[House Hearing, 107 Congress]
[From the U.S. Government Publishing Office]
RESEARCH INTO PERSIAN GULF WAR VETERANS' ILLNESSES
=======================================================================
HEARING
before the
SUBCOMMITTEE ON NATIONAL SECURITY,
VETERANS AFFAIRS AND INTERNATIONAL
RELATIONS
of the
COMMITTEE ON
GOVERNMENT REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED SEVENTH CONGRESS
SECOND SESSION
__________
OCTOBER 10, 2002
__________
Serial No. 107-237
__________
Printed for the use of the Committee on Government Reform
Available via the World Wide Web: http://www.gpo.gov/congress/house
http://www.house.gov/reform
______
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COMMITTEE ON GOVERNMENT REFORM
DAN BURTON, Indiana, Chairman
BENJAMIN A. GILMAN, New York HENRY A. WAXMAN, California
CONSTANCE A. MORELLA, Maryland TOM LANTOS, California
CHRISTOPHER SHAYS, Connecticut MAJOR R. OWENS, New York
ILEANA ROS-LEHTINEN, Florida EDOLPHUS TOWNS, New York
JOHN M. McHUGH, New York PAUL E. KANJORSKI, Pennsylvania
STEPHEN HORN, California CAROLYN B. MALONEY, New York
JOHN L. MICA, Florida ELEANOR HOLMES NORTON, Washington,
THOMAS M. DAVIS, Virginia DC
MARK E. SOUDER, Indiana ELIJAH E. CUMMINGS, Maryland
STEVEN C. LaTOURETTE, Ohio DENNIS J. KUCINICH, Ohio
BOB BARR, Georgia ROD R. BLAGOJEVICH, Illinois
DAN MILLER, Florida DANNY K. DAVIS, Illinois
DOUG OSE, California JOHN F. TIERNEY, Massachusetts
RON LEWIS, Kentucky JIM TURNER, Texas
JO ANN DAVIS, Virginia THOMAS H. ALLEN, Maine
TODD RUSSELL PLATTS, Pennsylvania JANICE D. SCHAKOWSKY, Illinois
DAVE WELDON, Florida WM. LACY CLAY, Missouri
CHRIS CANNON, Utah DIANE E. WATSON, California
ADAM H. PUTNAM, Florida STEPHEN F. LYNCH, Massachusetts
C.L. ``BUTCH'' OTTER, Idaho ------ ------
EDWARD L. SCHROCK, Virginia ------
JOHN J. DUNCAN, Jr., Tennessee BERNARD SANDERS, Vermont
JOHN SULLIVAN, Oklahoma (Independent)
Kevin Binger, Staff Director
Daniel R. Moll, Deputy Staff Director
James C. Wilson, Chief Counsel
Robert A. Briggs, Chief Clerk
Phil Schiliro, Minority Staff Director
Subcommittee on National Security, Veterans Affairs and International
Relations
CHRISTOPHER SHAYS, Connecticut, Chairman
ADAM H. PUTNAM, Florida DENNIS J. KUCINICH, Ohio
BENJAMIN A. GILMAN, New York BERNARD SANDERS, Vermont
ILEANA ROS-LEHTINEN, Florida THOMAS H. ALLEN, Maine
JOHN M. McHUGH, New York TOM LANTOS, California
STEVEN C. LaTOURETTE, Ohio JOHN F. TIERNEY, Massachusetts
RON LEWIS, Kentucky JANICE D. SCHAKOWSKY, Illinois
TODD RUSSELL PLATTS, Pennsylvania WM. LACY CLAY, Missouri
DAVE WELDON, Florida DIANE E. WATSON, California
C.L. ``BUTCH'' OTTER, Idaho STEPHEN F. LYNCH, Massachusetts
EDWARD L. SCHROCK, Virginia
Ex Officio
DAN BURTON, Indiana HENRY A. WAXMAN, California
Lawrence J. Halloran, Staff Director and Counsel
Kristine McElroy, Professional Staff Member
Jason Chung, Clerk
David Rapallo, Minority Counsel
C O N T E N T S
----------
Page
Hearing held on October 10, 2002................................. 1
Letters, statements, etc., submitted for the record by:
Shays, Hon. Christopher, a Representative in Congress from
the State of Connecticut:
Letter dated October 7, 2002............................. 6
Prepared statement of.................................... 3
Transcript of June 18, 2002.............................. 40
RESEARCH INTO PERSIAN GULF WAR VETERANS' ILLNESSES
----------
THURSDAY, OCTOBER 10, 2002
House of Representatives,
Subcommittee on National Security, Veterans Affairs
and International Relations,
Committee on Government Reform,
Washington, DC.
The subcommittee met, pursuant to notice, at 9:35 a.m., in
room 2247, Rayburn House Office Building, Hon. Christopher
Shays (chairman of the subcommittee) presiding.
Present: Representatives Shays, Putnam, and Gilman.
Staff present: Lawrence J. Halloran, staff director and
counsel; Kristine McElroy, professional staff member; Jason M.
Chung, clerk; David Rapallo, minority counsel; and Teresa
Coufal, minority staff assistant.
Mr. Shays. A quorum being present, the Subcommittee on
National Security, Veterans Affairs and International Relations
hearing entitled, ``Research Into Persian Gulf War Veterans'
Illnesses,'' is called to order.
