Shell Shock to Palali Syndrome
Posted on October 22nd, 2012

Dr. Ruwan M Jayatunge 

In war, there are no unwounded soldiers – Jose Narosky

Palali is a well-known area in the Jaffna Peninsula in the Northern Sri Lanka. Palali has an important airport that serves as the main lifeline in the North. A large number of soldiers travel to the Northern Peninsula through the Palali Airbase. During the Eelam War, Palali Air Base played a key role (like the Tan Son Nhut Air Base during the Vietnam conflict) providing essential food items, medicines and ammunition to the troops. Throughout the Eelam War, many battle casualties were transported to Colombo via Palali. Therefore, Palali is a part of the combatants who fought in the Eelam War for nearly three decades. Palali is in their memories, sometimes in their intrusions. Palali has become a symbol and metaphor that recounts combat trauma in Sri Lanka.  Palali represents the symptom complex of battle stresses that has been experienced by the new generation of combatants.  It has developed in to a syndrome.  Palali syndrome describes various clinical and psychosocial ailments experienced by the Sri Lankan combatants and in the final score how it affects the society at large.

 Shell shock to Palali Syndrome was a long and agonizing path for the soldiers who fought numerous battles. These battles were fought in different countries under different circumstances. But in every battle the combatants experienced the gruesome realties of war. Combat trauma made dramatic transformations among the soldiers. Some were healthy transformations and some transformations were extremely detrimental. Shell Shock and Palali Syndrome describe the destructive effects of combat trauma on soldiers, their family members and the society.

 In the early years of World War 1, Shell Shock was believed to be the result of a physical injury to the nerves. The term Shell Shock was coined by the British Pathologist Col. (Dr.) Fredrick Mott. He regarded Shell Shock as an organic condition produced by miniature hemorrhages of the brain. Shell Shocked soldiers exhibited symptoms of extreme fear, shaking, psychogenic blindness, psychogenic paralysis and sometimes aphonia.

Sheffield (2001) indicates that front line soldiers of the WW 1 were constantly exposed to artillery barrage and mortar attacks. It is estimated that 60% of deaths in World War I were caused by shrapnel. During World War I, 10% of British battle casualties were categorized as having some form of shell shock or neurasthenia. Jones et al., 2007 was of the view that Shell shock was largely free from stigma when used in the early phase of World War I because it was perceived as a wound, or a neurological lesion.

In 1915, Col. (Dr.) Fredrick Mott believed that shell shock was a neurological, lesion, a form of commotion cerebri, the result of powerful compressive forces. However, some experts expressed the view that the symptoms were more psychological than organic in origin. Mott examined the brains of two men dead of commotion cerebri (shell shock) and found no visible external injury to the brain. In addition, the Medics in 1915 found increasing numbers of soldiers who had been close to a detonation without receiving head injuries presented at casualty clearing stations with puzzling symptoms. They suffered from amnesia, poor concentration, headache, tinnitus, hypersensitivity to noise, dizziness, and tremor but did not recover with hospital treatment. In October 1917, Salmon reported that shell shock was responsible for one-seventh of all discharges from the British Army

The Army was less sympathetic to the ordinary soldiers with Shell Shock. According to the classified reports during the World War 1 306 British and Commonwealth soldiers were shot on the orders of General Douglas Haig and other senior offices. In contrast, the US Army executed none of their soldiers. Between 1914 and 1918, the British Army identified 80,000 men as suffering from Shell Shock.

 Private Abe Bevistein

Private Abe Bevistein was 16 years old when he was shot by a firing squad at Labourse, near Calais. He had been found guilty of deserting his post. Just before his court martial, Bevistein wrote home to his mother: “We were in the trenches. I was so cold I went out (and took shelter in a farmhouse). They took me to prison so I will have to go in front of the court. I will try my best to get out of it, so don’t worry.”

 Private Harry Farr

After two years of fighting on the Western Front Private Harry Farr became mentally and physically exhausted. There was no energy left for him. He refused to fight at the Battle of the Somme. Private Harry Farr was charged with cowardice after a 20-minute court martial. He was executed at the age of 25 in Oct 1916.  Before Private Farr’s death, he spent 5 months in hospital being treated for shell shock. In August 2006, the British Defense Secretary Des Browne announced that with Parliament’s support, there would be a general pardon for all 306 men executed in World War One. After 90 years of Private Harry Farr”‘s death he was pardoned and formally honored on a war memorial. Pte. Farr’s 94-year-old daughter Gertrude Harris received an official pardon letter from the Defense Ministry.    

 Shell Shocked Sri Lankan Combatants

During the World War 2, a small contingent of Sri Lankan soldiers attached to the British Army served in Italy, Singapore, Egypt and Burma. Some were exposed to active combat or witnessed the horrors of the WW2. Some historical data suggest that a few Sri Lankan veterans suffered from Shell Shock during the WW2. The renowned Sri Lankan novelist Mr. W.A Silva narrates the plight of a shell-shocked local soldier in one of his short stories.

