PRESIDENTIAL SPECIAL OVERSIGHT BOARD
FOR DEPARTMENT OF DEFENSE INVESTIGATIONS
OF GULF WAR CHEMICAL AND BIOLOGICAL INCIDENTS
Public Hearing
Day One
Thursday, November 19, 1998
Senate Hart Building
Washington, DC
CHAIRMAN:
Hon. Warren B. Rudman (biography)
VICE CHAIRMAN:
Hon. Jesse Brown (biography)
BOARD MEMBERS:
Dr. Vinh Cam (biography)
LTG (Ret.) Marc A. Cisneros (biography)
CSM (Ret.) David W. Moore (biography)
RADM (Ret.) Alan M. Steinman (biography)
ADM (Ret.) Elmo R. Zumwalt, Jr. (biography)
EXECUTIVE DIRECTOR:
COL (Ret.) Michael E. Naylon (biography)
CONTENTS
CALL TO ORDER
REMARKS BY BOARD MEMBERS
Hon. Warren B. Rudman, Chairman
ADM (Ret.) Elmo R. Zumwalt, Jr.
STATEMENTS OF GULF WAR VETERANS
SSG Joe Poe, Jr., U.S. Army (Ret.)
SPC Davis Austin, U.S. Army Reserve
SSG Douglas Waddell, U.S. Army (Ret.)
MAJ Denise Nichols, U.S. Air Force (Ret.)
SSG Robert Bergen, U.S. Air Force (Ret.)
CPO Larry Perry, U.S. Navy (Ret.)
CPT Seth Greene, U.S. Army Reserve
REPORT OF PERSIAN GULF VETERANS COORDINATING BOARD
BG Kevin Kiley, U.S. Army Medical Corps
Questions and Answers
(Luncheon Recess)
REPORT OF OFFICE OF THE SPECIAL ASSISTANT FOR GULF WAR ILLNESS
Questions and Answers
DEPARTMENT OF DEFENSE RESPONSE TO THE PAC
Questions and Answers
REPORTS FROM GULF WAR SYNDROME INVESTIGATORS
CLOSING REMARKS
Hon. Warren B. Rudman, Chairman
PROCEEDINGS
MR. JENNINGS
: My name is John Jennings. I am the designated federal officer of this Presidential Special Oversight Board’s public hearing. I hereby call this hearing to order.It is my honor to welcome all of you here this morning. On behalf of the President of the United States, I would like to thank the board members for their dedicated efforts in ensuring that our Department of Defense investigations into Gulf War chemical and biological incidents are both complete and credible.
By lending your skills and reputations to this effort, you send a clear signal to our Gulf War veterans that the federal government is making an honest and concerted effort to identify a cause or causes for the unexplained illnesses some of them suffer.
The President and our country salute you for the work you are doing on behalf of our veterans. They deserve the very best and you are giving them your very best.
As a transplanted New Englander, it is my honor to introduce Senator Warren Rudman, the chairman of this Special Oversight Board.
SENATOR RUDMAN
: Thank you, John, and good morning. The subject of Gulf War illness has been part of our vocabulary now for almost seven years. There are many sick Persian Gulf War veterans. There’s no shortage of opinion as to why veterans are sick. Many theories and opinions advanced as to why our veterans are sick lack the concrete scientific support they need, yet these unsupported theories alarm our veterans community and our press and influence opinions on the issue.At the same time that medical science cannot find a single cause that they can agree on for what has become known as Gulf War illness, medical science does recognize it knows that our veterans are sick. Our board knows and recognizes our veterans are sick but we don’t know why.
The executive order that establishes this board prohibits the board from conducting scientific research. However, it does not prohibit us from reviewing and examining scientific theories and research. We look forward to the testimony of those veterans and scientists who have come to address this board and will at subsequent hearing.
However, you should not look to this board to produce or endorse a scientific hypothesis as a solution to the mystery of Gulf War illness. The scientific answer to that question, if there is a scientific answer, lies in the future. Our government has allocated over $120 million to the effort, a significant portion of it in the private and university sector.
You can look to this board to be zealous in our scrutiny of the Defense Department and its thoroughness and its efforts in pursuit of information on the circumstances that occurred in the Gulf and their potential importance and relevance to this issue of Gulf War veterans and their illnesses.
Our primary concern is the Defense Department’s efforts on behalf of the United States Soldier, Airman, Sailor, Marine and Coast Guard service member, the veteran. Our board may consider recommending that the Defense Department discontinue investigations in a particular area. We may also recommend that they begin investigations in another area.
Our board will review, analyze, consider and react to well-researched, well-documented investigative work of the Defense Department in this regard. We anxiously await your support of your input and to your participation in our efforts. We feel the DoD can do a better job; we can all do a better job but we must begin somewhere and we begin today.
Finally, I want to remind you again that this board’s primary focus is the DoD’s conduct of ongoing investigations and efforts and implementation of the PAC recommendations. That is our focus.
I want to address just several other issues. Back in July, the press carried comments by some people upset with our “first secret meeting.” I want to just say on the record here that that day was the first day that all of us had met. We had been appointed by the President and I decided to convene an organizational meeting, with advice of counsel that it was proper, to get a briefing from the Defense Department generally on their efforts because most of the members of this panel were not personally aware of those efforts.
That meeting was organizational information only and it has been approved and it was proper and I was rather surprised that some people would have found a problem with that. This board, I can assure you, is not part of any effort to cover up anything but you have to start somewhere and that’s where we started.
Secondly, I want to just say that we have had a number of meetings and briefings since that time, not as a full board but individual task forces of this Board. Veterans have participated, invited, including the National Gulf War Resource Center, the AMVETS, the DAV, the VFW, the American Legion. And there is no question that unless there is a classified subject to consider, and that would probably be very unlikely, all of our sessions will be open to anyone who wishes to attend.
Finally, I want to tell you that we will make an interim report to the President within nine months of this meeting and a final report within 18 months. In the back of the room you can find the Executive Order. If you’d like a copy of it, the Charter issued by the White House, the agenda for today and tomorrow and biographical sketches of various board members.
Before I introduce the individual Board members for their comments, I want to recognize Mr. Jennings, who we appreciate your help in getting our business done and I also want to recognize Mr. Robert Bell, special assistant and counselor to the President of the United States and senior director, National Security Council, Defense Policy and Arms Control direr. Mr. Bell, we welcome you, and we appreciate your help.
Finally, yesterday I received a letter from the President which I thought I would read into today’s record, which reads as follows: Dear Senator Rudman, as you prepare to hold the Special Oversight Board’s first public hearing on November 19-20, 1998, I want to thank you and the Board members for your dedication to ensuring that our Department of Defense investigations into Gulf War chemical and biological incidents are both complete and credible.
By lending your skills and reputation to this effort, you send a clear signal to our Gulf War veterans that the federal government is making an honest and concerted effort to identify a cause or causes for the unexplained illnesses some of them suffer.
The Persian Gulf War Veterans Act of 1998 and the Veterans Programs Enhancement Act of 1998 both contain provisions for a non-governmental institution to review and evaluate existing information to determine potential health risks of service during the Persian Gulf War.
The review carried out pursuant to these provisions will not diminish the need for the Office of the Special Assistant for Gulf War Illnesses to continuous research on chemical and biological incidents, nor will it reduce the vital need for ongoing oversight by your Board over the 18-month period established in your charter. I salute you and the Board members for the work you are doing on behalf of our veterans.
.I am delighted to be able to now introduce the members of this Board appointed by the President of the United States and I must say that we have the kind of diversity of experience that I think bodes well for the kind of oversight that we want to do here. And I am just so happy to introduce them to you for whatever comments they wish to make.
Secretary Brown I hope will be joining us. He has been unavoidably delayed this morning but I’m sure he will be for most of these hearings. So let me first turn to someone who doesn’t need much of an introduction in the veterans community, Admiral Bud Zumwalt who, of course, was chief of Naval Operations in a most distinguished career and in many instances has proven his dedication to the veterans of this country. Admiral?
ADM ZUMWALT
: Thank you, Mr. Chairman. For 28 years I have been involved in support of the Vietnam veterans’ effort to get proper recognition and compensation for the health effects resulting from exposure to Agent Orange. Until this President came to office, only three diseases had been approved for compensation and those 15 years after the war ended.President Clinton took ownership of that issue and the government moved and we now have a total of 13 diseases that are compensable as a result of that presidential interest. For that reason, I have been not surprised but pleased that the President has again taken ownership of the issue concerning the exposure of veterans in Desert Storm and Desert Shield.
A far better process for review and oversight has been established than ever came to pass in the early years of Agent Orange. I believe it is a process that gives us every opportunity to get at the objective truth. I have had the pleasure of working with Senator Rudman in another capacity and I can tell you that he is totally objective and fair and will be a great chairman of this oversight effort and I, too, as he, am very pleased at the background of the Board members with whom I will have the opportunity to work.
Thank you.
SENATOR RUDMAN: Thank you, Admiral. Next I’d like to introduce retired Rear Admiral Alan Steinman, former surgeon general, United States Coast Guard. Admiral?
RADM STEINMAN
: Thank you, sir. I just want to say briefly that I am pleased and honored to be part of this committee. My whole professional career is as a physician, a medical officer specializing in occupational medicine, which I think gives me some unique qualifications to look and oversee what efforts the Defense Department is putting into turning over every stone to find out what is going on with our Gulf War injuries and illnesses.And other to say again that I am pleased and honored, I think I’ll not make any more comments to provide more time for our audience to talk to us rather than us to them. Thank you.
SENATOR RUDMAN: Thank you, Admiral. Next, someone who shared the experience of participating in the Gulf War, retired Command Sergeant Major David Moore.
CSM MOORE:
Thank you, Senator. I reserve perhaps comments at this time other than to say that I have held all the positions as a non-commissioned officer over the last 35 years. I have been exposed to the Vietnam era and also served in the Gulf and I share that with you to share my concern and honor to serve on this Board to represent the soldiers in the field who are the ones who are having difficulties with their health.So having been there, out there in the trenches, if you will, I can understand. And, again, I’m just happy to be carry on my career at this phase to be able to participate in those causes, hoping to find some end result as to the problems that the Persian Gulf veterans are having. Thank you.
SENATOR RUDMAN: Thank you very much. Next I’d like to introduce Dr. Vinh Cam from Greenwich, Connecticut who is a very eminent immunotoxicologist. Dr. Cam?
DR. CAM:
Well, as a member of the Special Oversight Board I want to welcome you all here today to what is an extremely important public hearing. I hope you will take this opportunity to air your concerns and also make recommendations. We are eager to receive your comments. The White House is listening, DoD is listening, the VA is listening.I’m pleased and very honored to be part of this effort. I want to assure you that our Board is here for you. We’re not only gathering facts but we also want to ensure that the health concerns of Gulf War veterans are thoroughly addressed. Furthermore, we would like to ensure that lessons learned from the Gulf War be applied to current and future military deployments.
So, once again, I want to thank you all for being here. We’re looking forward to your testimony.
SENATOR RUDMAN: Finally, currently the president of Texas A&M University at Kingsville, Texas but was the commanding general of the United States Army South Panama during the capture of Manuel Noriega and a very distinguished military career, retired Lieutenant General Marc Cisneros.
LTG CISNEROS
: Thank you, Mr. Chairman. Good morning, ladies and gentlemen. I’m very honored to be part of this group. Those of you that know me know I am not a member of any political party. My son served in Desert Storm as a national guardsman from Texas when I was a deputy commanding general of Fort Hood where we deployed over 27,000 soldiers.I am very honored because I do not consider myself betoken to any man other than God for whatever I have achieved. Those who served under me, the enlisted soldiers, know that I am honestly and genuinely concerned and I am very honored to have been selected in what I thought was a criteria for all of us that we were going to be the honest brokers and we would not have to support any party line.
And so I’m very honored to serve here on behalf of my fellow soldiers.
SENATOR RUDMAN: Thank you, General. From this time until approximately 10:30 to 10:45, depending on how much time each person takes and we’ve asked you to take five minutes, we know that’s not a lot of time but unfortunately we have a lot of people to hear in two days, I thought I would ask three of you to come up and take seats, or actually five. You can move the microphones between you.
