Testimony Provided to this week’s Congressional Hearing on Gulf War Illness

Hearings » Gulf War Illness: The Future for Dissatisfied Veterans

Statement of Anthony Hardie

Member, Research Advisory Committee on Gulf War Veterans' Illnesses; Gulf War Steering Committee, U.S. Department of Veterans Affairs; and Gulf War Illness Research Program Integration Panel, Congressionally Directed Medical Research Program, U.S. Department of Defense

Thank you to the Subcommittee for holding this third hearing in a very serious series seeking solutions on the Gulf War illness issues that have plagued so many thousands of Gulf War veterans for nearly 20 years.  As you already know, I am one of those 250,000 veterans affected by Gulf War illness issues.  I particularly thank Chairman Mitchell and Ranking Member Roe for your bipartisan, professional, committed leadership on this issue.

I also want to thank VA Secretary Eric Shinseki and VA Chief of Staff John Gingrich for their courageous, principled stance on championing issues related to Gulf War veterans.  As veterans themselves, we look to them with hopeful anticipation and continue to wish for their encouragement in achieving so many long-overdue and deeply needed goals on our behalf. 

From my own experience helping to lead one of the largest state veterans agencies in the country, I know that this leadership can sometimes mean battling those within your own organization, who can range from well-intentioned to apathetic to resistant to change to even those who think they know better than leadership and believe they and their ideas and ways of doing thing will be there long after the latest batch of appointees are gone.

But I also believe from my personal experiences and from meeting with VA leadership that their vision of culture change at VA can indeed be achieved.

Much of what needs to be said has been said already elsewhere, including in public comments to the current and former VA advisory committees, VA’s new, internal Gulf War Veterans’ Illnesses Task Force, and during the many Congressional hearings held over the last two decades on issues related to the health and well being of Gulf War veterans.

And, I continue to have faith in the new VA leadership, and I continue to believe that they will be effective on these issues as long as they keep them directed at the high level they are currently directed, right from the Office of the Secretary.

Instead, I want to take this opportunity to highlight just some key issues.

New National Research Project.  First, from my experience serving on various federal research advisory committees related to Gulf War veterans’ illnesses, it is clear that what is needed most urgently is fulfillment of the Institute of Medicine’s recommendation for a Manhattan Project style, nationally directed research program focused on finding and funding the best science to unlock the etiology of, and effective treatments for the toxin- and other environmental agent-induced illnesses of veterans of the 1991 Gulf War. And, as has been previously shown in other hearings and testimony, much of the hundreds of millions of dollars of previous research was misdirected, misspent, and made no difference in the health and lives of Gulf War veterans. Continuing to fund Gulf War illnesses research piece-meal, without a broader strategy, is inefficient and best and may well be ineffective at worst, leaving Gulf War veterans to continue to try to endure without effective treatments to improve our health and lives.  This large-scale research project most likely cannot be created without Congressional action.

New Kinds of Research.  Second, I have become convinced from my work with the brilliant scientists next to whom I have served on these various committees that the key to success lies in funding interdisciplinary, multi-focused, consortium-type research projects rather than funding one lone scientist testing a single theory.

Simplifying Gulf War illness claims.  Third, with regards to benefits, we as a nation can and must achieve better results with regards to the service-connected disability claims of veterans of the 1991 Gulf War.  VA must clarify, or Congress must enact legislation to clarify the current disability claims eligibility contained in 38 CFR 3.117.  Veterans with chronic multi-symptom illness should be rated for “chronic multi-symptom illness” as a single entity, not have to prove each individual symptom, ensure that each symptom subset is “undiagnosed,” and then be subjected to separate ratings for each symptom or set of symptoms.  

Correcting flaws in Gulf War presumptive rating schedule.  Fourth, in previous testimony and public submissions, I have provided details of highly problematic issues related to service connection for fibromyalgia, a presumptive condition for Gulf War veterans under 38 CFR 3.117 which is currently only allowable to a maximum of 40 percent when it should be allowable to 100 percent.  And, the symptoms of severe irritable bowel syndrome, a second presumptive condition for Gulf War veterans can be substantially or even totally disabling should not be limited to just 30 percent as it is currently under 38 CFR 3.117.  And, the diagnosis of fibromyalgia should not preclude service-connection for chronic fatigue syndrome (a third presumptive condition for Gulf War veterans that is allowable by itself up to a 100 percent rating, as it should be) as it currently does.  While I have already made specific recommendations to VA on these issues, implementing the change suggested in my third point, above, would be another way to alleviate these issues of overlap and unfairness.

