By Philip Whiteside, international news reporter

An upsurge in post-traumatic stress disorder among veterans of the UK's Afghanistan campaign will follow the takeover of the country by the Taliban, an expert has told Sky News.

Dr Walter Busuttil, a consultant psychiatrist and director of research for the charity , says the events unfolding on TV screens present a real danger to those who fought there.

He said: "It's likely that the numbers coming forward will increase; it's likely that their mental illness, if they already have it, will get worse if they're not treated, and it's likely the people who have been treated will relapse.

"So, it is a big deal."

He spoke as veterans' charities, including Help for Heroes, Combat Stress and others, and senior officers outlined their concerns for service personnel who fought in one of the most intense conflicts involving British forces in decades.

Some stages of the Afghan war are said to have seen the fiercest fighting by British troops since Korea or the Second World War.

And with most British operations taking place in a remote part of the country that was a heartland of the Taliban, all those who were sent there felt they were on the frontline.

Yet, with speeches by politicians repeatedly outlining the role the forces had to play in changing the hearts, minds and lives of Afghans, many of those taking part felt they were there as a force for good.

Now, those three factors are combining to make Afghanistan veterans particularly vulnerable.

Dr Busuttil said, over the years, increasing numbers of veterans have been coming forward with combat stress issues having served in Afghanistan.

He said a study by his team found that, from 2014 onwards, issues related to action in Afghanistan resulted in more referrals for treatment than those from the Iraq campaign.

In the last few years, the figures for Iran and Afghanistan combined are now greater than those coming forward for issues related to the Northern Ireland campaign, which lasted from 1969 to 1998.

A study by Kings College London in 2018 found that 17% of those who had been in combat operations in Afghanistan and Iraq had reported symptoms of post traumatic stress disorder (PTSD). The study remains ongoing and the percentage may increase over time. Another study found 13% have a severe alcohol problem.

But the reason many Afghanistan veterans in particular remain at risk at the moment is because of something called "moral injury".

Dr Busuttil added: "That is a way to describe situations that鈥� go against the grain and against your moral and ethical codes and even religious beliefs. You feel grossly let down by the organisation or by people who are leading you or by what you were told the war was all about.

"As a psychiatrist, I tend to get the more difficult people to stabilise. What they've told me is that, 'bloody hell, you know, when we went there, we fought a war. My men died, we struggled. I went there鈥� we got blown up, and now they've given the country away'.

"With Afghanistan, I think a lot of the guys thought they did a good job and they stopped the rebellion or the Taliban. They saved a lot of women as well from abuse. And there was a lot of meaning to that war. Whereas now there's a kind of personal betrayal about this. Why did we pull out? Why did NATO forces or America or our allies pull out?

"So moral injury is what we are seeing now developing in the patients we have. If they didn't have it, now they're going to get it.

"That is quite a big deal because it's really is a big stumbling block in relation to somebody getting better. It maintains the PTSD."

Sky News has spoken to a range of experts, veterans and commanding officers about the UK's involvement in Afghanistan, how they feel about the work they did there, and what the consequences have been.

  • For details about how to get help for PTSD, see the end of the article.

While the UK was involved right at the start of the conflict in 2001, after the US launched its 'war on terror' following the 9/11 attacks, it was in 2006 when some 3,000 UK troops were stationed in Helmand province that operations intensified.

Under NATO command, the Task Force Helmand headquarters was moved to the provincial capital Lashkar Gah and a series of forward operating bases (FOBs) established in nearby towns and villages from where troops could reach out to the local population, provide help if requested and maintain security. The operational base was at Camp Bastion, a sprawling encampment constructed out of steel and concrete in the flat desert, to ensure good visibility for miles around.

UK forces tended to serve six-month stints in the country, on numbered tours labelled Operation Herrick by the military command.

But Helmand was a Taliban heartland. The group had been roundly defeated in 2001, but having slipped into the shadows, began slowly to re-emerge a few years later as it fought back to take back what it saw as its country.

Very quickly after moving into Helmand, UK forces were forced to engage with Taliban fighters in a series of firefights as they were attacked while on manoeuvres.

From 2006 to 2014, the Taliban was forced on to the back foot in the province as it suffered a series of defeats following an array of mostly UK-led operations, to the extent that a 2010 map showing the loyalties of local populations reveals the people living in Helmand did not support the insurgents and remained neutral.

