Revealed: Army's growing toll of injured

The toll of serious injuries among British troops fighting in Afghanistan is escalating, with limb amputations at levels not seen since the Second World War, according to military medical experts.

As hundreds more soldiers prepare to go to the front line, figures obtained by The Independent on Sunday reveal that 145 have been seriously wounded so far this year, including 32 who have had limbs amputated – with more than a third of those losing at least two limbs, according to the Ministry of Defence. It is a steep rise on the 14 amputees recorded in 2007, out of 63 soldiers seriously injured.

In the week when the number of soldiers killed in Afghanistan this year reached 100 – the highest annual military death toll for more than a quarter of a century – figures obtained from the Ministry of Defence confirm that, in total, there have been more than 1,300 British soldiers killed or injured by insurgents in Afghanistan – almost triple the 451 casualties suffered in Iraq. More soldiers were wounded in action in Afghanistan this year – 432 – than in the whole of the Iraq war.

Casualties are expected to mount further as troops pay an increasingly high price in blood in the battle against the Taliban, with 500 additional troops, from 1st Battalion, the Royal Welsh, deploying this week as part of a renewed surge. The war in Afghanistan "will cost more lives before we are finished", warned the Defence Secretary, Bob Ainsworth, on Wednesday.

In the past three years, 80 soldiers have been so badly injured they have had arms or legs amputated. And one in four has lost at least two limbs.

The number of amputees is not far short of being the equivalent of an entire infantry company and is significantly higher than the 53 amputees from Iraq and the Falklands combined.

Frank Garside, a spokesman for the British Limbless Ex-Servicemen's Association (Blesma), said: "The problem is that you are going to get escalating numbers of amputees now because of the improvised explosive devices. This is the main problem and it is getting more and more worrying."

He added: "I think you really have to go back to the Second World War to see the high percentage levels of injuries that are producing amputees."

In a bitter irony, the increase in amputees reflects advances in medical treatment that are enabling doctors to save the lives of soldiers who just a few years ago would have died from their wounds.

Headley Court – the military rehabilitation centre that specialises in treating amputees – has seen the number of battle injuries it is dealing with double in the past year – from 132 in 2008 to 268 in 2009. Resources at the centre have become so stretched that it has had to take on a number of agency staff to help deal with the increase in patient numbers.

In a statement, the Ministry of Defence said: "Our hospitals and rehabilitation centres have the capacity to treat the number of military casualties seen to date. Continuing to provide the highest standard of medical care is a priority, and we have extensive plans in place to allow us to cope if there was a significant surge in casualties."

While many of those who have lost limbs are still in the Forces, they could face an uncertain future once they leave. "Many are still in service but there could come a point where there could be a big influx on to the NHS, and they may not receive the same quality of treatment," said Mr Garside.

The outlook for soldiers suffering mental injury is expected to be even bleaker, with thousands returning to the UK burdened by the trauma of horrors they have witnessed. By the most conservative of estimates, nearly 5 per cent of those deployed will suffer post-traumatic stress disorder (PTSD). With around 170,000 soldiers having served in both Iraq and Afghanistan, this means more than 8,000 soldiers could be afflicted.

New research suggests that the mental cost of the war could be much higher than previously thought, however. It shows that the onset of post-traumatic stress disorder is often delayed until soldiers are discharged from the Army, meaning the condition is not picked up by military doctors who are trained to recognise it.

Earlier this month, researchers at University College London (UCL) published a paper in the Journal of Abnormal Psychology which showed that delayed-onset post-traumatic stress disorder can develop within a month of a veteran's discharge from the Army.

Professor Chris Brewin, of UCL, said the figures could be 25 per cent higher than previously thought – adding another 1,800 veterans to the toll.

"While a veteran remains in the Army there is the support of colleagues, medics, and a busy day, which can divert attention from the trauma that may trigger PTSD," he said. "Once those support mechanisms have gone, then the person may start to dwell more on what they have seen. Prior to developing PTSD, those with delayed onset did show other stress symptoms, such as depression or alcohol abuse. This research shows that we should be continuing to monitor veterans for at least a year after discharge, as civilian doctors may not identify the symptoms. "

A sniper's tale: 'Your world kind of changes there and then'

Two weeks before he was due home, in March 2008, Corporal Simon Wiggins, 23, stepped on a landmine in Helmand province while on patrol. The sniper lost his leg, a finger, and suffered massive internal trauma.

"The place we were was kind of desolate because all of the local people had moved out. We knew if we saw anyone moving it was Taliban. We moved over a small stream and, on the other side, I stepped on a pressure pad and it just blew me up, took my leg.

"When I realised what had happened I was pissed off more than anything else. I took my helmet off and threw it. Your world kind of changes there and then; reality strikes. No one knows about being an amputee until you are one. I don't like it but, if you complain, you start getting depressed. There are a lot of guys out there that are a lot worse off than me, and that sorts me out."

Andrew Johnson