VA Staff Accountability.  Finally, VA staff must be held accountable for implementing the changes called for by Gulf War veterans, the scientific community, Congress, and VA appointees.  Even still, the advisory committees on which I serve are not always consulted on issues within their purview, advised of decisions made independently by VA staff without advisory committee consent, or heeded in the sound recommendations they make.

These issues internal to VA and the U.S. Department of Defense have been at the root of many of the concerns of Gulf War veterans, and have surfaced repeatedly, including as recently as last week with the issuance of VA’s new press release on funding $2.8 million in new Gulf War health research.

As a member of VA's new Gulf War Steering Committee (GWSC) and the Congressionally-chartered VA Research Advisory Committee on Gulf War Veterans' Illnesses, I was surprised to learn of VA's newly funded research related to the health of Gulf War veterans, not from VA staff as a member of these committees, but from a writer from the Veterans Today news website who emailed me the news, which was most surprisingly issued in the form of a press release. 

As a member of these committees and a typical ill Gulf War veteran, I also find the nature of the studies funded to be of concern.  None appear to be related to treatments for exposures from among the nearly comprehensive list of potentially hazardous exposures detailed in the Persian Gulf War Veterans Act of 1998.

I find it extremely disappointing that not only were the two committees with oversight and advisory roles yet again not provided input or even advance notice of these decisions (yet again, same as always in the past), but even the news of these funding decisions was not provided by anyone at VA (and still has not been provided) to our members on the VA's GWSC and the VA's RACGWVI.        

As Congressional and VA leaders know, these committees have substantial, Congressionally- and VA-chartered responsibilities related to overseeing VA’s performance of research related to ill Gulf War veterans.  These “oversights”, if we generously call these serious issues by that name – imply  that VA officials at several levels and in several capacities within VA do not take seriously the oversight and advisory roles of these committees. 

Indeed, the message from these actions is that VA staff can and will simply disregard the oversight and advisory committees created specifically, in part, to help prevent the range of problematic issues described in this letter.   This appears to be in direct contravention to the culture change and policy changes advocated by Sec. Shinseki and VA Chief of Staff John Gingrich.

Additionally, I found at least one statement of fact in the VA's press release that is cause for substantial concern. 

·    Number of Gulf War veterans with Gulf War Illnesses Downplayed.  The VA press release says, "In the years since they returned, nearly a quarter of these Veterans have experienced chronic symptoms....known collectively as “Gulf War Veterans’ illnesses."  This statement contradicts the VA-contracted Institute of Medicine Volume 8 study on Gulf War Veterans' health, released in April 2010, and cited later in the press release, which states the number of veterans at 250,000 -- at 35.9 percent, this number is substantially higher than VA's claim in the release of, "nearly a quarter".  For many years, VA has downplayed the severity of Gulf War veterans' serious and disabling illnesses, and this latest instance is unacceptable and should be corrected immediately in the online version of this press release.

But most importantly of all, the substance of the three studies is deeply concerning.  Instead of focusing on known Gulf War toxic exposures (as shown in the list in the Persian Gulf War Veterans Act of 1998) and ameliorating the range of health effects known to be associated with those exposures, instead, one of the three VA studies is still, after 20 years of criticism for this kind of focus, focused on stress and psycho-social adaptation to disability without treating the underlying physical health conditions (“mindfulness-based stress reduction”).  To put it simply, of course mindfulness training provides some small bit of health to people in their personal adaptation to conditions of pain and disability and no new, expensive study is needed to show that – but   most importantly this adaptation has absolutely no bearing on the underlying and all too real physical health of the 35.9 percent of Gulf War veterans still suffering from Gulf War illnesses.    To portray this stress management study as somehow providing meaningful treatment to veterans is deeply disappointing, disingenuous, and a disgrace to all 250,000 Gulf War veterans still suffering from very real physical illness related to their toxic exposures.

Similarly, a second of the three announced studies is about exercise to alleviate pain in Gulf War veterans.  Again, this area has been excessively studied by VA, DoD, and the scientific community, and even non-scientist health writers regularly note that exercise helps people with fibromyalgia and chronic pain, but worsen the fatigue and others symptoms in people suffering from chronic fatigue.   Gulf War veterans hardly need a new, expensive study to tell them more about what is already known.