The veteran film director Dharmasena Pathiraja’s 1981 movie Soldadu Unnahe (A Combatant) was a story about a Sri Lankan village youth who joined the British Army during the World War 2 and fought against the Axis Forces. After the war, he returns home with vivid combat memories. There were no welcome home signs for him. His mind was filled with combat related intrusions and the old veteran was alienated from mainstream society. He becomes a homeless man and lives among the vagrants.  

 War Neurosis

During the World War 2 traumatic reaction to combat was identifies as War Neurosis or Chronic Fatigue Syndrome. Nearly 10% of US Servicemen developed combat exhaustion in the WW2. Over 1363,000 soldiers were given medical discharges and 39% had Chronic Fatigue Syndrome.

One US Soldier of the WW2 wrote after killing a Japanese soldier who tried to throw a grenade at him. “I had just killed a man at close range,” “That I had clearly seen the pain on his face came as a jolt”‚¦. The expression on that man”‘s face filled me with shame and then disgust for the war and all the misery it was causing.”

 Section 8

During the Korean War, the term section 8 was widely used to describe causes of psychological combat trauma. Those who had been diagnosed with section 8 were dealt with in a very situational manner. Alexander L. Smith “-a Korean War veteran from Virginia Beach believes that all combat veterans returned home after the mission in Korea with some degree of emotional issues. When I returned to Straight Creek, Ky., I, too, went through emotional ups and downs and would walk for miles on railroad tracks trying to get my mind straight says Alexander L. Smith. For many years, I would occasionally have nightmares about seeing the swollen bodies of American soldiers lined up on the side of the road awaiting transfer back to the states, the sound of Russian T-34 tanks, or the sound of bugles and banzai attacks. Most of those feelings have gone now, having been replaced with stage four cancer.

 Vietnam Syndrome

The term PTSD or Post Traumatic Stress Disorder emerged soon after the Vietnam War. PTSD has been found in 15% of 500,000 men who were in Vietnam. There are estimated 50,000 veterans suffering from full-blown symptoms of PTSD. At least half a million Vietnam veterans lead lives plagued by serious war related readjustment problems.

Since 1969 I relive with my experiences in Vietnam says Private DXXX whom I have met at the Coatesville VA Philadelphia in 2006. As an African American soldier in Vietnam, we had to fight two war fronts he further said. During the Vietnam era, racial tensions were aggravating and some Officers treated us with utmost racial prejudice. Hence, we were fighting the enemy and the racial injustices. Therefore, it became a two way battle front for us Private DXXX revealed.

 Palali Syndrome

A new form of battle stress began in Sri Lanka mainly after 1983. Many Psychiatrists point out that a number of psychiatric illnesses have been increased as a result of the Northern Conflict. For a combat soldier in World War 2 who served for 4 years the average time spent in actual combat was approximately 40 days. In Vietnam, soldiers spent an average of about two thirds of their 12 or 13-month tours over 250 days in combat. But in Sri Lanka a large number of soldiers have spent 10-15 years in combat with short intervals.

For nearly three decades, Sri Lanka experienced a social calamity following an armed conflict and people were deeply traumatized. The echoes of the war trauma will affect Sri Lanka for generations. Although the origin and the history of this conflict was very complicated and carries many versions and explanations, after all it is a collective trauma for the Islanders. The North and South suffered from this conflict creating a large number of physically and psychologically traumatized victims. The combatants who experienced the war firsthand became profoundly affected by the physical and psychological consequences of the armed conflict. Many became the victims of the Palali syndrome. Unfortunately the International media has overlooked the magnitude of combat trauma experienced by the Sri Lankan combatants and often portrayed them as the perpetrators of violence.   

Palali Syndrome describes post traumatic reactions and post war re-adjustment problems experienced by some Sri Lankan combatants.  It narrates the psychological aftermath of the Eelam War in Sri Lanka. Even though the Eelam War is over  combat trauma is still hounding the Sri Lankan society rising as social violence, political violence, political extremism, criminal activities, domestic violence, suicides, homicides, alcohol and drug abuse, cruelty to children and various other forms.

 Combat Related PTSD in Sri Lanka

Since the early days of the Sri Lankan conflict (in 1982-83) medical doctors noticed drastic physical and psychological changes among the combatants who were exposed to the war in the North. Among the changes fatigue, headaches, somatic pains, irritability, changes in sleeping pattern, and depression were prominent. Some servicemen left the military prematurely. Way back in 1984 one eminent surgeon who treated battle casualties noticed certain psychological factors associated with the physical trauma. 

In 1980, the American Psychiatric Association added PTSD (Posttraumatic Stress Disorder) to the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III). Some Sri Lankan clinicians suspected possible combat related PTSD in Sri Lanka. But the large fraction of the academia and the military authorities were not ready to accept the American concept of PTSD.

 Is PTSD an American Illness?

Some have expressed the view that the clinical concepts of PTSD mainly developed in the Western Societies cannot be applied to countries with different socio cultural outlook on psychological trauma. In contrast to this notion research has shown that nearly all war victims experience recurrent and intrusive recollections, dreams, and sudden feelings of reliving the event (Bramsen, 1996). Although there are considerable controversies regarding the cross-cultural validity of PTSD human reaction to trauma is a universal phenomenon.

