National Defence Committee on Feb. 14th, 2008

[Denis Coderre, Liberal, Bourassa, QC]

Yes, I understand all of that, but I would like to know specifically which medications are prescribed?

[Capt(N) M.E.C. Courchesne]

I cannot name a specific medication.

[Denis Coderre, Liberal, Bourassa, QC]

Did I understand you to say that you also provide a diagnosis? For example, if a soldier deployed to Bosnia were exposed to uranium or radioactive material, and subsequently discovered that there was collateral damage—in other words, that he had contracted cancer because of that—would you be the people making the diagnosis?

[Capt(N) M.E.C. Courchesne]

No, we would not. We do not see patients directly. The diagnosis is made in a clinical setting.

[Denis Coderre, Liberal, Bourassa, QC]

Does the Department of National Defence not have physicians able to make a diagnosis and either confirm or refute the causal link if, for example, someone has been exposed to certain materials on the ground during his or her mission?

[Capt(N) M.E.C. Courchesne]

Are we talking about military personnel or people who have been released?

[Denis Coderre, Liberal, Bourassa, QC]

I'm talking about military personnel.

I come back

what the commander just said regarding the MOU. If we have a situation regarding a specific mission in which something happened and then they are released, you need to have some expertise on the situation itself.

[Cdr R.P. Briggs]

Sir, I can speak a little bit to that, because I used to work in occupational environmental health and was responsible for the deployable health hazard assessment teams.

With respect to depleted uranium, we do have an agreement, a memorandum of understanding—which hasn't been terribly well used—whereby families' physicians can send away for uranium urine testing on individuals who believe they might have been exposed to depleted uranium, such as the individuals who served in the Balkans conflict, or they can be referred to an actual clinic to have that done. These are folks who are no longer serving. That, again, is an MOU. Colonel Ken Scott, our director of medical policy, could say more about that; we have folks, like the director of force health protection, who could as well.

From time to time, we're asked by other governmental departments to examine whether there's any possibility somebody was exposed. We will go back and examine records to find out, to the best of our knowledge, what health hazards may have been present or not. We even get letters from members of Parliament requesting that we look into particular cases. I know that in the directorate of force health protection we do the best possible job of looking at health hazards. Of course, in retrospect, it's extremely difficult to say definitively—

[Denis Coderre, Liberal, Bourassa, QC]

I understand, but the MOU applies?

[Cdr R.P. Briggs]

For the depleted uranium, yes, sir.

[Denis Coderre, Liberal, Bourassa, QC]

Okay.

Let's go back to the decompression in Cypress. My understanding is that there's also something in Thailand for our people from Afghanistan.

Is it just a vacation, Colonel Darch? Is it just a good time?

[Col A.G. Darch]

During their deployment, people have a leave period of about two weeks somewhere in the middle of their deployment. They can do what they wish with that. They can travel back to Canada, which is covered by the CF, or they can go anywhere else they wish at their own cost. That would be an example of that.

[Denis Coderre, Liberal, Bourassa, QC]

Okay.

I'm trying to understand what happens if they are there for three to five days. Of course, when we're talking about anxiety disorders, or PTSD, we know that flashbacks can come afterwards, but not necessarily during that period of time.

Can you give me a specific example of what you mean by education? I know it's a matter of bridge-building to make sure that when they come back to their family they know it's not the same thing. I just witnessed some of the people in the artillery, and they're not a pretty sight; when they come back, they speak louder—but they've seen a few things.

Give me some concrete examples.

[Col A.G. Darch]

With the decompression in the third location, they are taken specifically through some of the things that will help them reintegrate with their families. Amongst those is the need to have realistic expectations when they go home, and not to be living in fantasies. Another, for example, is that if the husband has been deployed and the wife has taken over responsibilities for the finances and all of the household care, and everything, when he gets home, it's unrealistic for him to expect to go right back to where he left off and to take control of those away from his wife immediately. There has to be time for the two of them to reach a new equilibrium, because they'll both have changed during the time of the deployment. So there's education given from that perspective.

There's also education with respect to the fact that having been on deployment and experienced the circumstances they've worked under, those are not what they will face when they get home. They don't have to worry about grassy areas being mined; they don't have to worry about people hiding behind buildings to shoot at them, or worry that if a vehicle approaches them it might blow up and harm them. So there's education towards that.