I will call Staff Sergeant Joe Poe, Jr., United States Army (Ret), Mr. Michael R. Ange, Specialist Linda Davis, United States Army Reserve, Staff Sergeant Douglas Waddell, United States Army (Ret) and Major Denise Nichols, United States Army (Ret) -- United States Air Force (Ret); thank you very much. Can’t get that one wrong.
If the people I have called would like to come up and take a seat here. Let me thank all of you here today for offering to come forward and testify. We are anxious to hear your testimony. I think I’m going to call on you in the order in which you are listed on my schedule. That would mean that Staff Sergeant Joe Poe, Jr. would be first.
And I’m going to tell you all, having a lot of experience in this hearing room, that if you can pull that microphone fairly close in each instance, then we’re going to be able to hear you just fine. So if you’d like to proceed, Sgt. Poe, we’re looking forward to hearing from you.
SSG POE:
Thank you, sir. Can you hear me? I hope so. First of all, I wanted to have my statement to verify what I am. To all the veterans of the Board and those here in the room today, first of all I want to say welcome home to all of our veterans and to all others who are not here, I will say God bless you on this day.I will be as quick as I can. First, I respectfully to members of the Board, all present and for the record, I publicly protest the dual role of Mr. Bernard Rostker, recently nominated by the President of the United States and approved by the Senate as the new Undersecretary of the Army, while he simultaneously serves as the Special Assistant to the Deputy Secretary of Defense for Gulf War Illnesses.
His demonstrated ability to swerve and vacillate regarding verified reports and documents from professional military leaders and published material from medical doctors and researchers has been clearly established since his appointment on 12 November 1996.
Whether by design of appointment or personal desire, Mr. Rostker has clearly ignored professional input from outside his office. Evidence of his ability to spin the facts and effectuate his office’s policy of damage control will be presented by speakers present other than myself.
As a veteran and concerned citizen, I believe this dual role, not individual but the dual role, will present an extreme conflict of interest and serves only to bury data collected by his personnel deeper into the abyss of policy control and making that he is so well adept to, through his vast experience with RAND and other policy predictors and implementers.
Secondly, I am going to skip some. You all do have all of my things and I put in evidence everything so I will skip through to save time for people.
SENATOR RUDMAN: Sgt. Poe, we will incorporate your entire statement into the record as we will with everyone that is here that has a written statement and we appreciate your summarizing if you can.
SSG POE: I will jump around quick for you.
SENATOR RUDMAN: That’s fine.
SSG POE: On Monday the 26th of May 1998 at 1000 hours, myself and veterans named in the documentation met with two members of Mr. Rostker’s team for almost four hours.
The purpose was to again seek and establish a real working relationship with DoD, VA and the veteran community.
The DoD personnel we met with were Michael Kilpatrick, Captain, Medical Corps, United States Navy, director of medical and health benefits collaboration, and Joe Gordon, Colonel, USMC (Ret). He’s not there anymore. COL Lawhon is now in his place.
Our requests, statements and proposals were received openly. We were asked to assist the office as well in an effort to maintain open and continuing dialogue. This meeting was initiated by veterans seeking answers, treatment to GWI, Gulf War Illness and a hopeful establishment of non-confrontational credibility between DoD, VA and veterans. That transpired approximately six months ago.
We left the table with cautious optimism. This caution has proven itself warranted. We cooperated and subsequently were appeased, ignored and ultimately given conflicting or inaccurate information. We did not request or propose to climb the whole mountain. We strongly sought reciprocal efforts toward jointly breaching the foothills. This has not occurred.
SENATOR RUDMAN: Continue, Sgt. Poe. I know that you’ve got a longer statement there but we’ll give you some extra time. You go right ahead.
SSG POE: Thank you, sir. You’ve got everything so I will jump ahead fast.
SENATOR RUDMAN: Go ahead.
SSG POE: Our proposal that we (inaudible) into this like Memorial Day. I’m going to paraphrase some so we could get me out of here --
SENATOR RUDMAN: Very well.
SSG POE: We asked and proposed to continue existing protocols, not replace them, but continue existing protocol in VA and other facilities, such as your MRI, Magnetic Resonance Imaging for those presenting with neurological symptoms. However, when neurological difficulties continue, (inaudible) more cost effective to go into SPECT scans, Single Photon Emission Computer Tomography or PET scans to be added to the protocol, not replace MRI but added when it was necessary.
SPECT scans on the average are approximately one and a half times the cost of one MRI. However, when it is indicated that two or more MRIs may be required, the monetary savings justifies the SPECT scan itself. Moreover, SPECT/PET scans highlight areas of brain abnormality resulting from (1) head trauma, (2) stroke or (3) organic brain abnormalities and/or damage. That is what the SPECT scan does do, okay?
This is much more help -- this is very helpful to members of the Board to understand. If a veteran or anyone has not had a brain -- has not had a stroke or has not had a trauma to the head and the areas of the brain are highlight with a SPECT or PET scans, there has to be some form of toxins to go into the brain. Now, whether that be for (inaudible) or whatever but you know when the testing is done, you verify what is into a person’s body and you do rule it out.
So I wanted to make that very quick. The doctors, they will say things and some will say (inaudible). This also helps save money to veterans going back and forth, back and forth all over the country. It saves for the doctors and the technicians and the administrators don’t want to (inaudible) all over the place. We are concerned on that, too but not my SPECT, very much my SPECT to get to where we are today, still talking.
I’m going to skip on down. This further reduces the stresses incurred upon veterans and families, physicians, clinicians and administrators. Basically DoD and VA created and proliferated PTSD. Veterans get PTSD by sitting at the VA all day long. But I wanted to stress to the Board that it is very important to follow up on -- you have the follow up messages. I have found the Department of Defense team.
We ask for mandatory testing of Gulf War veterans presented with the symptoms or not for mycoplasmas and specifically Mycoplasma Fermentans, incognitus strain. We are not talking now to our current Mycoplasmas. We are talking things developed in laboratories. Whoever used it, I do not care. There is no such thing as friendly fire. What gets you, gets you.
Now, asked at that time that Dr. Nicolson of the Institute for Molecular Medicine, who utilizes exacting testing be a point of contact. Now, Dr. Nicolson is open to working with DoD to assess. One thing I want to know is that early into the year, I think it was in December, that DoD (inaudible) and at the cost of a little over $45,000.
I’ll be quick. We proposed centralized testing of which DoD come back and explained how that would be most difficult for them to do. I’m sorry.
SENATOR RUDMAN: Mr. Poe, we have extra time this morning. We started early so you get through whatever part of your statement you want to get through this morning. We appreciate your coming up here.
SSG POE: All the proposals that we did there, the third one for depleted uranium testing, mandatory depleted uranium testing for all war veterans including U.S. Army also and for the Gulf. At the time that we had the meeting, we asked for the new format for DU testing on all persons. Dr. Kilpatrick at the time said, you know, DU will not show up into the blood or the urinalysis after several weeks or so unless, of course, you got embedded fragments at that time.
We reminded him that we were talking -- we were a little bit incoherent -- we did mention a hair sampling for the DU. We have found out after that that hair sampling is not that accurate either but hair sampling, annual or not, is very inaccurate for internal DU that has penetrated to the bone. I’m not talking onto surface value, depleted uranium exposure.
So, he says, oh, yes, that is right. This is the thing to keep in mind. We asked after that (inaudible) for depleted uranium or (inaudible) MFI testing (inaudible) whenever it shows that it will be most important in neurological testing if the MRIs they were doing in the -- doing more and more MRIs. And we also did ask at that time if it was non-medical, we did ask at that time for them to verify why the only biological detecting capabilities were never deployed into the Gulf, our PACER/PBS units.
Now, at that time, Dr. Kilpatrick just said, oh, yes, that was a problem because we were speaking of a credibility problem. He said yes, that is a problem we are looking into and, as a matter of fact, that is why myself and my team from the Navy did deploy because of our biological capabilities, detection capabilities. I said, oh, where were you at? Oh, I was in Cairo but our teams did go into country. We did go into units that had like dysentery and what would be considered irregular abdominal (inaudible) into the air.
But he did at that time, the first meeting, (inaudible) six months ago almost now, yeah, that’s why we went because the PACERs did not go. This is the thing to keep in the mind. I’m going through very quick now and shut up.
At the National Gulf War Resource Center in Washington, D.C., I was approached by Joe Gordon and a Mr. Prather. And I was told, Joe, you know we have not been able to find a thing onto any PACER/PBS. I go, really? They said, are you sure that you know what you’re talking onto? I said, I do think so. He said, well, we are still looking and it is so very hard. No. Here is the thing, please do remember, members of the Board, I am not accusatory. I try to be respectful and truthful.
The first time that we demand almost six months ago, oh, yes, that is a problem, that’s why we deployed from the Navy. The second time that we did see them at Washington, D.C. a couple months ago, okay, it’s no, I just don’t know a thing onto it. Cannot find anything about PACER or PBS biological detector.
Now we go to Camp LeJeune, North Carolina approximately a month ago now. At that point in time we have the PACER (inaudible); it’s almost seven, eight years. America spends very much money and too much money sometimes, I do believe, on wrong things.
At that board -- I mean at the town hall meeting, I did bring up the PACER again. Oh, yes. That is all ready to go. At this point, sirs, members of the Board, all of you do have a transcribed from the tape where Col. Gerald Schumaker who is heading the PACER/PBS biological detection units did state on film while still serving into the military, you are familiar of Col. Schumaker, sir, I am certain.
I was in Panama as well, sir. Col. Schumaker you do know is reliable, sir. (Inaudible) the DoD team that was there says you cannot find the PACER biological units. Perhaps you can find Col. Schumaker. (Inaudible). I can’t find equipment that’s sitting in Dover, Delaware the whole time and never did deploy it, maybe they can find a colonel into the United States Army.
Sir, as members of the Board -- I’m sorry; ma’am, too, I present to you this morning a copy of the tape where Col. Schumaker, while still in the military and maintaining his integrity, did state what you have on the written transcript there. I don’t know how to get it up there.
SENATOR RUDMAN: We will get it.
SSG POE: There is a tape of him.
SENATOR RUDMAN: And we have the transcript.
SSG POE: You do have everything there that I do have down, okay? Dr. Kilpatrick asked us if we would help them and show our cooperation and willingness. I am not saying this attacking. I’m just saying it factual. Asked us if we could assist in finding American personnel or call particular American personnel who had shown with or had come in contact with SANG units, Saudi Arabia National Guard. We did do our part. We did our part.
We pushed information out, asked soldiers, troops to come forward from information we put out to find. And we did send them into contact. What they did with DoD team after that, I have no idea. That’s not my responsibility but you have everything we have there and the approval by the DoD team before that we did post anything.
I had better not say anymore because I took on too many other people’s time, okay? I will stop, only to say, sirs, is that you have who that I am. I do not lie; I do not cheat. What I am saying to you today is the truth. I will tell you anything that is not the truth. You do know that, sir, into the back of the seat over there, okay?
I will not say any more and I apologize for being so long to talk to you but I would like for the record that maybe the members of the Oversight Board will get the answers for the sake of our nation, for the sake of our nation. I am a veteran.
Many people do scream I am a such-and-such war veteran, I am a this kind of veteran. I am an American veteran, no matter where I did go or orders I did follow. And almost all members of this Board are veterans, no matter where that you did do go.
I would like for all the Board members to keep that in mind as they go into how this is being handled and how it is being the policy makers, the policy makers, the economists, ma’am, the economists are controlling this operation, not miracle doctors.
I would end on that and I would be quiet and thank you and God bless you and good fortune on the truth, sirs and ma’am.
SENATOR RUDMAN: Thank you very much, Sgt. Poe. We appreciate your testimony and we appreciate you coming up here from North Carolina. Mr. Ange -- do I pronounce your name correctly?
MR. ANGE:
It’s Ange, sir.SENATOR RUDMAN: Ange; thank you.