But the nature of the warfare changed.

A UK senior commander told Sky News that what had initially started as direct confrontation, which would involve upfront fights between insurgents and UK forces, morphed into an ambush phase, in which the Taliban would wait for British troops and then attack them without warning, and then a final phase which involved less direct action but featured extensive use of hidden improvised explosive devices (IEDs), which would hit soldiers who often thought they were protected by their vehicles.

More than 100,000 members of the UK armed forces had served in Afghanistan by 2012.

The latest figures the government publishes say 456 British service personnel died in the country (405 killed in hostile action), and, according to a March 2015 briefing paper by the Army's Directorate Land Warfare unit, 615 were seriously or very seriously wounded - this is out of the 2,188 listed as 'wounded in action'.

As well as the personal cost, it came at a high cost to the public purse. The Defence Resources Secretariat, in response to a freedom of information request in 2018, put the cost to the government of operations in Afghanistan between 2001 and 2015 at 拢22.2bn, but the briefing paper mentioned above by the Directorate Land Warfare said it was as high as 拢37bn by 2015 with the potential to rise to 拢40bn by 2020.

The precise number of people affected by PTSD is harder to gauge, but figures from Combat Stress 鈥� just one of many charities which help veterans 鈥� indicate it could be many thousands, with the charity having referred 792 for treatment in 2019 and 578 in 2020, a year that was heavily affected by the pandemic.

The justification for the war, which was initially to destroy al Qaeda in Afghanistan and prevent their return, changed slowly but gradually became fixed and was repeatedly outlined by politicians in Parliament and on the visits they would undertake regularly to see the troops.

In April 2006, then defence secretary John Reid, outlining the reason for the British presence in Helmand, said: "We're in the south to help and protect the Afghan people to reconstruct their economy and democracy."

In March 2013, announcing the wind-down of operations that would follow, then prime minister David Cameron said: "Britain has played a huge and honourable role in trying to do everything we can to give Afghanistan the chance of stability and security."

When I met members of the Royal Marines on a media embed with the forces in Helmand in December 2008, two days before they were about to go on a Christmas Day operation with the aim to remove Taliban insurgents from villages near Lashkar Gah, I was struck by their professionalism and commitment to the task. During Operation Sond Chara (Pashtun for Red Dagger), five UK service personnel lost their lives.

One corporal, a 27-year-old member of 42 Commando from Hampshire, told me: "I'd like to think we are making a difference to the lives of the people here."

It is that commitment by UK forces who served in Helmand and, in many cases, the belief they were "doing good" that has left many feeling angry, bitter, frustrated or just deeply sad today.

The PTSD sufferer

Joe Monroe had been an infantryman with the Green Howards before he was deployed with 52 Infantry Brigade to Afghanistan in autumn 2007 and posted to a forward operating base defending Lashkar Gah.

He'd already done tours of Iraq, Bosnia, Kosovo and Northern Ireland in the five years after joining, but told Sky News he was "on edge" when he arrived in Helmand, because he had heard it was such a "hotspot".

From the age of 13, all he had ever wanted was to join the army, so much so that his dad drove him to the enlistment centre at the age of 16 years and nine months, so he could sign the papers. 

His role in Helmand was to support the combat teams in the field as a medic, so that he would "patch you up enough to get you on a helicopter to get you home".

Joe, whose name has been changed to ensure his security, told Sky News: "It wasn't until probably about two, maybe three days after the old battalion had got out, when we got our first contact. And that's when it hit me - this isn't Iraq, this is Afghan. That continued daily for about two weeks.

"Every time when we went out, whether we went out early morning or late at night, we were getting contacted. It kind of reminded me of Iraq, apart from it was a lot closer and felt a lot more personal.

"They weren't stupid enough to attack the FOB, so they would wait for us to go out on a patrol. Most of our patrols were on foot around the surrounding area, (with us saying) 'we are here, we are doing our job, if you've got any problems'. Hearts and minds, that sort of thing.

"The first time I went into action as a medic, one of the blokes took some shrapnel to his neck. That is my first memory of Afghanistan - me and him in a ditch. Me with an FFD (first field dressing) over his neck, trying to keep him going.

"You would have the occasional RPG (rocket propelled grenade). Mainly it was small arms, the occasional heavy machine gun.

"We knew they were out there. We just didn't know where they were."