My statement is that if we have to send American armed
forces onto a potentially toxic battlefield in Iraq once again,
the lessons of the last Gulf war cannot be left behind. The
most important lesson is that diagnosis and treatment of the
wounds inflicted by multiple exposures to chemicals, pathogens,
toxins and medicines require an openness to new theories of
causation and cure.
That openness, and the promising research hypotheses it
spawns, have not always driven the Government-funded research
portfolio. But privately supported studies have brought new
insights into the mysteries of Gulf war syndromes.
In June, Mr. Sanders, Mr. Putnam and I participated in 2
days of extraordinary meetings in London on Gulf war veterans'
illnesses. Lord Alfred Morris of Manchester, who participated
in a subcommittee meeting here in January, invited us to meet
with veterans, parliamentarians, and researchers from the
United Kingdom. As in January, we were joined by Ross Perot, an
outspoken and tireless advocate for Gulf war veterans.
Our meetings in London were memorable for two reasons.
First, the U.K. veterans and surviving family members spoke
with the same quiet, aching eloquence we have heard so often in
this very room from their U.S. counterparts. They shared their
sense of frustration and betrayal over a decade of official
denials from both sides of the Atlantic about the role of
wartime exposures in causing their illnesses.
Second, a panel of researchers, mostly privately funded,
presented remarkable findings on subtle but objectively
discernible brain cell damage resulting from toxic exposures.
The damaged cells can send distorted chemical signals
throughout the body, explaining the variety of symptoms and
syndromes suffered by Gulf war veterans. We convene this
hearing today to make that compelling personal testimony, and
that important scientific data, a part of our official
subcommittee record so all those interested in the welfare of
Gulf war veterans can have access to this important
information. We already made the transcript of the London
meeting available to the Department of Veterans' Affairs
Research Advisory Committee on Gulf War Veterans Illnesses.
[The prepared statement of Hon. Christopher Shays follows:]
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Mr. Shays. So I ask unanimous consent to include in the
record of this hearing, the verbatim transcript of the meeting
held June 18, 2002, at Portcullis House, House of Commons,
London; the written statements of those who participated in the
June 18 meeting; and a letter from James Binns, chairman, VA
Research Advisory Committee on Gulf War Veterans Illnesses
Research dated October 7, 2002 accepting this material for
review by that panel.
Without objection, so ordered.
[The information referred to follows:]
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[The referenced transcript from June 18, 2002 follows:]
Mr. Shays. My Lords, Ladies and Gentlemen, Lord Morris of
Manchester.
Lord Morris. Congressman Shays, this is a moment to savor.
I speak as a parliamentarian here at Westminster for the last
38 years and I now invite you to proceed with and preside over
the first ever Congressional hearing to be held in the British
parliament. In doing so, I also welcome to London your
distinguished Congress colleagues. Congressman Bernie Sanders
and Adam Putnam are parliamentarians held in high regard in
your country and with you they are most warmly welcome here at
Westminster.
I welcome also this morning the visit to the UK of Ross
Perot whose humane concern for Gulf Veterans now in broken
health and the bereaved families of those who gave their lives
in liberating Kuwait is rightly honored by the ex-service
communities both here and in the United States. His dash and
dedication as a campaigner is an important resource for both of
us.
Christopher, the US and British troops fought side by side
in the war to liberate Kuwait. So, it is entirely appropriate
for the representatives of our two countries to work as closely
as possible to give a parliamentary attachment to the problems
of the Gulf Veterans with illnesses and the dependents of those
who died since the conflict. Of all the duties it falls to
parliamentarians to discharge, there is no more compelling
priority than to act justly towards those who are prepared to
lay down their lives for their country and the dependents of
those who did so. There was no delay in the response of our
troops to the call of duty in 1990, 1991; nor should there be
any further delay now in discharging in full our debt of honor
to them. That is much the best way, better than praise, than
showing our regard in admiration of the men and women who
served in the Gulf War.
Congressman Shays, you did me the honor and also my good
friend and colleague Bruce George as Chairman of the Commons
Defence Committee of inviting us to join you on the dais on
equal terms for the last meeting of your congressional
committee inquiry into Gulf War illnesses. I take pride in
joining you again today and to know Bruce George would again
have been with me but for a previous commitment he is honor-
bound to discharge. He and I wish you God speed in all these
proceedings at this historic hearing today. Congressman Shays.
Mr. Shays. Thank you, Lord Morris. It is indeed a
tremendous opportunity and privilege for me and my colleagues
to be with you today in what we call an investigative panel and
not to be technical with our rules in Congress we are not
swearing our witnesses in today since we are overseas. We are
on a fact-finding mission, this is an investigative panel,
probably one of the first and it is wonderful to have the
courtesy extended to us that you have extended.
My colleagues, Congressman Bernie Sanders of Vermont on my
left and Adam Putnam of Florida on my right and I deeply
appreciate the opportunity to be with you here today. Our
purpose is to continue an important dialogue about Gulf War
veterans' illnesses with our friends here in Britain. Last
January we invited the Chairman of the Commons Defence
Committee, Mr. Bruce George and Lord Morris to sit with us in
Washington as our subcommittee pursued its longstanding
investigation into the status and prospects of research into
the mysterious clusters of symptoms called Gulf War Syndrome.