There's also education about the signs and symptoms of operational stress injuries, so they can recognize them and seek help, or they can recognize them in their friends and recommend that they get help too.

[Denis Coderre, Liberal, Bourassa, QC]

Can the period be more than five days if there is some situation...?

[Col A.G. Darch]

The decompression in Cypress? No, sir, it's five days, and it's structured fairly clearly.

Within that, there are four specific lectures given, and the soldiers pick two of those. So they are invested in the process as well, because they choose what they want. Again, as I said, the focus of this is mainly to prepare them for reintegration back home.

[The Chair, Conservative, Rick Casson]

Thank you.

To the government, are you good to go?

The Bloc? Okay, Mr. Nadeau.

[Richard Nadeau, Bloc, Gatineau, QC]

Thank you, Mr. Chairman.

I have another question about services, but I'm not sure whether this is within your purview or not. I will ask my question anyway. I am thinking of Service Canada. A colleague told me about a young soldier who had left the Canadian Forces, after his return from Afghanistan, and wanted to get information because he didn't feel well. Instinctively, he felt he should get in touch with Service Canada. Service Canada is a telephone service that can be reached at 1-800-O-CANADA. I remember this because I am the Bloc Québécois spokesperson on issues relating to Service Canada. The young man was not at all satisfied with the information he received, because he was sent from pillar to post when he requested information about his mental health. He didn't feel well.

I would like to know whether soldiers have a simple way—or at least, a less complicated way—of accessing your medical services, even though you are unable to help them directly? Can you at least provide them with appropriate referrals, so that they can receive the information and services they require?

I tested this myself. The person on the other end of the line was sincere and wanted to help out, but this is a general service. The people on the other end of the line are not physicians. Is there something simple that could be done for soldiers—in the form of a telephone number or service? I don't believe a barracks on the street corner can provide that service.

What concrete services are provided to our soldiers who require them when they return and are no longer members of the military?

[Col A.G. Darch]

Sir, I believe it would be best if they went to Veterans Affairs. We deal with people in the service, so I would really have to defer answering that question in detail to Veterans Affairs.

[Richard Nadeau, Bloc, Gatineau, QC]

You are saying that I should ask Veterans Affairs? Well, it's fine for you to tell me that, but are you also making that information available to our soldiers when they leave the Canadian Forces? My father is 89 years old and, about three years ago, he found out that he could receive services from Veterans Affairs Canada, such as a walker, house work, etc. He is entitled to those services and he found that out from his brother, who is 90 years of age. So, we're talking about very elderly Second World War veterans. Since then, there have unfortunately been other conflicts across the globe in which we have participated.

But, for soldiers leaving the Forces now, is there something simple that Veterans Affairs can provide them with?

[Col A.G. Darch]

I believe that each soldier who is released from the military has a transition interview with Veterans Affairs. That should give them the information they need on how to access those capabilities.

[Richard Nadeau, Bloc, Gatineau, QC]

You say that you believe that… Do you see what I'm getting at? You yourself are not certain, and I know nothing about this.

Could a soldier leaving his regiment—and I don't know how it works in the divisions—contact the division? In a case such as this, could I tell him to call the unit he is from? Let's take a specific example: if he is from the Royal 22nd Regiment, can he contact the regiment, receive medical services and explain what he would like to do?

[Col A.G. Darch]

I know that Veterans Affairs is working a lot more closely with us now. They are actually putting groups of people on the major army bases in Canada. That will facilitate this transition. Another possibility for somebody like the soldier you mentioned is what's called the regimental family. The Van Doos have a very strong regimental association, so there might be some services that he could access through them.

[Capt(N) M.E.C. Courchesne]

A number of procedures have been greatly improved since the Second World War. People are aware of the services they have access to on their release. There is obviously the Department of Veterans Affairs, but there is also the Centre—and this is outside of my area of responsibility—where the information is provided. This is an organization that is within the purview of the Chief of Military Personnel, the DCSA Centre. I believe you have already spoken to Lieutenant-Colonel Blais. Those services are available to people who have been released. There is also a 1-800 number, but I am unaware of it.

[The Chair, Conservative, Rick Casson]

Thank you.

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