 The late Padmal De Silva”…’ “- Clinical Psychologist and lecturer at the Department of Psychology, Institute of Psychiatry UK believed that human response to trauma is universal but the cultural context of the trauma is an imperative dimension. The meaning of trauma is often culturally specific. Cultural factors may also influence the manner in which PTSD symptoms are manifested. 

 Even though the concept of Post-Traumatic Stress Disorder came from the West PTSD like symptoms were common among the people who lived elsewhere and experienced psychological trauma. Many cultures have written and dealt with natural and manmade disasters and most of the PTSD symptomatology could be seen among the victims irrespective of cultural differences.

In the Eelam War in Sri Lanka, combatants underwent a prolonged combat exposure and they had no fruitful psychological first aid system. There was no single military Psychologist to treat the combatants throughout the war. Although there were skilled surgeons to treat the battle wounds, a few psychiatrists and a handful of doctors treated the psychological victims of the war. The psychological casualties of the Eelam War suffered immensely. According to our rough estimations 8% -12% of the Sri Lankan soldiers who participated in active combat suffer from PTSD. Many of the victims are still undiagnosed and not on any type of psychological / psychiatric treatment.

For many years, some Sri Lankan authorities considered PTSD an American illness, which could never affect the Sri Lankan soldiers. Some advised the military not to dig into unnecessary issues like combat related PTSD, which could lead to litigation and compensation. Therefore, a deaf and blind policy was adopted for official convenience. There was an unofficial taboo to use the term PTSD. However, during this period combat stress increased in large numbers. Most of the victims were undiagnosed and untreated.

In 2002, I was invited to the Defense Review Committee at the BMICH to serve as a member by the Lt Gen Dennis Perera”- former Commander of the Sri Lanka Army. At the Defense Review Committee, I expressed my views on PTSD, which was taboo to the military and the mission performance. I stated that combat related PTSD has to be identified among the combatants using DSM 4 criteria and the sufferers should be treated effectively before it is too late. Dr. Narme Wicramsinghe the President of the Ranaviru Sewa Authority seconded my suggestion. The high-ranking Army officers who were there on that day kept silent and did not support my idea and one of the senior offices of the Air Force directly opposed it. However, Lt Gen Dennis Perera, a man with a vision understood the profound effects of combat stress. He supported our idea of screening and treating combat related PTSD in the Sri Lanka Army. This landmark decision helped us to study and treat PTSD in the Sri Lanka Army without any official restrictions.

In 2002, a Psychological treatment center for the combat veterans was opened at the Military Hospital Colombo and a large number of soldiers who were affected by combat stress were treated in this center. This treatment center used various types of psychotherapies such as Client Centered, CBT, Rational Emotive, EMDR etc. In 2005 a POW who suffered from malignant PTSD was able to get a military discharge. He was the first Sri Lankan Combatant who was medically discharged by the military under the diagnosis of PTSD. This landmark decision denotes the culmination of our continuous effort to educate and create awareness on combat related PTSD in Sri Lanka. 

Although this therapeutic center helped war affected combatants by 2006 one of the commanding authorities at the Military Hospital Colombo felt that the psychological treatment center has no use since there is no major war in the North. He transferred the staff and other resources to the operation theater and this psychotherapeutic center collapsed. Hence, the SL Army lost the valuable services of an eminent Psychiatrist Dr. Neil Fernando. I would describe this shortsighted and backstabbing act as the biggest betrayal to the Military.

 Combat Related PTSD Study in Sri Lanka

The first combat related PTSD study in Sri Lanka was conducted during 2002 “- 2006 period at the Military Hospital Colombo. This study was headed by Dr. Neil J Fernando Consultant Psychiatrist of the Sri Lanka Army and the former acting Director of Mental Health “- Ministry of Health Sri Lanka.

From August 2002 to March 2006, 824 members of Army infantry and services units who were referred to the Psychiatric ward Military Hospital Colombo were interviewed. This study was conducted while the soldiers were still on active duty. The study group included 824 soldiers and officers. These soldiers were administered the PTSD Check List based on DSM 4 with a structured interview. This schedule designed from similar trauma questionnaires used elsewhere in the world to detect PTSD. The presence or absence of PTSD was evaluated with the use of the PTSD Checklist. 

This was a convenient sample that was referred to the Psychiatric Unit Military Hospital Colombo. Mainly the referrals were done by the medical officers of the OPD, Consultants in the Medical and Surgical units, Palali Military Hospital, Victory Army Hospital Anuradhapura and other military treatment centers. The affected combatants had behavioral problems, psychosomatic ailments, depression and anxiety related symptoms, self-harm, attempted suicides, alcohol and substance abuse, and misconduct stress behaviors.

In this study among the 824 Sri Lankan combatants 56 were found with full blown symptoms of PTSD and 6 soldiers were found with partial PTSD. The PTSD rate was found as 6.7% following analysis of DSM 4 based questionnaire.

