UK GUARDIAN ARTICLE: 1991 Photographer's Kuwait Experiences

'If their tools had caused a single spark, the surging oil would have ignited'

Interview by Leo Benedictus
The Guardian, Thursday 28 May 2009
Article history

Sebastião Salgado's best shot: 'Sometimes they sat down and cried' ... Canadian firefighters in Kuwait battle to seal an oil well. Photograph: Sebastiao Salgado/Amazonas Images/nbpictures

I was in Kuwait in 1991. The first Gulf war had just finished, but the oil wells were still burning. To get into the country, I had to go to Saudi Arabia and hire a four-wheel drive the colour of the sand - because that was the colour of the US army vehicles. Then, to cross the border, someone told me to find a card in the same sort of colours as a US army ID card and wave it upside-down. Nobody stopped me, and I got through.

What was incredible inside Kuwait was the sense of being in this huge theatre the size of the planet, with these oil wells burning all around. Sometimes you would go two or three days without any sunlight getting through the vast clouds of black smoke, then suddenly the sky would open. It was also quite dangerous. There were unexploded cluster bombs in the sand. A journalist and a photographer were killed when a slick of oil ignited as they crossed it.

This photograph comes from a series of pictures I made with a group of specialist firefighters from Canada, who were trying to deal with a blazing oil well. Putting out the fire took days and days, but that wasn't the biggest problem, even though they then had to light another smaller fire, so that a lake of oil did not accumulate around them. It was capping the well, for these guys, that was hell. Saddam Hussein's men had used a large number of explosives, leaving the wellhead badly deformed. Because Kuwait is at the lowest point of a vast Middle Eastern oil field, the pressure was enormous, pushing the oil out with a noise like a 747's engines. Everything was completely black. You couldn't hear anyone speak.

It was an incredibly dangerous place to work, because the oil was very light, much like the fuel in cars - so it catches fire very quickly, and its smell is very strong. At one point, one of the Canadians got too close, inhaled too much gas, and fell down unconscious. Meanwhile, as these guys worked away with their tools and instruments, they knew that if they touched metal against metal hard enough to create a spark, a fire would have engulfed them. As I was photographing, we did sometimes have a kind of explosion, as gas burst up through the well, but it did not ignite. The firefighters were making a lot of money, of course, but the work was so tiring and so tough that a few times I saw some of them just sit down and cry.

Working in the middle of all this was extraordinary. One of my lenses got warped by the heat, so I was left with just two: a 35mm and a 60mm. This obliged me to stay very close to these guys the whole time. As a result, I was covered in oil, and felt so involved with the danger, the environment, the strange beauty and the hard work that was happening in front of me. The only way I could keep going was to carry a two-litre tank of petrol and a roll of kitchen paper inside my photo bag. I would put some petrol on the kitchen roll, clean my hands, the lens and the back of the camera, then go in again. Eventually, I felt part of the team, working with them for many days. We all became very close.

I work on stories rather than individual pictures. But for me, this one picture was special: it's an incredible shot of two guys trying to cap a well. They are completely covered in oil and one of them is standing like a statue that has become black over time. It reminds me of those images you see from the first world war, in the grey light of Verdun. The moment I took it,

I knew it would be good. At the same time, I was very afraid. My mouth was dry. That evening, when I got back to my hotel in Kuwait City, I found my jaw was tense and my gums were in pain from gritting my teeth all day long. But I had to be there to take these pictures. I knew I was witnessing powerful, extraordinary things that would not happen again.

Curriculum vitae

Born: Aimorés, Brazil, 1944.

Studied: "I am a former economist. I never went to photography school to learn photography."

Inspirations: "Bill Brandt was an incredible photographer. The many different studies he did in England - miners, nudes, life during the second world war - were important to me."

High point: "When I was starting out, when I put aside my career as an economist. I looked at every book, went to every show, did my first stories, developed my first films. A fabulous time."

Pet hate: "Photography has become a small world with so many jealous people. You do a story and then a lot of people try to do the same thing."

