Volume 22 Number 1 March 2014 Journal of Military and Veterans’ Health Peer Outdoor Support Therapy (POST) for Australian Contemporary Veterans On Return from Peacekeeping Y ME AR D T IC I I IL N M E A N S Army Malaria Institute - its Evolution and Achievements. Fourth Decade (1st Half): 1995-2000 A I S O S A C L I A A T R I T O S N U A IN C. The Journal of the Australasian Military Medicine Association AUSTRALASIAN MILITARY MEDICINEAUSTRALASIAN ASSOCIA MILITARY TION MEDICINE ASSOCIATION CONFERENCECONFERENCE 2014 2014 THE HILTON, SYDNEY. 17-19 OCTOBER AUSTRALASIAN MILITARY MEDICINE ASSOCIATION CONFERENCE 2014 THE HILTON, SYDNEY. 17-19 OCTOBER CALL FOR PAPERS NOW OPEN www.amma.asn.au/amma2014 THE HILTON, SYDNEY. 17-19 OCTOBER AUSTRALASIAN MILITARY MEDICINE ASSOCIATION CONFERENCE 2014 THE HILTON, SYDNEY. 17-19 OCTOBER Table of Contents Editorial Inside this edition ................................................................................................................................................... 3 President’s message ............................................................................................................................. 3 Review Articles Peer Outdoor Support Therapy (POST) for Australian Contemporary Veterans: A Review of the Literature ....................................................................................................................... 4 On Return from Peacekeeping: A review of current research on psychological well-being in military personnel returning from operational deployment ................................................................................. 24 History Army Malaria Institute - its Evolution and Achievements. Fourth Decade (1st Half): 1995-2000 ............. 30 The Evolution and Role Changes of The Australian Military Medic: A Review of The Literature ............... 50 View from the Front Legal Medicine Aspects of Practising Medicine in the Adf: A Personal Perspective .................................. 55 2013 AMMA/Repat Foundation Inc. Joint Conference Abstracts .................................................................................................................................................. 58 CALL FOR PAPERS NOW OPEN www.amma.asn.au/amma2014 Volume 22 Number 1; March 2014 Page 1 AUSTRALASIAN MILITARY MEDICINE ASSOCIATION CONFERENCE 2014 THE HILTON, SYDNEY. 17-19 OCTOBER Journal of Military and Veterans’ Health EDITORIAL BOARD INTERNATIONAL ADVISORY COMMITTEE Dr Andrew Robertson (Editor in Chief) Mohd Zin bin Bidin, Malaysian Armed Health Forces Dr Keith Horsley Ken Boffard, University of Witwatersrand Dr Peter Leggat Anne Campbell, former DG NZ Defence Medical Services Dr Helen Kelsall Annette Dobson, University of Queensland Dr Michael O’Connor Mike Dowsett, former DG Naval Health Services Australia Dr Bob Stacy Greg Gray, University of Iowa College of Public Health Dr Darryl Tong Art Smith, Uniformed Services University of Health Sciences Prof Peter Warfe Tyler Smith, US Millennium Cohort Study Simon Wessely, King’s Centre for Military Health Research Australasian Military Medicine Association PATRON STATEMENT OF OBJECTIVES Air Vice Marshal Hugh Bartholomeusz, AM The Australasian Military Association is an Surgeon General Australian Defence Force Reserves independent, professional scientific organisation of health professionals with the objectives of: COUNCIL • Promoting the study of military medicine President Dr Greg Mahoney • Bringing together those with an interest in military medicine Vice President Dr Nader Abou-Seif • Disseminating knowledge of military medicine Secretary Dr Janet Scott • Publishing and distributing a journal in military Treasurer Ms Jenny Lumsden medicine Council Members Dr Andrew Robertson • Promoting research in military medicine Mr Kerry Clifford Membership of the Association is open to doctors, Dr Peter Hurly dentists, nurses, pharmacists, paramedics and Mr Geoff Robinson anyone with a professional interest in any of the Public Officer Ms Paula Leishman disciplines of military medicine. The Association is totally independent of the Australian Defence Force. JMVH is published by the Australasian Military Medicine Association 113 Harrington Street Hobart Tas 7000 Australia Ph: +61 3 62347844 Email: [email protected] ISSN No. 1835-1271 Page 2 Journal of Military and Veterans’ Health Editorial Inside this edition Just over a hundred years ago, on 28th February and publishing on this important period in medical 1914, the E class submarines HMAS AE1, captained history, which saw the development of many medical by LCDR T. F. Besant, RN, and HMAS AE2, captained advances and helped set the foundations of medicine by LCDR H. H. G. D. Stoker, RN, were commissioned for the next 100 years. in