Hello, kilboj-ga!
POW's and other victims of torture and starvation suffer such an
intense combination of physical and emotional trauma that it is hard
to determine exactly what specific aspect of the trauma might be the
precipitating factor in any long-term health effects. Certainly, the
combination of starvation, beatings and intense psychological torment
would be expected to lead to health detriments later in life.
Many POW's succumbed to starvation and died in prison camps. But what
about those who survived? Is there any evidence that the months (and
sometimes years)of severe malnutrition led to poor health or early
death for those POW's who survived?
AN OVERVIEW OF LIFE IN THE CAMPS
=================================
Korean War POW's
"Of the 7,190 who were captured (mostly in the first nine months of
the war), approximately 3000 died in captivity, a mortality of 43%,
largely of starvation over a six month period (Nov 1950- April 1951
)."
The point is further made that the effects of starvation led to
decreased resistance among prisoners. Death resulted because the
prisoners no longer helped one another to survive.
"Starvation broke the spirit of POWs in 1950-1951. They ceased to help
each other, resulting in higher death rates."
From "Mass murder of US POWs in the Korean War."
http://www.cyberussr.com/hcunn/e-asia/korea-pow.html
==
Vietnam
"Americans captured by the Viet Cong had a terrible and grueling
ordeal ahead. The Viet Cong themselves were often deprived of adequate
food, and the need to be constantly moving only made life more
difficult to sustain. Americans were ill-equipped to cope with jungle
diseases and drastic change in diet. Torture was commonplace and
cruel. Many were mentally and physically depleted to the point of
starvation and death. Towards the end of the war, prisoners captured
in the south were routinely taken north for detention by the North
Vietnamese, and although torture was a daily threat, few died of
starvation during those late years."
From "DPatrol's Adopted Pow/MIA."
http://www.thesitefights.com/wepatrol/mia.html
==
"For Americans captured in South Vietnam, daily life could be expected
to be brutally difficult. Primarily, these men suffered from disease
induced by an unfamiliar and inadequate diet - dysentery, edema, skin
fungus and eczema. The inadequate diet coupled with inadequate
medical care led to the deaths of many. Besides dietary problems,
these POWs had other problems as well. They were moved regularly to
avoid being in areas that would be detected by U.S. troops, and
occasionally found themselves in the midst of U.S. bombing strikes.
Supply lines to the camps were frequently cut off, and when they were,
POWs and guards alike suffered. Unless they were able to remain in one
location long enough to grow vegetable crops and tend small animals,
their diet was limited to rice and what they could gather from the
jungle."
While in captivity, the brutal treatment coupled with starvation is described:
"The effects of starvation and torture frequently resulted in
hallucinations and extreme disorientation. Men were reduced to
animals, relying on the basic instinct of survival as their guide."
From "Orien Judson Walker, Jr.: Died In Captivity - 1966."
http://www.masshome.com/powmia/walker.html
===========================================================================
STARVATION AND LONG TERM HEALTH OF FORMER POW'S FROM WORLD WAR II AND KOREA
===========================================================================
"The Health of Former Prisoners of War: Results from the Medical
Examination Survey of Former POWs of World War II and the Korean
Conflict" (1992) provides the most comprehensive information
pertaining to long-term health problems associated with prison camp
life. The book may be viewed online at
http://books.nap.edu/books/0309047919/html/index.html
** Concerning long-term health ramifications due to starvation:
Beriberi, a disease associated with Vitamin B1 deficiency, was a
prevalent prison camp system that was still evident twenty years after
repatriation. (pages 96 and 97)
http://books.nap.edu/books/0309047919/html/96.html#pagetop
http://books.nap.edu/books/0309047919/html/97.html#pagetop
Peripheral neurological disorders associated with nutritional
deficiency was also evident many years after repatriation. Numbness
and tingling, burning and electrical sensation, reduction in feeling
and reduced deep tendon reflexes have been exhibited in POW's many
years after release from captivity. (Beginning page 106)
http://books.nap.edu/books/0309047919/html/106.html#pagetop
Current edema of the legs in former POW's, which has a direct
association with peripheral nerve disorders and nutritional
deficiency, may possibly be linked to malnutrition during internment.
http://books.nap.edu/books/0309047919/html/109.html#pagetop
Optic nerve disease associated with malnutrition might also be a
possible long-term health effect.
http://books.nap.edu/books/0309047919/html/109.html#pagetop
Ischemic heart disease linked to nutritional deficiency is also suspected:
"...the reporting of edema in prison camp is not only a general
measure of stress but also indicates a specific nutritional
deficiency, beriberi. A grossly deficient diet produces protein
deficiency and edema, which may be intensified by beriberi heart
disease. As noted earlier, the distribution of edema provides
important information about its cause, with protein deficiency
producing a more generalized edema and heart disease producing an
edema that tends to be more extensive in the legs. Thus, the
self-reported edema in the feet, ankles and legs is presumably related
to beriberi heart disease ("wet" beriberi) in prison camp, which is
caused by thiamin deficiency. There have been difficulties in linking
beriberi with subsequent heart disease in clinical studies because
typical medical finding are consistent with beriberi heart disease but
are not pathognomic.