 The Echoes of Palali Syndrome

War is a multi-layered, multi-factorial phenomenon, which is filled with gruesome acts of violence. In a war not only the combatants even, the civilians undergo a tremendous amount of combat related stresses. Stresses are unavoidable in a situation like war. Therefore, people who lived in war zones became heavily vulnerable. Their psychological makeups begin to change rapidly.

War is a wholly human-made catastrophe, which is a gigantic process of social and self-destruction. As Plato once said “only dead have seen the end of the war. This means the psychological scars following combat can stay behind for many years. It can change the psychological markup of a person making him more dysfunctional. As the Salvadorian psychologist Martin-Baro(1990) wrote of his own country, what was left traumatized were not just Salvadorian individuals , but Salvadorian society. This expression is very much applicable to Sri Lanka. Many combatants, civilians as well as members of the rebel groups have become the victims of Palali Syndrome.

Following the Sri Lankan conflict a large number of civilians, members of the Armed Forces and the LTTE carders had been killed. Total deaths estimate over 90,000 lives. Many had become permanently disabled. A large numbers carry psychological scars of the war with them and suffer silently. Some have sublimated their anxiety and stress to the family members and to the society. Hence, war trauma has become a vicious cycle.

The Country was in an armed conflict for thirty years and during that period, the society was severely traumatized. Even three years after the war the Sri Lankan society is still experiencing the repercussions of the Palali syndrome. Many distressing and heartbreaking stores reveal the magnitude of combat trauma in the country. If necessary psychosocial rehabilitation is not provided adequately to the victims of war trauma it would harm the spirit of the Nation. During the past years, psychological needs of the combatants were not properly addressed. Much attention was paid to the physical injuries rather than psychological damages. Effective psycho social rehabilitation was not conducted and the repercussions of the mismanagement of combat trauma are visible even today.

 Private LXCX29

Private LXCX29 joined the Sri Lanka Army in 1996 and served in the North. While serving he was exposed to combat situations. He was stunned by witnessing mortar attacks by the enemy and witnessed the deaths of several soldiers. He was shocked and could not participate in the military offensive anymore. His body started shaking and he vomited several times. He experienced a severe headache. Private LXCX29 was sent to the Medical Aid point and treated with analgesics. After several hours of rest, he was again forced to go to the active combat. He obeyed the orders with revulsion. He was frightened for his life. After the operation, he was again posted back to his mother unit. While serving in the unit he had nightmares and ruminations of the combat related events. He was afraid of participating in another military operation. When he got his leave turn, Private LXCX29 overstayed and did not report. He tried to find a job but failed. He had severe headaches, difficulty concentrating, was forgetful and became scared of loud noise. His mental health was at a stake. Unable to find a suitable employment Private LXCX29 was compelled to work as a labourer in a farm. With his failing mental health, Private LXCX29 worked in the farm for several years. His employment ended unexpectedly when the Military Police found his whereabouts. He was arrested and then taken to his Unit. He was dealt by the court martial under the military law. He was sent to 18 months in Prison.

 Private NXVX28

Private NXVX28 participated in several military operations and experienced physical and mental fatigue. He had intense rage, lack of motivation and avoidance. He had no way of explaining his difficulties to his platoon commander. Day by day his aversion and avoidance grew and he found it difficult to be in army camps. Seeing military uniforms and military vehicles on a daily basis caused him  severe distress.  He did not wish to be in the military anymore and became a deserter. In 2004 he was caught by the police and taken to the police station.  Somehow Private NXVX28 managed to escape from the police custody and he started running.  Several policemen chased him. Eventually Private NXVX28 realized that there was no escape from the police  and he decided to intentionally stick his leg under a passing train, He sustained a crush injury with massive bleeding.  He was then taken to the hospital and his leg was amputated. Nevertheless after his discharge from the hospital Private NXVX28 had to face charges.

 Private Wimalasurendra

Private Wimalasurendra served in the operational areas for several years and witnessed enemy attacks and the hardships of the war. He became de-motivated and frequently troubled by the work related stresses. In order to evade combat operations and to receive forced evacuation he went in to self-harm and shot his right hand. The bullet went through his right arm damaging the radius and ulna bones. He was taken to the Palali Hospital and treated accordingly. Upon his discharge he was posted to a nonoperational area and given light military duties.  While serving in a non-combat zone his sleep became disturbed and he had stress related physical and psychological symptoms. Private Wimalasurendra was referred for a medical assessment and diagnosed as having Adjustment Disorder. While taking treatment as an outpatient from the Military Hospital Colombo on the 25th of April 2006 Private Wimalasurendra became a collateral victim of the LTTE suicide bombing that aimed to kill the Army Commander General Sarath Fonseka.   The explosion killed at least eight persons including the LTTE female suicide cadre who disguised as a pregnant woman. The Army commander sustained critical injuries. Private Wimalasurendra was found among the dead.