MR. ANGE: Mr. Chairman, members of the Board, I am Michael Ange and although I serve as a national adjunct at the Unified Veterans of America, I am speaking here today as an individual. The views that I will express are my own and are not necessarily representative of the views of my organization.
We are here today at yet another hearing which will likely, and in the opinion of many veterans, end with the same result as the numerous other incessant hearings that have preceded this one. Meanwhile, sick veterans still lack medical care. Families are losing their loved ones to a malady called Gulf War Illness without any adequate explanation. Thousands have died while we sit and talk.
The morale of our active duty forces is affected by the continuing dishonesty and maltreatment of Gulf War veterans and here we are at another meeting. Insomuch as this Board has asked for comments and not evidence, I have decided to approach this hearing differently than the previous ones I’ve been at.
Let me first state that I commend the members of this Board for not attempting to put forth the facade that they are receiving evidence which we can expect to be acted upon. By classifying this input as a period for public comment, this Board has probably done the most honest thing that has been done by any governmental entity with regard to Gulf War Illness.
I will not waste the time of the Board or those present to hear these proceedings by attempting to identify the problem. Only the most ignorant, non-informed could possibly assume that the members of this Board do not yet have a full grasp of the problem.
I will state that in May of this year we met with members of Mr. Rostker’s staff in good faith with the opportunity to demonstrate an honest and forthright response to questions of concern to Gulf War veterans. We posed no question for which we lacked the answers prior to asking.
Our intent was simple: to demonstrate either the integrity that Mr. Rostker’s claims or in the alternative to demonstrate the lack of integrity and lack of honor which we have suspected. Mr. Rostker’s staff was quite cooperative in proving our fears.
In spite of many years of effort, the efforts of Gulf War veterans in the halls of Congress and through various other resources, their concerns still fall on deaf ears. Even the resulting executive orders and legislative facts which have been successfully pursued are ignored and disregarded by both the VA and the DoD.
It is time now that we leave the minutia of numbers and details and statistics, that we deal with facts and reality because statistics in the hand of many governmental bodies frequently serve to cover more than they reveal. At every town hall meeting and press conference perpetrated by DoD’s Office for Gulf War Illness Research, we repeatedly hear about the money they are throwing at this problem.
Ladies and gentlemen, if this problem requires the entire national budget, it is irrelevant. This question is not about money; it is about ethics; it is about duty; it is about honor. The American people, each and every one of you, have a contract with America’s servicemen and women and as we sit in yet another meeting, we are maliciously and indifferently violating our contract with the veterans of the Gulf War.
The truth is that we need no new legislation and we need no executive order providing for the care and treatment of our Gulf War veterans. Everything that we need is and has been contained in the code of federal regulations since before the Gulf War. All that is really required to resolve these problems is a restoration of integrity in the Offices of the Veterans Administration and the Department of Defense.
In each of the hearings and meetings I have attended, there has been much talk about obtaining information in order to decide what has to be done, so we have sat for seven years and analyzed the problem. When I was a young soldier working toward earning my sergeant stripes, a first sergeant gave me a piece of useful information which I will paraphrase here.
He commented that any idiot could find a problem and analyze it. A good NCO’s job is to find a solution. This former NCO is going to outline for you today a simple solution to this problem and others that plague our government.
There is only one problem in reality which impacts Gulf War veterans; lack of treatment, lack of information and lack of compensation are merely symptoms which are impacted by that unyielding problem. The problem, ladies and gentlemen, is that there exists a society of bureaucrats and politicians who have set themselves aside as a privileged class that operate and conduct themselves above the law without review and without moral obligation.
Let me give you some specific examples of how we can solve this problem by citing specific examples of misconduct. Before the Senate or congressional hearings, General Norman Schwarzkopf wilfully and demonstrably lied to the United States Congress regarding the exposure of his own troop to chemical agents. He has admitted and he has documented on videotape that he lied though he lacked the courage to use that term.
It is convenient that Gen. Schwarzkopf was not under oath at the time of his pseudo-testimony and therefore cannot be charged with perjury. However, certainly the code of ethics governing an officer of flag rank in the United States Army had been violated.
It is very apparent to most of us who have served and who watched the spectacle of his actions that this would constitute conduct unbecoming an officer, yet no action has been taken because the general considers himself among that elite class that functions above the law.
In the Veterans Administration regional offices throughout the country, there sit adjudication officers. In Winston-Salem, North Carolina, that adjudication officer is Mr. John Matuzak. These adjudicators have been tasked by executive order and legislative act to allow presumptive findings of service connection for Gulf War veterans that have unexplained illnesses, yet in case after case, Mr. Matuzak and his peers refuse to justly apply these directives.
I’ll try to summarize this very quickly, sir.
The only penalty incurred as a result of their violation of law is the penalty incurred by the veteran who must wait for years for these malicious and reprehensible acts to be corrected, if indeed they can be corrected at all.
There is no longer any question that has been documented incontrovertibly that the staff of economist Bernard Rostker have practiced to disseminate falsified information in official forms to Gulf War veterans, the media, members of the government and the American people.
In the 1970s, a famous politician observed that merely misleading the American people was grounds for impeachment of President Richard Nixon. If such proceedings should apply to the president as they are even being applied today a short distance from this chamber, then certainly they should apply to the members of the staff of an Assistant Secretary of Defense. The conduct of this military personnel is clearly conduct unbecoming an officer and they should be prosecuted as such.
What is most disturbing about my comments is that many of you have probably found my comments to be disturbing. Even those sitting in this audience have developed such a sense of apathy that it is nearly incomprehensible to them that bureaucrats, DoD officials and senior military officers shall be held criminally liable for their misconduct.
I’m not sure when this evolution or ethics in morals took place but it concerns me and it should appall each and every one of you if you have the courage to realistically examine this as the way things should be.
I am now ending yet another presentation at yet another hearing to discuss the problem facing Gulf War veterans. There is but one remaining question in my mind and that question is simply what side the members of this neutral Oversight Board will take in this conflict: the side of justice and honor or a position supporting the immoral actions of the Defense Department and the Veterans Administration.
Let me close my comments with a challenge. Even though this is not a legal hearing, it is an official forum and it is within the power of this Board to require anyone presenting evidence or comments to do so under oath. I challenge this Board to close a loophole so frequently used by DoD and the VA and require Assistant Secretary of Defense, Bernard Rostker, and any member of his staff, to testify in this proceeding under oath.
I speak with confidence that no veteran speaking before this Board will object to being held to the same standard. Thank you.
SENATOR RUDMAN: Thank you very much. SPC Davis Austin.
SPC AUSTIN
: Thank you for the opportunity to speak here today about an issue that is long overdue to be resolved. I am amazed at having to be here in the first place. The nine years of misinformation, denials and deception cannot be erased, especially from the hearts and minds of family members who could only watch while their loved ones, Gulf War veterans, died needlessly and died with the memory of our government turning its back on them.History repeating itself over and over again; well, I should say the government repeating itself over and over again. I want each one of you to know that as you look out here today and see our faces and see our pain, you will also see the thousands of faces that are unable to be here because they are dead. Each meeting you hold from this day forward, those thousands of faces will be watching you.
The VA claimed for several years after the Gulf War ended that nothing was wrong with us because the DoD stated repeatedly that the Gulf War veterans were not exposed to anything in the Gulf that would cause health problems. Then DoD’s hand was forced to acknowledge that we were in fact exposed to certain agents in the Gulf.
However, DoD stated that the levels were so low that it was impossible to cause long-term health problems. Now, how can the DoD say such a thing? Where is the proof? Where are the studies? And why does the DoD dismiss proof given to them by physicians, scientists and experts that have taken it upon themselves to find the truth of our illness and state that their findings are only theories and that there is no hard evidence to back their claims?
Just because someone is paid by our government does not make that person the one and only expert in their field. I don’t have a degree that labels me as an expert in a certain field and, if I did, I have the common sense to know that there are others who have more experience than I do so why would I dismiss their theories, findings and facts?
But that is exactly what the DoD is doing and having someone, an expert in economics, dismiss information pertaining to health problems makes no sense at all. Bernard Rostker is not helping the Gulf War veterans. He is causing more problems and pain to the veterans but he is helping the government in a financial sense by denying information about Gulf War veterans’ health which, in turn, lets the VA continue to deny compensation to the sick and dying Gulf War veterans.
I do believe that there is not just one single exposure that can be blamed for the Gulf veterans’ illnesses at this time but I do know that you cannot dismiss any of the exposures and state that there can be no serious health effects. As I’ve stated, the DoD repeated themselves saying no exposures, while thousands of Gulf War veterans were sick and dying, losing their families and homes, so the DoD should be held accountable for those lives lost and families torn apart.
Many Gulf War veterans were misdiagnosed and they died while the DoD kept up the denials. But what is so amazing is that this practice is still going on and Gulf War veterans are still dying.
I have written to Bernard Rostker’s office on a few occasions and the responses I received were not as professional and accurate as one would think. I understand that Bernard Rostker’s staff handles the information that is given out but Bernard Rostker is still held accountable for any misinformation that is released because that is the burden he took upon himself when he decided to take the position of special assistant for Gulf War Illnesses.
One case in particular, I asked his office for data on Gulf War veterans who had been diagnosed with cervical cancer and the reply from his office advised me that there were only two cervical cancer cases. And this information was given to me only a little over a month ago. I think asked if I was one of the two and I haven’t received a response.
I participated in the CCEP and went as far as phase two. I was told by my VA doctor that the VA in Birmingham, Alabama was participating in the CCEP so I elected to go to Alabama for phase three instead of Washington, D.C. I found out only this year that the VA in Alabama was a referral center and not part of the CCEP. Even though this occurred, my medical records are in the VA, CCEP referral center and the Kuwaiti Registry so therefore I see no way of my medical records not being part of the data from any source.
I also inquired about how long has the DoD been receiving blood and tissue samples from Gulf War veterans. The answer was vague as usual but my medical records show that biopsies and a pap smear that were done by my doctors at the VA in Salisbury, North Carolina, were sent directly to the DoD in 1996.
Having Bernard Rostker’s picture touching a tank that had been destroyed by depleted uranium was not at all impressive and a waste of taxpayers’ money. The Gulf news sent out by Bernard Rostker’s office is a waste.
Defending the DoD and being a movie critic should not be in the newsletter; making apologies for the DoD’s mishandling of vital information pertaining to our health problems should not be in the newsletter; giving profiles of doctors who just come aboard Bernard Rostker’s team should not be in the newsletter.
Put this information out to the media for all of America to hear. Put facts and truth in the newsletter if DoD wants to use taxpayers’ money but DoD needs to stop insulting our intelligence with heartless apologies and profiles of doctors who are not capable of handling this horrible sickness we, the Gulf veterans, are suffering from.
As far as the issue of data and how many veterans are suffering from different symptoms and diseases, why do the DoD and VA claim it is almost impossible to find out how many? If that is an impossible task for our government then I don’t see how this country can claim having any intelligence.
While sick and dying Gulf War veterans continue to suffer, DoD still continues to spend money going around the United States to try and convince the veterans, soldiers and the American people that we are not sick due to our service in the Gulf. That is as ignorant as taking a sick Gulf War veteran to a cemetery to try and convince them they are not sick.
Bernard Rostker keeps defending the DoD. I understand now why they call it the Department of Defense. Thank you.
SENATOR RUDMAN: Thank you very much. Sgt. Waddell.
SSG WADDELL:
Good morning, Mr. Chairman, members of the Board, Persian Gulf veterans, families and friends. It is with a combination of great pride but also disappointment that I stand before you today.I am proud to stand in a room full of history where so many great men and women have envisioned and forged our great nation as we know it today, but disappointed in that on this day I stand before you a fallen soldier, hurt by the visible illnesses and manifestations my body has undergone and illnesses that are unknown, unseen or misnamed for whatever reason.I am hurt to know that American fighting men and women across this nation have been ambushed by the very government they have chosen to serve. I am not here on this day to speak on personal issues but hopefully give insight to problems that I have seen with the system.
