer rates, and each has limitations.

Studies have found that the billing data used in McClatchy's analysis, which covered all treatments provided by the VA coded as cancer according to the International Classification of Diseases (ICD), has a tendency to overcount, while data from cancer registries such as the one used by the VA has a tendency to undercount.

McClatchy asked the VA through a Freedom of Information Act request for the internal data that the VA referenced in the statement above.

FOIA Response

In its response to that FOIA request, the Veterans Health Administration said parts of the cancer registry system were not being maintained.

"[The VA Central Cancer Registry] is not a viable source of VA cancer registry data at this time," the Veterans Health Administration wrote in a response to our open records request. "There are no staff working on [the VA Central Cancer Registry] so it is not functioning to any standard."

The VA then sent McClatchy raw data from its cancer registry that could not be adjusted for population and did not include a breakdown by service.

While the VA in its statement noted a decrease in cancers from 2010, viewing the raw cancer registry data over a longer period, from 2000 to 2017, showed an increase in some cancers. It was a similar trend to McClatchy's analysis of billing data over fiscal years 2000 to 2018.

The VA's cancer registry data shows the number of blood cancers increased 41 percent, while bladder, kidney and ureter cancers increased 70 percent. Skin cancers have increased 48 percent, brain cancers are up 20 percent. Liver and pancreatic cancers are up 151 percent — although they represent only a small number of actual cases. Prostate cancers are up 9 percent.

McClatchy's analysis of billing data showed decreases in treatments for brain, respiratory and testicular cancers. VA's cancer registry system showed increases in brain, respiratory and testicular cancers. The differing results are due to differences in methods of calculation and the makeup of the two datasets.

"Don't let anyone convince you that the information you're pulling is wrong. It's not wrong. It's just different from what VA has used," said Susan Lukas, a former VA official who now advocates for military reservists and veterans through the Reserve Officers Association. "One of the outcomes of your research comparing ICD codes to identify veterans with cancer is that it may be time for VA to use this international system instead of their internal cancer register."
———
©2019 The Kansas City Star (Kansas City, Mo.)
Visit The Kansas City Star (Kansas City, Mo.) at www.kansascity.com
Distributed by Tribune Content Agency, LLC.

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Councillor calls for streets to be named in honour of fallen soldiers

Expositor staff
Published on: January 17, 2020 | Last Updated: January 17, 2020 4:53 PM EST

17 Jan 2020

Capt. Richard Leary (left) and Trooper Larry John Zuidema Rudd were killed in action in Afghanistan. Postmedia

Two local soldiers who were killed in Afghanistan could soon have city streets named in their honour.

Coun. Richard Carpenter plans to introduce a motion to have the names of Trooper Larry John Zuidema Rudd and Capt. Richard Leary approved for use as street names.

Leary, platoon commander of the 2nd Battalion Princess Patricia’s Canadian Light Infantry regiment, based in Shilo, Man., died on June 3, 2008 of wounds suffered when Afghan and Canadian soldiers came under small-arms fire in the Panjwaii district of Afghanistan.

Rudd was killed May 24, 2010 when an improvised explosive device detonated during a routine security operation 20 kilometres southwest of Kandahar City.

The city’s engineering and planning departments are currently working on policies for the naming of municipal streets.

Carpenter’s motional also calls for city staff to make a submission to the Dominion Command of the Royal Canadian Legion about the use of the poppy symbol to be displayed on any city street sign that is associated with the name of a veteran.

In addition, the motion directs city staff to arrange for a re-dedication of the Veterans Memorial Parkway on May 24. In November 2007, council passed a resolution to change the name of the Brantford Southern Access Road (BSAR) to Veterans Memorial Parkway.

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'My soul is still in Rwanda': 25 years after the genocide, Roméo Dallaire still grapples with guilt
Social Sharing


CBC Radio ·
Posted: Apr 07, 2019 3:59 AM ET | Last Updated: April 7, 2019

VVi 15 Jan 2020

Retired Lt.-Gen. Roméo Dallaire speaks with The Sunday Edition host Michael Enright for the 25th anniversary of the Rwandan genocide. (Sinisa Jolic/CBC)

Retired Lt.-Gen. Roméo Dallaire does not mince words when speaking about Bill Clinton, who was U.S. president during the 1994 Rwandan genocide.

In an interview with The Sunday Edition host Michael Enright on the 25th anniversary of the genocide, Dallaire listened to a 1998 speech in which Clinton expressed regret for not acting sooner.

"We did not act quickly enough after the killing began," Clinton told genocide survivors in Kigali.

Dallaire rejects that assessment as downplaying just how thoroughly the U.S. ignored the crisis.

"Most of it is crap," he said.

"A month before the genocide, [Clinton] produced a presidential directive that stated that the United States will not engage in any humanitarian operation, unless it's in its self-interest," he said. "He had instructed his staff — and I've had the opportunity to meet with his subordinate staff — not to tell him what the hell was going on."