He said the mindset was one in which they felt, on the whole, like they were there to do good.

"Some of them were like, 'whoa, yeah, I'm just doing it for the money'. And I was like, and especially the senior NCOs, 'we're out here because we are making a difference, we need to bring the kind of democracy that we've got at home to Afghanistan. It can't be ruled by an iron fist. It has to be a democracy. It has to be fair and equal'.

"We lost quite a few blokes out there. It brought it into perspective that what we were doing has to be worth doing otherwise our tour alone just ruined 13, 14 families for no reason.

"Now I hear about the fall of Lashkar Gah, it's a bit of a bitter pill to swallow.

"I did get hit. We were in this ditch and peeling right, to withdraw I suppose, because the fight we were taking on was heavy fire, and as I stood up, I took a ricochet to the knee.

"It wasn't life-threatening but it took me down. I got myself to where I needed to be and鈥� patched myself up and got on with it鈥� It was just a flesh wound. I got flown back to Bastion because of the amount of blood that was on my trousers. They assumed I'd been severely hit. But they looked at it and said if it had been another two inches to the right, it would have completely destroyed my knee."

It was while he was at Bastion that an incident occurred he still feels unable to talk about but it resulted in things going "downhill from there".

"They put me back out (in the FOB), because squaddies being squaddies鈥� it was a case of 'don't worry about me. I'm fine'.

"But deep down, it wasn't. That day in Bastion changed me forever."

He said with about six weeks to go on his tour: "One of the blokes took a round to the lower abdomen. I patched him up and waited for the helicopter and my hands, my arms were covered in blood. And it was at that point I just sat there and said 'I can't do this anymore'."

Soon after returning to the UK, he left the army, and very quickly began drinking heavily. The heavy drinking turned into debt as he would "buy everyone in the pub a round because I didn't want to be the only one drinking".

Despite that, he married, had children and held down a job but would hide his drinking from his new wife, sometimes waiting until she had gone to sleep so he could drink until he passed out.

At one point he said he ended up in a coma through dehydration and malnutrition and had to have his heart shocked to re-establish its rhythm.

Although he was diagnosed with PTSD, his behaviour became increasingly erratic and culminated in a row with his wife during which he ripped all the doors off the kitchen cupboards in front of his children, resulting in his being told to leave the marital home.

He moved in with a friend but continued drinking and attempted suicide twice. The only reason he was unsuccessful the second time was because his friend came back earlier than expected from a visit to the shops.

Thankfully, that experience prompted him to call the Combat Stress charity, which helps people with PTSD, and he was given treatment and help that has put him on the road to recovery.

He now has a new partner and more children and is working towards becoming a trained counsellor for people with experiences like himself.

But he admits he is not fully healed, a fate that many who suffer from PTSD also face. He says his experience is too often the legacy of Afghanistan conflict.

"If you said to me, 'give me give me a couple of words that describes Afghanistan to you', I would say 'broken veterans'.

"It's almost like we've been dropped and forgotten about 鈥� we served over there, we got quite messed up, they are on to bigger and better things now."

The most severely injured

Among the hundreds who were severely or very severely injured are a number who were so badly wounded that experts say were it not for medical advancements that came during the Afghanistan war, they would not have survived. 

While many lost limbs, some suffered extensive further injuries that have left them with complex needs. 

On return to the UK, the majority of the most seriously injured were transferred to the Queen Elizabeth Hospital in Birmingham for medical treatment, and were then given rehabilitation at Headley Court in Surrey. 

In 2019, the Defence Medical Rehabilitation Centre was moved to Stanford Hall in Leicestershire. 

Phil Hall was a Royal Army Nursing Corps A&E nurse in Camp Bastion, leading a team of nurses that assisted the surgeons saving the lives of the casualties extracted from the battlefields and elsewhere. Since leaving the military, he has taken on the role of supporting those who were the most seriously injured for the charity. 

From his first Afghanistan deployment in April 2007 (Op Herrick 6), until the end of his last in October 2010 (Op Herrick 12), he said the nature of the injuries British forces were suffering changed. 

He told Sky News: "As time went on, we got more complex injuries鈥� that would involve maybe a first IED strike that was followed up by an ambush. They were very much those prolonged injuries. So you would have somebody who'd been in the field for a long period of time that maybe suffered from blast injuries and you'd also have that complicated by gunshot wounds. 

