VA’s Limited Scope of Research Not Focused on Treatments Prevents Gulf War Vets From Getting the Benefit of the Doubt

Written by staff of the U.S. House of Representatives Committee on Veterans' Affairs
Contact Kristal DeKleer

Washington, D.C. – On Thursday, July 30, 2009, the House Veterans’ Affairs Oversight and Investigations Subcommittee, led by Chairman Harry Mitchell (D-AZ), conducted a hearing to analyze and evaluate the scientific information on Gulf War Illness Research. The hearing focused specifically on the differences between finding of the Research Advisory Committee (RAC) and the Institute of Medicine (IOM) and how VA uses this research to formulate policy. Gulf War Illness research is critical because the questions surrounding the science continually affect the claims, benefits, compensation, and treatment of the veterans who served in the first Gulf War.

The United States deployed nearly 700,000 service members to the Persian Gulf in support of Operations Desert Shield and Desert Storm, beginning in 1990. Gulf War veterans were exposed to a multitude of toxins, agents and chemicals that were not documented. This created a challenge with the science and research since the amount and combination of chemicals is an unknown and cannot be replicated or studied in humans or animals. As a result, there are many veterans with undiagnosed illnesses and multi-symptom illnesses as a result of serving in the first Gulf War who are still suffering from toxin exposure and are fighting the VA to have Gulf War Illness recognized as a service-connected condition.

“We have learned and will continue to learn that Gulf War Illness Research is a challenge and a missing link appears to be a lack of documentation of exposure and compounds that exposed our veterans,” Chairman Mitchell said. “The future and direction of this research is vital because the questions surrounding the science continually impact the claims, benefits, compensation and treatment of veterans. This series of hearings has shed light on the fact that we aren’t doing enough for our Gulf War Veterans who deserve closure and recognition for what they have sacrificed in service for their country.”

In 1998, Congress mandated the appointment of a public advisory panel of independent scientists and veterans to advise the VA on federal research studies and programs to address the health consequences of the Gulf War. As directed, VA contracts with IOM to obtain independent and objective professional opinions concerning available scientific evidence. IOM has produced several studies with research parameters set by Congress regarding Gulf War Exposures.

The VA’s Research Advisory Committee (RAC) was appointed by the Secretary of Veterans Affairs in 2002 and directed to evaluate the effectiveness of government research in addressing central questions on the nature, causes, and treatments of Gulf War-related illnesses.

While both IOM and RAC agree that Gulf War Illness exists, the two organizations do not agree on the methodologies of the scientific research and come to markedly different conclusions. One major difference is how diagnosed and undiagnosed illnesses were evaluated. Currently, no diagnostic tests exist that allow diagnosis for Gulf War Illness, and undiagnosed illnesses are self reported. The other difference is how animal and human studies and findings were evaluated in formulating findings.

Dr. Lea Steele, former RAC scientific director, testified, “I want to be clear that members of the RAC have great respect for the IOM, generally, and were not anxious to criticize IOM’s Gulf War reports…. The differences between the RAC and IOM reports are not subtle, and are not explained by minor variations in the review methods used or how individual study results were interpreted or weighed. Rather, they are the result of major differences in the scope of questions addressed by the two reports, and the scope of the evidence used to answer those questions.”

“The research surrounding Gulf War Illness is complicated for many reasons – lack of veteran immunization records, little or no knowledge of specific chemical exposure, inadequate or nonexistent pre and post deployment health assessments,” said Bob Filner (D-CA), Chairman of the House Committee on Veterans’ Affairs. “What is not complicated is that Gulf War Illness exists. We cannot ask veterans to wait for 100% scientific evidence, but instead must act to provide care and medical treatment. The future of research is critical to America’s service members serving on the battlefield today, as well as our veterans who deserve closure and recognition for their sacrifices.”

Witness List

Panel 1:

· Lynn Goldman, M.D., MPH, Professor, John Hopkins University Bloomberg School of Public Health, Member, Committee on Gulf War and Health, Institute of Medicine, The National Academies

Accompanied by:

o Roberta Wedge, M.S., Senior Program Officer, Institute of Medicine, The National Academies

· James H. Binns, Chairman, Research Advisory Committee on Gulf War Veterans' Illnesses

· Lea Steele, Ph.D., Former Scientific Director, Research Advisory Committee on Gulf War Veterans’ Illnesses, Adjunct Associate Professor, Kansas State University School of Human Ecology

Panel 2:

· Robert W. Haley, M.D., FACE, FACP, Professor of Internal Medicine, University of Texas Southwestern Medical Center

· Roberta F. White, Ph.D., Professor and Chair of the Department of Environmental Health, Associate Dean for Research, Boston University School of Public Health

· Anthony Hardie, Madison, WI, Gulf War Veteran

Panel 3:

· Douglas E. Dembling, Associate Chief Officer for Program Coordination, Office of Public Health and Environmental Hazards, Veterans Health Administration, U.S. Department of Veterans Affairs

Accompanied by:

o Victoria A. Cassano, M.D., MPH, Acting Chief Consultant, Environmental Health Strategic Health Care Group, Veterans Health Administration, U.S. Department of Veterans Affairs

o Joel Kupersmith, M.D., Chief Research and Development Officer, Office of Research and Development, Veterans Health Administration, U.S. Department of Veterans Affairs

o David Barrans, Deputy Assistant General Counsel, Office of General Counsel, U.S. Department of Veterans Affairs

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Prepared testimony for the hearing and a link to the webcast from the hearing is available on the internet at this link: http://veterans.house.gov/hearings/hearing.aspx?newsid=455

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DALLAS NEWS EDITORIAL: A victory for Gulf War health research

Written by editorial staff, Dallas Morning News

05:22 PM CDT on Tuesday, July 28, 2009

The U.S. Department of Veterans Affairs and UT-Southwestern researchers had bumped heads so often that the VA's inspector general recently recommended that it cut off funding to the Dallas school's research into the causes of Gulf War illnesses.

Thankfully, cooler heads seem to have prevailed due to the intervention of Sen. Kay Bailey Hutchison and U.S. Rep. Chet Edwards of Waco. They say both sides are making reasonable concessions to keep this vital research project alive.