They suggested, and we immediately agreed, our inquiries into
the health of coalition forces would be helped by hearing from
veterans and health researchers in the UK. So we convened this
investigative panel in the hope today we can ease the pain and
improve the prognosis of US and UK veterans wounded more than a
decade ago.
The Scottish scientist, Sir James Dewar observed: ``Minds,
like parachutes, work only when open.'' Then, sadly, too many
minds on both sides of the Atlantic have been closed to the
evolving sciences of environmental toxicology and multiple
chemical sensitivities. These and other emerging fields of
study hold the promise of answers to nagging questions of
chronic ill-health suffered by many Gulf War veterans. These
questions need to be pursued more openly and more vigorously.
It is of little scientific relevance and of no comfort
whatsoever, to note outbreaks of mysterious, putatively stress-
mediated diseases have followed all modern wars. That sad fact
only proves one side was too blinded by victory to see the true
costs of war, the other too vanquished to do anything about it.
It is time to break that tragic cycle of myopic insensitivity--
and I stress the word insensitivity.
Winston Churchill said, ``It is no use saying `We are doing
our best.' You have got to succeed in doing what is
necessary.'' Today we ask: What is necessary at this
juncture to advance productive research? Accurate diagnosis,
effective treatment and fair compensation for sick Gulf War
veterans. Our witnesses today will help us answer that
important question. We look forward to their statements and to
the opportunity to take advantage of their experiences, their
insights and their considerable expertise.
[The statement of Mr. Shays follows:]
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Mr. Shays. My colleagues and I want to thank all our
witnesses and guests for joining us today. We sincerely are
very grateful to you. I will introduce our panelists in a
second but I would welcome an opening statement from Bernie
Sanders.
Mr. Sanders. Thank you very much, Chairman Shays and thank
you very much for the work you have led us on over the last
many, many years in taking on an establishment which for
whatever reason has chosen not to see the truth in the
suffering of so many soldiers in the US and the UK and, Lord
Morris, I thank you very much for your involvement in this
country.
I would make a few points: It boggles my mind why in the US
and perhaps in this country as well, men and women who have
served their country, put their lives on the line, have been
treated in the rather shameful manner in which they have been
treated. Unfortunately, the history of how we treat veterans
after they come home from war, whether it is radiation illness
in World War II or Asian Orange in Vietnam, suggests there is
something very, very wrong in how we thank the veterans who
have served our country.
Some very simple issues have to be addressed. In the US,
with which we are more familiar, 700,000 men and women went to
the Persian Gulf. They were people who were in good health,
else they would not have been in the military and gone
overseas. Today, approximately 125,000 out of those 700,000 men
and women are suffering one or another symptom of Gulf War
illness and what we have got to determine is whether in the US
there are 125,000 people who are malingerers, who are liars,
who are suffering from mass hysteria or are there 125,000
people who are ill. In my view and I think I speak for our
whole Committee, there are 125,000 people who are ill and at
least 5,000 here in the UK.
Everybody who has studied the issue understands that the
Gulf War was a chemical cesspool, that the men and women who
were over there were exposed to all kinds of toxins and that in
addition to that many of them took anti-nerve gas agents in the
US, pyridostigmine bromide and in addition to that took
vaccines for anthrax.
The good news is--to the degree there is any good news--
that there are some significant scientific breakthroughs taking
place in research and we will hear from Dr. Haley and others
tomorrow and for the first time in the US what we call ALS,
what you call Motor Neurons Disease has been recognized by the
US government and is compensable in terms of compensation from
the government for those men and women who served in the Gulf
because it turns out at the very least the likelihood is twice
as great for those people who went to the Gulf coming down with
ALS as those who did not. That is the first acknowledgement on
the part of the US government although I strongly expect there
will be more to come in the near future.
So I want to welcome and thank very much all of our guests
here, our friends in the UK for the work they have done and
together we are going to find the cause of Gulf War illness and
do everything we can, not only to get our veterans whole again
but to increase the contact that exists in the civilian
societies and the Gulf War veterans.
Mr. Shays. Thank you very much. Mr. Putnam, who is the Vice
Chairman of our Committee.
Mr. Putnam. Thank you very much. As a freshman in Congress
I am a newcomer to this fight that the Chairman and Mr. Sanders
have carried on virtually since the day the troops returned
home from the Gulf War. As the youngest member of Congress, it
strikes me this is something of a generational issue, where we
send our brightest and our best and youngest in society to go
off and protect the freedom and liberties we all hold dear. It
becomes very difficult to persuade them that those things are
the right and proper tasks to take on when the government
refuses to care for them after they come home, broken,
battered, bruised and suffering.
The purpose of this hearing and this effort in addition to
keeping our promise to making them whole is to refocus the
attention on Gulf War protection. Surely there have been
lessons leaned since the first Gulf War that we can apply to
the young men and women serving in Afghanistan today and sooner
or later will be asked with great likelihood to return to Iraq.
What have we learned about war protection? What do we know
today that we did not know ten years ago about chemical and
biological weapons? How have we interacted with our allies to
produce better vaccines, better treatment for the various risks
that all veterans face and the answer to that thus far has
been: Nothing. We have learned virtually nothing that has
changed the way we protect our soldiers, sailors, young men and
women we ask to go over and sacrifice so much.