  The Laborer Who Handled  Human Remains at the Palali Air Base

Mr. GXVXX52 worked as laborer in the Palali Air Field. His duties included placing dead soldiers into body bags and helping to transport the remains   to the undertakers in Colombo by air. While working at the air base he became acquainted with many soldiers and some of the combatants who died in action were known to him. He worked a number of years handling human remains at the Palali Air Base. By 2003 he had nightmares, intrusions about the dead soldiers and experienced severe avoidance. He started abusing alcohol to forget unpleasant ruminations. His life was becoming a hell and at a certain point he could not bear the suffering anymore. Mr. GXVXX52 willfully came to the Psychotherapeutic Center in Colombo and pleaded for help. He agreed to any kind of work other than handling human remains or work at the Palali Air Field which triggered his intrusive memories.

 A Distinguished Officer Turned in to a Serial Murder

Major Anuruddha Wijebahus”‘s story could be described as one of the horrifying stories of Palali Syndrome. Anuruddha Wijebahu was a bright student from a leading school in Kandy. After completing his school education, he joined the Kothalawala Military Academy and passed out as an infantry officer. He was attached to the (VIR) Vijayaba Infantry Regiment as a career officer. Anuruddha Wijebahu served in the operational areas experiencing numerous combat related stresses. Gradually his psychological makeup changed and there were clear personality changes in him. Although he sought psychological help, his treatment schedule was interrupted due to bureaucratic interferences. Henceforth he went to the operational areas without any treatment or monitoring. His mental health was declining and Major Anuruddha Wijebahu experienced transient severe headaches. He had extreme rage, hyper arousal, combat related ruminations and homicidal intensions. Without any type of treatment Major Anuruddha Wijebahu gradually became a cold-blooded serial killer and murdered a number of innocent men. When he was serving in the 215 Brigade in Mannar in 2004 He took one of his victims to the Manthottam camp and intoxicated him. Then he stabbed the victim then chopped off his body, put the remains in to a barrel, and then set fire. Later the Police caught him and while in custody at the Bogambara Prison, Major Anuruddha Wijebahu committed suicide. If the bureaucratic machinery did not interfere, this officer could have received appropriate treatment and we could have evaded a number of disastrous slaughters and spared his life.

 The Story of Army Jine

Army Jine was a brave soldier from the Sri Lanka Commando unit who had exceptional combat skills. Affected by the combat stress his conduct became intolerable. He was charged with disciplinary infractions. Hence, Jine became AWOL. While living as an absentee at large Jine committed highway robberies, murders and rapes. He lived in the jungle with the survival tactics, which he had mastered; Jine evaded the law and enforcement authorities for a long time. According to some reports, Jine had committed nearly 27 rapes. Eventually he was gun downed by the Police.

 Kadawatha Madura

Madura was a top sportsman in the Army who was mishandled by his superiors. Many occasions he was harassed and Madura underwent harsh work related stress. Following unbearable work related atmosphere he became AWOL and joined the underworld. Madura organized several armed robberies and he was engaged in extortions mainly in Kadawatha. Madura was shot dead in Kadawatha town when he was confronted by the Police.

 Wambotta the ex-Army Soldier

Kitulgamaralalage Ajith Wasantha alias Wambotta was born in Embilipitiya. In 1993, he joined the Army, enlisting as a member of the 3rd Sinha Regiment. After sometime, he left the Army and formed a criminal, gang, which consisted of over 50 heavily armed military deserters. Since Vambotta had the powerful political backing and political patronage, the Police found it was extremely difficult to make any arrests. The gang led by Wambotta had done over ten murders and a number of extortions. The notorious gangster Wambotta was ambushed and killed by another underworld gang at Aswatte in Kosgama.

 A Brigadier was charged with the shooting of his wife

In 2007, Police arrested Brigadier Chandana Rupasinghe, of the Puttalam Army Camp in connection with the death of his wife, who succumbed to gunshot injuries, at the National Hospital. Thejangani Rupasinghe, the 37-year-old wife of the Brigadier had been shot in the head. Brigadier Chandana Rupasinghe had served in the operational areas and participated in a number of military operations.

 A Lady Doctor was shot by a Disabled Soldier

In 2008, a disabled soldier of the Commando Regiment shot a lady doctor named Dr. Miss W.D. Lakshmi, of the Bandagiriya Central Dispensary following a personal argument. According to the internal sources, the disabled soldier who committed the murder was wounded in the battle and became a psychological casualty of the war. He was temporarily attached to the Udawalawe camp. The reports further reveal that the accused soldier had not received appropriate rehabilitation and psychological treatment probably suffered from PTSD. During the argument, he went in to a sudden rage and shot the Doctor.

 A Lady Accountant killed by a Deserter

At Mutwal a lady accountant from a private firm was murdered and her 12 year daughter was raped by an army soldier in 2008. The perpetrator became AWOL several months before the crime. He waited near her house then entered and committed the crime. The victim was assaulted with a blunt weapon to her head and she succumbed to the injuries.

 The SF Rider who became a Criminal

Lance Corporal Harshana Nuwan was an expert motor cycle rider in the Special Forces. He participated in a number of SF operations in the North. He encountered frequent battle stresses, which he could not cope with. Often he was charged with disciplinary breaches. To evade the punishments he became an absentee. While hiding from the military police Lance Corporal Harshana Nuwan organized several bank robberies in which he used his riding skills. He was nick named as Son Baba by the underworld. He masterminded several contact killings and abductions. The Police took an immense effort to track him down.