PUBLISHED NEWS: Dr. Kenny De Meirleir Announces He has Revealed the True Nature of ME/CFS (Myalgic Encephalomyelitis / Chronic Fatigue Syndrome)

May 28, 2009
Published at ProHealth today: At 11:00 AM London time on May 28, 2009, ME/CFS researcher Dr. Kenny De Meirleir, MD, PhD, spoke at a press conference unveiling his team's groundbreaking findings regarding the illness called Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS). The presentation covered the team's conclusions regarding the complex mechanisms of ME/CFS pathogenesis, a diagnostic test, and directions for therapeutic strategies.

(Dr. De Meirleir, a Belgian scientist known for his cutting edge ME/CFS research, is a professor at the Vrije Universiteit Brussels and Director of HIMMUNITAS Foundation Brussels.)

FOLLOWING ARE:
• A link to slides used in the press conference (accompanying script to come soon, perhaps in a presentation Dr. De Meirlier will give Friday, May 29 at Invest in ME’s International ME/CFS Conference in London)

• The preliminary draft abstract of an upcoming journal article by the De Meirleir research team (“Research on Extremely Disabled M.E. Patients Reveals the True Nature of the Disorder”)

SLIDES USED IN PRESS CONFERENCE
To view the slides Dr. De Meirleir used in his press conference, go to http://www.mefmaction.net/Portals/0/docs//CFSDeMeirleir.pdf.

ABSTRACT OF UPCOMING JOURNAL ARTICLE – Preliminary Draft
The De Meirleir research team will also publish a journal article on their work. The following draft was disseminated via the CO-CURE listserv May 28 by ME research reporter Jan van Roijen (j.van.roijen@CHELLO.NL).

Research on Extremely Disabled M.E. Patients Reveals the True Nature of the Disorder
By Kenny De Meirleir(1), Chris Roelant(2), Marc Fremont(2), Kristin Metzger(2), Henry Butt(3)

(1) Vrije Universiteit Brussel & HIMMUNITAS foundation, Brussels, Belgium
(2) Protea Biopharma, Brussels, Belgium
(3) Bioscreen & Bio 21, University of Melbourne, Melbourne, Australia

In this study we compared totally bedridden patients (Karnofski score 20-30) with less ill ME patients (Karnofski score 60-70), family controls, contact controls and non-contact controls.

EBV, HHV6 and Borna virus titers were not different in the three groups. Plasma LPS distinguished the groups, with the highest values in the bedridden patients.

LPS [lipopolysaccharide] is a strong activator of the immune system, and high plasma concentrations suggest a hyperpermeable gut. There are many possible causes for this, but a lack of 'local' energy production is one of them.

In a separate study (In Vivo, in press) we observed intestinal overgrowth of Gram positive D/L lactate-producing bacteria which are also known to produce H2S [hydrogen sulfide] in presence of certain heavy metals as a survival defense mechanism.

We therefore hypothesized that the urine of the bedridden ME patients would contain more H2S derived metabolites than the less ill and the controls. Using a proprietary simple color change urine test this hypothesis was confirmed.

In the extremely ill, urine added to the yellow color reagent immediately turns dark blue, whereas in the less ill the reaction is slower and in the controls no reaction occurs.

Being a potent neurotoxin, H2S induces photophobia, intolerance to noise,
mitochondrial dysfunction by inhibition of cytochrome oxidase, and depresses the cellular immune system and induces neutropenia and low numbers of CD8+ lymphocytes.

Its effects, at least in part explain the clinical condition of the severely disabled ME patients.

Furthermore the effects of the bacterial H2S induces increased ROS production by the liver and retaining of heavy metals particularly mercury in the body.

The latter is also neurotoxic, induces apoptosis, and interferes with the aerobic metabolism. Chronic increased production of H2S by intestinal bacteria leads to build-up of mercury in the body as proven by a Zn DTPA/DMPS challenge test.

Finally in 20% of the ME patients (in the severely ill) we found, using a special luminescence technique, aberrant prions which also interfere with the energy metabolism.

These patients have gone on to develop A.P.D. (aberrant prion disease – patent pending). These aberrant prions give rise to a transmissible disorder. 10% of the A.P.D. patients have very high prion counts in their saliva and can directly transmit it to others.

APD patients can transmit these proteins via blood and likely also through sexual contact which then can give rise to slowly developing aberrant prion disease.