I was a staff sergeant E-6 electronic intelligence intercepted stationed with the 307th military intelligence battalion out of Stuttgart, Germany. I was tasked every day to collect, correlate, integrate and to disseminate databases for seven corps commanders. In looking at the Gulf War registry database, I find it hard to overlook the oversights of collection, correlation, integration or dissemination of a database that has taken far too much time and money and far too many lives to be such a failure in finding causes of Persian Gulf illness.
In another instance, it can be looked at as a highly successful and efficient tool for covering up Persian Gulf illness and making it economically feasible to take care of sick and dying veterans and their families.
To my knowledge, there are five ways to put your name into the Gulf War registry database. The first is to dial the 1-800-PGW-VETS number. This is a VA 1-800 number to the registry. The second is to make personal contact with your local VA’s Persian Gulf representative. This person or persons should be located at your VA hospital.
The third method is to be notified by letter that your unit might have been exposed to chemical fallout. Every day this lists grows because of the indecisive knowledge of precise unit locations. The fourth method is if you have e-mail capabilities, you can fill out a survey at http://www.va.gov/. Note: These are all VA methods of registration.
DoD has four methods of its own depending on the branch of service that you are in. The fifth is that if you’re overseas, you may go to the nearest embassy and ask for the form benefits unit. Each one of the DoD’s methods seems to parallel one of the VA’s methods.
The problem I see with this is that all of these methods are on a volunteer basis. I think that every unit and soldier in the theater of operation should have been registered. I think that the surveys should be broken down so that each question can be correlated and integrated into the database so that specific data can be queried when needed.
This system would be much like the all-source analysis system used by DoD today. This would allow for immediate studies to be done and also the historical tracking of soldiers due to the long delay between the time of exposure and the time that the illness occurs. The correlation could be made between illnesses and the location of the presumed exposure.
Neither the VA system nor the DoD system should separate the database. This database should include all persons located in the theater of operation at the time of presumed exposure. This would include VA, DoD and all contracted support personnel. This would eliminate some of the statistical misrepresentation that we have noted today. This would also stop the tremendous waste of funds by double testing of phase one and phase two personnel separated by VA and DoD systems.
The database should be a permanent one. Neither a stroke of a pen nor a stroke of a key should eliminate the names and information of the personnel in the database. Left intact and followed, this database could provide an invaluable source of information to scientists and physicians in the present and our future.
In ending, the directors of the agencies, boards or committees should not, under any circumstances, be affiliated with the organization or element of organizations that data is being gathered. The director of this information-gathering and disseminating source should not be a part of DoD and certainly not the Undersecretary of the Army serving as a special assistant to the Deputy Secretary of Defense for Gulf War Illness due to a strong conflict of interest.
I feel that this would prove to be a grave disservice to the men and women in our military and their families and the great country they serve. Thank you.
SENATOR RUDMAN: Thank you very much, Sergeant. MAJ Nichols?
MAJ NICHOLS
: Good morning, Chairman and members of the Board. I’m Denise Nichols, served with the 1611 AESP, United States Air Force, activated for the war, flight nurse, had a mobile staging facility between Hopitan and Rafha, flag base Charlie.As we stand here today at the first public board meeting of the Presidential Oversight Committee, we, the veterans, yet again, ask why this is necessary? Yet again we follow the same path that was set up many years ago, a bureaucracy, it seems, with no ending, a bureaucracy that spends millions of dollars in order to delay justice and care for veterans.
The path we follow is the same as the gas veterans from the World War, as the atomic veterans and as the Agent Orange veterans. It’s truly a disgrace that this country can repeatedly call on its service personnel to go into harm’s way and then not expect to provide the care that is needed after a conflict.
It’s an outrage that each group of veterans must return and battle their own government to do the right morally and ethically correct action. This is not an entitlement program but a moral and financial obligation, moral restitution. It was earned.
We’ve been denied our rights as human beings and as citizens that were sworn to protect this country and the Constitution. The common saying with veterans describing this situation is the government will keep denying and the veterans will eventually grow exhausted, give up or die.
Does anyone ever think about that veteran that died of a service-connected illness before the statistical proof finally showed and a presumption of service connection made? What benefits can those survivors get, if any? What has each of those veterans and their family members gone through in the course of their illness? In the end, these veterans, their family members, their extended family and friends will be hesitant to trust their loved ones to military service.
Why do we not finally acknowledge that these denials cost us in things that are more important than dollars? Our belief in our government, in DoD and our leaders are shattered generation by generation. No wonder it gets hard to maintain recruitment retention and the cost associated with recruitment and retention keeps climbing after each war.
Why is our policy slanted against the veteran? Why do we care for one that has a shrapnel wound or loses a leg or a arm but yet deny unseen nuclear biological chemical injuries that occurred in combat? I, for one, would trade a shrapnel wound or a loss of a limb for these illnesses from which we suffer that are chronic, debilitating and definitely life-altering.
How much does it cost? Cost was everyone’s question that I dealt with on the Hill when we were fighting to get our recent legislation. Why is it that the checkbook is open when we go to war and yet closed when we return and need medical care? Is this poor after-action planning on the part of the DoD and the Administration or is it that no one wants to acknowledge and pay the after costs of a war?
This country can do better by considering the cost of medical care that will occur before future conflicts and include it in the figure beforehand. Yes, we’re the superpower that can fund every other issue from refugees that may have just been soldiers firing at our own troops or frozen chicken losses for a corporation or for humanitarian relief throughout the world.
National security starts at home and it’s time for DoD, the Administration, all of us to get that straight. We need to come together, sit down at the same table and get the secrets out especially on the health needs of our veterans because history shows that most nations fell when morals and ethics weren’t maintained.
So we look to this Oversight Committee that will go into the millennium to set about straightening out these policies with precedents that are rapid and complete. We look to you to get the DoD and the special investigation team to see the light, become proactive, acknowledge responsibility, make policy recommendations to assure the Gulf War veterans do finally get the best medical care and testing available now, and to take definitive action that guarantees future veterans will not face the same pattern of denials.
We need this Oversight Committee to think of cause and effect and to be more proactive and order -- prevent more of the consequences of the denial that we have experienced. The consequences of denial has led to what I term collateral friendly losses and damages. This means lives lost due to Gulf War veterans not being adequately and correctly tested and diagnosed.
It has already been acknowledged that this group of veterans has a higher than normal accidental death rate. We need to look at those veterans that are employed in the transportation industry. We have truck drivers, pilots, doctors, nurses that abilities have been greatly altered. We have memory problems, visual distortions, cognitive dysfunction that have not been given sufficient thought.
Nurses and doctors functioning as handicap that cannot remember drugs or dosages or other key items after they served in the Gulf. What about the active duty or reserve guard people that are still active? Let me talk about a few cases, and I’m shortening my remarks.
We have truck drivers that served in the Gulf that experience blackouts, memory problems, disorientation and visual problems. I’ve caught a few in Colorado that I can document. They have sought medical help, they have filed claims, done everything that they’re supposed to do.
One of these truck drivers had to resort, yet again, to taking to driving a 18-wheeler cross country when his family fell apart and he had to get money for legal aid.
He knew he was ill and shouldn’t but he had no alternative. He ended up getting lost, disoriented and having visual distortions while driving at night, a definite safety hazard for other people on the road.
He ended up in several VA hospitals on the east coast trying to get help on this trip. I was in touch with him. That happened last year, Christmas time. He was calling me long distance to tell me what was going on and I kept pleading with him, please, do not drive at dark; please, park that truck, call the truck company, get them to give you a bus ticket home. I begged him not only to protect him but others on the road.
I have another one out of Colorado that his wife has to go with him because otherwise he gets lost and disoriented. We have been telling you all about these problems since day one. These are just two of the cases that are accidents waiting to happen. They’re doing what they can to keep their families together, housed and fed but in the process they put other innocent civilian lives at risk.
We need assurances that Gulf War veterans in transportation provider positions are being accurately tested, monitored closer and assured that the safety of the public is not or has not been jeopardized already.
We should look very hard at our pilots. We call for you to have an independent group reexamine any crash involving a Gulf War veteran pilot that was attributed to pilot error and/or weather factor combinations. We call on you to draw all resources into this, transportation department, FAA, National Safety Board, DoD, flight surgeons and flight safety personnel in these investigations.
I call on you to have any Gulf War veteran pilot involved in a crash be physically evaluated by a special team, a specialist qualified in toxicology, neurology, immunology and to the substance that we were exposed to in the Gulf.
We invite you to ascertain what steps have been taken in regards to assessing the safe functioning of our Gulf War veterans, be it truck driver, pilot or other specialties and report your findings. We invite you to critically examine instants that we will all help identify. One of them was friendly shoot-down of the Iraqi -- over the Iraqi card area, friendly helicopter misidentified. What happened there? Memory? Visual problems? That needs reexamined.
There was a U.S. Air crash. I believe it was in 1994. That was a Gulf War veterans, General Horner was called to testify at that trial. What happened there? Review air crashes and identify if Gulf War veteran pilots were involved and if there’s a higher ratio of accidents in that group as has been shown with the Gulf War veterans accidental death rate.
We have told you of the memory problems and all the symptoms but true insight and preventative action has not occurred to our knowledge. I’ve been in contact with Gulf War veteran pilots. Some grounded themselves because they knew they were not in A-1 shape. Many of these have faced the same obstacles as the other Gulf War veterans.
One pilot clearly told me there is a problem, that they have tried but gotten no help. When offered a flying job in civilian life, these pilots were told just be quiet, don’t say anything. Since the government is not acknowledging it anyway and doctors are blinded by denial, these problems just continue.
I have alluded to these problems indirectly in congressional and presidential advisory committee hearings. I have approached congressional staff on the Transportation Committee and individual representatives and senatorial member staff that are assigned to the Transportation Committee.
We had briefings initiated by myself and conducted by members and experts within the Gulf War veterans community here in this senate building and three over on the House side I believe in 1996 and many staffers attended.
When the White House helicopter, Marine Squadron, was taxiing, ran into a utility pole and flipped and burned, I said enough.
I went to a staffer, and I’ll give you his name and who he worked for later. I asked him, find out if that one that’s assigned to the White House Marine Helicopter Squadron is a Gulf War veteran. He had the clearances to get the information. I sat there as he made the calls. When he got through to the person that should be able to tell him, they would neither deny nor confirm that it was a Gulf War veteran.
The pilot lived. Find him. Have him and other pilots examined by Dr. Haley, Dr. Baumzweiger. Reevaluate those crashes that have been written off as pilot error. No one wants to deal with this problem but we must. Denials lead to an adverse snowball effect. That snowball has occurred and it’s up to all of us to take corrective remedial action now.
A Gulf War veteran was flying an air ambulance in Denver. He was directed into the scene of the accident away from high power lines. They landed, stabilized the patient, loaded the patient, flight crew on board, took off, he flew right into the power lines that he had been directed in his approach to avoid. Memory? Visual distortion after dusk? I don’t know but I’m telling you, we need to look at this and quickly.
It’s up to you to take steps and investigate. When I’ve tried to get information, I haven’t been successful. Report back to us and the Congress the findings you uncover. Why is there not a more preventative triage approach available of VA claims and DoD health boards?
Besides rapid action for the veterans at risk of being homeless, we need those that have diagnoses of cancer, ALS, loss of organs, to be pulled and worked at the most rapid case. We need to have a hotline just for those cases and a system that meets the need. Whether they have been service-connected or not, the doubt should go to the veteran.
And those people that have duties that affect the well-being and safety of other innocents that I’ve just alluded to should have a separate triage category in order to save innocent lives and decrease the collateral friendly losses. We need to have emergency assistance similar to a natural disaster on a government level to address the needs for these veterans until their VA claims are settled.
This Oversight Board has the power to make policy recommendations to the Administration. We call on you to do this or to consider it. Let us know the pros and cons. Be proactive, preventative and helpful. In considering the effected of the denial and collateral damage, we also have Dr. Baumzweiger who will be presenting later to you all.