"We were dealing with injuries that were almost unsurvivable. With an IED blast, there's very little to compare that to in the civilian world. 

"It was a period when we had to do a lot of learning. And really, as the Herricks went through, we saw changes鈥� and it's (those) medical breakthroughs that we see today used in the NHS, in the ambulances." 

He believes he proved less vulnerable to PTSD as he had previously served on a number of combat tours before being deployed to Helmand, but after he left the Army and returned to the NHS, he felt compelled to apply for a job working with those who had the most complex needs as a result of their injuries. 

"People talk about the ultimate sacrifice of dying on the field - I think [of] some of the men and women that suffered those most horrific injuries; on top of being a bi-lateral or a triple amputee, they've also got a severe brain injury that leaves them incapable of having full ability to admin their own day. And they're the group that I work with. 

"They've usually got some visual impairment - they're either blind or they've got loss of hearing or a little bit of both - they've got multiple amputations, usually fingers missing as well, and on top of that, they've also got a lot of abdominal surgery that's gone on. 

"Within the NHS, people know how to deal with brain injury, people know how to deal with prosthetics, and everything is divided鈥� nobody's really sitting there coordinating for that patient. And on top of that, you've got to consider the mental health and wellbeing. And so what I do is try to make sure everybody's talking to each other. 

"In some ways they are forgotten. As soon as the cameras stopped rolling and Afghan(istan)'s over, people forget that there's guys fighting their own battles every day. 

"There's a chap I work with鈥� who says 'people don't see me as a veteran because I'm a fat bloke in a wheelchair'. He's got a severe global brain injury. Nobody looks at him and goes, 'he was in Afghan and got blown up'. But he was and everyone's forgotten that bit, they just see this disabled man. 

"My challenge is to make sure they're not forgotten and鈥� to use the critical knowledge I've gained over the last 20 years to make sure I engage the right people in ongoing support." 

Asked about how he thinks those he works with will be feeling right now, with ongoing coverage of the Taliban's takeover and the fallout, he says he is concerned about what he hears. 

"I work with a group of men and women who gave everything鈥� and for them to hear鈥� that it wasn't worth it, can't be nice. 

"Because they gave that ultimate sacrifice and service to this country as a peacekeeper - they didn't go out there for anything else other than to do the right thing - I think in honour of that, we need to be careful what sort of language we use about how we've got to the point that we are now."

The helicopter paramedic

Michelle Partington was the first female paramedic to be deployed on the ground in Afghanistan with the RAF Regiment when she was posted to Kandahar in 2009, and then returned in 2011 and 2012, based in Camp Bastion, where she was a medic whose job it was to head out to conflict zones on helicopters to help bring in the injured. 

She said within a short while of pretty much any 24-hour shift starting, the call would come in to head out and find an area where they could extract a casualty as safely as possible. 

She told Sky News: "It could be British forces or coalition forces, Afghan national police or army, or women and children. We picked up everybody. 

"It was mainly blast injuries. There was a lot of shrapnel as well. The blast injuries were quite horrific because鈥� they were putting lots of bolts and stuff into the IEDs. So they were a bit complex. 

"2012, it was mainly gunshot wounds to the neck, the arm, to the chest and stuff. They had got quite a few good snipers that were taking quite a few of the people out. 

"My first patient, I remember quite vividly. Basically, he was gone, he was pale and his eyes were black, he'd lost three limbs. We tried everything we could. Half his chest was gone. 

"I remember seeing him further down that year on the remembrance parade that they did鈥� This picture came up and it looked absolutely nothing like the casualty that we picked up. I will never forget his face. 

"Another shout鈥� was with six children who had been playing in an area and sadly stood on an IED. Four died instantly. Two lost limbs and one lost his eye and then one of them died. We found out later they were all part of the same family. 

"Nothing can prepare you. You can do all the amount of training - and we had the amputees in action and various other people as part of the training - it was as realistic as possible, but nothing can prepare you for when you go out there. It's not just what you see, it's the smells鈥� the sound鈥� the vibration of the helicopter鈥� and the noise, trying to communicate with people. It was just unbelievable. 

"Quite a lot of the time, certainly in 2012, helicopters were getting shot at. We ended up on our bellies having to be in a fire line, firing back because we couldn't get to the casualties. 