In a separate experiment 40 healthy blood donors were screened for A.P.D. One individual tested very positive, indicating that apparently healthy individuals can already be carriers and that blood transfusion carries the risk of transmitting A.P.D.

In conclusion, ME is a disorder which is caused by increased endogenous H2S production. For the latter many factors can be present.

Because of the effects of H2S in the body a chain of events will develop which have more and more negative effects on the aerobic metabolism and depression of the immune system leading to more and more infections and reactivation of endogenous viruses.

In its final stage aberrant transmissible prions develop which put the patients in a total energy depleted state.

ARMY NEWS SERVICE ARTICLE: Researchers narrow Gulf War Syndrome causes

May 26, 2009

By Kyle Hodges

WASHINGTON (Army News Service, May 27, 2009) -- Research completed and analyzed over the past year has narrowed the underlying causes of Gulf War Syndrome to three factors.

For 18 years, researchers struggled to pinpoint the causes of Gulf War Syndrome and its wide-ranging symptoms. Then last year, a group of researchers under the U.S. Army Medical Research and Materiel Command and the Congressionally Directed Medical Research Program narrowed the primary causes to three: chemical nerve agents, pesticides, and the use of Pyridostigmine Bromide pills.

A report titled Gulf War Illness and the Health of Gulf War Veterans was released by the Department of Veteran's Affairs in November 2008, consolidating all research on the syndrome to date.

"There is definitely something different that has happened to servicemembers during the Gulf War as opposed to what is happening to Soldiers now," said retired Col. Melissa Forsythe, program manager of the Congressionally Directed Medical Research Program.

"Today's Soldiers don't exhibit any of the same symptoms," Forsythe said. "We're talking about the same geographical region. So what happened to these servicemembers in 1990-91 that's not happening now? That's really the central question."

Chemical nerve agents, PB, and many of the pesticides to which Gulf War veterans were exposed belong to a class of chemicals called Acetylcholinesterase inhibitors.

These chemicals inactivate the enzyme Acetylcholinesterase, which is essential for breaking down the neurotransmitter chemical acetylcholine - a chemical which affects numerous bodily functions, according to the report.

Forsythe believes a mixture of the three items above in combination with vaccines given to Gulf War servicemembers can't be ruled out as a possible cause for Gulf War Syndrome.

The acute symptoms of excess exposure to Acetylcholinesterase inhibitors results in increased salivation and respiratory secretions, nausea, abdominal cramping, diarrhea, excess sweating, increased heart rate, and blood pressure.

Other side effects can include muscle twitching, cramps, weakness, tremors, paralysis, fatigue, mental confusion, headache, poor concentration, and general weakness. At sufficient doses, exposure to Acetylcholinesterase inhibiting chemicals can result in respiratory arrest and death.

Many of these side effects coincide with those of GWS.

Typically, Gulf War veterans exhibit a number of symptoms including chronic headaches, widespread diffused pain that moves to different parts of the body, fatigue, gastrointestinal problems, cognitive difficulties, skin rashes, and respiratory problems, said Forsythe.

Because of the wide range of symptoms, a diagnosis of GWS could be likened to finding a needle in a haystack, Forsythe said. There is no one test that will yield a definitive diagnosis for this illness that affects 25-32 percent of Gulf War veterans, she said, adding that the only way to diagnose the disease is to eliminate all other diseases with similar symptoms.

Today's GWS research focuses primarily on diagnosis and treatment rather than a single cure.

Studies focusing on the physical differences between ill and healthy Gulf War veterans may make a diagnosis easier and provide a much needed legitimacy to the illness.

"At first, servicemembers were told that the illness was all in their heads. So now, it's very validating for those servicemembers to see that there are real physical differences between themselves and the Gulf War Veterans that are not ill," said Forsythe.

Other GWS studies by the CDMRP include: research looking into the over-the-counter herbal supplement Co-enzyme Q10; the drug methylpristine, which may help with cognitive problems; and plans to look at self medications that Gulf War veterans have used and whether or not those were effective. Acupuncture is also being looked at for possible funding.

Currently, the only relief for GWS sufferers is to prescribe treatments for their individual symptoms, said Forsythe.