** The examination data from the current study now provide
epidemiologic evidence to suggest that earlier treatment in prison
camp is linked to increased ischemic heart disease four-and-a-half
decades later. However, one must interpret this association cautiously
because it has no established pathophysiologic basis."
http://books.nap.edu/books/0309047919/html/113.html#pagetop
Osteoarthritis associated with weight loss has also been noted.
Surprisingly, those POW's with less weight loss exhibited a higher
prevalence of osteoarthritis in later years than those who had lost
greater percentages of body weight during captivity.
http://books.nap.edu/books/0309047919/html/119.html#pagetop
========================================================================
VIETNAMESE POW'S SHOW SUPRISINGLY FEW LONG-TERM EFFECTS FROM STARVATION
========================================================================
** Aside from documented thinning of the bones directly related to
malnutrition, those that survived the Vietnamese prison camps have
relatively few long-term health effects.
Some excerpts follow from a truly fascinating article:
"Many endured more than six years of captivity, with stretches in
solitary for as many as half. They survived savage beatings,
unspeakable torture, starvation diets and the heartache of missing
their children grow up."
"Even so, more than a quarter-century after their release from the
hell of the "Hanoi Hilton" and other infamous prison camps in North
and South Vietnam, an extraordinary number of former U.S. prisoners of
war bear few lasting scars from their ordeals."
** "Most lost one-quarter of their weight thanks to a sparse diet of
watery soup and rice fouled by rodent feces and bugs.
Boils covered their bodies, and they fell prey to assorted illnesses.
They lived with constant fear that they were about to die. Equally
frightening was the fear of dishonoring themselves and their country."
** "But now their bodies show far less lasting damage than might be
imagined. A 20-year study of their medical condition by the Naval
Health Research Center in San Diego concluded in 1996 that they
weren't in much worse shape than a control group of other aviators who
never were POWs."
"The returned prisoners suffer from more arthritis and other joint
disorders than the comparison group, as well as from permanent nerve
damage in their extremities.
** They also are beset with thinning bones, largely a result of the
poor nutrition they received for so long.
"But they are no more likely to suffer from heart disease, cancer,
high blood pressure or ulcers-- all diseases believed to have at least
some connection to stress."
"Even more remarkable is their emotional health. That study, along
with subsequent research by Henman and Ambrose, found them to be
exceptionally well-balanced, vibrant, humble and mostly free of
negative psychological aftereffects."
Read "Scars healing for Vietnam POWs," by Lisa Hoffman. Scripps Howard
News Service.
http://www.southcoasttoday.com/daily/11-99/11-07-99/a02wn012.htm
========================================================================
ARMY COL. FLOYD "JIM" THOMPSON - Did Starvation Weaken this POW's Heart?
========================================================================
Who knows if former Col. Floyd "Jim" Thompson's lengthy internment as
a Vietnamese POW contributed to an early death. Was his stroke and
subsequent heart attack due to a heart weakened by starvation, or did
alcohol and stress after returning to the states contribute to his
demise? Did he die earlier than he would have if he had not
experienced so many years of torture?
The following excerpts are only a small part of his horrendous ordeal
as a Vietnamese POW:
"Army Col. Floyd "Jim'' Thompson, longest-held prisoner of war in
American history, died July 16, 2002 in Key West, Fla. At age 69, his
heart finally gave out, ending one of the most remarkable lives among
heroes of the Vietnam War."
"Through nine years of torture, starvation, unimaginable deprivation,
Thompson showed us the resiliency of the human spirit. He refused to
die, and until death Jim had a willfulness that inspired awe. He
survived on dreams of returning home to a loving wife, four adoring
children and a grateful nation. When none of that squared with
reality, years of bitterness followed."
"Months later, during a routine indoctrination session for POWs,
Thompson collapsed into a violent convulsion. That amazing heart was
in seizure, probably from starvation, doctors later surmised."