So, I look forward to this hearing to collaborate with our
tremendous friends here in the UK who jointly sacrificed with
our nation, who jointly sent very young men and women to defend
our civilization and who jointly have an obligation to care for
them when they return, because when the ticker tape is swept up
and the parades have ended, the costs, the obligations, the
responsibilities to those veterans have not ended and I look
forward to working with Lord Morris and the Chairman and
working towards a resolution of our government to caring for
our veterans. Thank you, Mr. Chairman.
Mr. Shays. Thank you, Mr. Putnam. Let me say we have four
panels. What we do back home in the US is that we invite our
panelists to speak for five minutes. We are allowed to go over
another five minutes and look at you in a sterner way. We do
not have our typical clock which goes green, yellow, red. I am
going to ask my staff to advise me of the time but we would
clearly like you to be somewhere around five minutes, but if
you go over a number of minutes your testimony it is so
important to us that we would like to hear it, but in ten
minutes I will stand up and create a scene.
[Laughter.]
[Mr. Perot enters.]
Mr. Shays. I am going to say, Ross Perot, we are going to
invite you to sit on this Panel and I am going to explain to
our audience when he gets back--if you are willing to be under
my leadership and control, Mr. Perot, I have given a statement
as well as Adam Putnam and Bernie Sanders and I would welcome
you to give in two, three or four minutes a statement to the
group that is here and you will be last on the list of
questions since you have no elective role here but as someone--
and let me say to our audience, Mr. Perot has been a champion
in helping us break through the traditional approach of the
government and medical community that has not wanted to look at
Gulf War syndrome with the seriousness it deserves. When others
have tried to use the medical community to demonstrate why our
Gulf War veterans are not sick and not in need of attention and
care, he has taken these matters up and made all the
difference.
Ross, I would explain this is technically not a legal
hearing of the US. It is an inquiry by an investigative panel.
We are not taking sworn evidence from our witnesses, but we
will take the entire record. We only have one day. I am going
to watch her [indicating court reporter] carefully and make
sure she is okay. We will read into the record and have the
same impact as if you were here. So, Mr. Perot, we welcome you.
Mr. Perot. Let me make it very clear, this is not stress.
This is troops in combat, wounded by chemical agents. Our
enemies and in this current war on terrorism, have these
chemical agents. One of these is Iraq. We know they have these
chemical agents. In the war on terrorism we just had another
instance today of car bombers. Think of the same people
spreading chemical agents across the waters. That can easily be
done. We do not know how to vaccinate people and to protect
them from it now and we do not know how to treat them after
they have been injected. These issues should investigated 24
hours a day, seven days a week to develop these technologies
and we can and I am sure we will, because it has gone far
beyond all the troops now and to the entire population where
literally millions of people can be impacted and the sooner we
start, the sooner we will have the answer.
So, I hope that we will follow Winston Churchill's words,
``We need action this day.''
Mr. Shays. Thank you, Mr. Perot. I will introduce the
panel. If I do not say it correctly, you correct me. Larry
Cammock is Chairman of The Royal British Legion Gulf War Branch
and Gulf Veterans Association. Shaun Rusling, Chairman of the
National Gulf Veterans and Families Association. Samantha
Thompson, widow of Gulf War veteran, Nigel Thompson who died of
Motor Neurons Disease in January, 2002. We welcome you here
today, Ma'am. John Nichol, former RAF Flight Lieutenant
Navigator, shot down and captured by the Iraqis during the Gulf
War. We are delighted to have all four of you, we will start
with you, Mr. Cammock and we look forward to hearing your
testimony. At the back of the room, if you cannot hear, I want
to know that. Mr. Cammock, you have the floor.
STATEMENT OF LARRY CAMMOCK, CHAIRMAN, THE ROYAL BRITISH LEGION,
GULF WAR BRANCH, AND GULF VETERANS ASSOCIATION; SHAUN RUSLING,
CHAIRMAN, NATIONAL GULF VETERANS AND FAMILIES ASSOCIATION;
SAMANTHA THOMPSON, WIDOW OF GULF WAR VETERAN NIGEL THOMPSON;
AND JOHN NICHOL, FORMER RAF FLIGHT LIEUTENANT NAVIGATOR
STATEMENT OF LARRY CAMMOCK
Mr. Cammock. I am Chairman of the Gulf Veterans Association
and Chairman of the Royal British Legion Gulf Veterans Branch.
I would like to thank you for inviting me to attend this
meeting and allowing me to present information for
consideration by the Committee. It is now 11 years since
veterans like myself came home from the Gulf War and first
started to experience the symptoms that are now called Gulf War
Syndrome.
In the first two years the symptoms quickly progressed
amongst veterans both here and in the United States. The death
toll kept rising in both countries. Denial has been the key
word and epidemiological studies the road to follow with the
direction focusing on psychological conditions. We have in the
UK over 5,000 veterans in receipt of a war pension for their
conditions, which they first suffered from on their return from
the gulf. To date there are 539 veterans who have died from
their conditions or from links to their conditions.
Gulf veterans would like a public inquiry to take place and
hopefully find the answers to the many questions that have been
asked of the Ministry of Defence. The veterans associations,
the Royal British Legion and individuals have asked these
questions. They have to date been given non-answers such as
``We are investigating the full issue of gulf illness'' and
``Gulf War Syndrome does not exist.''
