Heights of madness: diagnosis, suspicion & military discipline on the Siachen glacier

ABSTRACT

The Siachen Glacier was occupied by the Indian Army in 1984 and became the highest battlefield in the world. The Pakistan Army has been deployed in the surrounding regions and the continuation of the low intensity warfare between the two countries has led to many thousands of casualties on both sides. The Pakistan Army has developed an elaborate medical infrastructure for the management of casualties and high-altitude sicknesses including oedemas and mental health issues. The article explores how military discipline becomes entangled with medical surveillance in monitoring illnesses suffered by soldiers serving on the glacier. By drawing upon interviews with soldiers and officers from various cohorts, the article explores how soldiers learn to take care of each other’s unusual bodily experiences and report unusual changes to the medical staff. This entails that soldiers cultivate relations to attend to each other’s injuries but also relay judgements about the soldier-patient’s loyalty to serve for the Pakistan Army to military superiors. By showing how social networks through which diagnosis is formulated consists of an entanglement of professional evaluation, medical opinion and the hearsay of the soldier-patient’s comrades, the article considers the disciplinary networks which detect and suppress symptoms where self-expression of symptoms is treated as malingering.

KEYWORDS:

• Trauma
• Pakistan army
• Siachen
• malingering
• war
• environment

Acknowledgment

This research was supported by the Society for Psychological Anthropology/Robert Lemelson Foundation Fellowship, made possible by a generous donation from The Robert Lemelson Foundation. Kathy Trang and Amir Hampel from the Society for Psychological Anthropology (SPA) helped me frame some parts of the article. I would also like to thank Jeremy Greene and Clara Han for teaching the graduate seminar on ‘Normal and the Pathological’ out of which many of the ideas for the article emerged. I also thank my colleagues Michael Haeley and Sarah Zanolini from the History of Medicine who were part of the seminar and provided important comments. Special thanks to Naveeda Khan and Deborah Poole for their guidance and help. Amman Siddiqui from Johns Hopkins University and Sanveed Adnan from the Lahore University of Management Sciences helped in conducting archival research and in revising the article. Finally, I would like to thank the New York Academy of Medicine (NYAM) and the American Anthropological Association (AAA) for providing opportunities to presents parts of this article in New York, Vancouver and Seattle in 2019, 2020 and 2022, respectively. I would also like to thank Murphy Haliburton for his comments on some of the findings of paper and my colleagues Alyssa Basmaijan, Tianyi Bai, Aarushi Shah and Betselot Wondimu for their engagement as part of the panel on the embodiments of violence at the AAA meeting in Seattle in 2022. Finally, I would like to express my gratitude for the anonymous reviewers at Critical Military Studies for their comments.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Notes

1. In clinical psychiatry, the word ‘caseness’ is used for scores high enough on measures of depression and anxiety to be classified as clinical cases.

2. A general of the Pakistan Army, Ghafoor (1992) shares his experience of handling weapons on Siachen Glacier, ‘The gun tubes expand and contract with temperature changes when firing and then remain silent for extended periods. The effectiveness of ammunition can vary considerably. Projectiles do not penetrate the ground covered with deep snow; shrapnel is confined and absorbed. The impact of the burst can be reduced by 80%, and this also applies to grenades and free flight rockets. The frozen ground reduces the penetration of all munitions’..

3. Part of the reason why he may have used resistance may have to do with infections like cellulitis, which are common among soldiers in Siachen, as a young military doctor who gave the researchers a tour of the medical facility told.

4. Chacha (plural chachas) is used to refer to paternal uncle in Urdu but in the context of the Army is often also used to refer respectfully to older servants.

5. Havildar is the second-highest rank for Non-Commissioned Officers (NCOs). Typically a havildar has three naiks under him and each naik, in turn, has a few soldiers under command.

6. Since colonial times, British recruitment authorities would recruit men in bulk and assigned the the rank of Junior Commissioned Officer (JCO) to village elders to exert informal control over troops.

7. Angela Garcia (2010) uses the concept of “patient-prisoner” in her work on addiction and loss in rural New Mexico. For Garcia, the patient-prisoner is the subject who gets produced by juridical, medical, and carceral regimes that govern the drug addict through the dual logics of recovery and punishment.

Additional information

Funding

The work was supported by the Society for Psychological Anthropology .