We have veterans that I went with Dr. Baumzweiger once; it broke my heart. It was a very brave Marine that’s done very violent things. His family stood up despite the -- he killed a family member. Despite that, they stood up for their son. He’s in for life. We have more and more of those occurring. We cannot close our eyes to that, either.
The DoD is a branch of the government and that’s where our problem has been. They would rather not look at the after cost. The DoD is there to wage war, not to deal with the after-effect. We just need to -- they need to be involved somehow but they’ve been a real headache for all of us and it doesn’t help us.
There was some kind of failure of military leadership. Seymour Hearst mentions it in his book Against All Enemies. But the troops of the Gulf War and their families deserve medical answers now. It is a human right.
Medical testing, they’ve alluded to it already. I’ll just say that we’ve been bringing that up and I’ll shorten my remarks there but there is much more testing --
SENATOR RUDMAN: I’m going to let you go a few more minutes but I’ve given you now twice the time so try to wind it up. Thank you.
MAJ NICHOLS: I’m just summarizing. We’ve asked for viral testing, heavy metal screening, been denied. We’re finding vets with multiple viruses activated in their body. We need that extra effort and we don’t need our doctors that have stood up bravely to be criticized, discriminated against, discredited. We need clear help.
We need you to consider making a recommendation to the Administration to enable others that may be affected by Gulf War veterans, whether civilian or veteran, whether in theater or out, whether directly or secondarily exposed, to have their data and health records entered into the database and evaluated.
In summary, we are asking you, show us that the Administration acknowledges the true physical plight of the Gulf War veterans by action, not more bureaucracy, denial, delays, investigations and panels. Broaden the diagnostic testing and the actual care of all Gulf War veterans; release all documentation that may possibly give information on our exposures; assure that Gulf War veterans legislation is instituted quickly and without any delay.
Assure that all data requested is made publicly available and this would include a complete listing of the Gulf War veterans who have died and the diagnosed illnesses that are occurring; review the situation with pilots, truck drivers and other personnel that served for the obvious safety implications; have the Administration set up the hotlines and triage systems for the veterans with catastrophic needs, be it medical or true to professional abilities that may impact on innocent lives; set up a triage method for the claims backlogs.
Do not let this be yet another black mark on America’s military medical response in history. Restore faith now and rapidly. Our country, its citizens and, most of all, our veterans and their families, are due the truth. Don’t waste taxpayer dollars on faulty studies that continue the same. With the truth, Americans can deal with the problems.
Thank you.
SENATOR RUDMAN: Thank you, Major. Thank you all. We had actually five or six people scheduled. Some have been unable to get here today; at least they’re not here but let me read out the names of the remaining folks and those of you that are here, would you please come up and take your seat?
Ssgt Robert Bergen, United States Air Force (Ret), CPO Larry Perry, United States Navy (Ret). I believe we have SFC McGahee, Mr. James Green, CPT Joyce Von-Kleist and a Mr. Seth Greene. If any of you are in the room, I would like you to come forward. If not, then we will proceed with these two witnesses.
MR. DEES: Senator Rudman, I’ve been added to the list. I believe I’ve been omitted on that list right there. I represent Dr. Nicolson and I’d like the opportunity to present to the Board.
SENATOR RUDMAN: Just hold on one second here.
(Discussion off the record.)
SENATOR RUDMAN: Sgt. Bergen.
SSGT BERGEN
: Thank you. I’ve spent the past two weeks deciding on what I should present to this Board. I thought maybe I should talk about the chemical attack I went through or maybe I should talk about the experimental shot I received or how I got sick from the nerve agent pretreatment tablets.I could talk about how my beautiful wife and five-year-old daughter are now sick. Then there are the one or two veterans that I see weekly in our support group who die, either succumbing to the illness or committing suicide because they are tired of the fight. But I won’t, because others here have addressed these issues.
I would like to address the issue of Tri-Care and Champus not paying medical bills and the financial burden that veterans and their families are facing due to these unpaid bills. I personally have over $32,000 in medical bills that are not being paid. The indisputable fact that the United States government has drug its feet on helping Gulf War veterans has forced many of us to seek outside medical treatment.
I returned from Desert Storm on July 19, 1991. By September, I was being seen on a regular basis and had to be hospitalized for a severe viral-like infection. Over the next few years I was sent repeatedly to Wilford Hall Medical Center in San Antonio to be evaluated by their specialists. I was seen numerous times by almost every department but they could offer me no treatment.
I was the eighteenth participant in the DoD’s CCEP program. After 31 days as an inpatient, they, too, could offer me no treatment. Prior to Desert Storm, the first four years of my medical records were about 20 pages. I was active, played sports and was in great health. The four years following the Gulf War, my medical records grew to over 500 pages. I was constantly sick, some days unable to get out of bed.
In January 1996, I received a combat-related medical retirement. In February of that same year, I began a series of detailed evaluations at the VA Hospital in Oklahoma City. The VA did not know what to do, either. I saw some of the best physicians the government had to offer and none of them could help me. I continued my search for someone who could.
In December 1997 I contacted Dr. William Baumzweiger in Los Angeles, California. Within 10 minutes of talking to him on the phone, I knew this man could help me. My physician submitted a referral to Tri-Care which was immediately denied, stating, quote, unquote, there is no evidence for out-of-network services.
I called Tri-Care and was told again, quote, unquote, they did not think I was sick enough. I submitted a very detailed letter of reconsideration outlining the fact that I was paying for the travel and that the cost of treatment would be the same no matter where it was done. This, too, was denied.
At the same time, Dr. Baumzweiger’s office was working with Tri-Care and received an authorization number for treatment. On January 6, 1998, Tarzana Medical Center in Los Angeles also received authorization from Tri-Care to hospitalize me and I was admitted. Three days later, Tri-Care rescinded this authorization number and has since denied payment.
In June of 1998, my physician submitted a referral for both my wife and myself to go to California. Some bills have been paid; most have been denied. We plan to return early next year for a follow-up and to start our daughter on treatment.
This need to travel halfway across the country for medical treatment has cost my family everything. Like many, I am unable to work and so is my wife. We were forced to claim bankruptcy. My parents, grandparents, aunts, uncles and even cousins have helped to support us. They, too, are going broke for they are the ones who have paid our travel expenses to get treatment. They are the ones who help pay for our medications and they are the ones who brought me here today.
Many sick veterans like myself not only lost our health but have lost our future, our ability to earn a living and support our families, our creditworthiness and our homes. For us, the Gulf War continues, not by enemy guns faced in battle but by careless disregard, neglect and inefficiency from a system designed to protect itself from recrimination.
If veterans are ever going to receive the medical treatment necessary to stop this tragic deterioration of health, to stop the spread of illness to family, friends, spouses and children, we must be free to get the medical help from sources outside of the government establishment which has long held the position of playing God for so many of us.
The blatant refusal by Tri-Care and Champus to support these legitimate health care professionals and to pay for treatment that is bringing hope and relief to so many veterans must be addressed immediately. The view that the government is providing all that it can to veterans is flawed. You, the members of this commission, will leave at the end of this day better informed. I will end my day as so many other sick veterans, deeper in debt, more embittered and in poorer health.
Your concern and participation on this commission is very much appreciated but it is your influence and action to right the many wrongs that is so desperately needed and needed now.
Thank you.
SENATOR RUDMAN: Thank you, Sergeant. CPO Perry?
CPO PERRY: Excuse me. I’m trying to get the microphone over here.
Good morning. I’d like to thank you for inviting me here today to speak. I would like to see this to each of you on the panel member. You have taken upon your shoulders a big responsibility. There have been five panels before you came and the veteran really still needs a lot of help. We have a long way to go and it will be up to you, this panel, to help those veterans.
First of all, I’d like to say that, believe it or not, I have over 30 diagnosed illnesses. Even though I look healthy on the outside, I’m dying on the inside. I suffer everything from brain damage to nerve damage, just about all the immune problems, vision problems, sleep disturbances. I’ve been living on Prozac; so that gives you an idea of where I’m coming from.
I am the deputy commander of Unified Veterans of North Carolina. I am also the president of Desert Storm Veterans of North Carolina. And you have to bear with me. I’m not real good at this.
I am here today to tell you what happens to those that tell what happened in the Gulf. In other words, those that go public or tells others what experience they had in the Gulf to media or investigation teams and that kind of thing. I’m going to give you a personal story of my own and I know all that’s true.
I was the assistant officer in charge of a detachment Navy -- a Navy CB detachment located in Charlotte, North Carolina. I personally called 51 of my men and told them to pack their bags, that we’re going to the Gulf. This was in November of 1990. Our CB’s played a major role in the Gulf War, whether people know that or not. We were tasked with building a 200-mile road through the desert that allowed U.S. and coalition forces to come in behind the Iraqi forces located in Kuwait, Southern Iraq and Hakoi.
The road wound up being 10 lanes wide at the end and was built so fast that the Iraqis was totally surprised when they were caught in a crossfire. We came from the rear and all sides of the Iraqi troops due to the -- they never expected a road to get put through the desert in such a short period of time.
While I was there, I never fired a weapon but I sure as hell was shot at. I was hit -- we were hit with two direct scud missile attacks that Mr. Rostker’s office says is now back to a sonic boom. When fireballs are in the sky, it’s not a sonic boom. Our skin was on fire; we took -- we were starting to show immediate signs of flu-like symptoms and the longer we stayed in Saudi Arabia, the worst some of us got.
SENATOR RUDMAN: We welcome Mr. Greene to the table and he will testify when this gentleman is finished.
MR. GREENE: Thank you, sir.
CPO PERRY: When we came home, so many of my men were sick and being the assistant officer in charge, I tried to help them. When I tried to help them, all officers in charge and assistant officers in charge were called to the headquarters in Huntsville, Alabama. We were told that if anyone was dissatisfied with the way things were going, they could just get the hell out.
When I kept helping my men, I was put on report and put on restriction to the chief’s quarters at the reserve center and given a direct order not to talk to my men anymore. This happened two months in a row. I was given a 2(a) evaluation and put out of the Reserves, ending a 22-year career.
I went from a 4-0 Chief Petty Officer, being assistant officer in charge, to a prisoner with a 2(a) evaluation. I have never been so humiliated in all my life and I just couldn’t face going back to the Reserves anymore.
I have here before you an appeal for a Navy medical discharge because we were giving a paper discharging in the Gulf in early -- almost a month before we left. I got sick in the Gulf, I came home sick and so did many of my men and DoD had a policy that nobody was to be just throwed out the Navy for a physical reason or administrative reason for evaluation. They just got rid of me because I was making waves. That’s what happened to a lot of others and they just physically couldn’t drill anymore.
When we couldn’t get any help, I went public because nobody out there would listen to us. The story I told went nationwide and also it made a lot of high officials in Washington, D.C. very mad because of what I told that we were gassed in the Gulf and I have suffered retribution ever since.
I have had my VA claim turned down eight times. I applied for a Naval medical discharge, be turned down twice and I have wrote the President of the United States, two senators, Secretary William Cohen, Department of the Navy with no results. And guess who was the final person that -- the department that cares so much about our veterans signed the denial? Your future department secretary of the Army, Bernard Rostker, denied my claim.
Your system does not work. It didn’t work for me; it’s not working for others. I would have a man with that character that cares so much about a veteran and get him the whole United States Army.
I’ll wind it up briefly. I think -- I’m sorry I’m so nervous. I’ve had a rough three days. Mr. Rostker’s job has been to sweep all these case narratives under the rug. He has went to all these places with the MA test alarm, the fox vehicles, he has destroyed the credibility of all those and they say the alarm, sure, they went off but all substance alarms were negative. If it ever went off positive the first time, isn’t that a good indication there’s something there? But all substantive tests were negative.
We weren’t smart enough to win your war in 45 days. It’s taken us eight years to take and fight our government. These people that are whistle blowers need a safe haven. When we tell our story of what happened in the Gulf, we need some protection and we need some benefits to help us.
I’ve lived through living hell for eight years. I’ve been put in jail because I was not able to pay my child support on two occasions. And you don’t think I didn’t sit there and think about the VA and the DoD, me sitting in that damn jail and I didn’t have the money to support my family? I was mad. I’m still mad.
