ECOLOGY OF COMBAT FATIGUE AMONG TROOPS ENGAGED IN COUNTERINSURGENCY OPERATIONS.

A two staged study design combining features of cohort and cross sectional methods, was used to ascertain incidence of combat fatigue in troops deployed in counterinsurgency operations and study their living conditions as compared to troops deployed in similar terrain and climate but not taking part in counterinsurgency operations. Psychiatric morbidity both outdoor and indoor which was used as a surrogate measure for combat fatigue was almost three times higher for troops deployed in counterinsurgency operations (RR=3.21 and 3.11 respectively). Troops deployed in counterinsurgency operations also had significantly higher levels of dissatisfaction regarding medical and physical facilities like accommodation, food, water, clothing and recreational facilities as compared to troops not deployed. However there were no significant differences in posting and leave policies between the two groups. Troops in counterinsurgency however, did feel more often than other troops that their work was not appreciated. They also showed higher and significant signs of stress indicators such as use of alcohol, unfavourable response to task, diminished efficiency, frustration, maladjustment, tension, isolation, etc. In view of the study findings better interpersonal communications particularly task appreciation and improvement of medical and physical facilities for troops in CI Ops have been recommended.