MAIMED SOLDIERS AND SAILORS

Dominion, Volume 11, Issue 12, 9 October 1917, Page 8

MAIMED SOLDIERS AND SAILORS

THEIR TREATMENT AND TRAINING

AFTER-WAR EMPLOYMENT

Lieut-Colonel Sir Arthur Boscawen, M.P. (Parliamentary Secretary ip the Ministry of Pensions), issued recently a report oil the Inter-Allied Conference for the Study of Professional Kc-educatiou and other questions of interest to soldiers and Bailors disabled by the war, which was held in Paris in May last. He says:

I was struck very much with the gieat interest which the subject evoked. Kepresontativca of France, Belgium Russia, Portugal, Italy, and Serbia took attiva part in the discussions, and in addition to this the conference was largely attended, showing that the "Re-education des Mutiles de la guerre," as the French call it, is recognised by a great si ction of tho French public as a most urgent and important social problem. As If. Leon Bourgeois said nt the opening of the conference, there is a "solidarite morale" among tho Allied nations. It is possible that in this country we have somewhat lagged behind in the recognition of its importance, partly no doubt in consequonco of the fact that at tho beginning of the war our losses were very much smaller than those of the French, and that we did not anticipate our large army and heavy casualties. As regards treatment, I can only speak, of course, as a layman, but so fur as our hospital services and methods are concerned, I came to the conclusion that we have not much to learn. I would, however, call particular attention to the notes on the French organisation for the "prothesis," especially orthopaedic treatment, of disabled soldiers, and the suggestions contained in Sir Berkeley Moynihnn's valuable report. In one important respect the practice in France and among the Belgians differs from our own. No man is discharged from the Army until his cure is complete, so far rs this is possble. I know that this question has boon discussed frequently with the War Office, who have stated that they are unable to retain disabled men for a longer time in the Army than they do at present, but I think it my duty to record the fact that the French and Belgian military authorities accept a larger responsibility for the disabled, and, at all events, profess to retain them until tt.ey require no further treatment either as in-patients or out-patients. Thus the danger of men going back to work before they are physically fit to do 60, whereby health may be permanently impaired, is avoided. The only cases where treatmont after discharge is said to take placo in France or Belgium arc tV.ose in which a man's condition gots worse after he leaves the Army. Training or "Re-education Professionelle" Tho greatest amount of intorest .is taken in- this by the French, the Belgians, and so far as I can judge, by the Allies. Not only are workshops attached to all tho French' and Belgian hospitals, but also there are largo establishments specially set ur> for re-education. We visited what is porhaps the finest example of these, viz., the "Institut j\lilitairo Beige des Mutiles, lnvalides et Orphelins" at Povt-Villcs, which has been built on a magnificent sito overlooking the Seine half-way between Paris and Rouen, and accommodates about IIWO disabled men. Hero aro the most complete installation of electrical and other appliances for orthopaedic treatment and somo thirty separate workshops whero almost every conceivablo trado is taught. Training is compulsory, as it is in all French, Belgian, and Italian hospitals, the doctor having tho principal voice in deciding what trado the man is to learn, and being guided naturally by considerations of tho curative quality of various forms of manual training in each case. The man himself appears to have littlo voice' in deciding his future, while a battle royal between tho doctor and tho technical export often rages over his mutilated body. Here, asain, the o-ractico in France, Belgium, and Italy differs from our own in the fact that the. training in the hospitals is compulsory (on tho' advice and under tho supervision of tho doctor), whereas it is not compulsory in this country, even in orthopaedic and limbless hospitals which have workshops attached. T am told, however, by those who have experience of these .hospitals, that better results' aro obtained by allowing the (raining to bo voluntary and by appealing to tho good sense of the nien, which may be 60; and I recognise fully the disciplinary difficulty involved in punishing a man who has lost a limb for refusing training. I have also some doubts as to how far it. is really enforced in France in practice. In any case, compulsory training ceases in Franco and Italy as soon as the man is discharged from the Army. With the Belgians it is different. Unhappily, there is no Belgium for them to go back to. Tho State, therefore, has to maintain them, and this being so, it compels training so long as it. is considered that the man requires it. In France and Italy, however, as soon as the man is discharged from the Army he is free to do as he likes, and can and does refuse further training exactly as he.does here. Shortly before the Conference opened a very important paper was issued by the French Minister of Education, pointing out the extreme difficulty of getting discharged soldiers to avail themselves of the opportunities offered. Hero aro some extracts from it:— "Very many disabled soldiers refused to avail themsclvos of the facilities for 're-education professionelle' offered to them, cither in consequence of their listening to false ideas which are current, or through ignorance of the goods resulis obtained in the schools. Some persist in believing, in spito of assurances reiterated' over and over again, that the pension is reduced in consequence of reeducation; others seem to think that the fact that they have been wounded gives them a right to employment by the State. . . . Others, again, are tempted by the offer of obtaining good wages immediately, and accept employment which is bound to bo temporary only. Lastly, there are some who despair altogether of ever being able again to undertake manual labour, not realising the great improvements whjcfi can be produced in. their condition by training. "We must endeavour to dissipate theso prejudices and this ignorance by a vigorous propaganda. We must carry it on among the wounded men while they remain in hospital and when they have left it without having been trained. We must carry it on among their families, who, profoundly moved by the fate which awaits the disabled" soldier, forget, even when they are not ignorant of it, the organisation which exists for improving their condition. Beyond all things, we must make! it quite clear that neither tho lifo pension nor the renewable pension can be reduced in consequence of re-edu-cation. ...

"These arc the actual terms of the 'Act passed by the Chamber of Deputies. The discharged soldier is certain of receiving the whole of his life pension, even when he has been put in a position by means of re-education to earn wages equal to, or greater than, what he earned before. And in the same way the amount of the temporary pension, which is always subject to revision, depends in no way on his training, but solely on his physical condition. In deciding whether the temporary pension should be continued at the same rate, or diminished, or converted into a life pension, the discharged soldier is not asked whether he has been reeducated or not, lie is examined simply as to whether lie has recovered; and in what degree he has recovered, the use of his arm, his leg, etc."