That would be good news for thousands of veterans who returned home with mysterious, debilitating illness after ousting Saddam Hussein's troops from Kuwait in 1991. It also would be a victory for UT-Southwestern's Robert Haley, who for years was a lone researcher pursuing the roots of Gulf War illnesses.

Whatever caused them remains a mystery. Possibilities include reactions to nerve gas, nerve gas vaccines, other chemical weapons, pesticides, depleted uranium munitions or some combination. Whatever it was, some returning veterans had their lives turned upside down and still don't know why.

We hope the VA and UT-Southwestern are beyond the squabbles that had festered since Hutchison earmarked the original $75 million in 2005 to fund the five-year research program. The VA wanted researchers to provide medical records of veterans in the study, causing UT-Southwestern officials to balk and press for assurances that the records would not be used to deny benefits. UT-Southwestern also fought over payments for work rendered: Researchers had incurred about $19.2 million in expenses, billed the VA for $15.5 million but received only $9.1 million. Over time, these clashes almost brought the program to a sudden end, before Texas lawmakers played Dr. Phil.

UT-Southwestern now says it will provide the records the VA wants in the form that VA officials want. In turn, the VA promises to not use the research to deny benefits. The sides also are working to resolve the payment dispute.

As this disputes fades, we look forward to hearing what Haley will tell a Congressional subcommittee Thursday about Gulf War illnesses. He theorizes that the troops were exposed to something over there that caused their illnesses. However, some scientists disagree whether the illnesses are related to Gulf War service or whether the symptoms are more prevalent among veterans than among the general population.

The fact that the causes of Gulf War illnesses remain unknown nearly two decades after the conflict is precisely the reason this research is so important. Findings could change the lives and treatment options for thousands who served their country. These men and women deserve answers.

Georgia Gulf War Veteran with Gulf War Syndrome loses job, sues

By Jameson Cook, Macomb [Georgia] Daily Staff Writer

A former county public works employee has accused the department and his bosses of discrimination for having him clean toilets, work out of a closet and forcing him to resign due to his Gulf War Syndrome affliction.

Steven E. Hohensee Jr., 35, of New Haven, filed a discrimination lawsuit Wednesday against Macomb County Public Works Commissioner Anthony Marrocco, public works operations manager Dino Bucci and the public works department. He is asking Judge James Biernat of Macomb County Circuit Court to award him back pay and benefits, exemplary damages and re-employment with the county.

Hohensee said he was hired in January 2003 as an engineering technician and resigned in August 2007 after he was harassed. He said he was forced to work out of a broom closet, a sewer station and to clean toilets and sewers. Hohensee "resigned ... under protest, as having been subjected to a design by Defendants for constructive discharge," the lawsuit says.

Hohensee's attorney, Lawrence Schloss, could not be reached for comment Friday.

Marrocco's chief deputy, William Misterovich, said Friday his office had not yet been served with the legal papers and could not comment at this time.

Hohensee says in the lawsuit the defendants "were aware at all times" that he suffered from Gulf War Syndrome. With the knowledge of his superiors, he participated in "rehabilitation" regarding his condition in early 2007. His physician evaluated him on June 25, 2007, and indicated Hohensee could return to his job as an engineering technician.

But the defendants, the lawsuit says, required him to undergo a second examination, after which the physician said he should return to his post July 9, 2007, without restrictions.

From that date until his resignation about five weeks later, the lawsuit contends that Hohensee suffered from "adverse employment action and work place harassment" and written reprimands "for previously approved sick leave and (family) leave."

He was assigned to the broom closet, which he protested, and then was assigned to a sewer cleaning station to clean sewers and toilets, "accompanied by demeaning remarks and conditions for plaintiff's skills and job qualifications."

UK Govt Under Fire for Treatment of its Veterans, including on Gulf War Syndrome

Editor's Note: A July 27 article in The [London] Times written by The Times Home Staff, entitled, "From bomb tests to Gulf War Syndrome: battles the MoD won and lost," summarized the outcomes of several financial battles between the British defense department and its veterans and civilians. The struggles are not unlike those faced by the veterans of Britain's transatlantic former colony, the U.S.

While the full story is certainly worth reading, for the sake of space, only the Gulf War Syndrome portion is below:

Gulf War Syndrome. Up to 6,000 British troops complained of illnesses ranging from violent mood swings and extreme fatigue to blood disorders. Despite many studies the MoD found no evidence to support the existence of the syndrome. That stance was criticised in a pensions appeal in November 2005, forcing the MoD to acknowledge the term and award thousands of war pensions.

The full text of a parallel, same-day Times story written by Suzy Jagger and Deborah Haynes, entitled, "MoD under fire for trying to cut compensation for wounded soldiers," follows:

(London - July 27, 2009) - Critics said that the MoD’s treatment of wounded servicemen, some of whom have returned home injured only to start fighting the ministry over compensation, was “unseemly”.

The response followed a series of misjudgments by the MoD over its duty of care to troops and those working with them, spanning secrecy at inquests for soldiers killed in friendly fire incidents, help for Iraqi interpreters who worked for the British and settlement rights for Gurkhas to Gulf War Syndrome and exposure to atomic bomb tests in the 1950s.

Sir Malcom Rifkind, who was Tory defence secretary from 1992-95, told The Times: “This problem is not new. When I was defence secretary, medical advice given to the MoD was that post-traumatic stress disorder did not even exist. While that debate is behind us, the issue of how to compensate personnel who have suffered physical or mental injury is still on-going.”

He added: “Part of the problem is that there are two different cultures rubbing alongside one another within the department — a Civil Service culture and a military one. While they worked pretty well together most of the time, problems arose when there was a non-military phenomenon which had to be established as being caused by military experience — such as post-traumatic stress disorder.

“The real issue here is scale — how much should be paid in compensation for injury. Of course, such payments should be generous. Awards always used to be made and the system existed for many years, but problems arose when courts began to award very high settlements in civil cases.”