The third of the three VA announced studies is an animal study conducted over four years to assess the efficacy of drugs with anti-depressant, anti-oxidant, and anti-inflammatory properties.   At the end of those four years, presumably it will take some time to publish the results, after which, if success is found, new multi-year studies to study the efficacy of the treatments in humans will be required.  It is incomprehensible why, after 20 years of waiting, these treatments are not being tried in ill Gulf War veterans directly rather than in study design that will require more studies thereafter before treatments ever reach the Gulf War veterans who need them.  Even if this study of anti-depressants turns out to be effective, instead, this study will take years before any potential benefit can pave the way for yet another study, meaning many more years of waiting by the 35.9 percentof Gulf War veterans still suffering from Gulf War illnesses. 

In addition to the fact that adaptations to disability purporting to be “treatment” have already been excessively studied by VA and DoD over the last 20 years at costs ranging into the millions of dollars, to put it simply, after so many years of VA missteps, these latest missteps by VA are simply unacceptable, as I am sure Sec. Shinseki and you would agree.    Most importantly, these kinds of missteps are fully preventable if the oversight and advisory bodies cited above are actively engaged by VA staff and their recommendations heeded.  But again, these committees were not only not consulted; they still haven’t even been informed of these decisions made without their input on issues directly within their purview.

All these issues suggest that despite all the expressed good intentions, staff inside VA continue through their actions – whether intentional or not – to undermine these efforts.  Perhaps they want to do things the way they’ve always done them, perhaps they believe that what they’re doing is “right,” perhaps they want this Administration to fail, perhaps they have their own agendas, or perhaps they just don’t get it. 

In any case, given all of these facts and circumstances, on behalf of my fellow Gulf War veterans, I gave the following specific questions to VA leadership – questions I believe any reasonable person would have given the circumstances:

1. What specific corrective steps are being taken immediately by VA leadership to ensure that the stated oversight and advisory roles of the GWSC and RACGWVI are respected and followed by VA staff at all levels? These bodies cannot perform their intended functions when they are completely bypassed by VA staff.

1. When will VA begin a treatment-focused research program -- as called for in the more than a decade-old Persian Gulf War Veterans Act of 1998 -- that is based on alleviating the known health effects associated with the known toxic exposures of the 1991 Gulf War?  VA officials note in this press release, “The IOM report noted that the illnesses seen in Gulf War Veterans cannot be ascribed to any psychiatric disorder and likely result from genetic and environmental factors,” yet not one of these new expensive new studies focuses on environmental or genetic factors that caused 250,000 Gulf War veterans’ illnesses.

1. When will VA correct the factual error in the press release?  Again, in one place in VA’s press release VA cites the number of the 696,842 Gulf War veterans still suffering from Gulf War illnesses as “nearly a quarter,” when the Institute of Medicine, contracted by VA, shows this number to be  far, far higher -- at least 250,000, or 35.9 percent.   That’s one-third again higher than “nearly a quarter”.  More broadly, this latest instance of downplaying the severity of Gulf War illness appears to be indicative of a continuing, long term trend within VA.

1. When will VA provide the rewritten press release to every member of the two VA committees that have oversight over Gulf War veterans’ health issues?  (GWSC and RACGWVI)

For the last year, I have been using my leadership role to reassure my fellow ill Gulf War veterans – including through the Gulf War health news website I publish, 91outcomes.com, which has had more than 25,000 readers in the mere 16 months since it was created -- that change is coming, and that VA has a new focus and a dramatic culture shift that will almost certainly lead to effective treatments for Gulf War veterans’ toxin-induced disabilities. 

For most of us, like any other disabled veteran, all most of us has ever wanted is our health restored to a state as close as possible to its pre-war state.  Science tells us that may very well be possible, that effective remedies are within our reach – but the choices made in selecting these three studies do not reflect the direction that the scientists tell us should be the way forward.

VA’s serious factual, procedural, and research-focus errors have shaken my growing trust in the new VA.  But, I look to VA leadership to take immediate, good-faith steps to remedy these serious issues.  And, I remain optimistic that VA Secretary Eric Shinseki and VA Chief of Staff John Gingrich can find ways to effectively cause VA staff to conform to their stated vision of the “culture change” desperately needed by the at least 35.9 percent of Gulf War veterans still suffering from the life-long effects of their Gulf War toxic exposures – a vision that so many of us out here share with great hope and expectation. 