Unfortunately, record keeping practices during the Gulf War were not equal to today's standards, said Forsythe. Records on the use of Pyridostigmine Bromide and pesticides in theatre are virtually nonexistent.

PB had been approved, since 1955, for treatment of myasthenia gravis, a muscular disease. During the Gulf War, PB was not licensed for protection against chemical nerve agents by the U.S. Food and Drug Administration, but it was authorized by the FDA to be released to Soldiers in combat as an "investigational new drug" as a nerve agent pretreatment.

PB is now FDA approved as an effective pretreatment exclusively for the nerve agent soman and it is still issued to Soldiers for that purpose.

Pesticides are still used in theater, however, only a handful of those pesticides linked to GWS in the report are still in the Department of Defense's pest control inventory.

"Research is not necessarily fast, but is our best route in terms of helping people," said Forsythe. We know that people are out there suffering and they're trying to find their own remedies for symptoms. So our program, being focused on improving the diagnosis and treatments, is trying to get at the two prongs that can best serve those veterans who are ill."

Research Shows Elevated Disease Rates in Gulf War Veterans

Written by Anthony Hardie, 91outcomes

(91outcomes.blogspot.com) -- Recent news stories highlighted a 2005 study by Dr. Han Kang that showed significantly increased rates of unexplained multi-symptom illness among deployed veterans of the 1991 Gulf War.

However, several other studies by Dr. Kang and other researchers have also had significant findings for 1991 Gulf War veterans, including the following (follow the links for the cited study):

• Elevated rates of testicular cancer
• Increased deaths due to Brain cancer;
• Increased rates of Chronic Multisymptom Illness (CMI);
• Increased rates of Amyotrophic Lateral Sclerosis (ALS, or Lou Gehrig's Disease);
  
• Experiencing Clusters of neurological symptoms;
• Increased rates of Chronic Fatigue Syndrome (CFS);
• 6 subgroups among those with Fatigue Syndrome (FS): fatigue, pain, infectious, gastrointestinal, respiratory, and neurologic/mood/fatigue
• Increased rates of post-war hospitalization;
• Increased rates of depression and anxiety;
• Increased rates of death by motor vehicle accident.
  

Additionally, another important 2005 study by Dr. Kang and her research team had findings that "contradict the prevailing notion that perceived exposure to chemical warfare agents should be considered an important cause of morbidity [illness and disease] among Gulf War veterans."

Veterans of the 1991 Gulf War have been too ill, and for too long already. Effective treatments for the underlying illness have yet to be found or implemented.

Change is needed -- desperately.

ARMY TIMES ARTICLE: New study documents illness in Gulf War vets

By Kelly Kennedy - Staff writer
Posted : Friday May 22, 2009 12:13:19 EDT, The Army Times

A study funded by the Veterans Affairs and Defense departments found that Gulf War veterans have “significantly higher rates” of unexplained multi-symptom illness than veterans who did not deploy.

“Fourteen years after deployment, 1991 Gulf War veterans continue to report a higher prevalence of many adverse health outcomes, both physical and mental, compared with Gulf era veterans,” wrote lead author Han K. Kang of VA’s Environmental Epidemiology Service.

The survey compared Gulf War veterans to veterans of the same era who did not deploy to the Middle East. Researchers also found deployed veterans had been diagnosed with higher rates of chronic fatigue syndrome-like illness, post-traumatic stress disorder, functional impairment, health care use, and mental health disorders.

The study is important because few longitudinal surveys have been conducted to determine how many veterans are still sick or have become sick since they deployed in 1991.

The study found that twice as many vets who deployed stayed in bed or at home because they did not feel well within the two weeks prior to the study. And 29 percent of vets who deployed said their health affected their ability to work, compared to 19 percent of those who didn’t deploy.

Of 23 conditions listed in the study, veterans who deployed had significantly higher rates in all but three: skin cancer, “other cancer” and diabetes. They had significantly higher rates of all seven mental health disorders, including PTSD, depression and substance abuse disorder.

“Deployed veterans reported almost two times more functional impairment, a 50 percent higher rate of health-related activity limitation, and more clinic, doctors’ office visits, and inpatient hospital health care than the Gulf Era veterans,” Kang wrote. “Military service in the 1991 Gulf War appears to be continuing to affect the health status of veterans, which may impact future use of physical and mental health care services.”