Currently, soldiers who are injured in the course of duty are compensated under the Armed Forces Compensation Scheme, set up in 2005. But recent generous civil payouts have exposed the shortcomings of the arrangement. This week’s case centres on compensation awarded to Anthony Duncan, a soldier with the Light Dragoons, and Matthew McWilliams, a Royal Marine. Both men sustained severe leg injuries, one in training and the other in Iraq, and managed to increase significantly the sums awarded to them by appealing to a tribunal.

The MoD, concerned at the prospect of a big rise in the level of payouts, went to the High Court to try to overturn the ruling and suspended disbursements for three months for all but the worst injuries.

Robert Key, the Tory MP for Salisbury and a member of the Commons Defence Select Committee, said: “The MoD is in an extraordinary situation. Their keenness to avoid any overpayments is pretty unseemly and the public is up in arms against them because of the way they have treated the injured when they come home. A lot of public support for the MoD and the Government has been lost over this.”

He added that there were tensions within the MoD about how to handle the crisis. “The MoD is a hybrid of military people and civil servants. There is a complete lack of direction within the department about how to handle this and they also have the Treasury breathing down their necks the whole time making sure they have a tight rein on spending.

“But we will see a lot more of this because it is all getting much more litigious. The real issue is that the MoD have a duty of care, an obligation to the Armed Forces and they need to work out how they meet that.”

Jerome Church, a retired colonel and secretary-general of the British Limbless Ex-Service Men’s Association, said that a forthcoming review of compensation should be opened up to involve outside experts rather than be kept within the MoD.

An independent review would help to establish confidence in the scheme, he said, adding: “It will also have the effect of demonstrating that the Government of the day really does value our Armed Forces.”

Richard Younger-Ross, the Liberal Democrat MP for Teignbridge who is also a member of the Defence Select Committee, said: “The MoD has failed to recognise a proper compensation structure. Unfortunately, this issue has blighted Britain for generations — it has never been adequate.

“At the end of the First World War there was a campaign called Homes Fit for Heroes. It was a big issue then, too.”

An MoD spokesman said: “We are committed through the Armed Forces Compensation Scheme to paying appropriate compensation to wounded service personnel.

“It is not appropriate to compare the Armed Forces Compensation Scheme to civil negligence awards. The Armed Forces Compensation Scheme is a no-fault scheme. This means it is not necessary to go to court or prove negligence in order to receive an award, unlike civil damages cases.”

Gulf War illness research threatened by VA, UT-Southwestern disputes

Written by SCOTT K. PARKS / The Dallas Morning News

12:20 AM CDT on Sunday, July 26, 2009

(Dallas, July 26, 2009) - The UT Southwestern Medical Center conference room was brimming with dignitaries on April 21, 2006. U.S. Sen. Kay Bailey Hutchison and Dallas billionaire Ross Perot looked on as university administrators and the federal government agreed to spend $75 million to research the causes of Gulf War illness.

More than three years later, the U.S. Department of Veterans Affairs has spent only a fraction of the earmarked money, and contract disputes between the VA and UT Southwestern are threatening the entire project run by noted epidemiologist Robert Haley.

The parties who set up the project – the VA, UT Southwestern and Hutchison – say they are working to resolve the disputes and keep the contract going.

"We are going full tilt," Haley said last week. "My understanding is that we are doing research and not to worry."

But a flurry of behind-the-scenes activity this month indicates that plenty of people were worried about the future of Haley's investigation into why so many 1991 Persian Gulf War veterans suffer from chronic fatigue, loss of muscle control, headaches, dizziness, memory loss and joint pain.

A critical report issued by the VA's inspector general on July 15 sheds light on years of infighting and conflict between the VA's contract managers and UT Southwestern.

The main dispute centers on Haley's reluctance to fulfill a contractual obligation to provide the VA with some medical records of the veterans who participate in his study, according to the inspector general.

When Gulf War veterans sign up to participate in research studies – they subject themselves to sophisticated MRI brain scans and other tests – they must sign forms consenting to share their medical records with researchers.

Haley declined last week to talk about his position on the consent forms.

Tim Doke, UT Southwestern's vice president of communication and public affairs, said Haley and his team were concerned about veterans' privacy. But Doke acknowledged that researchers will retrace their steps and get the veterans to sign new consent forms acceptable to the VA.

"We are going to re-consent the veterans in the study so the amount of information the VA needs is available to them," he said. "Everyone is working in good faith."

The report also criticizes UT Southwestern for ignoring contract provisions requiring protection of veteran medical data and privacy.

"Given UTSWMC's continued refusal to comply with the terms and conditions of the contract, UTSWMC has given VA no option other than to terminate the contract for default," the inspector general report said.

Sen. Daniel Akaka, D-Hawaii, chairman of the Senate Veterans Affairs Committee, wrote to VA Secretary Eric Shinseki the day after the inspector general's report became public.

"I ask that you look into this matter immediately and implement the recommendation to terminate the contract for default so that VA's funds can be directed to research projects that will help those veterans affected by Gulf War Illness," Akaka wrote.

What's at stake

Millions of dollars are at stake, and Jim Bunker is among the many Gulf War veterans who want the money to keep flowing to UT Southwestern and Haley.

Bunker, now 50 and living in Topeka, Kan., was an Army artillery officer in the Persian Gulf from December 1990 to May 1991. He believes he was exposed to nerve gas after American troops blew up Iraqi ammunition dumps.

The VA classifies Bunker as 100 percent disabled from post traumatic stress disorder. He suffers from headaches, chronic fatigue, body aches and diminished ability to think clearly. He doesn't believe his symptoms result from stress. Instead, he blames his problems on battlefield exposure to toxic chemicals.

Bunker said Haley is the only researcher who is pursuing the real causes of Gulf War illness, which affects the brains of an estimated 200,000 veterans.

"They need to quit messing with our health care and just let him do his work," Bunker said. "He is not wasting the money."

When the VA and UT Southwestern inked the research contract in 2006, the deal was said to be worth $75 million in federal funding – $15 million a year for five years.

Today, no one is quite sure how much of that $75 million UT Southwestern will see.

Doke said Haley and his team have incurred an estimated $19.2 million in expenses so far. UT has sent an estimated $15.5 million worth of invoices to the VA and has received $9.1 million in reimbursement payments.

"This is not a trivial gap," Doke said.

