Prisoner of War Experience
Colonel Rhonda Cornum, Ph.D. MD
Medical Corps, United States Army
Colonel Cornum |
Prisoner of War
We all hope that no American serviceman, male or female, will be taken
prisoner. Historically however, the risk of capture is small but real in all conflicts.
Treatment of repatriated POWs has been discussed exhaustively, but has focused on men.
Women have represented a very small percentage of the military, and until recently, an
even smaller percentage of prisoners. Most of the information is probably equally
applicable to female as to male repatriated POWs, but there has been nothing written
specifically about the repatriation of women ex-POWs.
As the only woman ex-POW still on active duty, I would like to share my views on the
repatriation process.
Sexual Abuse
The primary concern of many health care providers, when caring
for a returning female POW, seems to be the possibility of sexual abuse. I believe this
emphasis on female sexual abuse is primarily cultural. I further believe this emphasis is
derived from concerns about potential psychological after-effects of sexual abuse, and
that it is based on the model of civilian women. It is vital to recognize that sexual
abuse in the context of the POW experience is very different, for several reasons.
- Women in the military are not necessarily representative of the "average"
American woman. A military career is still not considered a traditional path for women,
and women who choose a military career may have a different "willingness to take
risk" than women in the general population. They may not react like the
"average" woman in the civilian setting.
- Most women in the military recognize that they are engaged in a high-risk occupation,
and accept that there is a small but real risk of death and capture.
- Women in the military may have different priorities. For example, I was captured after
being wounded by small arms fire and involved in a very significant aircraft shoot-down.
My primary concerns were first, those that were life threatening (bleeding and internal
injuries), followed by those that could result in permanent disability (multiple long bone
fractures in my case). While I was subjected to an unpleasant episode of sexual abuse
during my captivity, it did not represent a threat to life, limb or chance of being
released, and therefore occupied a MUCH lower level of concern than it might have under
other circumstances.
It is my opinion that sexual abuse should be considered just one of many potential
physical and psychological torture techniques, whether the subject is male or female.
The Total Soldier
Importantly, the health care provider encountering repatriated
POW’s should evaluate their total condition, and not focus on any single aspect of
their condition unless it is obvious (broken bone, diarrhea, pregnant, etc).
The repatriated soldier (it is important to avoid the term
"patient") will tell you his or her primary concerns, and the health care system
should respond to those needs if at all possible.
Pre-deployment Planning
On a practical level, deployed women may find it valuable to use a
method of birth control that does not require either daily input (the pill) or voluntary
use (condoms or diaphragms). I recommend the IUD, Norplant, or Depo-Provera, particularly
for women at higher risk, especially aircrew.
It is important to introduce this concept before deployment, as
it can be a social problem for monogamous women to suddenly begin a contraceptive program
if their spouse does not understand the risk issue.
 The Typical Repatriated
Soldier
Because the circumstances of captivity are so different, it is difficult
to describe a "typical" repatriated soldier.
Some have been subjected to prolonged isolation and others not. Some
have been physically abused and others not. Some have been held captive for a very long
time, while others have been held only a short time. Clinically, they should be approached
as individuals, with unique experiences and clinical needs.
Stresses of Captivity
While individual experiences vary, many common stresses of
captivity may need to be addressed. Among these** are the physical stresses of:
Crowding
Diarrhea
Epidemic diseases
Exhaustion
Forced labor
Infectious organisms
Injuries |
Medical experimentation
Nutritional deprivation
Sleeplessness
Torture
Weather extremes
Wounds |
…and the psychological stresses of:
Boredom
Close long-term affiliation
Confinement
Danger
Family separation |
Fear/terror
Guilt
Humiliation
Isolation
Threats
Unpredictability |
** Textbook of Military Medicine, Office of the Surgeon General, United States
Army, The Prisoner of War, P. 435, 1995
Recovery
Most former POW’s will fully recover from these physical and
psychological stresses. Many will find a lasting emotional strength from their experience.
*Reprinted from:
Operational Obstetrics & Gynecology - 2nd Edition. The Health Care of Women in
Military Settings. NAVMEDPUB 6300-2C. January 1, 2000. Bureau of Medicine and
Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300 |
