National Defence Committee on Dec. 3rd, 2013

[Jean-François Larose, NDP, Repentigny, QC]

In terms of your research and development on reducing the impact on armoured vehicles, would you say that the impact on current vehicles has been completely eliminated with the changes you have made?

[Dr. Marc Fortin]

No country can claim that its vehicles are fully protected.

[Jean-François Larose, NDP, Repentigny, QC]

Vehicles have still been developed. I am thinking of South Africa; they have developed armoured vehicles. We know that a V system reduces the impact significantly, which is not the case for Canada’s vehicles.

[Dr. Marc Fortin]

In the first days of deployment in Afghanistan, DRDC has assigned almost 80 people to work on armour, known as underbelly armour.

[Jean-François Larose, NDP, Repentigny, QC]

That’s basically the V hull.

[Dr. Marc Fortin]

Let’s talk about the V hull, which is designed to strengthen the most vulnerable spots. That is why we have a database on the damage done to vehicles. We want to understand which spots are the weakest and take steps to strengthen those vehicles.

[Jean-François Larose, NDP, Repentigny, QC]

However, there is a limit with the first vehicles that were built. No one expected the IEDs.

[Dr. Marc Fortin]

That was a significant development in the war in Afghanistan, a major lesson for all the allies. DRDC provides advice on how to select the next generation of vehicles—

[Jean-François Larose, NDP, Repentigny, QC]

That is urgent.

[Dr. Marc Fortin]

—that Canada will acquire.

[The Chair, Conservative, Peter Kent]

Thank you very much, Mr. Larose.

Thank you, Dr. Fortin and Dr. Dursun, and Colonel Tremblay, for your appearance before us this morning.

This concludes the first hour. We thank you again for your attendance.

Colleagues, rather than suspending, as our first-hour witnesses depart and our second-hour witnesses settle in at the table, we have a motion before us from Mr. Williamson. Mr. Williamson, could you speak to it, please.

[John Williamson, Conservative, New Brunswick Southwest, NB]

Certainly, Mr. Chair. I sent this to the clerk a couple of days ago. I believe it's in order in respect of the time requirement. I'll read it for the benefit of the members. My motion is:

That the Chair of the Standing Committee of National Defence, on behalf of the Committee, direct the Clerk to call officials from the Department of National Defence and the Canadian Armed Forces as witnesses to appear before the Committee to provide an update on Canada's contribution to humanitarian efforts in the Philippines, for one hour on December 10th, 2013.

(Motion agreed to)

[The Chair, Conservative, Peter Kent]

Thank you very much.

Dr. Moldofsky, please approach the table.

Colleagues, we are joined for this second hour by Harvey Moldofsky, professor emeritus, department of psychiatry, faculty of medicine, Institute of Medical Science, University of Toronto.

Thank you very much, sir, for responding on relatively short notice. I hope your cold has improved. I welcome you to give us your opening remarks.

[Dr. Harvey Moldofsky, Professor Emeritus, Department of Psychiatry, Faculty of Medicine, Institute of Medical Science, University of Toronto, As an Individual]

Thank you very much, Mr. Chairman.

I think we're all fortunate. I'm not going to last 10 minutes. You won't have to tolerate my laryngitis.

I'm grateful to Mr. Ted Opitz for initiating this effort, because this is a matter that is of concern, I can see, to everyone here. I'd like to answer a question that you raised, which is what support we have from the universities with regard to PTSD, TBI, that sort of thing.

In my case, over the past 20 to 30 years, it's been zero. I was obliged to leave the university at age 65, and instead of getting a medal, they call me an “emeritus”, which means I can do all the same things but I don't have to attend committees.

[David Christopherson, NDP, Hamilton Centre, ON]

It's called the Senate.

[Dr. Harvey Moldofsky]

Please don't put me into that.

What I'm going to be talking about...and I was reflecting back on my notes, going back almost 10 years. When I heard at that time that the Canadian government was seriously considering going into Afghanistan, I put together a grant application suggesting that we look at predictors to PTSD and its symptoms. I've never received a response.