Researchers also found that 25 percent more vets who deployed than those who didn’t reported that they had been diagnosed with multi-symptom illness, and three-fourths had first experienced it by 1995.

“Veterans with MSI had significantly poorer physical health and mental health summary scores, more clinic visits and hospitalizations,” the study states.

Researchers surveyed 9,970 veterans, 6,111 of whom had deployed. The results appeared in the April edition of the Journal of Occupational and Environmental Medicine.

Researchers worked from the 1995 National Health Survey of Gulf War Era Veterans and Their Families, which consists of 15,000 deployed troops and 15,000 troops who did not deploy.

VA Official Recycles Testimony While Nothing Changes at VA for ill Gulf War Veterans

Written by Anthony Hardie, 91outcomes

(91outcomes.blogspot.com) -- In a stunning discovery reported here at 91outcomes first, Dr. Lawrence Deyton, Chief Public Health and Environmental Hazards Officer in the Veterans Health Administration of the U.S. Department of Veterans Affairs (VA) recycled large portions of his Congressional testimony this week from testimony he gave to Congress nearly two years ago, on July 26, 2007.

This week's May 19th, 2009 hearing was a critical review by the powerful House Veterans' Affairs Committtee's Subcommittee on Oversight and Investigations, entitled Gulf War Illness Research: Is Enough Being Done?

Despite appearing with two other highly paid VA bureaucrats -- including Mark Brown, who not surprisingly also appeared with Deyton at the July 2007 Congressional hearing -- no one at VA apparently wanted to bother with writing much new for Deyton's testimony except filler justification on VA's traditional and by law reliance on the Institute of Medicine "for independent and credible reviews."

Whole paragraphs from the 2007 testimony were recyled into Deyton's testimony on Tuesday.

From countless veterans' accounts, there are literally thousands of employees within VA dedicated to the VA's mission of serving those have borne the battle and their loved ones, particularly at the VA medical centers and clinics across the country.

Yet, it is no wonder that VA health care providers have no new treatments to offer the 175,000 to 210,000 ill Gulf War veterans when the the callous indifference of VA officials in Washington like Lawrence Deyton can't even find new words to describe his work unit's lack of new findings that might help these ill veterans.

Ironically, one of the new statments in the closing comments of Deyton's testimony this week was, "VA is an evolving organization that operates in a rapidly changing environment."

Apparently that didn't apply to his own testimony, indicative of the lack of change of his work unit during the last two decades, which is still without treatments, answers, or information for ill Gulf War veterans, their health care providers, and their families.

Change is needed -- Desperately.

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.”

AIR FORCE TIMES: Groups disagree about Gulf War illness research

By Kelly Kennedy - Staff writer, Air Force Times
Posted : Thursday May 21, 2009 7:59:28 EDT

The Pentagon and Department of Veterans Affairs say an Institute of Medicine study shows there is no Gulf War “syndrome,” and that there is nothing unique about the symptoms 1 in 4 Desert Storm veterans suffer.

But the congressionally mandated Research Advisory Committee on Gulf War Illness say that not only is there a series of symptoms that make up a definable illness, they know what caused that illness.

Those opposing views were on full display May 19 in the first of three congressional hearings about Gulf War Illness.

“We do believe that Gulf War illnesses are real — but there is no unique set of symptoms,” said Craig Postlewaite, deputy director of force readiness and health assurance under the assistant secretary of defense for health affairs.

He based that view on the IOM study that concluded veterans’ symptoms vary too much to be seen as unique and recommended no more epidemiological studies.

“We feel like their assessment is complete,” Postlewaite told the House Committee on Veterans’ Affairs’ subcommittee on oversight and investigations.

The Gulf War advisory committee disagreed. “They have the same types and patterns of excess symptoms,” Lea Steele, immediate past scientific director of the committee, told lawmakers. “Our review provides a clear conclusion.”

She said the research shows that veterans who took the most pyridostigmine bromide — anti-nerve-agent pills — and used the most insect repellent, including flea collars, were most likely to suffer from the cluster of symptoms of known as Gulf War illness.

