Veterans Helping Veterans: a NSW Example A.C. Baxter

World War II veterans are now in their seventies and eighties, Health problems that were experienced during the years of conflict have a lasting effect on this unique section of the community. Through VWAWC, a nucleus of veterans and the widows of veterans on the Central Coast of New South Wales have developed successful stratedes of support for the wider veteran community, to hek them accomplish healthier, happier ageing.

THE EFFECTS OF WARTIME EXPERIENCES ON HEALTH

During a war, servicemen are selected on physical fitness (Adena 1989) and prior to engaging in combat are exposed to rigorous training, designed to maximise each person’s physical and mental wellbeing. War takes its toll, even on the fittest.

The Repatriation Commission Report of 1945-46 classified the disabilities suffered by members of the forces enlisted for World War I1 (Repatriation Commission 1946). It is interesting to note that accidental injuries or wounds accounted for 13.032 of the recorded 68,097 disabilities. Gunshot, shell, bomb and bayonet wounds accounted for 6,188, whilst neuroses. psychoneuroses and mental disorders accounted for 9,044. (No other disease, accepted as related to war service, affected the number of ex-service men that neurosis. psychoneurosis and mental disorder accounted for at that time.)

As recorded by Barrett (1987) in We Were There: Australian soldiers of World War 11, half the respondents of a comprehensive survey of World War I1 veterans, maintained war service continued to have adverse effects on their general health.

It was far easier to provide information on the long term consequences of having contracted pulmonary tuberculosis, than i t was to provide information on the emotional crippling that the war caused for so many. After 50 years, men who witnessed particularly horrifying events continue to relive the horror.

One veteran is still haunted by the crash of an American Liberator bomber, where 59 men perished. Those who were not lucky enough to die on impact became human torches, engulfed in flame, as they ran screaming for help which was impossible to provide. This veteran lost sight of whether the recurring nightmare was real or imaginary. Following investigation of this man’s service, his psychiatrist was able to confirm the reality of the events witnessed in the nightmare (Barrett 1987). There are many World War I1 veterans who have lived with similar tragedies for 50 years.

Illness was the enemy in the Pacific. Diseases such as dengue fever, malaria, bronchitis, dermatitis and dysentery were almost routine for many of the troops, whereas wounds were more often the cause of debility for those men fighting in conflicts in Europe and the Mediterranean (Barrett 1987).

The health of former service men and women remains a concern to the Government. In the intervening years since World War 11. death and morbidity studies have been made of the veterans of that war.

Veterans who have been the subject of considerable research are the ex-prisoners of war of the Japanese. More than 22,000 Australian men and 65 women were taken prisoner. Just over 8,000. more than one third of those

captured, died while in captivity. Conditions in all camps were homfic.

In the Sandakan- Ranau camp in North Borneo, there were 2.500 Australian and British POWs. By mid 1943, less than eighteen months after the fall of Singapore, just six Australians had survived. Of 528 Australians on Ambon in 1942, only 121 returned home. One third of over 3,000 Australians of F Force on the B u r m m a i railway died in one year; whereas from 600 Australians on Blakang Mati island only 4 died (Nelson 1990).

It is impossible for those who did not suffer at the hands of the Japanese to understand the lifelong impact those years of internment have had on the detainees. Most confess that, even now, it is only with other ex-POWs that they feel truly relaxed, for only they understand.

“It is obvious that many prisoners of war will suffer for the remainder of their lives from disabilities related to their grim ordeal. Those who witnessed their fortitude and unconquerable spirit under conditions of great suffering, slow starvation and physical wretchedness hope that their disabilities will be fully comprehended and will receive generous consideration” (Dunlop 1946). In Weary Dunlop’s opinion, age exacerbated the long term effects of those illnesses suffered by the POWs (Dunlop 1990). It may not be too long a bow to draw, to assume that other servicemen and women who suffered deprivation andlor physical and mental trauma would expect a similar exacerbation of their war caused diseases.

It remains a mystery why the Australian POWs’ survival rate was much higher than that of the British, Americans or Dutch, sometimes 4 times higher than any other nationality. Pigott, in his book 1995 Changi Diary believes the reason Australia had a far greater survival rate than other nationalities was because of “the incredible price that they placed on their mates ... a deep and profound sense of humanity and compassion” (Sibree 1995).