The reimbursement gap stems from the disputes between VA contracting managers and UT Southwestern administrators. They've been disagreeing about whether researcher salary scales are justified and whether UT Southwestern or the VA should end up owning computers and other equipment purchased for the Gulf War illness project.

But the main bone of contention was how much medical information and data on human research subjects UT Southwestern is obligated to share with the VA.

The inspector general says that the VA's contract required Haley and his staff to share medical information with the VA and that the information would become the exclusive property of the VA.

In October 2008, Haley and his staff "unilaterally changed" the informed consent forms that veterans must sign to participate in the study, according to the inspector general's report. The changes, in effect, were designed to prevent the VA from getting some medical records.

It seems that Haley and his staff felt many veterans feared that the VA might somehow use the medical data to deny them benefits.

"The principal investigator [Haley] has not provided any evidence to support his conclusions," the inspector general's report said.

'Syndrome' label

The contract dispute between the VA and UT Southwestern is only the latest controversy surrounding the study of Gulf War illness.

Haley is a leading proponent of the theory that the multiple symptoms reported by thousands of Gulf War-era veterans should be labeled a "syndrome."

The symptoms are caused, he believes, by battlefield exposure to toxic agents such as pesticides, radioactive material used in armor-plated vehicles, sarin nerve gas and pills that veterans took as an antidote to nerve gas.

Others are not convinced. Some researchers believe the sick veterans suffer from psychological disturbances similar to post traumatic stress disorder.

"Our end-point goal here is to hand the VA a diagnostic test that they could then franchise out to all VA medical centers and see how many veterans have this brain illness," Haley said last week. "And then everyone can develop a promising set of treatment ideas."

A change in parties

The politics in Washington have changed dramatically since Hutchison obtained federal funding for the UT Southwestern project in 2005. Back then, she and her fellow Republicans controlled the House and Senate. And Republican President George W. Bush controlled the VA and other federal agencies.

Democrats now control both houses of Congress and President Barack Obama is in the White House, where everyone remembers that Texas went for Sen. John McCain in the 2008 presidential election. Obama's appointee, Shinseki, is now secretary of veterans affairs.

Privately, UT Southwestern and its supporters know the politics don't bode well for a smooth path to federal funding. U.S. Rep. Chet Edwards of Waco, who chairs the House Appropriations subcommittee on military construction and veterans affairs, may be UT Southwestern's ace in the hole in Washington. He is an influential Democrat on Capitol Hill.

Publicly, Hutchison, the VA and UT Southwestern are saying they want to put veterans' health care above bureaucratic bickering.

"I think there has been a legitimate disagreement, and that has caused a lot of delay," Hutchison last week. "Now, we've cleared the air and I have every confidence that this research will go forward."

Hutchison's confidence is based, in part, on a July 15 letter she received from Shinseki, who promises that "the VA has no intention" of using Haley's research in connection with VA determination of benefits for individuals who participate in the UT Southwestern study.

"As we have discussed," Shinseki wrote to Hutchison, "I very much want to see this study pursued to a successful conclusion."

AT A GLANCE: INSPECTOR GENERAL'S REPORT

The Office of Inspector General of the U.S. Department of Veterans Affairs reviewed a contract under which the VA is funding UT Southwestern Medical Center's research into the cause of Gulf War illness. Among the office's findings:

•The VA and UT Southwestern have struggled over which entity owns the data generated by research on thousands of Gulf War veterans suffering from various illnesses.

•UT Southwestern tried to prohibit the VA from getting access to some information gathered in the project. Both sides said they were concerned about veterans' privacy.

•The method that UT Southwestern used to calculate researcher salaries did not allow the VA to determine whether those salaries were proper under the contract.

•VA officials claimed ownership of all equipment that cost $5,000 per item – such as laptop computers. Only later did the VA realize that the contract stipulates that the equipment is owned by UT Southwestern.

•VA contract officers repeatedly rejected UT Southwestern invoices for reimbursement of expenses because they contained errors about unauthorized travel, salary rates and other matters.

•The VA and UT Southwestern argued about training of research personnel. UT asked the VA to waive some requirements under the contract, but the VA denied the request.

•In an effort to work more closely together, the VA moved personnel onto the UT Southwestern campus to work with researchers. But the VA provided its people with laptops that didn't have the proper software to do their jobs.

SOURCE: Department of Veterans Affairs, Office of Inspector General

sparks@dallasnews.com

Ill Missouri Gulf War Veteran on His Way to D.C. on His Tractor

Written by Gulf War veteran Michael Woods, on the blog, Matt Letterman's Tractor Ride to DC

July 25, 2009

Matt Letterman Hits the road Headed to Washington DC in search of real HELP from the Department of Veterans Affairs.

He left his rural Missouri home on his John Deer Tractor Yesterday.

Matt has been fighting for real help from the Department of Veterans Affairs for years now. While the VA agrees that he is Disabled beyound the ability of holding any real job. They have used loop holes in the laws to deny him the real help that he has been in need of for years.

Matt served in Operation Desert Storm in 1991 and has been suffering from disabiling illness ever since.

Gulf War Veterans pressed for passage of landmark legistlation in 1998 to help Gulf War Veterans with illnesses difficult or impossible for the VA to Diagnosis. In Matts case the VA is ignoring this important law. Under this law illnesses that remain undiagnosed for more than six months require the VA to rate these illnesses under the law specifically written for ill Gulf War veterans. Sadly, even to this day ill Gulf War veterans suffer these injustices because the VA does not require it's Health Care providers and Veterans benefits officials to be conversant in the laws and multi-symptom illness veterans face. A stark example of the ambivalence of the VA is the Veterans Health Initiative (VHI) Gulf War Veterans Health found on the web at http://www.publichealth.va.gov/exposures/gulfwar/ This document produced by the VA is a guide to clinicians on the illnesses veterans face. The Research Advisory Committee of Gulf War Illness has been trying for 5 years to get the VA to update this guide to reflect current science and understanding on the illness but the VA continues to resist. That is why Matt was not rated properly, because the VA does not follow Congressionally mandated laws and it's Doctors don’t know what the current science says about the multi-symptom illness.

