Rugby and dementia: Whose job it is to look after them?

Former All Black Craig Dowd rebuked the Players' Association for inaction. Photo / Getty Images

A Herald investigation has revealed that five men from the 1964 Ranfurly Shield-winning Taranaki rugby team have been diagnosed with dementia. Their families attribute their illness to concussions suffered during their playing days. Dylan Cleaver reports on the reaction of the Players' Association.

• RUGBY AND DEMENTIA SERIES - OVERVIEW

Faced with a doomsday scenario that could see hundreds of former rugby players living out their days in miserable circumstances, it begs the question: Whose job is it to look after them?

It is a prospect that taxes Players' Association chief executive Rob Nichol. His organisation was recently criticised for not doing enough to help former players in the wake of George Laupepe's conviction for cannabis cultivation.

His solution, for want of a better word, is that it is not just the sport that needs to aim higher.

"I don't think that's a rugby problem alone; it's a sport problem and even a societal problem," he says.

This is true. Rugby is by no means the only sport affected, but it is the national sport and we do put immense pressure on the best practitioners of 'our' game to be tough men, the sort who, as the cliche goes, you'd follow over the top.

They are also not the sort of people who would reach out for help, as pointed out by former prop Craig Dowd when he rebuked the Players' Association for inaction.

"Players or past players won't come forward to ask for help because they feel like failures," Dowd said. "You are dealing with a very macho world - they aren't okay but they won't admit to it."

Curiously, Dowd seemed to exempt the national body from fault when dealing with past players with issues, even though they benefited most from their efforts, but even Nichol concedes there is a limit to what New Zealand Rugby can be asked to do.

"That for me is more of a societal challenge," Nichol says. "If you say, 'Oh it's rugby's job to look after them,' I'd say rugby has a role to play, but because it affects more than rugby -- it affects a whole lot of contact sports where athletes and participants suffer head trauma -- you need a unified common sense approach to make sure as a country we are looking after these people."

What Nichol doesn't deal in is denial. To him, there is no point debating the root cause of those players who suffered head injuries and subsequent cognitive issues such as dementia.

Radio Sport's Kent Johns talks to Brooke Wolfe, son of former All Black Neil Wolfe:

"To be honest, for the past four or five years, we've just assumed there is a connection. Our starting point is if there is brain trauma and it's not correctly managed, there will be complications later in life. We don't need a scientist or anyone to tell us that, we're just assuming it. So we're pushing as hard as we can to make sure we're at the forefront globally in concussion management.

"If we stop and look back at a period in which concussion management wasn't at the levels required, there will definitely be players out there, not just in rugby but in other sports, who will be suffering because their concussion was not well managed, was not treated appropriately at the time."

There was a frightening lack of awareness of the dangers of repetitive head injuries in rugby and other contact sports, something that is being rectified now with varying degrees of "buy-in" depending on the level of rugby and the country where it is played.

A bloodied Craig Dowd leaves the field. Photo / Getty Images

Nichol says players are becoming more proactive when it comes to managing their health, but there's still a macho element out there who see leaving the field as a sign of weakness, much like going to the doctor is still something to be avoided at all costs for too many New Zealand males.

"Certainly as a society we're very reactive with our health, not proactive. We're still dealing with societal issues like that and that competitive nature of wanting to be part of the team, wanting to do your piece. We're still battling that."

New Zealand is now recognised as being ahead of the curve in terms of its diagnosis and treatment of head injuries, but rugby will never be a safe sport. Athletes are getting bigger. Collisions are becoming more traumatic.

"People just weren't aware of the dangers back then and if they were aware they were in denial. That's been a problem," Nichol says.

"Yes, it's getting much better but from a world perspective there is a massive variation between the different environments. In New Zealand high-performance rugby we've got quite an advanced situation in how we operate the new protocol around the head injury assessment process.

"But then there are other professional environments around the world where it's substandard, frankly. Through the International Players Association we're trying to address those.

"At the amateur and community level of the game there's been a big push around the 'recognise and remove' scenario, but the onus is on those at the coalface, the coaches, the referees and the players themselves to take ownership. We've got to get past that emotion of, 'I've got to stay on and see the game out.'

"If you suspect there's a concussion, get them off the field and get them some help."

That was never an option for those legends of Taranaki rugby, who played in an era without replacements, without television cameras and without judiciaries who punished those who attacked the heads.

They played, also in an era without pay, and they grew up in a society that taught them not to ask for help.

But help is what they need. And if it's not them, it will be the next generation of rugby players, and the ones after that...