There has been a distinct lack of funds, which would enable
the establishment of diagnostic protocols and treatments for
each veteran. This responsibility the veterans feel lies with
the Government. They should take care of their ex-service
personnel. The lesson of the last 11 years is that more could
and should have been done for this serious issue.
[The statement of Mr. Cammock follows:]
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Mr. Shays. You take my breath away, sir. Thank you very
much.
STATEMENT OF SHAUN RUSLING
Mr. Rusling. Thank you very much, Chairman. Before giving
my testimony to this honorable Committee, I would like to thank
the members for the invitation to the National Gulf Veterans
and Families Association to give our evidence over the illness
now known and recognized as Gulf War Syndrome.
Could I, on behalf of my members, offer our gratitude and
thanks to the Rt Honorable Lord Alf Morris for his unswerving
support and his continued efforts to help British Gulf War
Veterans who are suffering ill health from fighting for their
country in a war that is clearly recognized as the most toxic
war ever fought and at this point clearly mark out for the
committee our most sincere sadness that we have been abandoned
by our country and that successive governments since the Gulf
War have adopted a policy that is based on ``Don't look, don't
find and cannot see.''
The Ministry of Defence set up the Gulf Veterans Illness
Unit in 1996 after the former Permanent Secretaries of State,
Sir Richard Mottram and Dr. Edgar Buckley came under scathing
criticism by the Defence Committee under Mr. Menzies Campbell
QC MP and Mr. Bruce Geoge MP. On this matter I refer to Hansard
and the Defence Committee reports from that date and to the
present. Evidence has been presented to the said committee in
written and verbal format by the former Chairman Major Ian Hill
(deceased) and myself the current Chairman of the National Gulf
Veterans & Families Association.
It would be very easy to point out several Members of
Parliament and blame them. However they have only repeated the
Brief of government policy which is one of cover up of (GWS) at
all cost and to ensure that no responsibility for any actions
or none actions taken at the time of war is the responsibility
of anyone. The attitude of the MOD is one of go and seek
charitable help and hand outs. This crass attitude to those of
our armed forces servicemen and women who in the 21st century
have families to raise and mortgages to pay and are unable to
do so because thy are ill, because they fought for their
country, will devastate our fighting ability in the future.
If safeguards are not in place to ensure that ill and
injured soldiers get the best medical care and disablement
pensions etc, then politicians should not send men and women to
war in the 21st century or only at the cost of invasion. And in
taking that action it has been paramount to the Ministry of
Defence that every issue is spun and covered up by civil
servants of the GVIU working on the same brief refuting and
covering every issue up of any significance.
The MoD have been aided and abetted by the DoD to the point
of American dollars paid by the DoD to assist in the cover up
of GWS by employing medical doctors here in the UK, which are
Treasury Solicitors medical expert witnesses. These doctors of
the Kings College cannot claim to be unbiased they are in our,
the veterans' opinion, in a position of conflict of interests
and it is not our interests that they are concerned about.
The evidence is of poor medical value and used only in one
manner that is to be the use of epidemiology to lose our
illness in amongst the general populous and to down grade our
illness by the use of comments in medical papers like, Three
times more likely, to be ill as any other troops. This type of
evidence, which has been funded by the DoD and MoD is nothing
other than psychobable and government ploy.
The best medical evidence and most reliable that we have
seen are the nerutological findings of Dr. Robert Haley et al
based on proper medicine and not on form filling and paper
shuffling of figures. This evidence is supported by the
diagnosis of ill Gulf War veterans the length and breadth of
the UK diagnosed with Gulf War Syndrome, based on physical
medical investigation based on medicine by medical doctors not
spin doctors from the MoD whose interests lie elsewhere.
We here at the National Gulf Veterans & Families
Association have paid for our own investigations into our ill
health because our government has chosen to turn their back on
us. We have looked into the issue of organophosphates with
blood tests from Manchester University, which Dr. Mackness will
be speaking to you about later. In addition to the OPs we have
funded our own tests into vaccines given for the Gulf War at
the Bremen University Germany, also at The Tulane University,
New Orleans, USA.
Tests have been carried out at three independent
laboratories for depleted uranium in the urine of British Gulf
War veterans. The Waterloo University, Canada, the Memorial
University, Canada and the NERC isotope geosciences laboratory
here in England in the United Kingdom which I have presented
the results to you gentlemen today, which produce the results
on tests carried out in the UK. All three have shown the
presence of depleted uranium in the Gulf veterans' urine 11
years after the Gulf War. The controls used were found to be
negative. This evidence shows a significant exposure at the
time of the Gulf War. Professor Hooper will comment on these
matters, that will be this afternoon, in a scientific manner.
Mr. Shays. Can I interrupt you--can you all hear at the
back of the room?
We will ask you all to speak a lot louder.
Mr. Rusling. In addition to depleted uranium being found
extreme enrichment of 236U was also clearly present in the bone
of Mr. Michael Burrows and in the urine of Mr. Shaun Foulds,
leaving the question: Were the coalition troops the first to be
exposed to ``dirty bombs'' in 1991?
