Prisoners of War are members of the United States armed forces that were held captive during the time of war against their will. Many soldiers were captured during the Second World War, Korean, Vietnam and Gulf wars (Engdahl, 1991) . There were several ways POWs could be captured, this included either being gunned down or through front line battle among other means. POWs were subjected to intense forms of torture and psychological harm such as physical mutilation, isolation, starvation, electrocution, brainwashing, and humiliation among many other types of torture. These unconducive conditions have left most of the survivors susceptible to physical and mental health implications over time. Besides, the acts that happened on POWs during captivity have made most soldiers have post-traumatic stress disorder (PTSD). PTSD is visible especially among soldiers that have gone through a traumatic event. If severe symptoms, PTSD can alter normal day of a person. It is thus prudent to examine the commonly held understanding experienced by POWs during captivity in war by analyzing the various forms of treatment, conditions, and testimonies of former POWs. Exploring the psychological and psychological stresses experienced by POWs during imprisonment is also essential. The mechanisms used by POWs to cope in captivity and the long-term effect of confinement on the physical and mental state of POWs is also critical for understanding the impact of detention on POWs.
When in captivity, especially in a foreign country, it is not easy to understand the experience of those held captive. This was the same case especially to POWs in North Vietnam. Some of the former POWs in the Vietnam War included Sen. John McCain, Navy Commander. James Bond Stockdale, and Brigadier General Robinson Risner among many others who were held up in Hanoi Hilton prison camp (Page, 1990.) . They report various forms of torture inflicted on them. These forms are not only limited to the Vietnam war, but also other wars which had POWs as forms of torture are always alike. One way of treatment experienced by many POWs was isolation. Isolation was so thorough that POWs could go for months without seeing a fellow prisoner. Some were put in solitary for many years. Being in isolation deterred POWs from communicating (Page, 1990.) . Thus, they resorted to using the tap code, which was invented during the Korean War by Americans, instead of the Morse code to avoid being caught by North Vietnamese officials. As a form of treatment, confinement may seem light, by the disconnection from the outside world had a detrimental effect on the mental and psychological state of POWs and thus causing them PTSD even after their release.
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POWs, for example, those in Hanoi Hilton, regularly had their legs strapped in irons or at times in stocks. These bindings cut into their legs because of tightness, leading to infections. Soldiers also found it difficult to perform certain activities such as such as relieving themselves as they were tied to a bed. Prisoners could also be bound and hung on meat hook on prison ceilings. Guards would ten return in intervals to tighten the ropes (Engdahl, 1991) . This form of torture was inhuman as it caused injury on and abnormal swelling to the soldiers’ bodies. It is evident in Captain Gerald Coffees' text "Beyond survival" where when writing a letter back home he said using his left hand "Is the best I can do since my other arm and hand are healing so badly." (Coffee, 2013) The meat hook torture would go on for hours or even days.
POWs were held captive in prisons with poor conditions which have made them prone to PTSD. These conditions saw man POWs languish form months and years in crowded conditions in the camps. Overcrowding saw most soldiers develop sanitary-related illnesses, contamination of food and lack of fresh air due to poor ventilation. For example, during the Korean War, the health status of most POWs worsened due to the conditions they were held. POWs were confined in physically hygienically camps and poor living conditions. POWs were also not given full medical and dentist attention which affected their health status. Captain Coffee says, "I'd received medical care after a month or more, and my arm was mending after a fashion." (Coffee, 2013) Most of the physical and psychological disorders exhibited by POWs can be attributed to the conditions they were held during captivity.
Exposure to extreme stress levels is one of the most syndromes of psychiatry among POWs in captivity. The syndrome feature lies in the depressing stress levels produced rather than how rare it is. An analysis on former POWs depicts that the cruelty used upon them in concentration camps affected their psychological and mental state for a longer period, even after freedom. The stress experienced by POWs included instances of torture to source for information, like the next plan, which resulted to permanent injuries, and in dire situations, inmates could be murdered in cold blood to affect the psychological state of their colleagues. Captain Coffee says, “My heart thumped loudly and my body tensed for either the impact of bullets or draining relief of the bluff.” (Coffee, 2013) POWs also experienced psychological stress through political re-education, especially in the Korean and North Vietnam wars. Indoctrination techniques applied also did much harm to the POWs. The physiological stresses experienced by POWs led to the introduction of the Code of Conduct in the military that guides American soldiers today.
Captivity can be depressing, thus require POWs to adopt mechanisms that will help them cope. During the Korean, Vietnam and Gulf wars, most American POWs employed humor as a coping strategy in captivity. Another example is the Nazi concentration camps which were so horrible with no sense of humor. However, inmates used every method possible to make them laugh. It is because, in captivity, humor is an essential aspect that keeps POWs going and maintains a purpose to live despite seeing their colleagues perishing. Hope was also another coping mechanism used in captivity. Many POWs believed they would soon be free and see their families again. In the beginning, those held captive thought they would be held captive for six months to one year. However, that didn’t happen as some served up to seven years in the camps. Hope played a vital role in keeping the spirit of POWs alive that one-day freedom will be bestowed on them. These two, coupled with others, include some of the mechanisms used to cope while in captivity.
Captivity during war entails a variety of long-term physical and mental effects. Studies have confirmed that most POWs report unexplainable physical symptoms compared with their counterparts who were never held captive. Research has also shown that detrimental physical and mental health implications may be visible after a long period. Being held captive in a small space without physical fitness can eventually cause muscle atrophy. After release from captivity, most survivors develop traumatic experiences (Solomon, 2014) . PTSD is a likely diagnosis to former POWs, and this condition makes them develop psychological distress as a result of a life-threatening event which may lead to hopelessness and can last for years. Injuries inflicted during captivity may lead to disability in long-term. For example, the torturous methods, applied during the Vietnam War, of tying captives to a meat hook for several days may affect body joints and lead to disability in the long-term (Solomon, 2014) . The poor conditions of the camps also have long-term effects such as a defect of sight. Lack of mental checkup as witnessed in mot captives held during war show POWs to develop teeth loss or severe infection in the long-term. The long-term physical health includes depression which may lead to withdrawal from the public.
Conclusion
It is evident that prisoners of war go through a lot of challenges in captivity hence causing adverse effects on the physical and mental health status. During the Korean, Vietnam and the Gulf wars, American soldiers have narrated harrowing tales and experiences they went through while in captivity. They depict a case where they were put in isolation and cut off from the outside world for a long time without communication. This treatment saw some of them adopt various mechanisms which they used to cope. The state in which captives were held during the war had long-term physical and mental effect on the survivors. Therefore, it is crucial for better policies and programs to be adopted, that would see prisoners of war get back to the society without worrying about their physical or mental state.
References
Coffee, G. (2013). Beyond Survival: Building on the Hard Times-A POW's Inspiring Story . AudioInk Publishing.
Engdahl, B. E., & Page, W. F. (1991). Psychological effects of military captivity. In Epidemiology in Military and Veteran Populations . Natíonal Academy Press, Washington, DC.
Page, W. F. (Ed.). (1991). Epidemiology in Military and Veteran Populations: Proceedings of the Second Biennial Conference, March 7, 1990 . National Academies Press.
Solomon, Z., Greene, T., Ein-Dor, T., Zerach, G., Benyamini, Y., & Ohry, A. (2014). The long-term implications of war captivity for mortality and health. Journal of behavioral medicine , 37 (5), 849-859.
