TRC Final Report

Volume 4

Chapter 5

Subsection 6

The South African Medical Services

36 The South African Medical Services (SAMS) was the medical service of the South African Defence Force (SADF) – now the South African National Defence Force (SANDF). The SAMS was formed in 1979 as a distinct and separate section of the SADF. It was responsible for providing health services to members of the SADF (army, navy and airforce) and some health services in the former homelands and parts of Namibia and Angola for certain periods.

37 The SAMS included doctors, nurses, psychologists and non-professional, military-trained ‘medics’. These individuals were either conscripts or permanent members of the SADF and had to be trained and fully incorporated into the doctrine and standing operational procedures of the combat forces. This made the operation of the SAMS quite different from civilian care.

38 Military health professionals had a particularly difficult time in upholding international standards of medical ethics and human rights. While they were supposed to follow the same ethical codes as civilian medical workers, they were, at the same time, required to follow orders given by superiors. This created an atmosphere of dual loyalty for these individuals.

Experiences of a military medic¹⁸

Sean Callaghan had to choose the section of the military in which he wished to serve at the age of fifteen when he completed his papers for military conscription. At the time, he chose to be a military medic so he could “help people rather than kill them”. Two years later, he found himself working as a medic in the townships and on the Namibian and Angolan border.

The first time that many of the medics performed any medical procedures was in black hospitals because “frankly it didn’t matter if we made a mistake because they were black people”. He very quickly learned that “the only way to cope with the situation was to switch off my emotions immediately, not to feel anything for anybody, not to try and fit into any kind of humane circumstance; but just to be a cold machine that did what I was trained to do.”

In some camps, members of the SADF were given monetary incentives to carry out military objectives. At the Koevoet camp, they were paid for killing and recovering weapons from the enemy. This was a great motivating factor as the men could double or triple their incomes. In one instance, an officer became so frustrated when he could not find a firearm in a patient’s possession (which would have meant extra money) that he shot the patient through the head while Sean was attending to the patient’s wounds. John Deegan, the officer concerned, confirmed this in a statement to the Commission.

Torture was used during interrogation to extract information about the enemy and the whereabouts of arms caches, as such information could help increase the men’s incomes. Some of the procedures used included electric shock around the genitals and pouring boiling water over the chest and genitals. Medics were expected to treat the resultant injuries.

Prisoners of war were shot at point blank range and buried once enough information had been extracted from them. Bodies were often tied to Casspirs¹⁹ , and the men would drive around with them for a week with their skin being ripped off. This was done to intimidate prisoners, and to coerce them into identifying the bodies and disclosing the position of the deceased in the command structure, or face being one of the next bodies to be dragged by the Casspir.

There was virtually no psychological help for the men to deal with the tragedies that they witnessed. They often drank heavily or took drugs – one of the only ways to cope with the adverse circumstances. Suicides occurred frequently, as national servicemen could not take the pressures of constantly being in combat situations or so far away from their families. When Sean did go to the local psychiatrist for help, he was told to “grow up and carry on” because there was nothing wrong with him.

Once the men completed their military service, there was no debriefing or assistance to help them reintegrate into society. Although, according to the SAMS, Project Curamus was launched on 2 April 1990 to assist conscripts and permanent force members ‘disabled’ in the course of duty, the project seems to have focused primarily on physical disabilities, not psychological problems. After completing his military service, Sean suffered from post-traumatic stress disorder for ten years.

39 It is apparent from this account that military medics were forced to violate international and local standards of medical professional conduct and human rights and that many were personally traumatised by their experiences. Many of them have had great difficulty reintegrating into and becoming productive members of civilian society.

40 As yet, relatively little is known about the human rights violations committed by health professionals in the military. The SAMS submission to the Commission focused on the history, functions and administrative structure of the service, rather than considering any possible involvement in gross human rights violations. Many questions were deferred because they related to supposedly ‘classified’ (secret) operations. For example, the SAMS submission referred to three special projects undertaken by the Psychology Directorate. The reference was followed by the disclaimer: “As these projects have national strategic and security implications, they are not discussed in detail in this non-restricted document.” However, the little information that the Commission does have on the violation of human rights by the SAMS suggests that military objectives often took precedence over medical objectives. In June and July 1998, a special hearing on the SADF’s chemical and biological warfare programme uncovered new information about the extent of involvement by the medical profession in human rights violations.²⁰

41 The Commission investigated a number of allegations. There were reports of a particular psychologist who used aversion therapy and electric shocks on homosexual military men as part of a treatment for their ‘gayness’. Another doctor allegedly helped the military develop chemical weapons and truth serum to be used in questioning.