Here is a YouTube video about Matt
http://www.youtube.com/watch?v=fScb9awKf6o

If you want to help email lpgulfvet@aol.com or comment on this post and we will help get you in contact with Matt

At this moment 5:22 pm Saturday July 25th 2009 Matt is just outside of Paducah In the morning he will start his way across the state of Kentucky.

For more information on Gulf War Veterans Facts contact The National Gulf War Resource Center (NGWRC) Jim Bunker at 866-531-7183 or http://www.ngwrc.org/

Meaningful Week Ahead for Gulf War Veterans

Written by Anthony Hardie, 91outcomes

(91outcomes.blogspot.com - July 25, 2009) - The week ahead promises to be meaningful for veterans of the 1991 Gulf War, with a Congressional hearing on Gulf War Illness research timed in the middle of a joint leadership conference of the National Gulf War Resource Center (NGWRC) and Veterans of Modern Warfare (VMW).

The Congressional hearing, entitled, "The Implications of U.S. Department of Veterans Affairs' Limited Scope of Gulf War Illness Research," is the second in an investigative series on Gulf War illness research being conducted by the Subcommittee on Oversight and Investigations of the U.S. House of Representatives Commitee on Veterans' Affairs. The hearing will be held on Capitol Hill in Washington, D.C. on Thursday, July 30, beginning at 10:00 a.m. in the Committee's hearing room located at Room 340 in the Cannon House Office Building.

At the same time, the joint VMW and NGWRC Leadership Conference is being held at the Galt House Hotel & Suites in Louisville, Kentucky between July 27 and August 2, 2009, in conjunction with the national convention of Vietnam Veterans of America (VVA) and its sister supporting organization, Associates of Vietnam Veterans of America (AVVA).

Among the joint events key to Gulf War veterans and their advocates will be a presentation entitled, "Veterans of the 1991 Gulf War: Bittersweet Victory, Treatments on the Way?" and workshops on Gulf War veteran's VA claims and accessing military unit records through the federal Freedom of Information Act (FOIA), which may help to provide documentation support for these claims.

Other presentations slated for the joint leadership conference include veteran suicide prevention, Dryhootch of America, and VetJobs, and viewing a documentary by David Block, entitled, “Abandoned Heroes."

The joint leadership conference will also include presentations and workshops relevant to VMW's growing number of local chapters, including presentations entitled, "“Member/Leadership Outreach," “Forming a Chapter/Incorporation," "Conducting a Meeting/Documentation,” and, “Chapter Activities/Community Relations." Other workshops include VMW's national communications, including “VMW Website," “Social Networking,” and “Skype,” and a seminar entitled, "VMW–Adapting to the Mission."

The joint conference is scheduled to be rounded out with separate and joint business meetings, a Veterans Mall, and joint opening and closing ceremonies and an evening banquet with VVA and AVVA.

More information on the joint events, including registration, lodging, and agendas, is available from VMW, NGWRC, VVA, and AVVA.

Study Attributes Tripled Cancer Rates Among All Veterans to DU

Written by Kelly Kennedy - Staff writer, Army Times publications
Posted : Wednesday Jul 22, 2009 14:14:01 EDT

A new study shows that while active-duty service members have lower rates of cancer overall than civilians, they have higher rates of breast cancer and double the rates of prostate cancer.

And though that could be attributed in part to early screening efforts, the authors suggested prostate cancer rates have gone up as a result of troop exposure to depleted uranium, while breast cancer rates may have risen because military women are more inclined to use birth control pills and be exposed to industrial chemicals at levels most civilian women avoid.

In the June edition of Cancer Epidemiology Biomarkers & Prevention, lead writer Kangmin Zhu, of the Uniformed Services University of the Health Sciences, and colleagues stated that they wanted to find out if regular exercise and good health care, combined with a population that had been screened for major health issues, would yield lower rates of cancer.

They also wondered whether service members, who smoke at higher rates than civilians do, would have a higher rate of lung cancer. And the researchers also wanted to see whether sun exposure, as well as other deployment exposures such as immunizations and depleted uranium, would influence results.

But looking at the years 1990 to 2004, they found that colorectal cancer rates were “significantly lower” in the military population for white men; lung cancer rates were lower for white and black men, as well as white women; and cervical cancer rates were lower in black women.

However, breast and prostate cancers for military personnel were “significantly higher” among whites and blacks. Prostate cancer increased over that time for both the civilian and military populations, but the civilian rate doubled, while the rates for white male troops tripled.

Researchers again reasoned that this may be because of early screening — the cancer is being identified early.

“Several studies have now confirmed that cancer screening is associated with increases in breast and prostate cancer incidence rates,” Zhu wrote.

But there may be other reasons: A recent study shows 34 percent of female service members use oral birth control pills, compared to 29 percent of the general population. The pills have been linked to breast cancer.

“Military women are also more likely to be engaged in industrial jobs than females in the general population and hence potentially more likely to be exposed to chemicals that may be related to breast cancer,” Zhu wrote.

A study of military women 34 and younger find higher breast cancer rates than civilians, and the rate was even higher for those military women exposed to volatile organic chemicals as part of their work.

Zhu also linked prostate cancer to exposure.

“Although the results have been inconsistent, depleted uranium has been suggested to increase the risk of prostate cancer,” Zhu wrote. “Because military personnel are more likely to be exposed to depleted uranium, these factors may have contributed to the increased risk for prostate cancer in military members, although most of the elevated rates and more dramatic increase over time in rates in military personnel may be attributed to screening in the population.”

Testicular cancer rates were about the same for both populations.

Zhu reasoned that some cancer rates might be lower because service members are more likely to go in for cancer screening because they have free health care. Precancerous lesions and polyps might be treated early. Colorectal cancer rates may be lower for troops because they are less likely to be overweight and are more physically active.

Researchers were surprised to find, however, that lung cancer rates were lower in the military in all groups except black women. Troops smoke more than civilians do, but the researchers said service members are more likely to begin smoking as adults — rather than in their teens, as civilians tend to do.

“Cigarette smoking is the single most important risk factor for lung cancer,” Zhu wrote. “Therefore, the lower rate of lung cancer in military personnel is an unanticipated finding.”