For your final reference I refer to my own pensions appeal
tribunal decision held on 19th April 2002 some 9 years after
application, whereupon every possible excuse and dirty trick
was used by the Veterans Agency, formerly the War Pensions
Agency, from allowing my appeal to be heard by an independent
tribunal. I attach a copy and I look forward to your questions.
[The statement of Mr. Rusling follows:]
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Mr. Shays. Thank you very much.
Mrs. Thompson, wonderful to have you here. I just want you
to know that the questions will be friendly but we will learn a
lot from them. So, you can feel very welcome here and it is
truly a privilege to have you here today. You have the floor.
STATEMENT OF SAMANTHA THOMPSON
Mrs. Thompson. Nigel Thompson died in January 2002 after a
long and courageous battle against Motor Neurons Disease (ALS).
He was just 44 years old and leaves a widow, Samantha and a
seven year old daughter, Hannah who is here today.
Nigel was a Petty Officer in the Royal Navy Fleet Air Arm
and served in the Gulf War in 1991. Shortly after returning
from the Gulf he started displaying the symptoms of Motor
Neurone disease. Nigel always believed his terminal condition
to be attributable to his active service in the Gulf. Right up
to his death he fought tirelessly on behalf of all Gulf War
veterans as part of the campaign for recognition of Gulf War
illness. Nigel also repeatedly called for an independent public
inquiry into what went wrong during Operation Desert Storm that
left so many military personnel ill or dying.
Nigel joined the Royal Navy in September 1973 aged 16. As a
member of the Fleet Air Arm he spent most of his service career
with commando helicopter squadrons. His service at sea included
tours on numerous ships including HMS Hermes, the Fearless,
Cherry B and HMS Glamorgan. He also saw active service in
Northern Ireland, the Gulf and Bosnia.
Tragically in 1993 he was diagnosed with the terminal
condition Motor Neurone Disease and left the Navy in 1994 after
20 years service reaching the position of Petty Officer. He
would have undoubtedly been promoted to Chief Petty Officer if
it were not for his ill health, as he was on the promotion
signal for that year.
Nigel always maintained strong links with the Royal Navy
never blaming them for what happened to him. He worked
tirelessly on behalf of other Gulf War veterans and was a huge
supporter of the Royal British legion in every way. Despite his
condition and failing health, Nigel helped to raise
250,000 for the Legion and received the Wilkinson
Sword of Peace from Prime Minister Blair in 1998 for his
efforts.
There were approximately 50,000 British service personnel
who served in the Gulf conflict. As a military operation it
appeared a stunning success; unfortunately though on returning
home a substantial number of veterans became ill. Very early on
it became clear to Nigel and many others that a number of
potentially fatal mistakes had been made in the pre-treatment
of our troops against a possible chemical or biological attack
by the Iraqis. Nigel could always remember just how real the
threat of an Iraqi chemical attack actually was. This being the
case every means of protecting our troops had to be taken.
However, before authorizing the use of NAPS tablets, an
unlicensed drug and then totally ignoring the warnings of
organophosphates and anthrax the MoD were guilty of the worst
kind of negligence.
Taken together these three undisputed facts alone show
scant disregard for the long term health of our troops, add to
that the question of why no such problem surfaced after other
recent conflicts, then you have to question the policy of mass
inoculations. Put all of this together and you can see why
veterans have concerns.
The MoD will say that they acted in the best interests of
our troops but it appears that not enough research was
undertaken prior to the administration of the drugs given to
protect them against the very real threat they faced in the
desert. Nigel always maintained that had his condition been
triggered by something that happened in the Gulf he would far
rather it had been the enemy responsible than his own side. But
sadly that does not seem to be the case.
Nigel very much doubted that his name would ever appear on
a plaque dedicated to the people killed in the Gulf War but he
was adamant that the Gulf War was going to be responsible for
his death just as certain as if he had been killed in action.
The people working in Whitehall at the MoD today are
exactly the same people who worked there when faxes about
anthrax went missing and written warnings about the overuse of
OPs were being ignored. The only way the whole truth will ever
come out is if the Prime Minister orders a full and independent
public inquiry.
Nigel would often speak of the photo inside the front cover
of the Royal Navy Divisional Officer's handbook. It is of a
young sailor and wren. At the bottom of the page it says ``the
most important factor.'' He always said it was a pity that the
people making the decisions at the Ministry of Defence hadn't
bothered to look at the photo. It seemed to Nigel that the day
you handed in your ID card the MoD washed their hands of you
and it was the Royal British Legion who were thankfully there
to pick up the pieces. He would say however that from now on
the MoD must realize that the men and women who put their lives
on the line for this country will be knocking on their doors if
problems ensue.
The Gulf War has to be the last time something like this
happens. British troops deserve better, they are not just
numbers but people, intelligent people and should start being
treated that way.
Life has been incredibly difficult since Nigel died almost
five months ago. Our lives have literally been turned upside
down. Everything revolved around Nigel and his care; my days
were spent caring for him practically 24 hours a day.
Thankfully a wonderful team of carers assisted me in this
privileged task towards the end, as his needs increased. Now
there is no care to be done for Nigel, no carers in our home or
wheel chairs. It is a very quiet house now.
Our daughter misses her father immensely and this Sunday
will be very hard for her, as it will be our first Father's Day
without Nigel. We plan to visit West Malvern where he is buried
so Hannah can lay some flowers on her father's grave. A most
heart-breaking event for a seven year old.