If ever there was leadership that can indeed get this right, I believe it is them, aided by the able, committed, and professional leaders in Congress including you on this committee.  Please, don’t let us down now when the end is finally in sight.

Again, thank you for holding today’s hearing, for all that you have done for all veterans, and all that you continue to do.

Congressional Hearing on Gulf War Illness Issues Scheduled for July

Written by Anthony Hardie, 91outcomes.com Publisher/Editor

(91outcomes.com) – The U.S. House subcommittee on veterans affairs oversight and investigations has announced its third and final hearing of a three-part series on Gulf War illness issues. 

The hearing, entitled, “Gulf War Illness: The Future for Dissatisfied Veterans,” will be held at 10:00 a.m. on Tuesday, July 27, 2010 in the House Veterans’ Affairs Committee hearing room on Capitol Hill .

A recent Institute of Medicine report found that 250,000 veterans of the 1991 Gulf War – more than one-third – continue to suffer from what the IOM termed chronic multisymptom illness (CMI), more commonly known as Gulf War Syndrome or Gulf War Illness. 

The IOM also found that rates of PTSD and other psychiatric conditions were much lower than CMI rates in Gulf War veterans, and emphatically stated that the multisymptom illness prevalent in Gulf War veterans could not be attributed to a psychiatric cause, providing further vindication for the hundreds of thousands of Gulf War veterans who have been suffering from debilitating physical conditions for nearly 20 years.

Last August, U.S. Department of Veterans Affairs (VA) Secretary Eric Shinseki launched a comprehensive internal task force on Gulf War veterans’ illness issues, chaired by VA Chief of Staff John Gingrich, himself a Gulf War veteran. 

Earlier this year, VA’s internal Task Force not only released its initial draft report to the public  -- unusual for an internal government task force -- but also allowed and requested public comments.  

The transparency measures, on an issue that has drawn frustration and hostility for years from ill Gulf War veterans, were well received by the Gulf War veteran community.  The measures, from a federal agency previously known more for stonewalling and denial on Gulf War illness issues, renewed hope in many quarters that real change aimed at genuinely providing new improvements in the health and lives of Gulf War veterans is finally on its way.

A final copy of the VA task force’s report is expected just prior to the upcoming Congressional hearing.

More information on the hearing can be found here:  http://veterans.house.gov/hearings/hearing.aspx?NewsID=601.

BREAKING NEWS: New Congressional Hearing on Gulf War Illness Scheduled for July 30

By Anthony Hardie, 91outcomes

(91outcomes.blogspot.com) -- The Subcommittee on Investigations and Oversight of the U.S. House of Representatives Committee on Veterans' Affairs has announced it's next hearing on the research related to Gulf War illness, which affects between 175,000 and 210,000 of the 697,000 veterans of the 1991 Gulf War.

The hearing, entitled, The Implications of VA’s Limited Scope of Gulf War Illness Research, will be held on Thursday morning, July 30th, 2009 at 10:00 a.m. in the Veterans' Affairs Commtitee Hearing Room in the Cannon House Office Building on Capitol Hill in Washington, DC.

The hearing is the second of an announced series of at least three hearings by the Subcommittee on Gulf War Veterans' Illnesses.

The first in the series was held on May 19th, was entitled, Gulf War Illness Research: Is Enough Being Done?

91outcomes website posts about the May 19th hearing included the following:

• The opening statement by Subcommittee Chair Rep. Harry Mitchell (D-AZ).
• Links to testimony from the Full Witness List;
  
• House Veterans' Affairs Committee Chair Bob Filner's press release about the hearing, entitled, VA Unresponsive to Questions, Needs of Gulf War Veterans;
• An Air Force Time article about the hearing; and
• A special series of 91outcomes exclusives:

1. Background on those testifying at the hearing;
   
2. An article providing an overview of the hearing;
   
3. An article about the VA using recycled testimony; and,
4. An opinion piece entitled, VA Rolls Out Same Old Cast of Characters.
   

MAY 19TH CONGRESSIONAL HEARING -- Little Change Yet for Ill Gulf War Veterans, Federal Officials

Written by Anthony Hardie, 91outcomes

(91outcomes.blogspot.com) -- Army veteran Paul Sullivan of San Antonio, Texas gave perhaps the clearest answer to the question posed by Tuesday’s Congressional hearing, Gulf War Illness Research: Is Enough Being Done?