Portsmouth, England. Both submarines had In this issue, we have some excellent review articles been laid down in Vickers Yard, Barrow-in-Furness, on returning from peace-keeping and veterans England, with AE1 being launched on 22 May 1913 support. There are also articles on the evolution of the and AE2 on 18 June 1913. Two days later, on 02 military medic, a further article on the history of the March 1914, they departed Portsmouth for Australia. Army Malaria Institute, and a personal commentary On 24 May 1914, they arrived in Sydney. The passage on medico-legal challenges in military health, which of 83 days was, at the time, the longest journey ever should invoke discussion in this important area. undertaken by a submarine. Even at this stage, various militaries around the world were gearing up We encourage all our authors to consider submitting for an expected war. Unfortunately, within a year, articles, with themed issues on veterans’ health (July both submarines had been lost on active service, 2014), tropical medicine (October 2014), mental with AE1 lost during the campaign in German New health (January 2015) and trauma management Guinea, and AE2 lost in the Sea of Marmora during (April 2015) coming up in the next 12 months. All the Gallipoli Campaign. articles are welcome, from original military health studies to reviews to operational perspectives. Articles In the lead up to 100th anniversary of the are peer-reviewed and now completely available commencement of the Great War (World War I), we online at http://jmvh.org/. We are also progressively will be publishing a number of historical papers making all the articles from the Journal over the last looking at military health services in the war. In 21 years available online in the next few months. particular, our next issue in April 2014 will focus on the tremendous service provided, and the I look forward to your contribution. challenges faced, by our military and naval medical Dr Andy Robertson, CSC, PSM services during the initial stages of the war. I would Editor-in-Chief encourage all our readers to consider researching President’s message Greetings and welcome to the first Journal of Military Our Journal remains a fundamental function of and Veterans’ Health for 2014. As the Journal goes to the Association and Council is committed to its press, AMMA council is preparing to meet in Sydney publication and improvement. We would encourage to finalise some of the arrangements for our Annual anyone in the military community to submit and Conference (17-19 October). 2014 marks a 100 years article for publication whether it is a randomised since the beginning of World War I, and it is perhaps control trail or a case report; from medical officers to timely that we remember the sacrifice of those who medical assistants. The journal is willing to assist, served Australia in that war and conflicts since. This mentor, and encourage first time and junior authors year’s theme is “100 Years on, and your country still as it has an extensive editorial and consultative needs you”, for we should never forget the volatile board. nature of international relations and the potential to Finally, I would like to congratulate Bruce Waxman harm Australia’s interests. (OAM), Geoffrey Quail (OAM) and Len Brennan (AM) This year it is the intent of Council to commission an on being recognised for their outstanding work and external review of the Journal to look into all aspects generosity in the Australia Day honours. of its operation. We hope that this review will provide Greg Mahoney some guidance to ensure that the Journal improves AMMA President and provides members with a quality publication. Volume 22 Number 1; March 2014 Page 3 Review Articles Peer Outdoor Support Therapy (POST) for Australian Contemporary Veterans: A Review of the Literature Kendall Bird Abstract Peer outdoor support therapy (POST) is one approach utilised in Canada, the United States and the United Kingdom to address mental illness and distress amongst contemporary veterans. In the current paper several areas of veteran psychological therapeutic treatment are reviewed. Research studies for therapist-led treatments and standard practice recommendations are summarised, then critiqued within the wider literature taking into account unique veteran need and known challenges to treatment which can impact responsiveness, reluctance and retention. Research review results regarding peer support interventions and outdoor therapy interventions for non- veteran and contemporary veteran populations are outlined, alongside an overview of known POST programs for veterans. The implications of the reviewed literature and research are discussed, particularly the need for further research into the role outdoor peer support may play