Disability and the Aftermath of War: The Emergence of Veterans’ Care

By Joaquin Magno

The consequences of serving with the armed forces are significant. With the necessary, high-risk, and high-pressure environment and tasks required of military personnel, the prevalence of issues surrounding veterans’ physical and mental health should be of great importance to all. It is for this reason that understanding the origins of the relationship between veterans and the treatment of disability are significant.

This article seeks to examine the creation of programs to support former military personnel who have sustained physical and/or psychological disabilities during their service. In doing so, we hope to reveal how dynamic and adaptable civil society can be when it comes to providing support for those who need it.

By virtue of being deeply involved in multiple industrialized wars where personnel becoming disabled was common, alongside taking many measures to support disabled veterans, this article will primarily engage with the United States and the United Kingdom.

Likewise, it is important to note what constitutes disability. For example, for the Equality Act (2010) in the UK, individuals must suffer “substantial and long-term effects on the ability to carry out day-to-day activities” to have their conditions classified as disabilities (source). This therefore includes physical and psychological trauma sustained as a result of military service.

The origins of ad hoc support for physical and mental ailments for veterans originates much earlier than official government programs. Initially, healthcare for those injured or disabled in warfare was highly rudimentary, reflecting the level of knowledge and technological development in the medical profession as a whole (source). As the discipline of psychology, and thus, the discipline of psychiatry were at a similarly undeveloped stage, it makes sense that mental health support for veterans was highly non-existent (source).

We began to see formalized government support for physically disabled veterans at the end of the 19th century, with the Spanish-American War (1898). With troops fighting in tropical locations such as Cuba and the Philippines, the prevalence of malaria, typhoid, yellow fever, and jungle rot (which may lead to amputation) increased notably. This forced adaptation within the US military to expand on existing ad hoc treatments for those injured or disabled in war, creating formalized military hospitals for the first time (source).

As the methods of industrialized warfare developed further in World War I (1914), the number of disabled veterans rose drastically. Due to the prevalence of World War I veterans, and strong documentation in the UK, we will be examining their statistics. In the UK alone, nearly two million veterans returned to the country with some kind of disability:

“over 40,000 were amputees; some had facial disfigurement or had been blinded. Others suffered from deafness, tuberculosis or lung damage caused by poison gas. There were thousands of cases of shell shock from the horrors of warfare, diagnosed today as post-traumatic stress disorder.” (source)

From the wake of the destruction of World War I, one can see a major turning point in social assistance for disabled veterans. With massive numbers of people returning to civil life with physical and mental disabilities, governments were incentivized to ensure a smooth transition for them, so that they would not be alienated by society, the workforce, or their families.

In terms of support for said veterans’ physical disabilities, medical science progressed such that prostheses were more accessible and less cumbersome for veterans with amputated limbs or facial disfigurement (source). Likewise, the advent of plastic surgery in 1917 made reconstruction more viable within military hospitals (source). This made it so that those who were physically disabled by the devastation of industrialized warfare, had greater capacity to lead the lives they wished to lead. Although prostheses and facial reconstruction technology were nowhere near up to modern standards, the specific push towards supporting the large number of veterans with physical disabilities is evident.

The aftermath of World War I led to progression in support for veterans who struggled with their mental health after their service. ‘Shell shock’, ‘war neurosis’, or post-traumatic stress disorder as we know it now, was extremely prevalent amongst the veteran population following World War I. By only 1916, 40% of incapacitated military personnel were suffering from the condition. Institutionally, 20 new hospitals were created after the war to support these veterans (source).

War psychiatry rose rapidly as a new subfield of psychiatry, used to prevent soldiers from becoming debilitated due to psychological strain in combat, alongside helping veterans handle their post-traumatic stress. Initially, the disability caused by post-traumatic stress disorder was regarded as a weakness, or failure of one’s character. Such perceptions in society and the medical profession led to these veterans being regarded as effeminate, lazy, and/or pathetic, demonstrating the depths of stigma that can be found at the roots of war psychiatry (source). Instead of providing support for these debilitating conditions and recognizing them as the disabilities that they were, veterans suffering from them were vilified for their supposed personal failures, a practice that exists today surrounding other mental health issues.

Despite this climate of prejudice, Arthur Hurst, an officer of the British Army who worked at Guy’s Hospital, developed innovative therapeutic methods to support those disabled by shell shock. Instead of resorting to electric shock therapy or isolation, Hurst’s gentler, multidisciplinary approach at the rural, open-air Seale Hayne agricultural college pioneered future approaches to treating war trauma, and other psychological conditions and disabilities (source).

Demonstrating that these institutions developed further in the hundred years following World War I, current statistics on veterans’ care show immense growth.

In the UK, the Veterans’ Covenant Healthcare Alliance is made up of 49 hospitals and ambulance trusts that specifically serve veterans, beyond typical NHS coverage. Reflecting success, there is no statistically significant difference between the self-reported general health of the approximately 2.4 million veterans in the UK and the country’s general population. (source). In the US, the Veterans’ Health Association provides care at 1298 medical facilities throughout the country, supporting American veterans with health conditions and disabilities, tied to their service or otherwise. Approximately 9 million individuals enjoy benefits and coverage from this program (source).

Through examining the immense capacity for humanity to innovate and adapt in order to support disabled individuals, one can see a massive level of care and desire to do good. It is in cases such as these where it is clear that when mobilized, solidarity can yield immense benefits not only for those who are directly supported, but for future generations as well.