The researchers used data from the military’s Automated Central Tumor Registry, as well as the civilian Surveillance, Epidemiology and End Results program for the National Cancer Institute. They adjusted the civilian data to include only those age groups one might expect to find in the military.

The full report is available online.

VA Fails Gulf War Veterans Yet Again

Written by Kelly Kennedy - Staff writer, Army Times publications, Friday Jul 17, 2009 15:09:56 EDT

(WASHINGTON, D.C.) - After the Inspector General for the Department of Veterans Affairs issued a report Wednesday stating that a university had violated a contract for research on Gulf War Illness — and that VA had wrongfully awarded the contract in the first place — a lawmaker called for canceling it entirely.

“I ask that you look into this matter immediately and implement the Inspector General’s recommendation to terminate the contract for default so VA’s funds can be directed to research projects that will help those veterans affected by Gulf War Illness,” wrote Sen. Daniel Akaka, D-Hawaii, in a letter to VA Secretary Eric Shinseki dated Thursday.

The contract confusion has wasted more than two years and millions of dollars that could have been used to help veterans, according to the report.

But Paul Sullivan, executive director of Veterans for Common Sense, asked that a new contract be reinstated so that several years’ worth of research into the connection between sarin, pesticides and anti-nerve agent pills to Gulf War Illness will not be lost.

“We hope VA and Congress and the University of Texas can cooperate to fix the minor contracting issues,” Sullivan said. “We believe independent research must go forward.”

The process for the $15 million undefined service contract went badly from the start, according to the IG report.

VA’s Office of Contract Review said the department should offer the University of Texas Southwestern Medical Center at Dallas a grant to do research pertaining to Gulf War veterans. But because VA didn’t want to take extra time to seek grant authority, it assumed — incorrectly, according to the IG — that it had to give the university the right to identify, conduct and manage research projects under the contract to comply with congressional rules for the use of such funds.

“Because VA did not have a defined need, the scope of the contract and the work performed under the task orders issued against the contract was dictated by [the university], including the review and approval of every research project to be conducted,” the IG report said.

In essence, the IG said, “The contract was merely a funding mechanism to support [the university’s] research program.” [Editor's Note: That's exactly right - making it all the more unclear to Gulf War veterans and their advocates why VA is failing to implement the program.]

The IG cited other failures, including the lack of a required pilot study in collaboration with the university, and a change made by the university in the parameters of the study that was at the heart of the contract, which the school did not report to VA. The department did not learn of the change until several months after the fact, the IG said.

According to the report, the university has been in default on the contract since Oct. 2 because it refused to allow VA access to patient data gathered in the study. The IG said VA should terminate the contract.

“Gulf War Illness is a serious disorder affecting many veterans,” Akaka wrote in his letter to Shinseki. “Only through focused, serious research will we be able to truly understand this illness.”

VA officials did not respond to requests for comment.

University officials say they also hope to see the research continued.

“We have been in discussions with [VA] for some time and believe we have reached an agreement how we can move forward,” said John Walls, assistant vice president for public affairs at UT Southwestern Medical Center. “But it would be inappropriate and premature for us to provide any specific detail.”

Gulf War Veteran M.D. Appointed to VA

Senior Policy Advisor for Health Affairs Stephen Ondra

Written by Rachel Hatch, Illinois Wesleyan University news, July 17, 2009

(BLOOMINGTON, Ill.) - Illinois Wesleyan University alumnus Stephen Ondra has been appointed by President Barack Obama as the Senior Policy Advisor for Health Affairs in the Office of the Secretary at the Department of Veterans Affairs.

Ondra, a 1980 alum who has built a reputation as one of the most renowned neurosurgeons in the nation, will advise Secretary Eric K. Shinseki on developing policies and initiatives aimed at the health system for veterans.

A veteran of the of Operations Desert Shield and Desert Storm, Ondra was awarded a Bronze Star and the Army Commendation Medal during his service as a military doctor. “I have always believed that public service is a calling and an honor,” said Ondra, who hopes his knowledge of both the military and medicine will be of assistance in Washington. “I believe that I have a relatively unique combination of experiences that help me understand the changes needed in our health system in general, and for our Veterans in particular.”

Ondra spent months on the campaign trail for President Obama, advising on veteran and health issues, but said they never discussed a White House appointment. “The mantra of ‘no drama, no ego and no promises,’ was a real way of life [on the campaign],” said Ondra. “Everyone was working to get the President elected and the country headed in a new direction.”

Ondra is no stranger to Washington. For decades, he has been advising members of the Department of Defense, Congress and the Executive Branch on health care issues. This is, however, his first government appointment, and one that is tackling the intricate issue of health care for veterans, and the overall health care system. “The complexity of the issues and the needed solutions are daunting,” said Ondra. “The current system is both economically unsustainable and fails to give the country the value that we need or the quality we should have. We can and must do better.”

Stephen Ondra, a 1980 Illinois Wesleyan alumnus, walked down the steps of The Ames Library with Professor Emeritus Bruce Criley during Homecoming of 2008.

As the director of spine surgery in neurosurgery at Northwestern University in Chicago, Ondra was used to long hours, a schedule he continues at the White House with 12- to 14-hour-days being the norm. Ondra took a leave of absence from Northwestern to accept the appointment in the Obama Administration, and moved his family to Washintgon. “Luckily, my wife and children understand the importance of this work,” said Ondra of relocating his family. “Having been in the military, my family already understood and appreciated that it is not just the service member or public servant that serves, it is the entire family.”

Ondra said he is proud to be able to take a role in what he calls “historic times,” and looks forward to the work ahead. “Being able to help address those challenges as a part of the Obama Administration, is challenging, exciting and humbling. Fortunately, the people that I work with and have encountered in the administration, as well as across government, are the brightest and most dedicated group of people that I have ever had the privilege to work with.”

