‘War shock’

The words were flung by bystanders at the policemen moments after one of them fired at the civilian he had earlier ordered to stand down: “Sana nag-warning shot kayo! Me tama po ‘yan, dating militar po ‘yan na nagkaroon ng war shock!”

What the witnesses meant was that the policemen’s target had a mental health problem that would have accounted for the erratic behavior the cops said the man had displayed earlier, in violation of the quarantine. In the standoff that followed, Master Sergeant Daniel Florendo Jr. shot ex-Army corporal Winston Ragos twice as Ragos was seen reaching for something in his bag. Ragos expired before reaching the hospital.

The shooting incident last April 21 in Barangay Pasong Putik, Quezon City not only generated a firestorm against what was seen as the authorities’ harsh and heavy hand in implementing the lockdown ordered by President Duterte to contain the COVID-19 contagion. It also brought to the fore an otherwise taboo subject among men in uniform: the mental health of soldiers and how there is little understanding extended to those who are suffering from post-traumatic stress disorder (PTSD) caused by combat duty—what the bystanders referred to as “war shock.”

In an extraordinary statement, the Philippine Army mourned the death of Ragos and appealed for greater public understanding of PTSD. “To a soldier, the wounds of war are not just physical but also mental, and their scars are not always seen,” it said. “The Philippine Army seeks awareness on the plight of former soldiers struggling with mental problems. Even though they are no longer soldiers, they continue fighting a silent and lifelong battle.”

A 2017 paper written by Cariñez dela Cruz Fajarito and Rosalito G. de Guzman of the University of Santo Tomas and published in the Philippine E-Journals website looked into case studies of Filipino active duty soldiers diagnosed with the disability, and noted that combat-related PTSD (previously referred to as battle fatigue, war zone stress or shell shock during World War I and II) could be developed after military personnel “are exposed to traumatic event(s) in a war zone.”

This was the case for Ragos, who enlisted in the Army in March 2010 and was assigned to the 31st Infantry Battalion under the 9th Infantry Division in the Bicol region, which saw fierce encounters with the New People’s Army. Army spokesperson Col. Ramon Zagala said in an interview that this could have triggered Ragos’ PTSD. Ragos was first confined at the Armed Forces of the Philippines Medical Center (AFPMC), better known as V. Luna General Hospital, from November 2010 to August 2011, for psychotherapy and medication. During his almost seven years in the Army, he would be on and off treatment. In 2016, AFPMC doctors declared he was no longer fit to serve. He was honorably discharged in January 2017, and was continuing his therapy at the Veterans Memorial Medical Center when he was killed by Florendo.

“We took care of him when he was still an active soldier, going in and out of the hospital,” Zagala said. “PTSD is really a serious condition,” he added, especially among soldiers who have been through horrendous encounters with rebel groups, like the Abu Sayyaf in Mindanao, or those who served in Marawi during the 2017 siege. The Army General Hospital recorded “between 10 and 12 clear-cut cases” of Army soldiers with PTSD after the five-month-long Marawi battle, while the AFPMC admitted 23 soldiers for PTSD, as reported by this paper in September last year. Most of the PTSD patients in the AFPMC, in fact, are from the Army.

While the AFP covers all expenses for mental patients admitted in the AFPMC, many soldiers still choose to suffer in silence instead of seeking treatment due to the stigma attached to mental illness, especially in the context of the military’s hypermasculine culture. Soldiers in the Philippines, the UST paper said, are “hesitant to seek treatment… they are ‘too shy’ to even admit that they are experiencing mental issues. That is why most of the time, these soldiers keep their problems to themselves, until such time that their behavior would be very unusual…” This, unfortunately, only worsens their condition and often leads to antisocial or violent behavior that creates problems with other soldiers or their families who suffer the effects of their undisclosed trauma.

Following Ragos’ shooting, Army chief Lt. Gen. Gilbert Gapay has ordered a policy review of the Philippine Army’s trauma risk management protocols to see how the service can take better care of its troops even after they leave the service. In their “silent and lifelong battle” with PTSD, former soldiers need as much help and compassion as possible—from both the government and the public, for whom they had risked their lives and so much more.