Dallaire was in charge of the UN peacekeeping mission during the genocide against the Tutsi minority. In 100 days, more than 800,000 Rwandans — most of them Tutsis and moderate Hutus — were slaughtered by the Rwandan military and Hutu militia.

In the months leading up to the genocide, Dallaire repeatedly warned the UN Security Council something catastrophic was brewing. But he said world leaders were too concerned with preventing peacekeeper casualties to let him act.

Dallaire returned to Canada devastated and angry, haunted by his inability to prevent the genocide or convince the international community to do more to stop it.

"I've been under 20 years, nearly, of therapy. They have tried, by every means possible, to take away my guilt," Dallaire said.
"Command is sort of like being a woman who's pregnant. You can't be pregnant during the week, and on weekends have a break … There is no, 'I did my best and I'm sorry.' You are held accountable for your command. There is nothing that can take that away, and should never be anything."

The Jan. 11 'genocide fax'

Dallaire was deployed to Rwanda with a small UN peacekeeping force in 1993. He was supposed to oversee a truce between the Hutus and the Tutsis, but his powers were tightly constricted by Chapter 6 of the UN Charter.

"You were supposed to be a facilitator, not a soldier, and the use of force was purely for self-protection," he said.

On Jan. 11, 1994, a commander told Dallaire militias were preparing to commit mass atrocities. He sent the UN Security Council in New York what is known as the "genocide fax," saying he was prepared to take action — even though it fell outside the mandate of Chapter 6.

I got the fastest response from New York that I ever got: 'You will not intervene. You will not put troops at risk.'

- Retired Lt.-Gen. Roméo Dallaire

"[The militias] would be able to kill a thousand Tutsis in 20 minutes, as they were planning. [We wanted] to try to go after the arms caches, and throw off the extremists from doing that," he said.

"After the 11th of January fax, I got the fastest response from New York that I ever got: 'You will not intervene. You will not put troops at risk.'"

Dallaire later learned that Clinton and the UN Security Council were reluctant to let him act because of what had happened in Somalia the year before.

In October 1993, an American special operations team launched a raid in Mogadishu, and two Black Hawk helicopters were shot down. Eighteen Americans, two UN peacekeepers and hundreds of Somali citizens were killed.

Rwanda mass graves could contain over 2,000 bodies from genocide
"There was a fear … that if I went in and did these things, that we'd end up in a firefight similar to Mogadishu, and I would take casualties," he said.

For two months, Dallaire kept asking the UN to let him take some limited actions to prevent violence.

"We were about to start doing them when the genocide started," he said.

Humiliation, mutilation and rape as acts of war

When the Rwandan president's airplane was shot down by a missile on the evening of April 6, 1994, Hutus blamed Tutsis. It was the spark that lit a bonfire.

Rwandan radio was full of calls to "destroy the cockroaches," meaning the Tutsis. Death squads roamed the streets. People were hacked to death by machete — a slow, brutal process.

"They realized that, 'Hey, why just try to kill them? It's such a hell of a lot of hard work, and there are so many of them.' So they would cut breasts off, Achilles heel, they'd hit them around the neck — enough for them to just not be able to move, to stay in the sun and bleed to death. They would do that even with children," Dallaire said.

"It wasn't just wanting to kill them. They wanted them to suffer."

The worst dimension, said Dallaire, was "the introduction of a weapon of conflict that is used extensively still, that is considered by [the] International Criminal Court as torture, as a crime against humanity, and that's rape."

Up to half a million women and children were raped, mutilated or murdered during the genocide.

After escaping Rwanda's genocide, this woman confronted the neighbour who handed her over to would-be killers
Even once the genocide was underway, members of the UN Security Council continued to debate whether Dallaire had the mandate to act.

In 1994, Lt.-Gen. Dallaire spoke frequently with Michael Enright, who was the host of As It Happens at the time. In this interview, less than a month into the genocide, Dallaire said he and his troops were trying to remain optimistic more help was on the way.
The Sunday Edition

'There is no desire to leave': May 4, 1994

On May 4, 1994, Dallaire told Enright he and his peacekeeping troops hoped they were the "advance party" to a larger force. 2:15
He remembers speaking with UN Secretary General Boutros Boutros-Ghali three weeks into the genocide, after more than 2,000 peacekeeping troops had already been withdrawn.

"He told me, 'Listen, the world cannot handle 450 peacekeepers being killed,'" said Dallaire.

"I had a responsibility to the lives of my soldiers. But I also had a responsibility to the people of Rwanda."

Aftermath

In mid-July 1994, the Tutsi guerrilla army finally prevailed. Hutus — both the guilty and innocents terrified of retribution — fled the country en masse.