 An Army Sergeant Plants a Bomb in a School Van

An army explosives expert was arrested for alleged involvement in the Kurunegala school van explosion which left one 12-year-old school girl dead and 11 injured in 2009. According to the initial investigations indicated that the army sergeant had smuggled two kilos of C-4 explosives out of the Minneriya camp and planted them on the van around midnight in an apparent bid to kill the owner-driver, whom he suspected of having an illicit affair with his wife.

 The Murder of Dr Goodwill of Karandeniya

Two Army soldiers suspected of killing Dr. Priyanka Prasad Jayasinghe a respected medical practitioner of Karandeniya using a9.mm pistol had been arrested by the Police. The two soldiers have allegedly taken a contract from an Army captain to kill Dr. Priyanka Prasad Jayasinghe of the Borakanda government hospital in the Karandeniya of Galle district. This murder subsequently caused mass protests in Karandeniya.

 From combatants to criminals ”- a report by Nadia Fazlulhaq

The war is over, but the lack of proper psychological counselling for battle-weary men has resulted in a wave of crimes. Investigations into recent crimes, have revealed a disturbing trend of the involvement of members of the armed forces who have deserted as well as those still serving. From the killing of MP Bharatha Lakshman, grease devils who instilled fear in elderly women, to the murder of a popular doctor in Karandeniya and other killings in Udawalawe and Homagama, those who were arrested were military deserters and soldiers.

The main suspects who were arrested by Police in the shooting of former MP Bharatha Lakshman Premachandra included members of the army commando unit and another from the Special Task Force who had served in Vaharai, Mavil-Aru and Sampur. The suspect who was taken in, in connection with the killing of two elderly women in Kahawatte was a 22 year-old army deserter who had served in Vidatheltivu area during last few months of the war. The deserter, a father-of-one has admitted to the killings that took place on April 3 and June 19 this year, according to police.

In October this year, a family of four including two children aged eight and ten, were killed in Panahakaduwa, Udawalawa. The chief suspect arrested by Police was also an army deserter. While the main suspect behind the killing of Dr. Prasad Jayasinghe of the Karandeniya Hospital was a Captain in the army, those who committed the crime included a commando and a member of the army engineer unit. In September another army deserter was taken into custody in connection with the brutal slaying of three persons of a single family at Dolakade in Homagama. The victims included a Kapu Mahattaya from a local devale, his mistress and the woman”‘s brother. The same month, the bodies of an elderly couple in their 70″‘s were found lying in their house in Akmeemana. Both had suffered heavy cut injuries. A soldier was arrested for killing the couple over a land dispute.

In April, this year a navy officer was arrested by Baduraliya Police for killing his young wife and two year-old daughter and dumping their bodies in a nearby forest. Mount Lavinia Police arrested two deserters from the Army and the Navy after they kidnapped a child and demanded a ransom of Rs. 500,000. In October, STF”‘s Chief Inspector B.A.Jayathilake (57) reportedly killed Assistant Superintendent of Police Sarath Sisira Kumara (45) and committed suicide in the Mahaoya STF camp. Officer Jayathilake was a father of three school-going children. Another army deserter who was involved in an illicit affair with a wife of a wealthy businessman in Giriulla, killed the businessman in June this year. In December, a soldier hurled a hand-grenade after opening fire inside the Tissamaharama Police station critically injuring his 19 year-old wife. (From combatants to criminals Nadia Fazlulhaq. December 25, 2011 Sunday Times)

 Mysterious Kahawatta Killings

Fear Psychosis erupted in in Kahawatta in 2008 following murders of 7 elderly women. Most of the murders were committed by hitting on the head using a blunt weapon. The police had launched a manhunt and arrested an army deserter who was mentally unsound and obsessed by seeing blood. According to the Police he killed his last victim on June 19 2008 on Opeta-Kahawatte estate. His first victim- O.P. Karunawathie, 56, a distant relative of the suspect, was killed in mid-May inside her own house where she lived alone, followed by the second killing of 54-year-old Jayanthi Menike on June 19. As reported by Leon Berenger – the Journalist attached to the Sunday Times the perpetrator was motivated towards the killings by the earlier slaying of four women by a serial killer on the same estate in 2008. One man was arrested and is currently in jail in connection with those killings.

 Palali Syndrome and Social Violence

Lance Corporal GXEXX33 participated in the Operation Rana Gosa that started in 1999. He experienced numerous traumatic war related events during this military campaign. He became highly distressed when he witnessed the death of several his platoon members following enemy fire. One soldier who was on his right flank died instantly in Aandankulam due to a sniper bullet. In another event he saw how his best friend lost his leg when he stepped on a Jonny Batta (antipersonnel land mine). His lower leg bones were crushed badly injuring the leg and he cried for help. L/Cpl GXEXX33 was stunned and became helpless.