As she gets older, Hannah will undoubtedly start to ask
questions about her father's illness and untimely death. I only
hope I can give her the answers to these questions. I hope I am
still not asking them myself.
[The statement of Mrs. Thompson follows:]
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Mr. Shays. Your husband is a hero, ma'am. Your Dad, young
lady, is a hero to this country and to the world of freedom.
Flight Lieutenant Nichol?
STATEMENT OF JOHN NICHOL
Flight Lieutenant Nichol. I am John Nichol and during 15
years of service in the Royal Air Force I served in the
Falklands and saw action in Bosnia and of course during
Operation Desert Storm, the Gulf War in 1991, when I was a
navigator flying Tornadoes. On the first day of that war my
aircraft was shot down and I was captured by the Iraqis and I
spent seven weeks as a prisoner of war. So, my experiences of
Desert Storm include all of those experienced by service
personnel during that conflict and additionally the trauma of a
brutal interrogation and torture by my Iraqi captors.
Although my war was brutal, I returned to my family and
friends with my senses and my health intact. Some of my friends
did not return and many of my colleagues are still suffering
the effect of that war 11 years on.
I retired from the Royal Air Force in 1996 and now have a
career in the media and as an author, having published seven
books. I have maintained my contact with the Services through a
number of different charities and I am currently the President
of the Gulf War Branch of the Royal British Legion. I am also a
member of the Inter Parliamentary Group formed in 1994 to help
present a credible case to have Gulf War veterans' concerns
resolved. Many Gulf War veterans have grievances regarding the
way they were treated following their return from the conflict,
particularly those who subsequently left the Armed Forces.
Almost as soon as the war ended, many veterans started to
complain of ill health for which they could find no
attributable cause. At first, this started as a trickle but
then became a steady stream and currently of the 50,000 British
personnel deployed to the Gulf, in the region of 10 percent,
5,000 previously fit men and women are reporting ill health
with a variety of symptoms. Most importantly, they belief their
varying problems are directly linked to their service in the
Gulf. Worse, they have suffered considerable angst due to the
way in which they have been treated and because of the lack of
recognition regarding their situation.
The epidemiological studies conducted into the health of
Gulf War veterans have confirmed that those who served in the
Gulf display more ill health than one similar group that did
not deploy to the Gulf and another group drawn from those who
served in Bosnia. It is my believe and that of the Gulf War
Group, that the circumstances in this conflict were markedly
different to recent conflicts elsewhere and that it is some of
the very actions taken to protect those of us who served there
that could have produced the conditions so prevalent amongst
veterans who complain of ill health.
My suspicion and the suspicion of many others, is that some
or all of the things that were different regarding deployment
and service in the Gulf are responsible for the situation. What
was so different?
First, we had the multiple immunization program (some
veterans were given injections for up to 14 different
conditions in the space of 2 weeks.) Secondly, we had the issue
of pyridostigmine bromide (NAPS tablets) as protection against
chemical and biological agents. There was the exposure to smoke
when withdrawing Iraqi troops fired the Kuwaiti oil wells.
There was also the possible exposure to organophosphates used
as pesticides during deployment. There was also the possible
exposure to chemical weapons, particularly those who were under
the Khamisiyah plume when it was destroyed. Then the exposure
to depleted uranium from munitions expended mainly by Allied
Forces.
The possible inter-reaction of these many factors is
incalculable. But, if we look only at the immunization program,
if 50,000 individuals were inoculated against measles it would
not be unusual for a small percentage to show symptoms of an
adverse reaction. Therefore, if the same number are immunized
against 14 different diseases in the space of two weeks, there
is no telling how their bodies might react. All of the other
items I mentioned could have made a number of veterans unwell
in their own right.
Most of these factors were not present in recent conflicts.
Indeed I can remember experiencing none of them during my
deployment to the Falkland Islands in 1982 or during my service
over Bosnia in 1993. And subsequently, the level of ill health
amongst veterans from these conflicts seems to be much lower
than amongst their colleagues from the Gulf War.
In the main, all the action taken by our Ministry of
Defence, the immunization program, the use of pesticides etc.,
to protect those of us who served in the Gulf was done in the
best interests of the Gulf veterans. However, when the troops
returned and started to complain of medical problems, the MoD's
reaction was far from satisfying. The initial response was to
state that they were open-minded about the existence of a
problem. But that supposed open-mindedness was usually tinged
with cynicism and very little was done to assist those who were
becoming more unwell.
Some examples include the inadequate debriefing of those
returning from the conflict, particularly reservists called
from civilian life into action. There was the apparent loss or
destruction of individuals' medical records. There was the
initial denial by the MoD that organophosphates had been used
as pesticides; sluggishness in establishing a medical
assessment program. It took four years to place this on a full
time basis and even now there is great suspicion from veterans
with regard to its effectiveness.
There is also a lack of monitoring and specific treatment
from Gulf War veterans. It is only recently that our country's
general practitioners, which all veterans have to turn to once
they have left the service, have been advised of the possible
conditions veterans may present with. And with the demise of
the Service hospitals there is virtually nowhere where the ex-
Service community can be referred for priority treatment. We
believe that this is also a problem being experienced by those
currently serving in the Armed Forces where drastic cuts in the
Service medical provisions are leaving our Service personnel
exposed to problems not experienced in the past.