"I remember looking through my sights suddenly thinking 'this is for real'. 

"I couldn't cope with that because my role is to preserve life, not take it. I struggle with that鈥� quite a bit. And we were in that situation three times, three times too many." 

After returning to the UK following her first tour, she noticed she began to isolate herself more than she would have previously, but after the tour in 2012 things began to go downhill rapidly. 

"I was having panic attacks as soon as I left the front door, I wasn't interested in anything. I was either angry or really upset. My moods were just ridiculous. And I crashed and burned quite literally. I was sent home with a pack of tablets and (they) said it was probably just an adjustment disorder and unfortunately it wasn't. 

"I kept looking at the tablets鈥� I just wanted to take the whole lot in one shot because I just couldn't bear living in the nightmare I was living in. And I felt that way probably two or three times over a two-year period, probably more than that. 

"I couldn't communicate what was wrong with me. My fianc茅 left me, I lost my house, I lost my job, and I lost who I was as a person. 

"I was in a really dark place for probably a couple of years." 

She only recovered because she was contacted by Hidden Wounds, a service provided by Help for Heroes, which arranged a programme of treatment for her PTSD. 

She subsequently went on to compete in powerlifting and rowing events in the Invictus Games with others who had suffered similar trauma, but even that sparked uncomfortable feelings. 

"I went to the first training camp, I looked at the... amputees and I felt guilty initially because some of the casualties would say to us, when they came on (to the helicopter), 'don't let me live like this'. 

"But then I started to see that actually they were living their lives and they've learnt to adjust. I have to do the same. And鈥� it was good that I met the other people with PTSD, as, for the first time, I kind of tried to understand that it was a normal reaction to an abnormal situation." 

Today, Michelle runs her own business providing mental health training as a consultant and says, "thankfully" she has been able to use a "negative experience in a positive way". 

The commanding officers

One of the problems that has been identified in official documents is the allegation that the mission was hindered by the lack of a plan to make sure all the forces involved were working effectively together.

While many frontline UK forces remain bitter that the work they did on the ground may be undone by the Taliban victory, several of those in charge at the time remain frustrated they were unable to achieve what they were there to do because of the lack of a clear plan.

Jerry Thomas, who was a brigadier in charge of Task Force Helmand from October 2006 and oversaw the move of the brigade headquarters to Lashkar Gah and several other combat missions to improve security throughout the province, told Sky News what has resulted is an inevitable consequence of a short-term approach. 

He said: "What we're suffering from is Western short-termism and an inability to see that this might have been a mission that we needed to be there for 30 or 40 years to get them up to the stage where they could overcome not just the Taliban militarily, but the Taliban ideologically, philosophically, religiously as well."

It was not untypical of the underestimation of the Taliban.

He said that because of all the intelligence they had received until his command, his brigade trained for a "support operation type mission鈥� providing security within which people like the Provincial Reconstruction Team (PRT)鈥� other non-governmental organisations鈥� could do the reconstruction". 

He added: "We were on our final exercise on Salisbury Plain (in the UK) when (out in Afghanistan) 16 Air Assault Brigade and 3 Para, some Fusiliers and some Gurkhas got really bogged down in鈥� the three district centres to the north (of Lashkar Gah). Also, down to the south, in Garmsir鈥� the Taliban started to push up from there as well." 

By early December of 2006, after they were deployed to Helmand, the role his troops were taking on turned from a support mission into what was closer to a "high intensity counterinsurgency", in which some of his troops were "blowing their way out of compound walls using bar charges, designed for the cold war鈥� to blow up Soviet tanks". 

"We went in not expecting to be fighting at the level we were," he added. "If we'd known what we were going into, of course, we would have done the training in a completely different way." 

He said he requested more forces to help get the job done effectively, but was refused.  

"One of the things for me as a commander that really p****d me off was listening to Tony Blair standing in the House of Commons saying 'whatever the task force commander wants, he can have'. And me saying 'I need an extra commando, an extra battalion, an extra battery of guns if we are going to do this properly', and being told on the鈥� fourth time of asking 'Jerry, stop asking鈥� we don't have it'." 

Despite his frustrations, like other subsequent commanders, he had successes, like retaking the strategic centre of Sangin from the Taliban with barely a shot being fired, and overseeing a number of other dangerous operations, as well as developing a good working relationship with the Lashkar Gah-based UK PRT, that resulted in improvements for the lives of people in the area. 