I went ahead with the encouragement and support of colleagues at DRDC and Don Richardson at the operational stress injury clinic. Over the past decade, they have referred patients to me and I'm not a typical psychiatrist. I'm not seeing crazy people, except families and relatives—

[David Christopherson, NDP, Hamilton Centre, ON]

Except today.

[Dr. Harvey Moldofsky]

—but I'm seeing people who suffer illnesses that no one understands. That's my specialty. I've been doing this for more than 40 years. I have ventured into areas that never existed and now are quite common. That's because I was interested in how the brain works and how the brain is connected to the physical as well as the mental health of people. It's not like I'm just taking a snapshot or asking a few questions; I actually look, see, and try to understand.

The work that I did showed that the key issue in our health is the operation of the brain, the sleeping and waking brain. The brain does not stop, awake or asleep. If we don't sleep properly, we become ill. If we deprive an animal of sleep, the animal dies. We haven't done it to people, and it never will be done. This has taken me into studying sleep-wake physiology, the operation of the immune and endocrine systems, and the relationship to illnesses that nobody understands but gives them a variety of names as though we do understand.

PTSD falls into that realm. We keep hearing that this is a mental health problem. No, it's a problem of the whole body. We were able to show that if you disrupt deep sleep, you can artificially induce physical symptoms, pain. In the people that I have been privileged to study in the military over more than a decade, 93% of them have pain in various parts of the body, but nobody even asks about it and no one seems to be trying to treat it.

They suffer from profound fatigue, but the focus is on the mental part of this. The way it's dealt with in the clinics is to give pills. I don't think that's the answer, because the pills, as the U.S. military and the British have found, are not working. In fact, the Americans have put in a request for applications for novel forms of treatment.

This is an area that I have been involved in. I have studied non-military people who had suffered motor vehicle accidents, industrial accidents. I've studied people who've been subject to torture. I've seen military people in other countries who have experienced torture. They all have sleep problems. In fact, a recent publication said this is the hallmark. If we don't tackle it and understand it, we're never going to get anywhere.

The work that I've done has shown that there is an alteration in the brainwave pattern over the night in these people. In people, not military, but people who have suffered from a condition called fibromyalgia, I have shown how very recently a novel medication not typically prescribed—it's available but under very tough circumstances—does improve deep sleep and magically their pain improves, their fatigue improves, and their mood improves. It's not a cure, but it's a way in. Based on the research I've done, we have shown that this is an area which we need to get into.

One of the fundamental problems is at an organizational level. Everybody is going to tell you that it's wonderful, we're doing the research, but then we start at looking at where they are doing it and what they are doing, and I'm not impressed.

There's a lack of coordination and integration in a key issue: early detection of what's called TBI and PTSD. It's not happening. I'm still seeing people from Rwanda and Bosnia. It tells you something. They don't appear within days or weeks; they're too ashamed. They appear later. They're not necessarily active; these are vets who are largely neglected and feel guilty and do not want to say anything.

Only when they get into trouble.... And this is something I've come up with, predictors to trouble. What are the areas of trouble? You know them; you've been reading about it in the press. Suicide is the most common cause of death in the U.S. military. We don't even know the prevalence in our Canadian vets. Why? It's very hard to even know the prevalence of suicide deaths among the active military.

Even more troublesome to me is that I found a predictor that just came out after my investigation into serial murders that were investigated by the FBI. I happened to have a self-rating test that was hidden in a larger test, where I looked at two areas, anger and hostility, and suspicion and paranoid thinking. Those with PTSD who are not responding, and this was after combat, have very high levels.

[The Chair, Conservative, Peter Kent]

Forgive me for interrupting, Dr. Moldofsky, but you have very effectively, very eloquently filled the 10 minutes for your opening remarks, and you have, I'm sure, provided members of the committee with some interesting areas of questioning.

We'll begin with Mr. Opitz, please.

[Ted Opitz, Conservative, Etobicoke Centre, ON]

Thank you, Mr. Chair.

Through you, I'm delighted that Dr. Moldofsky is here today, that he's been able to make it. I'm sorry you have such a bad cold, but I'm delighted that you fought through it to be here today.

