The vital role of research
Armed forces operate in extreme environments, face exceptional physiological and psychological stresses, and encounter many extraordinary and unique operational, occupational, and environmental health hazards of natural, industrial, or hostile origin. The nature of these hazards and the unique context in which they must be countered require extensive applied health research that is specific to the biological, occupational, organizational, socio-cultural and other particularities of military personnel, be it in the promotion, the protection or the restoration of health.
Most advances in military health research, such as Penicillin, many trauma surgical and critical care interventions, and rehabilitation medicine are applicable to the general civilian population. Much applied civilian research does not, however, address military health priorities or is often unsuitable for application in military contexts.
The need for military-specific health research has therefore long been recognized by the armed forces.
The first scientist in what is now Canada, Michel Sarrazin (1659-1734), was Surgeon-Major to the colonial regular troops of New France. A member of l’Académie royale des sciences, he systematically studied many things including the medicinal uses of new world plants. Over two centuries later in 1938, the president of the National Research Council, former Chief of the General Staff Lieutenant-General Andrew McNaughton, established the entity that later became the Canadian Institutes for Health Research. Knowing that war, with its difficult medical challenges, was approaching, he asked his old RCAMC friend, Nobel Laureate Major Sir Frederick Banting, MC, to chair the NRC’s newly-established Associate Committee on Medical Research. Sir Frederick was reluctant to do so, but General McNaughton appealed to his sense of duty. Major Banting proceeded to establish a network of academic researchers that proved very useful during the Second World War.
To this day, applied military health research remains a fundamental responsibility and requirement of the Canadian Forces Health Services, and its operational and clinical importance was particularly emphasized by the past few years of intense operations in Afghanistan.
Such research is pursued extensively within the Surgeon General Health Research Program and by Defence Research and Development Canada (DRDC), often in collaboration with other government departments and military allies. Veteran’s Affairs Canada similarly researches health issues relevant to Canadian veterans. The fruits of our work inform both military and domestic civilian health protection, as it did Sunnybrook Trauma Centre’s response to Toronto’s mass shooting casualties on July 16, 2012. Its medical director and trauma leader is one of the CF’s top medical researchers and trauma surgeons, Col Homer Tien.
DND and VAC health research capacity are, however, limited. At the same time, there have always been elements of Canadian academia interested in conducting research relevant to the CF and veterans. To coordinate and capitalize on this interest and on the broader national academic research capacity, former Surgeon General Commodore Hans Jung proposed the concept of an academic military and veteran health research consortium in 2009. In response, Queen’s University and the Royal Military College subsequently established the Canadian Institute for Military and Veteran Health Research, an innovative network of 25 Canadian universities to conduct research addressing the health interests of CF members, veterans and their families.
With their data, knowledge of military health priorities, and understanding of the military operational context, CF Health Services and DRDC researchers can effectively inform or partner with academic experts to independently confirm or collaboratively supplement military health research. CIMVHR has already contributed to education and knowledge translation through an annual scientific Military and Veteran’s Health Research Forum, and its network includes military rehabilitation and military trauma research chairs at the University of Alberta and at Sunnybrook Health Sciences Centre respectively.
CIMVHR can link key researchers with appropriate projects to provide valuable knowledge exchange and broaden research teams. It did so, for example, by linking CF Health Services with the national experts in occupationally-induced mental illness at the Centre for Addiction and Mental Health, as well as with Dr Ruth Lanius of the University of Western Ontario to collaboratively study the brain mechanisms and clinical effects of biofeedback for PTSD.
Through presentation of their research at the Military and Veteran Health Research Forum, academic researchers can promote and establish collaboration with others sharing similar interests, as did Dr Brad McFadyen of Laval University for his research on the use of avatars for rehabilitation of CF members suffering Chronic Non-Specific Low Back Pain and mild Traumatic Brain Injury.
Given evolving military operational health hazards and resulting health issues, research will always remain critical to providing CF members and veterans the best possible health protection and care. CIMVHR’s facilitation and supplementation of DND and VAC research capabilities is a welcome contribution to the health of those to whom Canada owes so much.
Brigadier-General Jean-Robert Bernier is the Canadian Forces Surgeon General and Commander of the Health Services Group.
BGen Bernier will be a keynote speaker at the third annual Military and Veteran’s Health Research Forum Nov 26-28 in Kingston. For more information, visit: www.cimvhr.ca.