“As an ill Gulf War veteran who has worked on this issue for 17 years both inside and outside government, the answer is no,” testified Sullivan, Executive Director of Veterans for Common Sense, former Executive Director and co-founder of the National Gulf War Resource Center, and a former VA employee in VA's Data Management Office.

“In the past, we have seen service-related illnesses ignored, misunderstood, or swept under the rug,” said Subcommittee Chairman Harry Mitchell (D-Ariz.) in his opening statement.

Rick Weidman, a Vietnam veteran and Government Relations Director for Vietnam Veterans of America (VVA), added: “In regard to Gulf War Illness, VA has known the basic outline as to what was wrong with up to 200, 000 of those who served in the Gulf for a decade. Yet they continue to drag their feet in addressing the justifiable compensation requests of these veterans, and to give them the runaround on medical care.”

Weidman, a longstanding veterans’ advocate, continued in his testimony, “One has to ask, what is wrong with this institution (VA) that it would treat the men and women who are literally its very reason for existing in such a high-handed and disrespectful manner, even in the face of consistent scientific advice and good judgment?”

Dr. Roberta White, Ph.D., who has been researching Gulf War veterans’ illnesses since 1993, stated for the record that her team found not only low rates of PTSD among ill veterans, but also “systematic relationships,” between, “self-reported exposures to pesticides and to nerve gas agents and health complaints in specific body systems.” This early research was later validated by other research efforts.

White’s team also found decreased white matter in the brains of ill Gulf War veterans, cognitive and neuropsychological deficits not explained by psychiatric diagnoses, and that ill Gulf War veterans’ health complaints remained stable and without improvement over time – no surprise to ill Gulf War veterans. White is the current scientific director of the Congressionally chartered Federal Research Advisory Committee on Gulf War Veterans’ Illnesses.

Army veteran Jim Bunker of Topeka, Kan., courageously told the Congressional investigators in his halting voice of his current Gulf War illness symptoms, which are typical for literally tens of thousands Gulf War veterans:

• Numbness, weakness, and/or tingling in arms and legs
  
  
• Headaches
  
  
• Cognitive dysfunction
  
  
• Gastric reflux disease
  
  
• Fibromyalgia
  
  
• Mouth sores and skin peeling from roof of mouth
  
  
• Skin rashes
  
  
• Sinusitis
  
  

Later in the hearing, when federal agency officials implied there was nothing wrong with Gulf War veterans, one Congressman pointedly asked, “What about Bunker?” Bunker had become a visible symbol of what has been and continues to be wrong with between 175,000 and 210,000 veterans from among the 696,842 who served in the 1991 Gulf War.

Meanwhile, a CIA official testified regarding the 1991 Gulf War theater of operations chemical agent releases known to the agency. He failed to mention incidents known to the Pentagon or described by veterans to Congress in Congressional hearings over the past two decades, relying purely on what CIA “knew”. He showed little knowledge of ground conditions, during which chemical alarms – when used – continuously went off.

 

He failed to mention chemical agent releases and exposures known to veterans and some within the Pentagon at the time that occurred in al Jubayl and Ra’s al-Mishab, chemical minefields in southeastern Kuwait, blister agent releases that caused the rapid Iraqi evacuation of a unit’s bunker complex in north-eastern Kuwait, and countless others like the incident Bunker described that personally affected him.

VA, predictably, recycled old testimony from a previous Congressional hearing, suggesting that VA has done everything possible to help Gulf War veterans, who do not suffer from a “unique illness.” Predictably, Dr. Lawrence Deyton stated that VA would wait until 2010 for an Institute of Medicine (IOM) review of the November 2008 report of the Research Advisory Committee (RAC) on Gulf War Veterans’ Illnesses.

The RAC’s findings were covered in detail by Dr. Lea Steele, Ph.D., of the University of Kansas, who passionately and compassionately presented the report’s findings during the Hearing.

Steele echoed the report’s findings in her prepared testimony:

Oddly, in his testimony the Department of Defense official claimed credit for funding recent research years focused on treatments for ill Gulf War veterans – an irony given DoD’s enduring opposition to the funding as DoD officials have reportedly made clear to House Defense Appropriations staffers.