But that alone, was not enough. 

"All the optimism: I can't say I never thought 'this is going to end well'... If you think you're going to turn around what is almost essentially a feudal society riven by tribal frictions in 20 years, then you're dreaming."

Even higher up the chain of command was Richard Nugee, who was stationed at ISAF headquarters in Kabul twice, as a brigadier in 2006 and a chief of staff in 2013. He says, because of the successes forces like the British had had, there should have been hope.

He said, after 2014: "Our general view was with the Afghan military forces and the police, there were 350,000 of them, their air force was never going to be strong enough on its own and needed NATO airpower to support them. The Taliban were very respectful of NATO air power. It provided a degree of stability.

"2013, we handed over the lead to the Afghan security forces and we were there in the background in terms of train, advise and assist mission, and with鈥� our special forces.

"There was a general feeling that that relatively reduced level of violence would continue. The Afghan army were not on the retreat. There were a number of鈥� incidents where they were able, with NATO air support, to push back the Taliban. The Taliban didn't seem to be gaining any territory. The Afghan army were losing a lot of people, and there was always a concern that they would just run out of people of fighting age, but it wasn't at the critical level.

"There was no reason why the situation should change. For every day, every year that we could continue to deliver鈥� a freer environment, the less likely they were to fall back into what is happening now鈥� and there was no reason why the Afghans should collapse. And I think that proved to be the case in seven years.

"I have spoken to some veterans and some families who are just furious鈥� but I think that our strategy was to continue to鈥� focus on what we call 'Sandhurst in the Sun' and build an army鈥� where it had good quality leadership鈥� that actually would stand on its own two feet eventually, but that would take time.

"I recall, but it may be the wrong figure and it certainly wasn't a published figure鈥� we were sort of thinking in the region of 10 to 20 years.

"The intent has not survived for as long as we would have wished it to survive, to really embed what we would do. And I think that's a shame, because the original intent, I think, worked."

The civilian in the battlefield

As well as the thousands of British troops in Afghanistan at any one time, underlying the efforts to improve the lives of Afghans in Helmand were a team of civilians from a group called the Provincial Reconstruction Team (PRT).

These UK government employees would be stationed at Lashkar Gah or in the FOBs with the aim of working hand-in-hand with the military to develop relationships with the community and its leaders, and to identify and facilitate what could be done to help people living in the nearby towns and villages.

Among them was Lou Perrotta, who trained a team of stabilisation advisers to work in the country, worked in Afghanistan herself for many months each year and is the co-author of a book about the experiences of those advisers, Making Peace In War.

Having now left the civil service, she told Sky News that after 2006 when the UK deployed to Helmand: "Our approach, from the get-go, was to try and do this with a much more comprehensive approach, and for most of its history, if not all, there was a joint civil-military lead, which was unusual.

"The stabilisation unit had two roles: One was to find people who you could deploy to these situations鈥� work with a wide range of people, be really quick on your feet, see an opportunity, exploit it, take risks; able from inside the forward operating base - often very, very physically difficult conditions and dangerous - to work with the military.

The UK government funded the building of schools in Helmand, often using local workers

The UK government funded the building of schools in Helmand, often using local workers

"The other job was, not from a top-down policy perspective, but from the ground up, just asking people what works? What happened? What did you do? What worked? What didn't work? What mistakes did you make? What do you wish you hadn't done and why? And trying to draw actual lessons.

"What kind of added benefit could you get from spending relatively modest amounts of money? And how could you help to repair relationships between the state and populations, sometimes between different tribes who were at each other's throats? In the hope that that was going to buy the hearts and minds of the locals and鈥� give them more confidence in government.

"Rather than a purely military or diplomatic development, you could actually achieve something by working together and being a bit more clever, using small amounts of money. Sometimes it worked and sometimes it didn't.

"There were definite small successes that you could see were making a difference鈥� There was quite a lot of positive stuff going on, particularly at the district level, often depending on the nature of the district governor."

Among the projects funded in Lashkar Gah, was a park

Among the projects funded in Lashkar Gah, was a park

But she said what the advisers and military combined could achieve was always going to be limited by the range of countries and organisations involved, and the way they interacted with each other.

"The international engagement was chaotic. The strategic objectives were both ridiculous and constantly shifting.