Earning his medical degree from Rush Medical College in 1984, Ondra performed his surgical internship and neurosurgical residency at Walter Reed Army Medical Center. Following his deployment in Desert Storm and Desert Shield, he was assigned to Walter Reed and became the Director of Spine and Skull-base Surgery. After leaving military service in 1994, Ondra joined the Clinical Faculty at the University of Michigan. In 1996, he moved to Illinois' Northwestern University, where he served as the Residency Program Director Vice Chair, Director of Spine Surgery, Director of the Spinal Deformity Fellowship, Director of Spine Research, and Medical Director of the Neuro-Spine Intensive Care Units. He also chaired the Medical Device and Technology Committee at Northwestern Memorial Hospital. In 2006, he was promoted to Professor of Neurological Surgery at Northwestern. In 2008, he served on the Veterans Affairs group in the Obama-Biden Presidential Transition Team, as well as on the Obama-Biden Campaign Health Policy and Veteran's Policy committees.

VA Fails Gulf War Veterans Again: VA Report Calls for Termination of Gulf War Illness Reseach

Written by Anthony Hardie, 91outcomes

(91outcomes.blogspot.com - July 16, 2009.) - In a 23-page report issued Wednesday, July 15, 2009 by the federal VA's Office of the Inspector General (OIG), the VA calls for the outright termination of a contract providing $75 million for Gulf War illness research.

The $75 million in Gulf War illness research funding was provided to the University of Texas-Southwestern in Dallas through an earmark inserted into a federal appropriations bill by Senator Kay Bailey Hutchison (R-Texas). The research was to be led by Dr. Robert Hailey, a scientist whose breakthrough findings earlier this decade identified three separate syndromes among ill Gulf War veterans.

Citing five dubious reasons (which the report's authors call, "issues") why that VA has not followed the law requiring the funding be provided in accordance with the law, the report's authors coldly state that they believe that there is no option but for VA to terminate the contract "for default."

In most of the years since the funding was earmarked for UT-Southwestern, VA has failed to initiate other meaningful research on behalf of Gulf War veterans.

With the apparent failure of this program, almost all research for Gulf War vetterans' is being conducted outside VA in the Defense Department's Congressionally Directed Medical Reseach Program.

According to a high-level VA official who wished to remain anonymous, VA officials, particularly in the medical research part of VA, have been extremely hesitant "from the outset" in implementing this program for fear that future VA research might also be "outsourced."

With the program's apparent demise, it now appears that this parochialism may have led to the successful destruction of the $75 million research project to benefit ill Gulf War veterans.

At the time of enactment of the funding requirement, there was significant discussion on Capitol Hill about VA's failures to adequately perform medical and scientific research aimed at improving Gulf War veterans' health. These concerns were seen as the link to the necessity of earmarking the funding outside VA.

Following passage of the Persian Gulf War Veterans Act of 1998 and related legislation, VA failed for years to fully implement the laws. Testifying before Congress in 1999, VA gave reasons -- which sound strikingly similar to the reasons in VA's current OIG report on Dr. Haley's research -- as to why they couldn't implement the various laws benefiting Gulf War veterans.

Among those laws that VA failed to implement was the requirement for the creation of Research Advisory Committee on Gulf War Veterans' Illnesses. VA officials dragged their feet for years, and only instituted the committee after prodding by Congress -- long after the statutory deadline.

Nearly seven years later, pressure by Gulf War veterans led Congress to convene yet another investigative hearing regarding VA's failures with regards to Gulf War veterans. Entitled, "Examining VA Implementation of the Persian Gulf War Veterans Act of 1998," a Subcommittee of the U.S. House of Representatives Committee on Government Reform and Oversight took VA to task yet again.

In the July 15 OIG report, the authors conclude, "Many of the problems we identified could have been avoided if VA was able to treat and administer the earmark simply as a grant. Since VA management chose not to pursue grant authorization, they opted to misuse Federal procurement regulations and policy. We believe that a contract should not have been used to provide funds to UTSWMC or any other entity. If there was a Congressional mandate for UTSWMC to conduct this research, the funds should have been given directly to UTSWMC or VA should have been given, or sought, grant authority."

While there is little mention of any investigative work by VA's OIG in seeking to determine Congressional intent, Sen. Kay Bailey Hutchison's website states:

"In the Fiscal Year (FY) 2006, Military Construction and Veterans Affairs Appropriations Conference Report, Sen. Hutchison directed [emphasis added] the U.S. Department of Veterans Affairs to spend at least $15 million of Gulf War Illness research in FY 2006 and in each of the next four fiscal years, for a total of $75 million. The results of the efforts will help protect the military and civilians from such chemical agent exposure in the future and provide vital basic knowledge from which treatments can be developed."

Despite clear evidence of a Congressional mandate to provide the funds to UT-Southwestern, it is all the more unclear why VA's OIG, rather than recommending VA seek grant authority, instead recommends outright cancellation of the contract with Dr. Haley and UT-Southwestern.

Is change for Gulf War veterans coming?

==============================

The summary of the VA OIG's report is as follows:

"At the request of the former Secretary of Veterans Affairs, we conducted a review of the contract between the Department of Veterans Affairs and The University of Texas Southwestern Medical Center at Dallas (UTSWMC). The contract was awarded for the purpose of conducting research into Gulf War Illness. We concluded that VA was not required by Public Law 109-114 to enter into a contract with UTSWMC nor did VA satisfy the direction provided in Conference Report 109-305.

"The Public Law simply required VA to spend not less than $15 million for Gulf War Illness research and the Conference Report directed VA to enter into a pilot study involving collaborative research with UTSWMC. Our review determined that no pilot study was conducted and there is no collaborative research under the contract. Our review of the contract found that UTSWMC had the responsibility to identify, conduct, and manage all research projects with no input from VA.

"The contract with UTSWMC was merely a funding mechanism to support UTSWMC’s research program, and as such, should have been administered as a grant. However, VA managers decided not to seek grant authority and awarded a contract which inappropriately cited 38 U.S.C. § 8153 as the authority to award a contract to UTSWMC on a sole source basis. The use of § 8153 contracting authority was inappropriate because VA had no defined need for the services and the use of a contract (rather than a grant) created numerous management and contract administration issues for both VA and UTSWMC.

"The most significant issue is UTSWMC’s refusal to comply with the terms and conditions of the contract related to the ownership of the data. UTSWMC unilaterally, and without notice, changed the informed consent form to prohibit VA access to certain data obtained by UTSWMC in conducting the research. VA has issued a cure notice to UTSWMC; however, UTSWMC states that they will not cure the data rights issues contained in the notice and has refused to discontinue use of the revised form and to use the consent form that was agreed to by the parties at contract award.