Due to powerful support from Gulf War veterans' advocates, Congress has provided annual funding to DoD anyway, and it falls under the well-run Congressionally Directed Medical Research Program (CDMRP) based at Ft. Detrick, Maryland. The Congressional funding has been provided with clear instructions to DoD on its possible uses, with requirements to focus on treatments and prohibitions against more unneeded DoD research on stress and psychological causes for ill Gulf War veterans’ all too real array of symptom clusters.

In short, veterans and science are in full agreement that the Gulf War’s veritable toxic soup made between 175,000 and 210,000 Gulf War veterans ill with chronic, multi-symptom illness, that their illnesses have not improved over time, and that effective treatments still do not exist – in large part due to long-term failures by the federal agencies charged with caring for ensuring the well-being of these veterans.

And the federal response? CIA officials are still blindly and wrongly claiming there were few or no chemical releases that reached Gulf War troops, DoD officials are overly proud of the “lessons learned” from the Gulf War while Gulf War veterans continue to suffer, and the same low-level VA officials providing the same recycled testimony are still implying or outright stating that everything that could be done for Gulf War veterans was and is being done.

Tell that to Jim Bunker as he, like tens of thousands of other ill Gulf War veterans, struggles with walking, sleeping, and communicating.

All might be well safe with the Beltway in the Land of Washington. But all is certainly not well for the 175,000 to 210,000 Gulf War veterans who still continue to suffer the lingering, untreated outcomes of their Gulf War service.

Change is needed – desperately.

[Watch the Hearing via Multimedia Link now]

“A renewed federal research commitment is needed to identify effective treatments for Gulf War illness, improve understanding of this condition, and address other priority Gulf War health issues. Adequate funding and appropriate program management is required to achieve the critical objectives of improving the health of Gulf War veterans and preventing similar problems in future deployments. As noted by the Committee this is a national obligation, made especially urgent by the many years that Gulf War veterans have waited for answers and assistance.”

NEWS FROM…

CHAIRMAN BOB FILNER

HOUSE COMMITTEE ON VETERANS’ AFFAIRS

VA Unresponsive to Questions, Needs of Gulf War Veterans

Washington, D.C. – On Tuesday, May 19, 2009, the House Veterans’ Affairs Oversight and Investigations Subcommittee, led by Chairman Harry Mitchell (D-AZ), conducted the first of a series of hearings on Gulf War Illness research. The hearing provided a review of the history of the research that has been conducted on Gulf War Illness, examined the methodology used by the Department of Veterans Affairs (VA) to determine possible exposure to toxins and pesticides, and focused on the ongoing challenges veterans face as a result of their service in Operations Desert Shield and Desert Storm.

“It has been almost 19 years since the United States deployed some 700,000 service members to the Gulf in support of Operations Desert Shield and Desert Storm,” said Chairman Mitchell. “When these troops returned home, some reported symptoms that were believed to be related to their service. Still today, these same veterans are looking for answers about proper medical treatment and the benefits that they bravely earned. While we hear about numerous studies and millions of dollars spent on Gulf War Illness research, many questions remain unanswered. Today, we will attempt to establish an understanding of the research that has been conducted – and the actions that have been taken – in relation to Gulf War Illness.”

According to Congressional testimony, VA had concerns that returning veterans might have certain unique health problems including respiratory effects from exposure to the intense oil fire smoke even before the 1991 Gulf War cease-fire. During the summer of 1993, U.S. troops’ exposure to chemical warfare (CW) agents first became an issue. The Department of Defense (DoD) and the Central Intelligence Agency (CIA) concluded that no troops had been exposed for two reasons: there were no forward-deployed CW agent munitions, and plumes of CW agents released from the bombing that destroyed the chemical facilities could not have reached the troops. This conclusion was maintained until June 1996, when DoD publicly acknowledged that U.S. troops had destroyed stockpiles of chemical munitions at Khamisiyah after the war.

In 1998, Congress passed legislation, the Persian Gulf War Veterans Act of 1998 and the Veterans Programs Enhancement Act of 1998, which directed the VA Secretary to seek to enter into an agreement with the National Academy of Sciences (NAS) to review and evaluate the available scientific evidence regarding associations between illnesses and exposure to toxic agents, environmental or wartime hazards, or preventive medicines or vaccines to which service members may have been exposed during service in the Persian Gulf during the Persian Gulf War. Congress directed the NAS to identify agents, hazards, medicines, and vaccines to which service members may have been exposed during the Persian Gulf War.