"Because it was very international, like all the members of NATO, the US and everybody else - both the overt and the covert international community - Pakistan, Iran a bit less - it was difficult to get any sense of coherence. Many of the actors were playing to domestic audiences; in fact, all to some extent.

"So the incoherence of the international effort was never going to be able to deliver anything. And although we were making great efforts by 2007 to have a much more coherent input between the military and civilians, that wasn't the same necessarily across the board.

"99.9% of the international actors didn't understand Afghanistan 鈥� they just saw it as poor and war-torn and poorly educated and oppressive of women, rather than seeing there were all sorts of complicated, sometimes very functional, local political ways of doing things.

"The Afghan way of doing things is totally inconsistent with our views of how things should be. The idea of merit and transparency and accountability and all this other stuff is just different. It just doesn't work and, of course, fails to acknowledge outside influences like Pakistan."

Conclusions

So, are there any lessons to be learned from what has happened in Afghanistan, now the Taliban has raised its flag over Kabul, just days after taking Lashkar Gah and Kandahar, where the British fought the insurgents back for eight years?

And are there any signs of what might or should happen in the future?

Lou Perrotta said it is possible that, despite the failures, 20 years of foreign influence and the passage of history around the world may mean the future is not as bleak for the Afghans as some are predicting.

"I'm possibly being optimistic and hopeful here but the sort of pundits who are talking about it are assuming that it will go straight back to women being stoned to death 鈥� maybe, but I don't think we should necessarily assume that.

"It's a very conservative, Islamic country, and so some of (those Islamic principles) will be welcomed. Fingers crossed, I'm hoping that, perhaps particularly (because of) Pakistan but also any kind of Saudi influences, it is a bit moderated from what it might have been 10 or 20 years ago.

"My sense is that everybody has evolved. The Afghans will have have changed themselves or have changed much of their sort of sense and feelings about women in particular, perhaps, and education, and how you go about things, purely by virtue of having had this heavy Western presence in the country for 20 years.

"The evolution of mobile phones and access to information and the internet will change who they are. And what they know about the world is very different from 20 years ago."

Despite that, she says if any lessons are to be learned, it is that the UK should leave other nations well alone.

"We should keep our nose out of other people's business," she said. "It's not about should, it's about what you know. Before we start poking our nose into other people's business, we need to have a realistic objective that's achievable. If you can't achieve it鈥� then don't start, because you're only going to make matters worse."

Richard Nugee has similar sentiments but hopes that the Afghanistan failure will not result in the army never being used as a force for good in the future.

He said: "It would be a very sad lesson if we never deployed anywhere else, because I genuinely think we're a force for good. But I think maybe a lesson that is learnt is that, actually, this is difficult - we need to go into things with our eyes open.

"Going into Helmand without understanding the consequences - Helmand was the heartland of the Taliban 鈥� and we were going right into the middle of that... understanding that more would have led to different decisions, quite possibly. And we paid the price with an awful lot of lives.

"I have the utmost respect for the soldiers. I went to Helmand鈥� to Lashkar Gah and Kandahar, but I didn't fight there in the way that they had to. I would really hope that the lesson that is learnt isn't that the army failed - the lesson is you need to think very carefully about what you're doing and resource it properly to make sure that what you are trying to do is resourced to the ability to make it happen. And I don't think that necessarily was in the thinking in 2006 when we went into Helmand."

In the meantime he says more needs to be done for the generation of veterans who served there.

"We must make sure the mental health of our soldiers is well looked after. We need to look after those who have been physically injured but it's the mental health that concerns me, because it's unpredictable.

"I'm absolutely sure that what is happening in Afghanistan will affect people's mental health - particularly those who lost friends right next to them. That's why we still need to continue. Our generation of veterans, all generations of veterans, must be looked after."

Advice for coping with the news from Afghanistan from Help for Heroes

  • Acknowledge the situation and how you feel about it, even if the emotions are challenging
  • Chat about how you're feeling with someone you trust
  • Practise self-care and put your wellbeing first
  • Reach out for professional support if you need it
  • Look out for those around you who might be struggling too

To get help, on any of the issues raised in this article, contact , , or

Credits:

Words, reporting and digital production: Philip Whiteside

Graphics: Pippa Oakley, designer; Sonia Figueiredo Dos Santos, junior designer

Pictures: PA; Reuters; Philip Whiteside

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