Eyewitness: Marines show no mercy for tortured souls

His screams exploded in the night at the tiny base in southern Helmand as he fought liked a trapped animal to escape his one man mosquito net. The terror of his nightmare was so vivid that it took four of his fellow US Marines to hold him down.

Once they had him subdued, they made but a few cursory comments before leaving him sitting in his sandy dugout, a silent, slumped and isolated figure.

Even more disturbing than the scene that had just played out was the to reaction to my questions about his welfare.

“Yeh, he does that all the time. He is just a f***ing coward. He doesn't leave the COP,” blurted out one marine mercilessly.

This was Combat Outpost Sharp, named after a 20-year-old Lance Corporal whose life had been ended by a bullet to the neck during two months of unrelenting combat. Near Mian Poshtay, it was the American's most southerly Helmand base and described at the time as their most violent area of operations.

There was only one company of less than 100 men there yet the nightmare-tortured marine was just one of two that were now confined to its few square meters, refusing to patrol or face the endless IEDs (improvised explosive devices) and bullets beyond its defences.

They had not been returned to the main US base in Helmand, Camp Leatherneck, simply assigned menial tasks and dismissed by their colleagues as failed marines.

Until then I had always subscribed to the commonly held view that the American military was more adept at dealing with combat stress, after all it was the US that had coined the term Post Traumatic Stress Disorder after Vietnam.

Statistically the rates are far higher in the US. Last year, in a Royal Society journal, Neil Greenberg of the Academic Centre for Defence Mental Health at King's College London and colleagues reported that studies of American soldiers showed PTSD prevalence rates of in excess of 30 per cent compared to four per cent in UK troops. The British military puts the discrepancy down to the fact that US Army soldiers endure longer – year long – tours of duty, often in the most brutal areas of operation and have a different psychological reaction to stress. Others, however, claim it is because the Americans are more willing to diagnose – and consequently treat – PTSD.

Yet in this tiny outpost at the heart of a war, where many of the marines I spoke to had endured some of Iraq's fiercest battles – such as the infamous fight for Fallujah – before being sent to Afghanistan's frontline, there seemed little appetite to acknowledge any mental health problems.

There was scant sympathy, let alone treatment, for two marines who appeared largely ostracised - left to unpack stores and scream in the night.