"After losing his family, Thompson fought to save his career. Again,
alcohol interfered, aggravating a nine-year professional gap with
officer peers. Thompson never blamed the Army or the war for his
troubles."
"He suffered a massive stroke in 1981, which forced him to retire.
Disabled, he moved to Key West and shut himself off from family and
friends. His identity as a former POW, as longest-held, made life
worthwhile."
From "America's Longest-Held Prisoner Of War Remembered," by Tom Philpott.
http://www.militaryupdate.com/Thompson.htm
========================
FUTURE RESEARCH STUDIES
=========================
January, 1998, brings the dedication of the Robert E. Mitchell Center
for Prisoner of War Studies. Research projects underway at this time
include studies to determine if there is any increased incidence of
carotid artery disease in the RPOW group and if there is any increased
tendency toward diabetes.
** Studies planned for the near future include determining whether the
calcium losses from starvation diets experienced by the RPOWS in
captivity persisted and whether it might affect bone density
Naval Operational Medicine Institute
http://www.nomi.med.navy.mil/Text/RPOW/default.htm
======================
ADDITIONAL REFERENCES
======================
From "The Roots of the Cambodian Health Crisis."
http://www.hartnet.org/khmer/pagepapr.html
"Starvation was identified as a major cause of post trauma health
problems in survivors of the Nazi Holocaust. (Eitinger, 1973; Thygesen
et al, 1970 ) One of the most comprehensive studies of the effects of
starvation on the human body and mind are found in the heroic research
of the physicians of the Warsaw Ghetto. While starving themselves,
they meticulously kept records of their own conditions and that of
their patients, describing in detail the stages of starvation and
their attempts to understand and treat them. These documents were
smuggled out of the Ghetto and hidden until after the war.
(Winick,(ed) 1979). The dramatic changes in the body during
starvation, described in this study leave little room for doubt that
the body cannot spontaneously recover from near death starvation.
Autopsies in the Ghetto as well as those done in Concentration Camps
show hearts that have shrunk to half their normal size, mitral valve
prolapse, change in the composition of bone and blood, as well as
changes in the brain."
"Concentration Camp Syndrome, a syndrome first observed in survivors
of the Holocaust under Nazi Germany and in POW's (Prisoners of War)
includes the symptoms of premature aging, reduced resistance to
disease, headache, fatigue, gastrointestinal disorders, depression,
social adjustment problems, and posttraumatic stress disorder. This
syndrome, as described in the medical literature, persists for decades
and causes poor health, emotional suffering, and early death. The key
contributors to Concentration Camp Syndrome are believed to be
*** long term starvation,
overuse of muscles and bones, exposure to the elements and exposure to disease.
Psychiatric symptoms and Starvation
---------------------------------------
"The study of Concentration Camp Survivors and Prisoners of War
(POW's) which began during internment and continued after World War II
offer a 50 year view of the course of disability in survivors. Leo
Eitinger a world renowned expert on Concentration Camp Syndrome
initially described the syndrome as being organic in nature, but over
time, he developed a integrated understanding of the relationship of
the psychological and physiological aspects of the disorder. He
describes the psychic symptoms of Concentration Camp Syndrome:
increased lassitude, failing memory and inability to concentrate,
dysphoric moodiness, emotional lability, sleeplessness, sense of
insufficiency, lack of initiative, nervousness or irritability,
vertigo, vegetative lability, and headaches. Eitinger found that 85 of
100 concentration camp survivors had 5 or more of these symptoms.
* Eitinger concludes that these psychic symptoms are the result of
starvation induced organic brain changes."(Eitinger, 1961)
Cardiovascular Disease and Starvation
--------------------------------------
"Starvation and torture involve extreme stress to the heart and
vascular system. Eitinger and Strom found clear evidence of excess
mortality from coronary heart disease among Holocaust survivors,and of
excessively severe morbidity from cardiovascular diseases with a high
rate of recidivism, especially coronary heart disease and
hypertension. Inbona describes that his survivor patients in France
had nearly universal tachycardia and other heartbeat problems.
*Their hearts turn senile typically twenty years earlier than normal.
He also found frequent circulation problems in the legs that make it
difficult to stand for long periods of time."
Skeletal Disorders
-------------------
"Malnutrition and starvation can lead to various disorders of the
skeletal system caused by decalcification, according to Deveen.