In the aftermath, 40,000 people perished in cholera outbreaks in refugee camps.

Near the end of the conflict, Dallaire asked to be relieved of his command. He also began acting recklessly, hoping it might bring an end to his pain and guilt.

"Although I was ordered to have an escort, because of the death threats … I would escape from the headquarters and just go and drive," said Dallaire.

"I was always hoping that I'd end up in an ambush and I'd be killed."

After returning to Canada, Dallaire attempted suicide four times.

One night, after an emotionally gruelling therapy session, he bought a bottle of scotch, sat on a park bench and drank the whole thing. He spent hours crying and preparing to end his life.

'I remember crying and crying': Roméo Dallaire

Roméo Dallaire talks to Michael Enright about his suicide attempts

"I ended up walking in the park. I just barely made a couple steps, apparently, then I stumbled. Then I kept screaming for people to come and kill me," he said.

"I begged my sister-in-law, all the way to the hospital, and during the night when I woke up a couple of times. I kept screaming at her to find a way to kill me."

He woke up "sick as a dog," but alive. He channelled his pain and frustration into work.

"I worked and worked and worked to try to kill myself at work, because I wasn't succeeding in doing it any other way," he said.

AudioRoméo Dallaire on PTSD and the deaths of 4 Canadian soldiers

'A large part of my soul is still in Rwanda'

Dallaire threw himself into projects to prevent the recruitment of child soldiers, because he realized many of the atrocities he witnessed in Rwanda were perpetrated by children.

He is heartened by the growing human rights field, and believes NGOs are starting to have more influence on public opinion and policy.
"There is a generation out there, under 25 ... they don't need borders. They can understand the environment from a world sense, they can understand human rights from all sides," he said.

"I've become more and more convinced that one day we will resolve our frictions without having to use force and conflict … It might take a couple of centuries, but I'm certainly giving it a shot."

Dallaire said his desire to die finally ended a year and a half ago. But he believes he will never go back to being the person he was before the genocide.

"I still say a large part of my soul is still in Rwanda," he said.

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Online Consultation – National Monument to Canada’s Mission in Afghanistan / Consultation en ligne – Monument commémoratif national de la mission du Canada en Afghanistan

VVi 03 Jan 2020

(le français suit)

Dear Stakeholders and Advisory Group members;

As you may be aware, the creation of a National Monument to Canada’s Mission in Afghanistan is currently underway. The Monument will recognize the commitment and sacrifice of Canadians who served in Afghanistan as well as the support provided to them at home. The Monument will be located in Ottawa, Ontario near the Canadian War Museum.

Many Canadians died as a result of their service in Afghanistan, including Canadian Armed Forces members, a diplomat, foreign aid workers, a government contractor and a journalist. Thousands of Canadians were also injured—physically and psychologically—during the mission.

At this time, we are consulting on design considerations for the monument via PubliVate Inc., an independent company who will host the online consultation on our behalf. The consultation will include questions on the Monument’s objectives, its form and character, and the type of visitor experience sought. The questionnaire can be accessed here (https://canadaremembersafghanistan.ca/) and will be available from 2-20 January, 2020.

Your opinion is important. We encourage you to participate in the consultation and to promote and share within your organization and/or networks. Feedback received will help inform the Monument design guidelines, which will ultimately guide design teams in developing their concepts.

Later this year, you will have another opportunity to provide input through public consultations on the finalist teams’ design concepts, prior to the selection and announcement of the winning Monument design. For more information about the National Monument to Canada’s Mission in Afghanistan, we invite you to click here (https://www.veterans.gc.ca/…/afghanistan-remembered/monument).
Thank you.

The Honourable Lawrence MacAulay
Minister of Veterans Affairs and Associate Minister of National Defence
-------------------------------------------------------
Chers intervenants et membres des groupes consultatifs,

Comme vous le savez probablement, la création d’un monument commémoratif national de la mission du Canada en Afghanistan est en cours. Le monument reconnaîtra le dévouement et les sacrifices des Canadiens qui ont servi en Afghanistan, ainsi que le soutien qu’ils ont reçu ici au pays. Le monument sera situé à Ottawa, Ontario, près du Musée canadien de la guerre.

De nombreux Canadiens sont morts alors qu’ils étaient en service en Afghanistan, notamment des membres des Forces armées canadiennes, un diplomate, des travailleurs humanitaires étrangers, un entrepreneur gouvernemental et un journaliste. Des milliers de Canadiens ont également été blessés – physiquement et psychologiquement – au cours de la mission.

Nous avons entrepris des travaux en vue de déterminer les facteurs à prendre en considération dans la conception du monument. À cet effet, PubliVate Inc., une entreprise indépendante, a reçu le mandat de mener une consultation en ligne en notre nom. Celle‑ci comprendra des questions sur les objectifs du monument, sa structure et son caractère, ainsi que le type d’expérience du visiteur recherchée. Vous pourrez accéder à ce questionnaire du 2 au 20 janvier 2020 en cliquant ici (https://lecanadasesouvientafghanistan.ca/fr/).