Between January 1, 2000 and September 12, 2006, NAS issued four reports on health effects of various toxins, chemical warfare agents, and insecticides. Each report concluded that the available evidence did not warrant a presumption of service connection for any disease discussed in the report. The fifth report, released October 16, 2006, reviewed published, peer-reviewed scientific and medical literature on long-term health effects from infectious diseases associated with Southwest Asia. VA is currently drafting a proposed rule to establish presumptive service connection for nine infectious diseases discussed in the report and providing guidance regarding long-term health effects associated with those diseases. It was determined, however, that the scientific evidence in the report does not warrant a presumption of service connection for any illnesses caused by these diseases or agents.

Veterans raised a number of concerns at the hearing, mostly based on lack of information, outreach, and resources available from the VA. Veterans reported frustration that there is no formal Gulf War I Registry, no service-connected benefits for maladies, inadequate research to determine the cause of illness, no formal recognition by the VA of Gulf War Illness, and a lack of epidemiological tools in use to further track effects of Operation Desert Storm and Operation Desert Shield.

Recommendations from witnesses included increasing the VA research budget, formal recognition by DoD and VA of Gulf War Illness, access to disability benefits, and an end to the perceived secrecy that surrounds research findings, treatments, and new information. Also discussed was the immediate need to implement an electronic medical health record that fully incorporates the veteran’s military record. Rick Weidman of Vietnam Veterans of America testified,

“VA needs to move quickly to modify the Computerized Patient Records System (CPRS) or VISTA, to incorporate a military history that will include branch of service, periods of service, places assigned and when, military occupational specialties, and notes on what happened to the individual that may be of note. This also needs to be searchable on a nationwide basis, so that if an individual has an unusual medical condition, then the physician can search and find out if others who served in their unit at the same time have the same or similar conditions. This would be an invaluable epidemiologic tool that could/would point VA in the direction of where there needs to be research that is directed where there are obviously problems. You may ask why they never did this before? Well, we have come to the inescapable conclusion that they never did it because they did not want the information. As the cost to make this change to the CPRS is really minimal, we can come up with no other explanation that makes any sense whatsoever.”

“If Gulf War veterans have been harmed by their service to their country, we must ensure they are taken care of through presumptive service connection for that illness,” said Bob Filner (D-CA), Chairman of the House Committee on Veterans’ Affairs. “I support President Obama’s call to develop joint electronic medical records that contain military records. Not only is this information sharing between the DoD and VA imperative to more accurately treat maladies and service connected injuries, it will allow the VA to refocus its efforts and direct care to its wounded warriors. It is time for the VA to compassionately and immediately serve its clients.”

Subsequent hearings on this issue will take a multi-level view of the methodology and conclusions of Gulf War Illness research, how the review of information was compiled, and why certain methods were employed.

###

TODAY'S CONGRESSIONAL HEARING Opening Statement of Hon. Harry Mitchell, Chairman, Subcommittee on Oversight and Investigations

Thank you to everyone for attending today’s Oversight and Investigations Subcommittee hearing entitled, Gulf War Illness Research: Is Enough Being Done?

We meet today to shed light on a topic that is critically important to the House Committee on Veterans’ Affairs: The health and care of our Gulf War veterans.

This hearing is not the first to address Gulf War Illness, and it certainly will not be the last. Today’s is the first in a series of Oversight and Investigations Subcommittee hearings examining the impact of toxin exposures during the 1990-1991 Persian Gulf War and the subsequent research and response by government agencies including the Departments of Defense and Veterans Affairs.

It has been almost 19 years since the United States deployed some 700,000 service members to the Gulf in support of Operations Desert Shield and Desert Storm. When these troops returned home, some reported symptoms that were believed to be related to their service. Still today, these same veterans are looking for answers about proper medical treatment and the benefits that they bravely earned. While we hear about numerous studies and millions of dollars spent on Gulf War Illness research, many questions remain unanswered. In the end, we still don’t know how to respond to Gulf War veterans who asks: “Why am I sick or will I get sick?”