Rheumatism, osteoporosis, and other disorders are reported with great
frequency in the literature. These disorders develop slowly, and are
often confused with natural aging. But epidemiological evidence shows
that concentration camp survivors experience much earlier onset
(premature aging) of these skeletal diseases. Thygesen et al detail a
number of studies that show early onset and extreme severity of these
diseases; Eitinger & Strøm found 47.5% incidence of musculoskeletal
diseases, much greater than average severity. Eitinger & Strøm pointed
out that musculoskeletal diseases can be very debilitating, and thus a
major factor in many survivors inability to maintain employment. Khmer
Health Advocates reports almost universal experience of body pain in
adolescent and adult survivors."
Vision Problems
----------------
"Chronic health problems as well as signs of premature aging greatly
diminish the quality of life for survivors. Vision changes were
prevalent in concentration camp survivors with the early development
of cataracts due to nutritional deficiencies."
====
From "Joe Broderick's 115 days of hell," by William D. Behling. Beloit
Daily News. http://www.beloitdailynews.com/796/behl22.htm
"For a long time, Joe simply didn't talk about those awful 115 days.
He kept the bad memories bottled up inside. Often, there were
nightmares. The experience has left him with hands and feet very
sensitive to cold. He had to have heart surgery a while back, and has
other physical problems probably related to the cold and
near-starvation of those winter months in the stalags of northern
Germany. Many of the survivors he knows are even worse off than he,
physically."
====
From "Chapter 18 - Prisoners of War." Report of the Review of
Veterans' Entitlements.
http://www.veteransreview.gov.au/report/chapters/ch18.htm
An Australian "Report of the Review of Veterans' Entitlements"
discusses long-term ailments noted in POW's from various countries who
served in specific wars, but does not directly tie these ailments to
starvation. Whether starvation contributed to the detriments to
long-term health can only be speculated upon.
"The United States is the only country to have conducted comparative
and comprehensive health studies into POWs from Europe, the Pacific,
Korea and Vietnam. These studies found that most of the 95,532
American POWs (E) were held captive for about one year and
approximately one per cent died, a death rate equivalent to that of
Australian POWs (E) (USDVA 1980, p. 31). Among the 34,648 American
POWs (J), the average internee spent about three years in captivity
and 37 per cent died (USDVA 1980, p. 33), a rate similar to that of
Australian POWs (J). The number of Australian POWs (K) is not large
enough to provide a valid sample for that group, but the average
American POW (K) spent about two years in captivity and 38 per cent of
the 7140 American POWs died in captivity (USDVA 1980, p. 35). Most of
the American POW (K) deaths occurred before August 1951. There is no
reason to believe that the conditions experienced by Australian POWs
(K) during captivity differed substantially from those experienced by
American POWs, given that they were held in the same camps for the
same period.
18.23 "The United States studies found that POWs (E) were often ill on
repatriation but did not exhibit the same degree and type of chronic
health problems as other POW groups. For instance, POWs (J) and POWs
(K) experienced an unusually high number of problems due to infectious
diseases and were hospitalised twice as often as POWs (E) (Beebe 1981,
p. 36).
*** Additionally, the studies showed that POWs (J) and POWs (K)
experienced an increased mortality rate in the 13 years after
repatriation, while POWs (E) did not.
*** POWs (J) and POWs (K) were also significantly more disabled and
suffered from an unusually high number of health problems due to
infectious and parasitic diseases, compared both to control groups and
to American POWs (E) (Beebe 1981, pp. 36?7).
*** The similarities between the American and Australian mortality
rates also suggest that specific cultural and environmental factors
affected the experiences of POWs, largely according to whether they
were detained in Japanese, Korean or European camps. More importantly,
the studies indicate that such factors, specific to the experiences of
POWs (J) and (K), significantly affected the health and mortality
rates of those groups, whilst in POW camps and upon repatriation, in
comparison to POWs (E)."
Conclusions
-----------
*** "Moreover, studies of American POWs (E) and (J) after repatriation
show higher mortality rates and rates of long-term health effects
among the latter group."
***********************************
Well, I must say that this research has elicited both intense sadness
and true admiration for former and current POW's that have faced (or
are currently facing) such extreme physical and psychological torture.
I am overwhelmed by the intense human ability and desire to survive
the most horrific circumstances.
No matter what country we live in, we should all consider the extreme
sacrifice and iron will many of our fellow human beings have displayed
to serve our homelands. Many of these former POW's continue to live
the rest of their lives without complaint, desire for sympathy or
recognition.
I commend all of these survivors and hold a special place in my heart
for the thousands around the world who struggled valiantly, but were
unable to survive such tortuous conditions.
Sincerely,
umiat
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