The DoD absolutely should be removed from this investigation. They got the rule book and they got all the rules and if they don’t like them, they can change them. They can produce what they want to and they can cover up what they want to. And my war will be over when our vets get the help they need, the help they deserve and the help they’ve earned.
Thank you, sir.
SENATOR RUDMAN: Thank you. Mr. Greene.
MR. GREENE
: Good morning, Senator Rudman and guests, panel. My name is Seth Greene and I’m a military police captain in the District of Columbia Army Reserve National Guard. I was in the headquarters in headquarters detachment 372nd military police battalion when we was notified that we was activated for the Gulf War.Our mission was to operate a enemy prison of war holding facility which was in Iraq. We also manned military police checkpoints, critical site points and to prevent anyone from going into the clear and unclear bunkers up there in Iraq.
There was a lot of souvenir hawkers after the ground war ceased and this was all throughout Log Base Echo which is in Saudi Arabia and Log Base Nelligan which was in Iraq and we actually manned it both at the same time, operating it at our level as a battalion. We had two national guard MP companies under us and one active component MP company under us. I actually worked in the S-3 operations section.
My health at this time is from fair to poor. My civilian job, I’m a federal police officer. I have joint aches and swelling, pain and pressure in my lower back, periodic rashes on my chest, upper back, behind my knees and lower abdomen, heartburn and I get this reflex, chronic reflex. I guess they call it acid reflex. That’s one of the things I’m learning now.
I get twitching in my right eye causing headaches over the eye and it always feels like there’s something in my eye. I’m taking what he said is like an ibuprofen drops in my eye. That’s what the doctor is telling me at this time.I get tingling and numbness in both my arms and legs. Just to tie a tie is something I just couldn’t do today; something as simple as that. Diarrhea, the passing of blood in the stool, nervousness, short temper, nightmares, pain and pressure in my chest, shoulders, neck, feeling like -- just can’t sleep comfortably in the daytime so I’m now working nights. I’ve become nocturnal. I feel safe as long as it’s day because there’s more activity going on and more folks going on.
I was in a area where because we’re National Guard, the Department of Defense is asking about all the people that was up in Iraq during the time of the chemical and biological bomb going off but we were a National Guard unit under an active component MP brigade which was in the seventh corp.
Now, most of the things I’m saying shows the active component combat arms units that were in that area but nothing about the National Guard units. And another issue was that a lot of folks got lost out there in the desert. I don’t care if they had the GPS which was the gravitational satellite positioning. When the sandstorms blew, when you’re out there, you had nothing to -- in map reading you find a reference point and you fixate on that and then you intersect from that.
The sand dune that was here on your right-hand side, in a matter of two hours it could be on your left-hand side. So there was -- I don’t care how special forces, I don’t care who you were, you got lost out in that desert; everybody did. Where you say you may be, you may not have been.
Where our base camp was located at, if a Chinook landed dropping off EPWs, which was enemy prisoners of war, at our location, from their grid instrumentation it would tell us you all are not where you say you are. This is where our instrument tells us you’re located at. Okay; fine. Another one would land and tell us something different.
The communications -- the tactical lines that we had, if we was trying to reach somebody in Saudi Arabia, you would go through different nodes. If they had a sandstorm in that node, you had to wait. You get a whole lot of static. You couldn’t get information coming from the rear back to the forward.
No one told us about the explosion that was going on. No one told us when the smoke came and encompassed us to mask or to protect ourselves. It was like an everyday thing, just keep on pushing because the mission drives the train and you’re a soldier and just keep the mission going because it’s folks lives out there that depending on everybody being a spoke in the wheel and making this wheel revolve around, rotate.
My deployment has caused a strain on me with my family. I’m one of those now that are separated pending divorce. My coming back and the withdrawal from my family has caused -- because I’m doing a self-assessment of what’s going on with me and has caused them to just, you know, you’re not involved with us. We can’t take no more of this. From the time I come back in ‘91 till today, I’m still trying to find out what’s wrong with me.
It’s just been totally a nightmare for me. From a financial standpoint, because I was a captain, that wasn’t so bad but my only problem was on the back side was that I had to pay more taxes because the combination of my being on active duty and my civilian job, when you project your withholdings for that year as in my household, we were trying to break even. But because of all the complications or because of what they did from the Department of Defense with my active component, it put me in a position where I had to make a substantial payment to the IRS and that was -- not just myself but there were other folks also.
The deployment on me for my social standpoint, except for family gatherings, I don’t have the energy and I don’t want to deal with it. I’m nervous sitting here talking to you all but part of me is saying it has to be spoken, someone has to tell the story.
From the time I come back and filed my claim with the VA, I’ve been getting the runaround. Everything is still pending and this is 1998 now, from the time I first put my initial claim in. I’ve been going to my appointments up there. One of my fellow officers, she been told that she’s been denied because all her illness have been diagnosed and the Gulf War is undiagnosed.
In the National Guard, for us to come on active duty, we went through a meticulous exam to come on active duty and I’m prior service enlisted so I’ve already done had that before. But the outprocessing for us National Guard and Reserve personnel when we was telling the folks that, look, these are some symptoms I’m having that I didn’t have prior to, don’t worry about it; it will go away.
It was more like a stamp, kick, next, stamp, kick, next, that type of a -- and it’s just frustrating when you have problems and you yourself figure you got enough sense to do a self-evaluation or to read something and you don’t know what’s going on.
No one can tell you or pinpoint, the problem comes, it affects me on my job, I had to file with the merits protection system to keep them off my back because they said I was calling in sick too much. But if I couldn’t get out of bed to perform my duties and wear a badge and gun and be able to function properly, I wouldn’t know what to do.
At this point I’d like to say that with the Department of Defense Gulf War health care program, I have to say thank you that that is in existence and please make sure that it stays. And I’d like to also thank the American Legion for their support and assistance and the information that they gave me in understanding some of the medical problems that I have and some of the other also veterans support organizations.
I think that a lot of the active component military folks are camouflaging their ailments. A lot of us folks who have jobs, we’re camouflaging it because if you see someone else that’s going through the hell that they have to go through, you don’t want to go through that so you suck it up and you don’t want to get on the registry, you don’t want no one else to know that you’re having the same problems. All you want to do is, hey, I got to stay in here for my family.
Another issue, last, is that most of us, if you come off of active duty, no one is going to accept you for any kind of health insurance because of the problems you already have so you’re not going to get no additional treatment in the civilian arena.
Those of us who -- if you’re unemployed as a Desert Storm veteran, and I know plenty that are, the VA is hard to give you -- it’s hard to get treatment, health insurance because of the ailments that you have. No one wants to take that risk for you. So without the Department of Defense Gulf War health care plan, it’s going to be very hard. It’s going to be very hard, sir.
SENATOR RUDMAN: You all set?
MR. GREENE: Yes, sir. Thank you.
SENATOR RUDMAN: Let me just ask two quick questions, running behind, of the two witnesses. Sgt. Bergen, I was listening to your testimony fairly closely and I thought that you said you received a combat-related discharge; is that correct?
SSGT BERGEN: Yes, sir.
SENATOR RUDMAN: That was not, however, a medical discharge?
SSGT BERGEN: It was medical; yes, sir.
SENATOR RUDMAN: Well, does that not mean that a finding was made by people in the Army at the time of your discharge that you could not serve because of a condition that occurred after you came in the Service?
SSGT BERGEN: I was medically retired due to PTSD and joint degeneration, fibromyalgia.
SENATOR RUDMAN: Something you did not have when you entered the Service.
SSGT BERGEN: Correct; correct. My medical records clearly stated even as far back as September of ‘91 that my illness was due or most likely due to my service in the Gulf War.
SENATOR RUDMAN: But that medical discharge did not have medical compensation attached to it?
SSGT BERGEN: Yes, sir; it did.
SENATOR RUDMAN: It did.
SSGT BERGEN: Yes, sir.
SENATOR RUDMAN: Are you receiving that now?
SSGT BERGEN: Yes, I am.
SENATOR RUDMAN: Oh, you are. Then what is the issue you are addressing that you cannot get medical care?
SSGT BERGEN: They are not wanting to treat it. It’s the same story that I received while I was active duty; more Motrin, we’ll take care of your symptoms but we don’t know what else to do for you.
SENATOR RUDMAN: Well, is it possible they don’t know what else to do for you or you think there’s a place that does know what to do for you?
SSGT BERGEN: I know there’s a place that knows what to do for me.
SENATOR RUDMAN: Okay. All right. Let me ask Chief Perry, you mentioned about you had 30 diagnosed illnesses. I take it that you were -- you did not receive a medically-related discharge when you left; is that correct?
CPO PERRY: No, I didn’t, sir. I actually got thrown out of the Navy. I was not recommended for advancement or retention --
SENATOR RUDMAN: But you were honorably discharged from the Navy.
CPO PERRY: You call a 2(a) discharge honorably? It said honorably but it was disgusting.
SENATOR RUDMAN: And you’ve since applied for disability and it’s been turned down.
CPO PERRY: My VA claim has been turned down eight times, my Navy medical discharge has been turned down three times.
SENATOR RUDMAN: But the 30 problems that you have that you discussed in your statement, these have been diagnosed by physicians?
CPO PERRY: Yes, sir.
SENATOR RUDMAN: I want to -- we’re going to take a quick break here. There are two gentlemen in the room here from the VA, Dr. Murphy and Dr. Wallen. Can you identify yourselves? Well, there’s a lady here and a gentleman. There are people here from the VA in the room. If you want to talk to them at all, they’re here and would be very happy to have you chat with them if you’d like to. This is not part of what this commission does but they happen to be here and I thought --
CPO PERRY: Sir, excuse me.
SENATOR RUDMAN: Yeah.
CPO PERRY: I was in the Washington VA Medical Center referral center but when I mentioned about chemical and biological warfare I was actually thrown out of the Washington VA Medical Center.
SENATOR RUDMAN: Well, thank you. We’re going to take a five-minute -- yes.
SSGT BERGEN: I’m sorry, sir. Relating back to the health care and the treatment, within the last month I was approached by a Gulf War veteran in Oklahoma during one of our meetings, showed me documentation that day he had left the VA Hospital in Oklahoma City. He had the same diagnosis that I have. They were not treating him. They told him they did not know what to do. And that was for brain stem damage, demyelinization of the nerve endings.
SENATOR RUDMAN: Well, thank you all very much. We’re going to take a quick break. Those people scheduled to go on at 10:45 will. We’ll be running a few minutes late.
Thank you.
(Brief recess.)
SENATOR RUDMAN: All right. We’ll come to order and we’ll invite to the table Dr. Gerrity, Dr. Roswell and General Kiley, Persian Gulf veterans coordinating board to get an update on research initiatives and findings. We have -- we’re running a little bit late here so I will ask you to move forward as best you can but yours is very important testimony and we’re not going to hurry you in that sense. Any particular order in which you’d like to proceed?
DR. ROSWELL
: I’ll begin, Mr. Chairman.SENATOR RUDMAN: Thank you, Doctor.
DR. ROSWELL: Good morning, Mr. Chairman. It’s a pleasure to be here. Board members, it’s our privilege to be here today before you to share with you a little bit of background information about the Persian Gulf Veterans Coordinating Board.
The Coordinating Board was established under authority of Title 31, United States Code Section 1535 on January 21, 1994. The board is co-chaired by the Secretaries of Defense, Health and Human Services and Veterans Affairs and operates with a small support staff in office space in Washington, D.C. provided by the three Departments.
The board basically is committed to jointly resolve, first diligently to pursue an accurate and comprehensive understanding of what factors have contributed to health problems reported by Persian Gulf veterans and their families, second, to ensure that all of the men and women who so honorably served their country in the Persian Gulf have full access to the complete range of health care services necessary for problems they now experience and thirdly, the board is committed to aggressively seek clear and consistent descriptive terminology to document current health problems for the purposes of disability compensation.