There were degrees of that horror.

VWAWC It is with the same concern for their mates and their

widows that members of the New South Wales Central Coast Veterans’ and Widows’ Advocacy and Welfare Committee (VWAWC) have taken on the responsibility of research, advocacy and provision of information to those members of the veteran community who are no longer able to assume these responsibilities on their own behalf.

Currently in NSW, the Department of Veterans’ Affairs services a client group of 119,164 consisting of 88,837 veterans and 30,327 dependents, mainly war widows (DVA 1994). The Central Coast region, including both the Gosford and

Wyong shires, embraces approximately 9,000 DVA clients. The majority of these are World War I1 veterans and widows of those veterans. Through VWAWC veteran

132 Australian Journal on Ageing, Vol. 14, No. 3

clients have assumed responsibility for a healthier, happier ageing.

The Central Coast VWAWC was established in 1991 as an initiative of a pilot program, the Veterans’ Independence Program, funded by the DVA. Because of the influence war service has had on the health of veterans, the DVA has endeavoured to co-operate with its beneficiaries and be guided by them as decisions are made about the provision of care for this ageing population.

The aims and objectives of the VWAWC are to encourage and support veterans and widows to remain independent in their own homes and, through regular meetings, provide a forum at which they may raise issues that affect their independence. The committee. through representation to the appropriate service, then ensures the issues are dealt with.

VWAWC ACTIVITIES Education

It has been the practice of the VWAWC, after consultation with members, to invite a guest speaker to the monthly meetings. These guest speakers are from within the local community, usually the Home and Community Care (HACC) funded services, or from within the DVA. The purpose of these speakers has been to provide information on a specific subject which has been raised by the rank and file membership of the VWAWC. From the information conveyed, and from members reporting back to their own organisation, a better understanding of an issue has been gained. It has been the wish of the members that on certain issues, working parties be formed to enable an ongoing commitment to be maintained.

Participation The Central Coast VWAWC has been heavily involved in

arranging local activities for Veterans’ Health Week, another health promotion initiative introduced in 1992 by the DVA. Over the ensuing years the participation rates have increased greatly, with most local ex-service organisations ensuring they have input into the activities planned for the Week.

Members of the VWAWC working party, established specifically for Veterans’ Health Week, have acquired new skills through their involvement in the organisation of these activities. They are required to liaise with local Council regarding use of council facilities, co-ordinate the use of private venues and naturally ensure widespread promotion of the Week via local radio and print media. Through this active participation, members feel a sense of increased worth to their community, and derive immense satisfaction from the success of the efforts.

Communication By gaining insight into the workings of the HACC funded

services, through the guest speakers addressing the VWAWC monthly meetings, members of the VWAWC acknowledged the existence of “gaps in services” and decided that rather than blame the actual service providers and the State or Commonwealth Governments, VWAWC should look to overcome these gaps. A survey of client needs, conducted by the DVA in 1993 identified the following: * the imponance to the veteran community of living

independently in their own homes for as long as possible;

* the difficulties that aged veterans experience i n

arranging maintenance and repairs of homes; * the importance of locating trustworthy trades people.

VWAWC established a working party to research and produce a directory of trades people who were aware of the needs of the aged community and would respond in a reliable and reputable manner. The end result was a trades and services calendar which is produced annually with funding from the subscription fees payable by the affiliated ex-service organisations.

The calendar is produced for both the Wyong and Gosford shires, with listings of all local community and home support services, predominately HACC services and trades people with whom contact has been made regarding their inclusion and the service VWAWC expects of them. These trades people cover all areas of home maintenance including housekeeping, lawn mowing, window cleaning, plumbing and electrical services together with general handyman duties. The trades people concerned pay a yearly subscription fee and also receive a copy of the calendar.

The calendar is distributed through the local ex-service organisations and is made available to the HACC services at no charge. The working party continually reviews the listings, with members of the ex-service community providing names of trades people they have used for inclusion.

This ongoing project has allowed VWAWC to communicate widely with members of the local ex-service community who are no longer able to attend VWAWC or ex-service organisation meetings and require assistance of the sort provided by the trades service calendar in order to remain independent and safe within their own home.

THE FUTURE The veteran community expresses grave concern over the

level of care that will be required to assist ageing veterans and war widows in their endeavors to remain in their own home for as long as possible. Over the past two years AGB McNair (1994) was commissioned by the DVA to conduct two major surveys of veterans, widows and, in some instances, their carers.