This kind of research is clearly important to us. I saw the nodding heads of my colleagues. You've resonated on a few points, especially the predictors. We met with some of your colleagues at DRDC. This is something that interests me tremendously, in that if we can delve into these predictors, if we can use some of your research and their research in terms of.... You talked about the waking and sleeping brain, and the correlation between pain and some of those psychiatric disorders that we've all now come to understand through many of our soldiers who suffer through this.

Along with your colleagues, you're also doing some of that research based on the immune and endocrine systems of the body, for example, Dr. Paul is working on the melatonin levels to see if those could be regulated in the brain, which would assist with the production of restful, restorative sleep—not just sleep, as we discussed. You may want to delve into that. There are several forms of sleep, but only one really refreshes the body and the individual.

Doctor, if you could talk about some of the circadian rhythms, some of the chemical imbalances that might be regulated through production of a device that can measure hormones through saliva and other factors, that would be helpful.

[Dr. Harvey Moldofsky]

Thank you very much.

You've opened up a much larger window, and that is it was largely with the support of DCIEM and DRDC that I was privileged to get into this area in 1980. I was interested in precisely what is going on in the brain as it links to the immune system. At that time no one believed there was any linkage. We went ahead and showed that there was, and that there are hormones of the immune system that put us to sleep and wake us up. The reason we're all here today is that all these things are working automatically, and we don't have to think about them, but if we start to screw around with our sleep, they don't function.

The work that I pioneered in with colleagues in Toronto led me to work with the Canadian Space Agency and in turn with NASA and the Russian space agency because we became interested in long-term survival in the most adverse circumstances over a long period of time. We learned a lot and showed that disruption of sleep in the cosmonauts and astronauts was linked to hormones that would be associated with inflammation and infection. They didn't have it, but they were vulnerable.

Although I'm not doing that now because I'm emeritus, I've been focusing on the sleep-wake physiology aspects. I'm leaving it to my colleagues to come up with novel things, and I'm hopeful that we can collaborate.

[Ted Opitz, Conservative, Etobicoke Centre, ON]

Dr. Moldofsky, do you think that, as Mr. Fortin ahead of you said, there is no magic bullet for this at this point in time? I think that some of this research would be very helpful in being able to look ahead to pre-deployments, look at soldiers, do some of this testing on a hormonal basis, and be able to identify those individuals who are most susceptible to these chemical stresses within the body.

That would, I would suspect, lead to treatments. You can't do it during combat, but you can certainly do it pre-combat and then post-combat be able to begin to treat these individuals as quickly as possible for those symptoms and issues before this begins to manifest in a very negative way. Could you comment on that, sir?

[Dr. Harvey Moldofsky]

In 1994—I'm sorry, in 2004—that was my grant application—at that time, we had devices that would allow us to go into the field and study them before they went into combat, and to see them afterwards, and to look for precisely that.

Now I'm looking at them months or years later, and they're full of compounds and on every known medication that someone can throw at them. I don't think that's the way. I think we've got to teach early detection to physicians in the military. We have to go through a screening system and we've got to do something for them right away.

There is a lot of education that is involved in this. I think that before we venture into the practicalities of the kind of research that you have been hearing about, this is what we've got to do. We've got to know the numbers. We've got to know who these people are. Until we can properly identify them, we're cursed because this is going to go on for decades to come, and we don't know how many will survive.

I'm not just talking about the military people themselves; I'm talking about their families and their spouses. As my friends in England have shown, those with PTSD who come back from Iraq and Afghanistan show more dangerous behaviour, as identified by the police in England.

[The Chair, Conservative, Peter Kent]

Thank you, Dr. Moldofsky.

The seven minutes have expired.

Our second questioner is Mr. Christopherson.

[David Christopherson, NDP, Hamilton Centre, ON]

Thank you very much, Doctor.

I can't think of anything more important than talking about the lives of our military personnel, our fellow citizens. I think it struck us all....

I just want to be clear. There are two things. You said that the greatest cause of death in the armed forces is suicide. Did you mean that exactly the way it sounds, that in terms of all the reasons why armed forces personnel die, including in battle, suicide is the highest? Then, if I could link that sir, you mentioned that we don't have the stats. Can you tell me why you think we don't have those stats?