"We believe UTSWMC’s continued refusal to comply with the terms and conditions set forth in the contract gives VA no option but to terminate the contract for default."

7 Times as Many UK Gulf War Veterans Dead of Suicide than in Combat

Written by Kim Sengupta and Nigel Morris, Friday Jul 17, 2009

LONDON - Britain faces a "ticking timebomb" of mental illness and suicide among young Army veterans who return from hand-to-hand combat in Afghanistan, the Conservative Party has warned.

A lack of mental health care for veterans, combined with the strains of fighting the Taleban, will mean many survivors of the conflict pay a heavy price in psychological problems and self-harm, according to party leader David Cameron and the shadow defence secretary Liam Fox.

Mental health experts joined the politicians in warning that not enough was being done to care for returning members of the armed forces.

Research suggests that veterans aged 18 to 23 are up to three times more likely to commit suicide than their civilian counterparts. Setting out plans to boost mental health care for returning troops, Fox and Cameron argued that more veterans of the Falklands campaign and the first Gulf War killed themselves after quitting the forces than died in action.

An estimated 264 Falklands veterans have committed suicide since the conflict ended, compared with 255 soldiers killed in action, according to an ex-servicemen's organisation.

During the 1991 Gulf War, 24 British soldiers died but the Ministry of Defence said last year that 169 veterans of the conflict had died from "intentional self-harm" or in circumstances that led to open verdicts at inquests.

Fox said: "The suicide figures for past conflicts are deeply concerning. I worry that with the intensity of current operations in Afghanistan we are building up a timebomb of mental health problems."

David Hill, director of operations for the charity Combat Stress, said it took an average of 14 years for veterans to ask for help with post-traumatic stress disorder.

Hill said: "Servicemen and women are exposed to stresses that most people won't be exposed to in their lives. In Afghanistan, they are exposed to them quite early in their careers. There is a general lack of understanding about how intense these stresses can be."

- INDEPENDENT

NY Gulf War Veteran with Terminal Brain Cancer Granted 'Dying Wish'

Editor's Note: Brain cancer has been measured in one study at twice the rate among Gulf War veterans exposed to the sarin and cyclosarin plume following U.S. detonation of an Iraqi munitions bunker at Khamisiyah, Iraq in March 1991 versus their non-exposed Gulf War veteran counterparts.

A Gulf War veteran brain bank has been established by the federal VA at the recommendation of the federal Research Advisory Committee on Gulf War Veterans' Illnesses. However, the federal VA has yet to make information about it publicly available on the Internet.

Gulf War veterans have been calling for publicly available data on Gulf War veterans' rates of serious diseases for many years.

=====================

Written by Denise Richardson, Staff Writer, Oneonta (NY) Daily Star, July 15, 2009.

(ONEONTA, NY) - A 1979 Oneonta High School graduate and Gulf War veteran had a bird's eye view of his hometown Tuesday from a helicopter.

Gene Pier, 48, spent an hour flying _ and hovering _ in a Schweizer helicopter with pilot Pat Dillon, of Adirondack Helicopters.

``It was a thrill,'' Pier said after stepping out of the cockpit at the Oneonta Municipal Airport and giving two thumbs up to relatives watching. He proclaimed to them and to the world: ``He's still flying!''

Relatives said they arranged the ride to fulfill a ``dying wish'' for Pier, who spoke of a desire to fly helicopters and operate a medical-evacuation service. Pier was diagnosed with a brain tumor in early 2007, they said, and he has had two surgeries and chemotherapy treatment.

``It's terminal, we're all sorry to say,'' said Lynn (Pier) Gibbs, his mother.

It's been a rocky road,'' said Valerie (Pier) Gordon, of Oneonta, his sister and a 1980 OHS graduate. ``We're just trying to make his dreams come true _ he deserves it.''

At Oneonta Municipal Airport, about 10 family members listened for the chopper's sound, then watched as it approached the runway and rose again into the skies. Clouds drifted overhead as the wind blew, but the sunshine didn't yield.

Pier joined the Marines after graduating from OHS, said his sister, Christine Andrews, a 1978 OHS graduate who lives in Harpersfield. He later joined the Army and trained as a helicopter pilot, she said.

Pier, a chief warrant officer assigned to Fort Drum near Watertown, was seriously injured in a helicopter accident in Saudi Arabia on Feb. 7, 1991. Pier, who worked on an air ambulance, was among four soldiers hurt when the UH-1 Huey helicopter crashed on a noncombat mission. The pilot, Richard Lee, of Independence, Mo., was killed.

Gordon said Pier received a Purple Heart after the crash, giving the medal to the pilot's widow.

Pier's leg injury from the crash precluded him from flying helicopters, Andrews said.

But he maintained a love of helicopters and flying, his family said. On Tuesday, he rode in Dillon's aircraft.

Dillon said the Schweizer helicopter has two sets of controls, and Pier was able to share in the flying. Pier showed that he remembered his flying experience and did a good job with the controls, Dillon said.

Pier explained ``the first takeoff was mine,'' and the pilots talked about the challenges posed by the wind. Pier said that from the air, he saw the clouds, mountains, the upper and lower reservoirs and Oneonta High School.

Pier and Sonja, his wife of 11 years, live in South Carolina and arrived Friday for a visit. Sonja, who paid for the flight, found words difficult Tuesday afternoon, but smiled when asked about her first sight of him.

``Our eyes met, and after that,'' she said, ``that was it.''

His local relatives live in Oneonta and Harpersfield, and his mother lives in South Carolina.

Pier has been an umpire at softball and volleyball games, and has been an advocate for children in an arbitration pretrial intervention program in Florence, S.C., family members said.

Gordon said she arranged the helicopter ride with Dillon, who charged $300 and waived the $600 cost of flying the helicopter from Griffiss International Airport in Oneida County to Oneonta.

``He had no problems doing this for my brother,'' she said.

Dillon said he understands the love of flying and was moved by Pier's story.

``To help a fellow pilot,'' Dillon said, ``is my pleasure.''