The first was a survey of health and lifestyle which involved interviews with 2644 clients not living in institutions.

The second was a survey of needs and attitudes. The main aim of this survey was to identify and prioritise needs in relation to income and health benefits. According to the study, Veterans’ Affairs beneficiaries are, in 1995, similar to the general community in their perception of their own health and care needs. 98% of those surveyed rated staying in their own home as being a strong priority with 88% rating it as very important. 89% of older veterans confirmed the need to have people nearby to provide care or perform tasks when they were no longer able to. “The most commonly rated priority for DVA to improve over the next 5 years is services designed to enable people to remain in their own home.”

Veterans and war widows represent a significant proportion of the aged community which relies upon home support from government funded services such as the HACC program. At present, members of the veteran community have found these services are unable to cope with the demand placed upon them by initiatives such as early hospital discharge, and the move to keep aged persons and persons with a disability in their own home.

The DVA. with its mission statement and corporate plan

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has set in place programs aimed at assisting the ageing veteran community. These programs are mainly concerned with income support and health care.

Informal groups such as VWAWC have demonstrated that through participation, education and communication, issues which affect a person's quality of life can be addressed at a local level where the veterans themselves are influential in the provision of care. This is not to say that either the State or Commonwealth Governments can overlook their obligation to provide funding for these essential community and home support services. However it does prove, that where kindred organisations combine their resources, their efforts can achieve results which will enhance the quality of life of their members.

Mr A.C. Baxter is president o/the NSW Central Coast Veterans' and widows' Advocacv and Welfare Committee.

Address correspondence to A.C. Barrcr. VWAWC. PO Box 821. Gosfod, NSW 2250.

REFERENCES Adena M. (1989) The health of Australian vetenns. Medical J o u m l of

Barrctt, 1. (1987) We We- There: Australian Soldiers oJ World War I / . Sydney:

Department of Veterans' Affairs. NSW Branch (1994) Untitled. Sydney: DVA.

Dunlop, E. (1990) A personal view. In. Lifelong Captives. Canberra: Department

Dunlop. E. (1946) Medical expcriences in Japanese captivity. British Medical

McNair. AGE (1994) Australian Veterans cmd Wur Widows: Their Lives. Their Needs. Findings from surveys commissioned from the DepMment of Vetenns' Affairs. Canbcm: Australian Government Publishing Service.

Nelson. H. (1990) The medical legacy of POWs of rhe Japanese. In. Li/elong Captives. Canbem: Department of Veterans' Aff;lin.

Repatriation Commission (1946) Sratistical AMlYSI's of War Pensions for Year Ended 30 June 1946. Canbcm: Repatriation Commission.

Sib=. B. (1995) The diggers were great survivors. Canberra Ernes. 21

Australia. 150. 336357 .

Penguin.

of Veterans' Affairs.

Journal. 48 1-486.

JanUiVy.

Profiling Veterans

Young Veterans Young veterans (ie. those aged between 42 and 54 years old) probably served in the Vietnam War. The proportions of young veterans reporting good or very good health are very similar to that of the total veteran

population. At the same time, however, a higher proportion report poor health, while a lower proportion say their health is fair. Young veterans have different health needs. Nervous disorders, anxiety states, dermatitis and back and joint disorders are

more common among them than among older veterans. So, surprisingly, are memory loss and dementia. One in two young veterans report that their medical conditions cause them a lot of bother. But there appears to be no

difference between young veterans and the total veteran population in the incidence of long-term medical conditions. Young veterans include a higher incidence of high and very high risk drinkers than would be expected from data on males

of the same age in the general population, but their smoking incidence is similar. They are less likely to be overweight or obese.

Around one third of young veterans report some difficulty with activities of daily living - about the same as in the total veteran population. They are more likely to report problems with talking and being understood. getting in or out of bed or a chair, using public transport, managing money and writing.

Despite having similar health and functional status to that of the total veteran population, young veterans are less likely to receive assistance with housework or garden maintenance.

Young veterans are generally aware of the Vietnam Veterans Counselling Service (VVCS), and report its services as satisfactory. The majority prefer VVCS offices to remain separate from DVA offices.

I34 Australian Journal on Ageing, Vol. 14. No. 3