Victims of the sarin gas attacks in Tokyo as well as animal studies produced the same cluster of symptoms, she said. The pills, pesticides and nerve agent are similar chemicals, so it appears that troops essentially overdosed.

“Clearly, we need to get the research right,” said Rep. Dennis Kucinich, D-Ohio. “And the need to get it right is urgent.”

James Bunker, who served as an artillery officer in the war, provided an example of why.

Bunker had a history of rushing through high school in three years, a great love of chess and an aptitude for math. But during the hearing, he stumbled over words and a piece of paper in his hands shook as he read his testimony. He no longer plays chess because he lacks the cognitive ability to plan out his moves.

After deploying with the 5th Field Artillery Regiment, he said his unit’s chemical alarms sounded. Soon after, he developed breathing problems, muscle twitches, leg cramps, vomiting and convulsing. He was given an antidote for nerve agent and sent home to a hospital.

Now, he has nerve problems in his right leg and has lost the use of his right arm. He suffers headaches, cognitive dysfunction, gastric reflux disease, fibromyalgia, mouth sores, skin rashes and sinusitis.

“It’s hard to live a life where you can be talking to someone normally one minute and the next you can’t make a sentence to save your life,” Bunker said. “Often, VA tells me this is all in my head or it’s depression.”

Paul Sullivan, executive director of Veterans for Common Sense, said sick veterans want to know why they’re sick, where they can get treatment, and that their healthcare and benefits will be paid for by the country that sent them to war.

“VA should publicly recognize our illnesses,” he said.

Sullivan asked that VA be investigated to see if the IOM study was properly conducted. Congress mandated that study, but VA limited its scope to exclude animal studies and research where exposure dosage was unknown.

That defines much of the available research; no one kept track of how much anti-nerve agent troops took or measured the amount of sarin they were exposed to when the military blew up a massive Iraqi chemical depot just after the 1991 war, making it impossible to document exposure dosages.

In its work, the Gulf War illness advisory committee did include animal studies and research where the dosage was unknown.

Steele said about half of troops who deployed for the 1991 war took anti-nerve agent pills and used personal pesticides such as DEET, and were also exposed to sarin.

“We have no indication that any of them experienced any acute symptoms of exposure,” Postlewaite said.

“What about Bunker?” asked Rep. Phil Roe, R-Tenn.

“As you know, there are many reasons for seizures,” Postlewaite said, noting that current troops would again be given anti-nerve agent pills if battlefield commanders determined a need for them.

Sullivan also asked for training so VA doctors would be familiar with Gulf War illness — and that they be told it’s not a mental health condition.

Richard Weidman, executive director for policy and government affairs for Vietnam Veterans of America, asked that the government keep track of where current service members are located in the combat zones, and that VA include in their medical records a query of where veterans were located when they were deployed.

As it stands, there’s no way to look for patterns, he said. For example, if 30 veterans who all served in Baghdad develop brain cancer, VA would have no way to know whether this was a group that might have been exposed to a particular toxin.

“This is nuts,” Weidman said.

In one medical unit, he said, seven out of 150 people developed multiple sclerosis after serving in Desert Storm. “It’s astronomical. It doesn’t happen by chance.”

And it’s almost impossible to spot if no one keeps track of who served where, he said.

“If you don’t have the stats, you don’t have a problem,” Weidman said, implying that VA doesn’t want to know if there’s a problem.

“We have been and continue to be very concerned about these veterans’ health issues,” insisted Lawrence Deyton, chief public health and environmental hazards officer for VA’s Veterans Health Administration.

Deyton said Gulf War veterans experience symptoms at a rate 25 percent higher than veterans of that era who did not deploy.

But he acknowledged that VA could do better and said new VA Secretary Eric Shinseki has begin efforts to develop a simpler procedure for veterans to quickly and easily get benefits for service-connected ailments.

Congress decided to hold the series of hearings because of the new reports from the IOM and the research advisory committee, as well as the change in VA leadership.

Rep. Harry Mitchell, D-Ariz., chairman of the House Veterans’ Affairs oversight and investigations panel, said many questions still need to be answered.

In the end, Mitchell said, “We still don’t know how to respond to Gulf War veterans who ask: ‘Why am I sick? Will I get well again?’ ”

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.