In order to facilitate these activities, the board created three working groups dealing with compensation issues, research and clinical issues. Membership on these working groups includes key policy and decision makers from each of the three Departments working collaboratively to achieve greater uniformity in the development and coordination of Gulf War programs.
In addition to assisting with work group activities, the support staff maintains a repository of information about Gulf War programs, activities and research providing this information to clinicians, investigators, veterans and various oversight groups when requested. The staff have also been involved in responding to media requests for information or for interviews, developing and providing educational presentation for both veterans and clinicians and writing scientific articles for publication in peer review medical journal.
During the last four and a half years that the Persian Gulf Veterans Coordinating Board has been in existence, we have learned many things. I would like to just share some personal observations about what I believe we have learned in the last four and a half years as a coordinating board bringing together talent from all three of these very important Departments.
First, we have learned the value of coordination of efforts among various government agencies working on a common problem. Second, we have learned that the illnesses Gulf War veterans are suffering from are very real. Third, we have learned that these illnesses are quite varied in their onset, manifestation and clinical course, making it unlikely that they are the result of a single factor or causative agent.
Fourth, we have learned that similar illnesses have been found in veterans of previous conflicts dating all the way back to the U.S. Civil War, suggesting that these illnesses are indeed related to the combat experience or combat exposures. Fifth, we have learned that Gulf War veterans deserve the best possible care we can provide without questioning what might be causing their illnesses.
Sixth, we have learned that we must make special efforts to educate and sensitize clinicians to the specialized needs of Gulf War veterans. We have learned that veterans should be provided disability compensation when their health cannot be restored and that we must do everything we can to facilitate the rapid provision and adjudication of disability claims.
Eighth, we have learned the importance of communicating potential risk associated with the combat experience before, during and after the battle. Nine, we have learned that our full understanding of future combat-related illnesses will require a more thorough evaluation of military personnel before the threat of deployment becomes a reality.
Ten, we have learned that satisfactory readjustment to civilian life is essential to the health and well-being of those who have served in combat. We have learned that known military occupational exposures are not likely to have caused the majority of unexplained illnesses present in Gulf War veterans. However, we have also learned that we must develop a better understanding of the possible long-term health consequences of military occupational and combat exposures.
We have learned that in our efforts to find a cause for unexplained illnesses, we must not overlook the need to develop effective treatments even though we may not know the cause of the illnesses we’re treating. And finally and most importantly, we have learned that our primary focus must be on sick veterans, not on clinicians, not on investigators nor politicians or journalists, not on activists or government agencies concerned with these issues. Our focus must be on the veterans who now need our help.
Mr. Chairman, it’s a pleasure to be here. I’d like to introduce General Kevin Kiley who chairs the clinical working group who will give you an overview of some of the clinical working group activities.
BG KILEY
: Mr. Chairman, distinguished members of the panel, thanks for the opportunity to present a brief overview and update of the activities of the clinical working group of the Persian Gulf Veterans Coordinating Board.As stated, I’m Brigadier General Kevin Kiley, Medical Corps, United States Army and have succeeded Major General John Parker in May of this year as the chairman of the working group. I’m a Gulf War veteran, a physician and presently serve as the assistant surgeon general for force projection, deputy chief of staff for operations and health policy and services, United States Army Medical Command and chief, United States Army Medical Corps.
Immediately prior to the war in the Gulf I assumed command of the 15th EVAC Hospital at Fort Polk, Louisiana and later deployed that hospital to Saudi Arabia in support of our forces during Desert Shield and Desert Storm.
During my four months of Gulf service, I experienced many of the same exposures that Gulf veterans have concerned with and that you’ve heard from today including Anthrax vaccinations, PV pills, chemical detector alarms, smoke from the oil fires and the austere desert environments and having experienced that firsthand, I have a respect for the sacrifice of Gulf War veterans and their families that they’ve made for our nation and am sympathetic, very sympathetic to their health concerns.
One of the three objectives of the Coordinating Board is to ensure that all personnel deployed to the Gulf region with the United States Armed Forces have full and ongoing access to the complete range of health care they need for whatever medical challenges they may face as a consequence of their service in the Gulf. This is perhaps the primary function of the Clinical Working Group.
In an effort to fulfill that objective, the clinical working group provides direction and coordination for DoD and VA clinical efforts aimed at caring for Gulf War veterans. This includes coordination of the DoD and VA clinical examination registries, implementation of uniform assessment questionnaires asking about relevant exposure symptoms, medical and reproductive histories and an individualized relative exhaustive physical and laboratory exam.
The clinical working group provides guidance to DoD and VA designed to ensure that registers are clearly defined as a thorough means for identifying and reporting illness among Gulf War veterans and their families. The work group also manages the development of educational tools and programs regarding Gulf War veterans’ health issues and concerns.
In the early ‘90s, both the Department of Veterans Affairs and the Department of Defense developed their clinical exam registries. The Department of Defense program is known as a Comprehensive Clinical Evaluation Program, the CCEP and the VA program is called the Persian Gulf’s registry.
Both Departments use a comparable two-phase clinical evaluation program for Gulf War veterans with health concerns related to the war. The phase one exam uses a common VA and DoD clinical exam protocol consisting of a thorough clinical exam and standardized exposure and reproductive health questionnaires.
For those who remain undiagnosed or describe persistent health concerns after phase one exam, a comprehensive multi-specialty leave-no-stone-unturned phase two assessment is done.
In 1995, in response to tasking from Dr. Sue Bailey, now the assistant secretary of defense for health affairs and LtGen Ronald Blank, now the surgeon general of the United States Army, the Department of Defense constructed a unique treatment program for Gulf War veterans who remain undiagnosed after the phase one and phase two CCEP evaluations.
Walter Reed Army Medical Center’s specialized care program remains in operation and is currently the only multi-disciplinary program worldwide that specifically offers treatment for Gulf War veterans with unexplained illnesses.
As we speak, the VA is also constructing several demonstration projects nationally that will offer treatment for Gulf War veterans. These projects are expected to use models of care that are similar to the methods of the specialized care program Walter Reed employs, methods known to successfully treat civilian workers with undiagnosed chronic pain symptoms, for example, such as low back pain.
These DoD and VA clinical care programs for Gulf War veterans have been carefully reviewed by several highly qualified advisory groups from the National Academy of Science, the Institute of Medicine as well as the Presidential Advisory Committee of Gulf War Veterans Illnesses. These groups have given the VA registry and CCEP programs high marks for quality interagency exam compatibility and the appropriateness of clinical diagnoses and treatment.
To date, nearly a hundred thousand symptomatic or concerned veterans have been examined in these two programs. The DoD, CCEP and the military health care systems accommodate the families of Gulf War veterans if they have health concerns they relate to the Gulf War, although the VA registry has very limited congressional authority to examine family members of Gulf War veterans and no authority to treat family members of Gulf War veterans.
The Department of Veterans Affairs Office of Public Health and Environmental Agents has held two national conferences, one in 1996 and the other in ‘97 for VA register and DoD CCEP health care providers. The conferences helped these providers learn the latest clinical and research advances concerning the diagnosis and treatment of Gulf War veteran illness.
In 1998, the Gulf War VA registry and DoD CCEP physicians participated in the 1998 conference on federally sponsored Gulf War Veterans Illness research. Clinical sessions were held daily for the Gulf War care providers.
This meeting allowed clinicians and researchers to learn from each other and to share clinical issues, treatment dilemmas and to familiarize with the latest research efforts to try to find answers for Gulf War veterans. This meeting is an important activity for ensuring that all relevant research is rapidly disseminated and appropriately applied to the care of Gulf War veterans.
In 1998, the VA developed, published and disseminated a guide to Gulf War veterans’ health. This continuing medical education guide was developed for all interested Gulf War providers in DoD and VA and is readily accessible from the Internet.
The Presidential Advisory Committee on Gulf War Veterans Illness has recommended that DoD and VA devise a comprehensive health risk communication plan aimed at enhancing the accurate dissemination of new information to Gulf War veterans and improving the avenues through which they make health concerns known to these agencies.
The clinical working group initiated the plan, the Coordinating Board staff developed and refined it and it was delivered to the National Security Council on 30 January 1998. The initial plan is implemented and a revised and updated version is nearing completion.
The Coordinating Board has added a risk communications specialist to its staff who is now overseeing this effort within a subgroup of the clinical working group. This new and revised plan is intended for all concerned federal departmental agencies and will call for the involvement of public, veteran and veteran-support organization advisors.
In addition to the existing examination registries, DoD and VA have worked together to develop a comprehensive program and protocol to evaluate Gulf War veterans who are concerned about depleted Uranium exposure during their Gulf War service. DoD has identified these military personnel and veterans who may have been wounded and still retain DU fragments or those who worked in and around armored vehicles hit by depleted Uranium munitions.
These military personnel and veterans were subsequently contacted and offered entry into the DU medical follow-up program. DoD and VA have issued directives in the DU medical follow-up program as fully active. Many veterans have already been examined including a 24-hour urine sample collected for Uranium analysis. The DU medical follow-up program was instituted to assess each veteran’s current state of health and Uranium level.
As more military personnel and veterans complete the protocol, the clinical working group will monitor the results, make recommendations concerning the advisability of extending DU evaluations to an even broader group of Gulf War veterans.
DoD and VA have collaborated together to ensure that all Gulf War veterans selected for participation in the VA national survey have an equal and maximum opportunity to participate in the support study regardless of their military or beneficiary status.
The national survey is an epidemiologic study of the current health status of Gulf War veterans and the clinical working group was one key form in which interagency collaborative efforts were forged occur to maximize the voluntary participation of any active duty Reserve or National Guard member selected for the exam.
DoD is authorized funded transportation and lodging on temporary duty orders for all selected active duty personnel. Reserve and National Guard personnel are activated and similarly paid to travel and receive exams. This is one more example of the way the clinical working group has enhanced cooperative efforts in a wide range of issues pertaining to the health of the men and women who served our country during Operations Desert Shield and Desert Storm.
Mr. Chairman, in conclusion I would like to say although I’m frankly brand new on this committee, I’m already exceptionally impressed with the professionalism and dedication and concern of those committee members that I’m proud to serve with.
Thank you, sir.
DR. ROSWELL: Mr. Chairman, the research activities of the Persian Gulf Coordinating Board will be detailed for the Board by Dr. Tim Gerrity, who is the executive director of the research working group.
DR. GERRITY
: Thank you, Dr. Roswell. Mr. Chairman and members of the Special Oversight Board, thank you for this opportunity to discuss the status of the current and projected federal research program on Gulf War veterans’ illnesses. I meant that parenthetically. I will provide you with a full written statement for the record.SENATOR RUDMAN: We’ll incorporate that statement in the record so you can summarize as you wish.
DR. GERRITY: I’m special assistant chief research and development officer in the Department of Veterans Affairs. I’m also the executive director of the research working group of the Persian Gulf Veterans Coordinating Board. I might add parenthetically that my involvement with Persian Gulf War health concerns dates back to March 10, 1991 when I arrived in the Gulf area as a part of an interagency team to assess the potential health consequences of the oil well fires at that time.
In both of my current capacities, I report directly to Dr. John Feussner, VA’s chief research and development officer and chairperson of the research working group of the Persian Gulf Veterans Coordinating Board. Dr. Feussner regrets he cannot be here because of a long-term prior commitment. Today, I will focus my presentation on the goals, status and findings, costs and new initiatives in federally funded research on Gulf War veterans’ illnesses.
First, I will focus on the goals of research as conceived by the research working group and embodied in its Working Plan for Research on Gulf War Veterans’ Illnesses. The appearance of illnesses among Gulf War veterans, especially illnesses that are difficult to diagnose, led to the need for a comprehensive research program with the following goals: (1) establish the nature and prevalence of symptoms, diagnosable diseases and other conditions in Persian Gulf veterans in comparison to appropriate control populations; second, identify possible risk factors or any excess morbidity or mortality among Persian Gulf veterans and thirdly, identify appropriate diagnostic tools, treatment methods and prevention and intervention strategies for conditions found among Persian Gulf veterans.