 After the Operation Rana Gosa  L/Cpl. GXEXX33 was posted to 56 Division in Vavuniya. While serving there he frequently became restless. Several times the platoon Sergeant reprimanded him for having quarrels at the Corporal Club. He began to abuse alcohol and smoked cannabis to forget the disturbing memories of the Operation Rana Gosa. When the tension intensified he became AWOL for three months. During that period he stayed at home and took indigenous treatment for his sleep disturbances and constant headaches. When he reported back he had to undergo disciplinary charges. The Military Tribunal decided to demote him and hence he lost his hard earned rank.  L/ Cpl  GXEXX33 became very upset about the decision and after the demotion he performed military duties with  decreased motivation.  Often he had conflicts with his platoon Sergeant and on one occasion he threatened to shoot the Sergeant.

Following the accumulating work related stresses and symptoms of war trauma L/ Cpl  GXEXX33 decided to leave the Army. Again he became AWOL and this time he sought refuge with a local politician. The local politician introduced him to one of the leading politicians and a cabinet minister who had power in the Central Province. L/ Cpl.  GXEXX33 became his unofficial bodyguard. With the political patronage L/ Cpl. GXEXX33 felt safe and neither Police nor the CCMP (Military Police) could arrest him. In 2001 Parliamentary elections L/ Cpl.  GXEXX33 served his political master and was engaged in political violence in the Kandy district. He was responsible for several politically motivated assaults and arson.

The Domino Effects of Palali Syndrome

Lt PXXC35X served in the army for nearly 15 years with exceptional military skills. He was  awarded the  RSP (Combat Excellence Medal). Obviously there was a shining career path for him. His dreams of becoming a war hero ended up unexpectedly when his platoon was ambushed by the enemy at Mandathive. While engaging the enemy Lt PXXC35X lost two of his best men whom he knew for several years. These men fought with him side by side. It was a disastrous incident for him. Later he blamed his commanding officer for not doing an appropriate reconnaissance in the enemy infiltrated area before sending his men. He personally felt that the commanding officer was responsible for the death of these two NCOs. After this incident he had cynicism, irritability, combat related dreams and difficulty in concentrating. He became more and more isolated and stopped associating with his colleagues. He could not trust his superiors anymore. Frequently he went to the Officer”‘s Mess and started drinking alone. After he got drunk he had violent arguments with senior officers. Lt PXXC35X was charged with indiscipline and neglecting his duties. He was reprimanded by the Commanding Officer.

When he came home Lt PXXC35X spent his time drinking and abandoning the family duties. When he was under the influence of liquor he frequently abused his wife and children. Following unbearable domestic violence his wife left him with the children. Lt PXXC35X became more and more isolated. His wife filed for divorce. He also had trouble at the camp. His Commanding Officer issued a restraining order and Lt PXXC35X was forbidden to have alcohol at the Officer”‘s mess. This action increased his resentment towards his Commanding Officer. While performing his military duties Lt PXXC35X deliberately risked his life a number of times and on one occasion he sustained a minor injury to his leg as a result of enemy mortar fire. He was admitted to the hospital and treated for several days. Upon his discharge he got seven day medical leave and he went home.

When he came home he had an argument with one of his neighbors and Lt PXXC35X threatened to kill him. The neighbor lodged a complaint against Lt PXXC35X at the local police station. When a policeman came to inquire about the complaint Lt PXXC35X felt that the police constable acted disrespectfully. He had an argument with the constable and later Lt PXXC35X the policeman. Lt PXXC35X was charged with obstructing a police officer and remanded for several days. He was bailed out by his brother and then taken to a psychiatrist. He was diagnosed with Adjustment Disorder.

 Army Deserters and the Crime Wave

According to the 2012 data, 50,000 army soldiers have deserted the Army following the 30-year period. Some of the deserters had been psychologically traumatized by the war and a considerable numbers are operating with the underworld gangs. In the year 2000 a total number of 12,681 of robberies were reported, of which 76 was committed by army deserters. In 2011 there has been 11,789 cases reported of which 63 has been carried out by the deserters. From January to 30 May 2012 4893, and 20 of them have been committed by deserters.

The desertion rate in the Sri Lankan armed forces is one of the highest in South Asia. As of September 2008, there were over 15,000 deserters from the Army alone. This constitutes about 10 per cent of the total strength of Sri Lanka Army. Averaging 10 per year, desertions shot up during Eelam War III (1995-2001). The numbers came down considerably during the ceasefire period (2002-2005). However, with the commencement of Eelam War IV from mid-2006, desertion has once again been on the rise. A significant implication of desertion is the phenomenal increase in crime, especially in central and southern Sri Lanka. Since the deserters are trained in warfare, they are preferred by underworld criminal gangs for extortions, abductions, kidnappings for ransom, murders and robberies.