Votre opinion compte. Nous vous invitons à participer à cette consultation et à encourager les membres de votre organisation et du réseau d’intervenants à faire de même. Votre rétroaction aidera à orienter l’élaboration des lignes directrices pour le monument, lesquelles serviront à guider les équipes de conception dans l’élaboration de leurs concepts.

Plus tard cette année, vous aurez de nouveau l’occasion de fournir une rétroaction par le biais de consultations publiques sur les concepts élaborés par les équipes finalistes avant la sélection et l’annonce de la conception retenue pour le monument. Pour en savoir davantage sur le Monument commémoratif national de la mission du Canada en Afghanistan, veuillez cliquer ici (https://www.veterans.gc.ca/…/afghanistan-remembered/monument).

Merci.

L’honorable Lawrence MacAulay
Ministre des Anciens Combattants et ministre associé de la Défense nationale

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Quilts of Valour – Canada Society - National Sew Day February 2 2020

VVi 08 Jan 2020 no

Please circulate this announcement among your members.

This is a wonderful organization with amazing people who sew quilts for veterans. They appreciate everyone's support and encouragement, however great or small.

Thanks very much.

Jerry Kovacs

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Quilts of Valour – Canada Society National Sew Day

February 1, 2020

Make a Block – Make a Quilt – Make a Difference

We are thrilled to announce our 2nd Annual National Sew Day on February 1, 2020!

Gather with us to cut, iron, sew, quilt, and finish Quilts of Valour™ in this year’s Brave and Bold pattern.

Quilts of Valour representatives and quilting groups in your area will set up locations and times.

For more information and updates on events in your area, contact your local representative https://www.quiltsofvalour.ca/contact.htm  .

For patterns and more detail, check out the "what's new" section on our website https://www.quiltsofvalour.ca/

Quilts of Valour – Canada Society provides quilts handmade by volunteers to Canadian Forces members and veterans who experience illness or injury as a result of their service. For more information about donating, volunteering, or to nominate someone to receive a quilt, visit https://www.quiltsofvalour.ca/
 
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Results of scientific inquiry into malaria drugs used by US troops expected in March

Patricia Kime
December 26, 2019

VVi 06 Jan 2020 db


During the response to the Ebola epidemic in West Africa, troops were issued the medication malarone to prevent malaria. The National Academies of Sciences, Engineering and Medicine is reviewing the scientific evidence on whether ant-imalaria drugs can cause long-term health effects. (Staff Sgt. V. Michelle Woods/Army)

A scientific panel plans to publish next year the results of year-long study of anti-malarial drugs used by U.S. troops and other federal workers, a review greatly anticipated by former service members and Peace Corps volunteers who say their debilitating mental and physical health symptoms were caused by mefloquine, a once-a-week malaria preventive issued to thousands who served overseas.

At the request of the Department of Veterans Affairs, National Academies of Sciences, Engineering and Medicine researchers are examining existing scientific literature to determine whether anti-malaria drugs, including mefloquine, also known as Lariam, cause brain damage, neurological conditions or psychiatric disorders.

During a meeting of the panel earlier this year, military veterans and Peace Corps volunteers told members how their lives were shattered by mefloquine — a prescription they were ordered to take but frequently wasn’t documented in their health records.

Marine Col. Timothy Dunn, who retired in 2018 after nearly 30 years of service, said he began experiencing vivid dreams, insomnia, anxiety, depression and “brain fog” as soon as he began taking mefloquine on deployment in 2006.

Since then, his symptoms have worsened, he said, to include vertigo, ringing in his ears and loss of balance.

“You have to do something to look at this closely and make a fair and just determination,” Dunn told the panel. “There are many more than I who have had this problem.”

Sarah Thompson, a Peace Corps volunteer in Burkina Faso from 2010 to 2012, said she was issued a large dose of mefloquine on arriving in the country and then took it once a week for two years.

She developed psychiatric symptoms, which she reported to her medical advisers, and later, disabling dizziness and vertigo. It wasn’t until she returned home, however, that she learned of mefloquine’s potential side effects because she never received the original packaging or instructions.

“It’s been over six years since my return from West Africa and I continue to experience the side effects from this drug,” Thompson told the panel March 27. “I know countless other volunteers who continue to struggle on a daily basis and who are on disability which can be confidently attributed to this drug.”

U.S. service members routinely take malaria prophylaxis medications when deploying to countries where malaria is endemic, such as Afghanistan, Djibouti and throughout Africa. But anti-malarials also were prescribed in places where the mosquito-borne disease is not prevalent, such as Iraq, which has been malaria-free since 2008.

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