About 100 former Canadian peacekeepers from British Columbia, most of whom served in the former Yugoslavia, will participate in the program, which was launched last month at UBC. Six specially trained family doctors and former peacekeepers who have completed a pilot program will provide the counselling.

Dr. Marvin Westwood of UBC's Department of Psychology says involving former peacekeepers in counselling is essential because soldiers more readily trust those with a military background. In a pilot project that preceded the counselling program, that credibility helped participating peacekeepers become "emotionally expressive, talking about what really happened."

During the pilot project, soldiers re-enacted experiences such as being taken hostage. When it ended, 8 soldiers volunteered for additional training in order to help lead this fall's expanded project.

An estimated 40% of peacekeepers will be affected by some type of PTSD (see page 1187). Westwood says most soldiers with symptoms of the disorder — these include nightmares and depression — are in denial for up to a year. And unlike their counterparts from WW II, says Westwood, peacekeepers experience additional trauma because their rules of engagement often prevent them from intervening to prevent slaughter, as was the case in Rwanda and Bosnia.

Three groups of peacekeepers who completed the pilot program reported improvement in several areas, including family and work relationships and quality of sleep. The pilot project was supported by Veterans Affairs Canada, but the $150 000 cost of the expanded counselling program is being paid by the Royal Canadian Legion. "It was evident to us that these peacekeepers had endured some pretty horrendous things and needed assistance when they came home," says Linda Sawyer, executive director of the Legion's Pacific Command.

Physicians participating in the program are trained to recognize trauma-related symptoms. Westwood says the physician participation is important because "they are the frontline people that returning peacekeepers will eventually turn to. And we also wanted to raise the consciousness of physicians regarding combat-related trauma."

Soldiers tend to under-report psychological symptoms to military physicians because they worry such reports will damage their careers. "They tell us outright that they would never tell a military doctor, ever, that they had any psychological symptoms," says Westwood, because those doctors would be obliged to report that information.

Dr. David Kuhl, an expert in resolving psychological trauma and a project participant, says it has already been determined that WW II veterans sometimes suppressed traumatic memories for 50 years. He says today's peacekeepers appear "to be following the same pathway. We need to be aware of how some of these psychological features could translate into illness experiences."