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Mich. Gulf War Veteran Wins VA Claim After 15 Years

Written by Anthony Hardie, 91outcomes

(91outcomes.blogspot.com) -- Journalist Ted Roelofs had an excellent article in today's Grand Rapids Press about Michigan's state budget cuts to funding for claims service officers. Tucked down at the bottom was a reference to western Michigan Gulf War veteran Don Harp, for whom it took 15 years to "win" his disability claim from the VA.

According to the article, the Army veteran's claim was for "combat injuries, a closed-head injury, and Gulf War Syndrome."

For countless Gulf War veterans of the 1991 Gulf War and the service officers who have sought to assist them, VA's repeated denials of Gulf War veterans' claims has all too often been the norm rather than an exception.

The most current VA report on Gulf War veterans (Aug. 2007, pp. 7-8) shows that out of 696,842 veterans of the 1991 Gulf War, an astronomical 40 percent (278,149) filed claims for VA service-connected disability -- highlighting just how many Gulf War veterans have been significantly affected by their military service.

Veterans claims service officers have long known that filing for undiagnosed illnesses for Gulf War veterans is next to impossible to have approved. Even still, VA shows 12,788 claims filed by 1991 Gulf War veterans for undiagnosed illnesses, with only 26 percent (3,280) of those approved -- meaning 74 percent were denied!

The Grand Rapids article noted that Harp was among the veterans planning to protest the State's budget cuts that included a $1 million cut to funding for the state's 11 veterans service organizations that provide assistance to Michigan's veterans filing disability claims with the VA.

While Michigan's cuts are deeply disappointing and politically questionable, some underlying questions remain for the federal government, including Congress and the new Obama Administration.

First, for veterans like Harp, where is the outreach been that VA repeatedly told Congress it has been conducting?

The U.S. Senate perenially introduces legislation (S. 315 in the current Congress) that would define outreach for the VA and require VA to fiscally account for what it spends on outreach as a line item -- only to have VA officials protest that such legislation is unneccesary, and that VA is already conducting it. Certainly that's not true for Mr. Harp and the other 74 percent of Gulf War veterans claiming undiagnosed illnesses following their Gulf War service.

Second, where is the claims assistance that VA supposedly provides, as required by law under the Veterans Claims Assistance Act of 2000? Why did it take 15 years for this veteran to get his claim approved?

Third, what is VA doing to alleviate the fiscal burden on States and Counties that cause nearly every State and the Counties in about half the states to have to provide service officers to assist their veterans? Most veterans likely have no idea that with the exception of State Veterans Homes and Cemeteries, the benefits, programs, and services provided to them by their States, Counties, and veterans service organizations -- including assistance with VA claims -- is done without a dime of federal support.

Only the federal government creates veterans. So, why is it then left to the States, Counties, and innumerable Veterans Service Organizations to help veterans fight VA to get their claims approved (like the unnamed Catholic War Veterans service officer hometown hero who helped Harp)?

This valiant Vietnam and Gulf War veteran was given the final word in the Grand Rapids article: "Without these people, guys like me would have been shafted. If we have to hire attorneys, we are going to get shafted big time," Harp said.

Finally, the real story is that Gulf War veterans like Harp are still unable to receive effective treatments for Gulf War Syndrome. A November 2008 federal government report finally recognized that, "Gulf War illness is real, that it is the result of neurotoxic exposures during Gulf War deployment, and that few veterans have recovered or substantially improved with time." (p.17) Yet, despite years of effort by the Gulf War veteran community seeking effective treatment from VA, the report also noted:
who, the article noted, had to wait

"Substantial federal Gulf War research funding has been used for studies that have little or no relevance to the health of Gulf War veterans, and for research on stress and psychiatric illness....[and] overall federal funding for Gulf War research has declined dramatically since 2001....

"A renewed federal research commitment is needed to identify effective treatments for Gulf War illness and address other priority Gulf War health issues. Adequate funding is required to achieve the critical objectives of improving the health of Gulf War veterans and preventing similar problems in future deployments. This is a national obligation, made especially urgent by the many years that Gulf War veterans have waited for answers and assistance." (p.2)

Change is needed for our nation's Gulf War veterans -- desperately.