Deserters are also sought after due to their possession of sophisticated weapons and knowledge of the loopholes in laws. Rival gangs also hire deserters to settle scores and demarcate their areas of operation. Thus one finds the “‘brothers in arms”‘ fighting on opposite sides of rival gangs. Army deserters are also used by leading political parties during elections for intimidation and rigging. An increase in the number of election-related violent incidents is not unrelated to the increase in desertions. While the political parties require deserters to augment their muscle power, the deserters, in turn, need political patronage to continue as fugitives. For this reason, the issue has not been given adequate attention by successive political leaderships. Thus, desertion has not only increased the proliferation of sophisticated arms, but also led to spiraling violence in society. ( Runaway Soldiers: Desertions in the Sri Lankan Army – by Dr. N Manoharan)

 Nearly 400 soldiers had committed Suicide in the Post War Sri Lanka

In 2006, one senior officer attached to the Military Hospital Colombo closed the Combat Stress Treatment Center that was headed by the Consultant Psychiatrist Dr. Neil Fernando. Following this unwise action many combatants suffered from battle stress had no way to receive appropriate psychotherapy. In later years this short sighted action was criticized by many as the biggest betrayal to the Sri Lanka Army and it has caused an immense damage to the image of the military. Many combatants who suffered from battle stress   had no way to receive psychotherapy and counseling became deserters. Some committed suicide. According to the Military Spokesman Brig. Ruwan Wanigasooriya nearly 400 soldiers committed suicide between 2009 – 2012 postwar period in Sri Lanka. These victims suffered from various stress related conditions and some were diagnosed with PTSD.

 Combat Trauma in the Post War Era

There were many examples from other countries that reveal how combat trauma affected in the post war era. For example soon after the American Civil War, traumatized solders formed an extremist movement that called the KKK which engaged in racial violence. Many American volunteers who participated in the Spanish Civil War engaged in social violence and some Lincoln Brigade soldiers became top criminals during the Great Depression. Post-Vietnam War caused vast social chaos in USA. Similarly, many Afghanistan veterans of the Red Army engaged in organized crimes in the former USSR.

Combat trauma could emerge in the post war era and this period is considered as a vulnerable period to the society. Research has indicated that some psychological traumatic reactions can surface after many years of the original traumatic incident. The late reactions of PTSD can manifest many years after the war. Therefore effective measures have to be taken to address the social calamites associated in post war period.

 Psychosocial Rehabilitation of the Victims of Palali Syndrome

The magnitude of combat trauma in Sri Lanka cannot be ignored. Most of the psychological scars are unhealed and it can affect the person as well as the society. These psychological and emotional traumas resulted from witnessing killings, handling human remains, exposure to life and death situations, and numerous other battle stresses. This is a form of invisible trauma in the military. But it has direct implications on the mental health of the soldiers as well as their family members and the society at large.

The combatants contributed enormously to end the war in Sri Lanka. Their blood and sweat were used by the politicians for their glory and at the end of the day the combatants did not receive appropriate psychosocial rehabilitation. This is a heartbreaking situation and every day we hear social miseries that have direct or indirect connections with the Palali syndrome.  The war trauma is still hounding the society in gigantic proportions.   

There are many psychological victims of the Palali syndrome who need professional support. Among them are active and ex members of the military and their family members. The Nation has a moral responsibility to look after the wellbeing of the soldiers who sacrificed their physical and mental health for an unified Sri Lanka.

 

2 Responses to “Shell Shock to Palali Syndrome”

  1. KAL Says:

    An interesting article, but there one inaccuracy.

    The author states that soldiers from World War II were diagnosed with chronic fatigue syndrome. This is impossible as the term chronic fatigue syndrome was not created until 1988 by Holmes et al. (1) Prior to Holmes et al, the term used (Acheson 1959), and still used in Europe, is myalgic encephalomyelitis. Post-viral fatigue syndrome is another term used.

    The World Health Organization International Classification of Diseases 10th edition classifies ME under Other Diseases of the Brain, Chapter 6 (G93.3). The classification is entirely separate from and should not be confused with undifferentiated fatigue syndrome in F48.0 according to the WHO.

    Severity and specificity are critical to making a differential diagnosis. One of the key symptoms for ME/CFS is post-exertional malaise lasting 24-hours or longer unrelieved by rest in a pattern with swollen lymph nodes, muscle pain, and objectively shown memory and concentration problems. (2)

    Although like any other disease there may be co-occurring depression and anxiety they are secondary to the disease. Many patients do not experience depression or anxiety.

    1. Holmes et al Chronic Fatigue Syndrome: A Working Case Definition
    Ann Intern Med. 1988; 108:387-389

    2. Carruthers, B. M., van de Sande, M. I., De Meirleir, K. L., Klimas, N. G., Broderick, G., Mitchell, T., Staines, D., Powles, A. C. P., Speight, N., Vallings, R., Bateman, L., Baumgarten-Austrheim, B., Bell, D. S., Carlo-Stella, N., Chia, J., Darragh, A., Jo, D., Lewis, D., Light, A. R., Marshall-Gradisbik, S., Mena, I., Mikovits, J. A., Miwa, K., Murovska, M., Pall, M. L. and Stevens, S. (2011), Myalgic encephalomyelitis: International Consensus Criteria. Journal of Internal Medicine, 270: 327–338.

  2. . Says:

    KAL Thank you for the correction . It should be Combat Fatigue Syndrome not Chronic Fatigue Syndrome. I apologise
    Dr Ruwan M Jayatunge

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