Indian Defence Review

One of our military veterans, Major DP Singh, better known as the Blade Runner, is a Battle Casualty of the Kargil War. He made the telling point in a recent interview to journalist Barkha Dutt that the “Armed Forces are not business houses, decisions about soldiers cannot be made based on profit & loss.” He was referring to the recent amendments in the disability rules, that incidentally apply only to our military and not to other Central Government Services, that have arbitrarily reduced percentages of disability for what have come to be characterised as “lifestyle diseases”.

Ironically, military disability pensions are much lower, probably half that of what a civilian serving with the Central Government would receive, which in itself is a matter of shame and reflects poorly on the government. Lifestyle diseases, by the way, primarily imply common Non-Communicable Diseases(NCDs) such as Alzheimer’s, arteriosclerosis, cancer, chronic liver disease/cirrhosis, chronic obstructive pulmonary disease (COPD), diabetes, hypertension, heart disease, nephritis/CRF, and stroke.

Dr Mukesh Sharma and Dr P K Majumdar in their paper Occupational Lifestyle Diseases: An Emerging Issue, published in the Indian Journal of Occupational and Environmental Medicine (Dec 2009) characterised lifestyle diseases as those “whose occurrence is primarily based on daily habits of people and are a result of an inappropriate relationship of people with their environment and are preventable, and can be lowered with changes in diet, lifestyle, and environment”.

They go on to suggest that “the onset of these lifestyle diseases is insidious, they take years to develop, and once encountered do not lend themselves easily to cure. The main factors contributing to the lifestyle diseases include bad food habits, physical inactivity, wrong body posture, and disturbed biological clock”. 

They however do admit that “occupational lifestyle diseases include those caused by the factors present in the vicinity like heat, sound, dust, fumes, smoke, cold, and other pollutants. These factors are responsible for allergy, respiratory and hearing problems, and heat or cold shock. Those occupations, in which there is a huge temperature or pressure difference, cause a disturbed homeostasis leading to disease….. Similarly people working in high temperatures face problems related to BP, metabolism, and organ failure due to shock. Extreme cold working condition causes hypothermia and shock. People in the fishing or shipping industry face seasickness or motion sickness along with other risk factors contributing to a diseased condition”.A study on working women quoted by them suggests “that long hours and working under strict deadlines cause up to 75% of working women to suffer from depression or general anxiety disorder, compared to women with lesser levels of psychological demand at work”.

Anybody familiar with our military would be aware of the extremely difficult conditions that they function. Repeated tenures in High Altitude and Counter Insurgency Areas take their toll, including the onset of Post-Traumatic Stress Disorder (PTSD), a condition that our military hierarchy and medical authorities deliberately ignore.  Peace tenures are no less stress free with the focus shifting to training that keeps individuals away from their place of duty for over a third of the year. Then there are specialised units which maintain readiness alert for undertaking a range of combat operations within hours. In all of this personal and family life suffers, more so since peace tenures are restricted to three years and there is always a shortage of family accommodation. There can be no getting away from accepting the fact that all of this impacts an individual’s mental and physical well-being. 

Quite clearly, without specifically saying so, the military hierarchy has attempted to imply that primarily lifestyle diseases are caused by an individual’s “bad habits”, such as excessive intake of alcohol, smoking etc.They have attempted to put in place a system that denies disability pension to those suffering from NCD by renaming it as “Impairment Relief”. This is nothing more than sheer deceitfulness. Moreover, it is also a shameful admission that the command structure has failed in ensuring high levels of combat proficiency, morale and motivation. It suggests that the conduct of regular physical training and periodic Battle Physical Efficiency Tests and routine medical checks that every soldier has to undergo are mere eyewash!

The simple unvarnished truth is that, as the paper quoted above suggests, an individual’s medical condition is impacted by many diverse factors other than his own choices, including external factors such as stress, tension and environmental conditions over which he has no control. More importantly, it also points out that such deterioration takes place over time and will only manifest itself later. Simply put, a soldier who may have served in Siachen or in a high stress Counter Insurgency environment may well display signs of NCD years later while posted in peace station. To deny him the benefit of a receiving disability pension is a sheer travesty of justice. Medical Officers who formulate or agree to the implementation of such egregious and skewed policy are doing their personal reputations no favours and certainly not acting as competent medical professionals.

The manner in which this issue has been engineered with the help of an unsubstantiated CAG Report, that is not worth the paper it is written on, suggests complicity at the highest levels of the military to suborn existing policy on the award of disability pension. A policy that had been arrived at over time, with numerous interventions from the judiciary, is being changed through subterfuge, bias and an utter lack of comprehension of the correct medical facts.

While they may be correct in assuming that it will help reduce the military’s revenue expenditure, and in turn earn them a few brownie points with the government, the miniscule savings are not worth the catastrophic damage they are wreaking on morale and motivation of our Armed Forces personnel. On the other hand, if their actions have been motivated by a genuine attempt to stop manipulation of the system, that could have been achieved by instituting appropriate checks and balances. It certainly does not justify throwing out the baby with the bathwater.