The research necessary to achieve these goals includes basic research, clinical research and epidemiological research. Where appropriate and feasible, research should address family members of veterans as well as the veterans per se.
I will now move on to a discussion of important research results. The results of a number of new research studies have been published recently which, along with previous research results, are helping to form a body of knowledge that will lead to reliable models of the health problems of Gulf War veterans. In addition, there have been some valuable preliminary findings reported at major scientific meetings. However, until peer-reviewed, these findings must be treated with great caution.
Before reviewing some of these findings, it is important to note that all research studies have strengths and limitations. Among the limitations, epidemiological studies are frequently subject to a variety of biases. For example, studies that rely on self-reported symptoms and exposures are subject to what is called recall bias, and studies that rely on self-selected cohorts, such as registry participants, are subject to what is called selection bias.
Biases can distort the magnitude of differences between cohorts and affect the strength of associations between exposures and outcomes in either direction. Other factors potentially affecting epidemiological outcomes include sample size and response rate.
Research using animal models is also subject to limitations and its applicability to a specific situation for humans. Sources of limitations include extrapolation of biological processes from one animal species to another and extrapolation of experimental dosing regimens, that is, the route of administration, the amount and the duration, in animals to real human exposure conditions.
The presence of limitations in a particular study does not necessarily invalidate its findings or conclusions but must be taken into account in evaluating a study’s overall weight and impact. For this reason, the strengths and limitations of each of the new reports of study findings are cited as a guide.
It is impossible at this time to discuss in detail with you all research advances so I will focus my attention on a few important areas of investigation including the brain and nervous system, health effects of low-level exposure to chemical warfare nerve agents, mortality outcomes, reproductive outcomes and the area of symptoms and general health.
In the area of the brain and nervous system, a number of papers focusing on neuropsychological performance, psychological health and symptoms have been published. These studies suggest that a number of symptoms reported by Gulf War veterans may be explained by psychological distress. However, findings reported in these papers indicate that psychological distress alone may not explain all of the increased symptom reporting.
In addition, new research in post-traumatic stress disorder is shedding new light on the nature, prevention and treatment of the disorder. These findings will assist all veterans of deployments with this disorder, including Gulf War veterans. It will also contribute to the improvement of health outcomes in veterans of future deployments.
In the area of health effects of low-level exposure to chemical warfare nerve agents, follow-up studies of victims of the sarin terrorist attacks in Matsumoto and Tokyo, Japan, two years and six to eight months following exposure, respectively, are enhancing our understanding of the potential for long-term sequelae of exposure to sarin. A VA scientist collaborated in some of this work.
The importance of these studies is the involvement of documented exposure to sarin. Results suggest that exposures causing immediate health responses may lead to persistent chronic effects in a dose-dependent fashion; that is, depending upon how much they were exposed to. These effects may vary from clinically undetectable, except through the use of highly sensitive measurement techniques, to clinically significant with overt signs and symptoms. These effects may not be related to the acutely toxic effects of cholinesterase reductions.
These findings are consistent with a DoD-funded study in laboratory rates that reported that after anticholinesterase treatment when cholinesterase levels returned to pre-treatment control levels, learning deficits persisted in the animals. However, the rats studied were quite symptomatic when exposed.
The fact that these studies report long-term responses following acute exposures at levels sufficient to produce immediate observable effects somewhat diminishes the relevance to Gulf War veterans because there is no documented evidence of any acute health phenomenon during the Gulf War that is consistent with an exposure to a chemical warfare nerve agent.
However, the findings reinforce models of anticholinesterase toxicity that extend beyond the immediate effect and may not be directly related to cholinesterase inhibition. Because of the lack of data on long-term health effects from subclinical exposures to anticholinesterase nerve agents, the research working group worked with DoD to develop solicitations for new research addressing this particular question.
In the area of mortality outcomes, results from a follow-up of the original VA mortality study through 1995 show that disease-specific deaths do not occur at any greater frequency among Gulf War veterans than among their non-deployed counterparts. This result is consistent with the first mortality study published in the New England Journal of Medicine.
However, deaths by accidents, in particular motor vehicle accidents, are more frequent than Gulf War veterans. Preliminary results of a study examining the latter findings suggest that behaviors such as speeding and not wearing a seat belt may be contributing factors to the increased motor vehicle deaths among Gulf War veterans.
In the area of reproductive health, two studies from the Naval Health Research Center in San Diego, California indicate that there is no difference in the rates of birth defects in the offspring of Gulf War veterans compared to their non-deployed counterparts.
A major study of discharge records, over 75,000, from medical military facilities found no difference in birth defects overall in the offspring of Gulf War veterans compared to non-deployed veterans. A substudy examining the rate of a rare birth defect known as Coldenhar Syndrome did not detect a statistically significant difference between the rate of Goldenhar Syndrome in the offspring of Gulf War veterans compared to non-deployed veterans. Additional studies are, however, continuing to pursue the question of adverse reproductive outcomes in Gulf War veterans.
Lastly, in the area of symptoms and general health, researchers find that Gulf War veterans self-report a variety of symptoms and conditions, to a greater extent than non-deployed era veterans, that do not easily fit into a narrowly-defined pattern of disease.
This is demonstrated in both the study of Iowa Gulf War veterans, published in the Journal of the American Medical Association and in a recently published study, also in JAMA, reporting on the health of a group of deployed and non-deployed Pennsylvania Air National Guardsmen. I will discuss this study at a later moment. Consequently, research into the general problems of symptoms and general health status among Gulf War veterans continues to be very, very important.
Researchers are beginning to better understand the reliability of self-reported symptoms and exposures by conducting test-retest reliability studies and exposure validation studies. I’d like to talk briefly about the aforementioned study on the Pennsylvania Air National Guardsmen.
The Centers for Disease Control and Prevention recently reported the study in JAMA and the results of the study -- reported the results of the study of the Air National Guardsmen. Using a symptom-based case definition, that is, a case definition defined as having one or more chronic symptoms from at two of three categories; fatigue, mood-cognition and musculoskeletal.
Investigators found that 39 percent of deployed Air National Guardsmen satisfied criteria for being mild to moderate cases compared with 14 percent among non-deployed Guardsmen. Although the number of cases was three times as great among the deployed Guardsmen, it is significant to note that cases were also present in the non-deployed Guardsmen.
In addition to these research results, a number of new research projects and initiatives have been started and some significant milestones have been reached. Many of the new projects and initiatives are the direct result of recommendations from a variety of sources including the Presidential Advisory Committee, the Institute of Medicine Panel on the Health Consequences of Service in the Persian Gulf War, Congress, veterans and the research working group.
In collaboration with DoD, VA has initiated two major multi-site, randomized controlled treatment trials for Gulf War veterans’ illnesses. One trial, known as the Exercise/Behavioral Therapy or EBT trial, is based on successful application in small single-site trials of aerobic exercise and cognitive behavioral therapy, also known as CBT, in reducing the impact of illness symptoms in persons suffering from a variety of chronic diseases.
These treatments are not meant to cure unexplained illnesses in Gulf War veterans but to help veterans positively cope with their symptoms and thereby increase their ability to function in everyday lift. In addition to the EBT trail, a multi-site treatment trial of long-term antibiotic therapy in ill Gulf War veterans will be implemented.
The Antibiotic Treatment or ABT trial was motivated by two important observations. First, some scientists have promoted the chronic, that is six to twelve months’ use, of doxycycline in ill Gulf War veterans as treatment for a putative infection with the organism mycoplasma fermentans.
To date, no causal connection has been established between a mycoplasma infection and the types of illnesses being experienced by Gulf War veterans. However, chronic doxycycline therapy is not benign and can be associated with significant side effects. Consequently, VA firmly believes that it owes veterans evidence for efficacy, or the lack thereof, of this treatment approach so they do not unnecessarily take antibiotics for prolonged periods of time.
Second, small single site studies have suggested that mycoplasma organisms may indeed be responsible for some chronic musculoskeletal pain and treatment with appropriate antibiotics has reduced or eliminated this pain.
Both of these trials that have been initiated have been scientifically peer-reviewed by a federally chartered review committee. They are anticipated to begin in early calendar year 1999 and be completed within approximately two years.
The advantage of large multi-site trials involving thousands of subjects, which these will, is that the outcomes of these trials will be highly definitive. These two trials represent a major shift in the approach of the research working group toward Gulf War veterans’ illnesses.
In addition to the treatment trials, there are a number of other important initiatives that are worth noting. DoD has funded new research projects on the health effects of low-level exposures to chemical warfare nerve agent, interactions of multiple chemical stressors, historical war syndromes and other new research.
The Centers for Disease Control funded two major cooperative agreements with Boston University and Robert Wood Johnson Medical Center to study in-depth the characteristics of Gulf War veterans’ illnesses and to attempt to develop a valid case definition.
The Iowa Study of Gulf War Veterans that reported over one year ago an excess of self-reported symptoms among deployed Iowa veterans will be extended to include physical examinations with a focus on an outcome of asthma.
The number of new activities can go on. I will leave that for you to read about that in the written testimony. What I’d like to do now is to turn to the issue of research funding.
The federal research portfolio for Gulf War veterans’ illnesses is diverse in scope. Federally funded research covers an array of different exposures and health outcomes using epidemiological, clinical, basic and applied research approaches. In approximate terms, roughly one-third of the research is divided among epidemiological, clinical and basic and applied research, respectively.
Since 1994 and through 1997 the federal government has sponsored 121 research projects and has committed $115 million in resources to these projects. Please note I will focus on funding through FY ’97 as we are currently accounting for FY ’98 funding and expenditures.
Over half of these projects involve non-government scientists. Through February 1998, 39 of the 121 projects have been completed, 78 projects are ongoing and four have been awarded funds that are pending startup.
As the number of active research projects has increased from 32 in 1994 to as many as 90 in 1998, the patterns of investment have changed. The proportion of research projects funded in epidemiology research has appropriately declined while the number of research projects on chemical weapons, both in relative and absolute terms, has markedly increased as well as, I might note, a focus on treatment.
As noted earlier, beginning in 1999 new research will begin to focus on clinical trials for treatment of Gulf War veterans. VA and DoD have committed approximately $20 million for two large multi-site, randomized, controlled treatment trials.
When we examine all of the areas of research upon which the federal government has focused, we find that the expenditure of funds has been greatest for research on the brain and nervous system, followed by research on symptoms and general health. The reporting by veterans of symptoms that could be tied to the brain and nervous system has largely driven research on this focus area.
The research approaches include psychological, neurobehavioral and neurological outcomes. Research on symptoms and general health have largely been epidemiological in nature designed to better characterize the illnesses of veterans. The third largest investment is in research on diagnosis that is directed toward characterizing Gulf War veterans’ illnesses and on specific diagnostic tests such as the research on a serological assay and a skin test for leishmaniasis exposure.
I will close by briefly discussing the accomplishments of the research working group. By drawing the three departments together, the RWG has been able to jointly develop a research strategy, jointly serve as a forum for researchers to present ideas and findings, jointly respond to emerging research issues and problems.
Through the priority setting process carried on within the RWG, each department is able to independently develop approaches to addressing those priorities. These approaches are then returned to the RWG for joint discussion, resolution and recommendations.
The RWG has served as an umbrella under which the federal government has been able to respond to many research issues outside the context of the RWG’s regular meetings. When emerging research issues arise within an individual department, the RWG is engaged to ensure that each department participates in discussions on these issues.
The RWG has guided the federal research portfolio using a number of sources of input. These sources include results from ongoing research, various expert panels and oversight committees such as the Institute of Medicine, the Defense Science Board, NIH, Congressional committees including the Human Resources Subcommittee, the Presidential Advisory Committee on Gulf War Veterans’ Illnesses, independent scientists and veterans.
The RWG has synthesized the advice and information into a research strategy embodied in a Working Plan for Research on Persian Gulf Veterans’ Illnesses first released in August 1995 and revised in November 1996. As a part of the next Annual Report to Congress: Federally Sponsored Research on Gulf War Veterans’ Illnesses, this strategy will be revisited and assessed by the RWG for needs to st