Today, we will attempt to establish an understanding of the research that has been conducted – and the actions that have been taken – in relation to Gulf War Illness. To better assess Gulf War Illness and its impact on veterans, we will look at another at-risk population, veterans who were exposed to the harmful toxins Agent Orange in Vietnam. In the past, we have seen service-related illnesses ignored, misunderstood, or swept under the rug. We must learn from those mistakes and ensure that our research and conclusions are accurate so that Gulf War Veterans are assured of the right diagnosis and the care and benefits they richly deserve.

Subsequent hearings on this issue will take a multi-level view of the methodology and conclusions of Gulf War Illness research and how the review of information was compiled and why certain methods were employed.

With a growing chorus of concern over the accuracy of existing research, and with a new administration leading the VA, it is time for us to make a fresh and comprehensive assessment of this issue and the body of research surrounding it.

We will hear testimony today from a Gulf War veteran, Veterans Service Organizations, two distinguished researchers from the Research Advisory Committee on Gulf War Illnesses, as well as government officials. I would like to thank all of our witnesses for appearing here today. I’d also like to extend my thanks to Jim Binns, who chaired the Research Advisory Committee on Gulf War Veterans’ Illnesses, for his contributions to this hearing and this issue.

I trust this hearing will provide useful insights to begin our evaluation of the existing research on toxic exposure and the work being done to care for Gulf War veterans and protect future generations of war fighters.

ARMY TIMES: Vets urge more action on Gulf War syndrome

July 27, 2007
Written by Rick Maze - Staff writer, Army Times

Sheila Vemmer / Staff Many 1991 Gulf War vets "have simply given up" on trying to get help from the Veterans Affairs Department, says Army veteran Anthony Hardie.

(Washington, DC) A group of Persian Gulf War veterans told House lawmakers they feel overlooked with all of the focus on benefits and treatment for veterans of the wars in Iraq and Afghanistan.

Some veterans of Operation Desert Storm, the 1991 war to force Iraqi invaders out of Kuwait, have given up on the Department of Veterans Affairs and are seeking private care or not seeking treatment for what they believe are war-related disabilities.

“I have heard from countless other Gulf War veterans who, like many Vietnam veterans before them, have stopped going to the VA or have simply given up and have done their best to adapt to the substantial lifestyle changes required by their disabilities,” Army veteran Anthony Hardie said.

Hardie, who continues to suffer from the so-called “Kuwait cough” that started after he breathed in smoke from oil fires during the Gulf War, was one of the witnesses at a July 25 hearing of the House Veterans’ Affairs health subcommittee.

He said VA is still seeing Gulf War veterans who have undiagnosed problems, but “being seen is not the same thing as being treated.”

Retired Air Force Reserve Maj. Montra Denise Nichols, a registered nurse who said she saw the beginning signs of the mysterious Gulf War syndrome while deployed with her aeromedical evacuation group along the border between Iraq and Saudi Arabia, also said veterans are being overlooked.

Despite promises from VA to provide research, treatment, support groups and a patient registry, many veterans feel responsible for educating their own doctors.

Nichols called it “unacceptable for ill patients who look to their doctors for relief to have to bring in stacks of research that shows the direction the physicians should be examining.”

Another Gulf War veteran, retired Air Force Brig. Gen. Thomas Mikolajcik, said the failure to do more could end up hurting new generations of veterans.

Mikolajcik was diagnosed in 2003 with the usually fatal amyotrophic lateral sclerosis, or ALS, known as Lou Gerhrig’s disease. He said a 2001 study shows Gulf War veterans are twice as likely to have ALS as the general population, and a 2005 study found that all veterans, dating back to World War II, have an ALS rate 1.6 times that of the general population.

The cause and possible link to military service is unknown, he said, but he urged Congress to do more in terms of research and treatment.

“There will be young men, women and families celebrating a return from Iraq and Afghanistan alive who have no idea that they may soon be facing a certain death from ALS,” he said.

The chairman of VA’s advisory committee on research into Gulf War-related disabilities said veterans who think they are not getting enough attention may be right.

“Gulf War illnesses remain a major unmet veterans’ health problem,” said James Binns, chairman of VA’s research advisory committee on Gulf War veterans’ illnesses.

Sixteen years after operations Desert Shield and Desert Storm, Binns said serious health problems continue and most of the money spent on research has been wasted.

“One in four of those who served — 175,000 veterans — remain seriously ill, and there are currently no effective treatments,” he said, referring to the multisymptom illness known as Gulf War syndrome.