The veterans themselves departed for the Gulf in an ``A1''
condition of health. They now expect, indeed they have a right,
to have their problems recognized and addressed and where
mistakes have been made, this should be acknowledged. In
comparison with our American colleagues, the British veterans
believe that little has been done to address their problems.
For instance, ongoing medical support, particularly for those
who have left the Armed Forces is sadly lacking. Many veterans
have had real difficulty obtaining their full medical records.
Some have suffered wilful obstruction.
British veterans are dependent on our National Health
Service recognizing and addressing their problems, whereas our
American colleagues have the benefit of veterans' medical
support. Difficulties have arisen for some veterans in
achieving full recognition of their condition being
attributable to their Gulf service and this has delayed or
reduced their level of war pension.
The results of the errors that have been made and the
inadequate provisions to support veterans have left
considerable disquiet amongst those who served in this theater
of war. In addition, the needs of many that have fallen on hard
times have yet to be answered, even as far as the issue of a
sensible level of war pension. In an offensive snub to those
who have risked their lives, many veterans are forced into an
undignified fight for a pension which should be offered to them
with pride.
Veterans feel neglected and believe that the only answer is
for the Prime Minister to approve the establishment of a public
inquiry in which all of these issues might be openly reviewed
and the lessons learned actioned quickly. If there is nothing
to hide, why shy away from an open inquiry to establish why our
veterans are dying?
To finish, I heard this anecdote from an American
campaigner:
``If 100 people went to a banquet and during the night one
got sick--you would never know the cause. But if that same 100
people went to a banquet and 10 of them became sick
afterwards--you might never know what caused the sickness--but
you can be damned sure that the banquet was to blame.'' I am
one of the lucky ones, I didn't get sick, butyearsyy of my
colleagues did and some, as you have heard today have died in
tragic circumstances. Two British governments how now said that
there is no evidence that Gulf War Syndrome or sickness or
whatever we decide to call, it exists. Yet how can we prove it,
how can we recreate what happened 11 years ago? Are we to take
a group of volunteers, expose them to a cocktail of drugs,
force them to breathe the smoke from oil fires, feed them NAPS
tablets, spray them with pesticides, then expose them to
depleted uranium and chemical weapons? We can never recreate
those conditions.
I suspect we may never know what happened to our people 11
years ago during Desert Storm, but I do know this: The men and
women of our Armed Forces have always been willing to make the
ultimate sacrifice and give their lives in the service of their
country. With the Gulf War long over, many are still making
that ultimate sacrifice. And in the aftermath of the conflict
some of our political leaders are too quick to detach
themselves from us. I would expect so much more than that.
Congressman Putnam, you said earlier on the tickertape has
been swept up, the victory parades are over, but 11 years on,
the veterans are sick, still dying and they deserve better.
[The statement of Flight Lieutenant Nichol follows:]
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Mr. Shays. A very powerful statement, Lieutenant, powerful
particularly given you are a hero of the Gulf War and you are
not speaking for yourself, you are speaking for all those men
and women you served with.
Mrs. Thompson, I was thinking after you had completed,
wouldn't it have been nice if we had got here before January
2002 to hear directly from your husband; but how proud your
husband would be to have heard you today.
Mr. Rusling and Mr. Nichol, you have been speaking out for
so long on this topic and it is a privilege to have you here.
Feel free to take ten minutes, we have time and we came here to
make sure we got the information we needed so we are not
leaving until we get the questions.
Mr. Sanders. Thank you, Mr. Chairman. Thank you all four
for your testimony. I want to say the struggle you are waging
here is terribly important for tens of thousands of American
soldiers suffering the same problems. It is important we work
together and I thank you all very much for what you have just
said.
Let me start off, I am not an expert on the British
military but I assume the men and women you sent off were
strong and well-trained?
Mr. Shays. There was no answer but everybody's head went up
and down.
Mr. Sanders. Mr. Cammock, in your statement you mentioned
that you held a meeting and that 500 veterans came to that
meeting complaining of a variety of illnesses and since that
time 98 people who served in the Gulf have taken their own
lives?
Mr. Cammock. That is correct.
Mr. Sanders. I would assume if you started off with a
healthy group of people trained in the military that these
numbers are astonishing. Can you give me some explanation how
so many people have complained of illnesses and why so many
people have taken their own lives from what was initially a
very healthy group of people?
Mr. Cammock. Initially, the first meeting that formed the
Association was due to a reunion--
Mr. Shays. Can I ask you to speak a little louder?
Mr. Cammock. Sorry. Initially the first meeting of veterans
from the Gulf was held every 12 months, it was an annual
reunion for the veterans who went to the Gulf and we lost quite
a few of the men due to a friendly fire incident. The regiment
concerned was a local regiment in North East England. They held
their reunion and the members of that regiment were surprised
that some of their associates coming into the reunion obviously
showing signs of illness, some of them on crutches, some with
walking sticks and one or two were confined to wheelchairs.
That was in the 12 month period coming back from the Gulf.
From that, two of the people who were at that reunion
contacted local MPs and they queried what was wrong with these
people to begin with. From that, the two MPs put a notice into
the local evening papers asking for other veterans who had
served during the Gulf War who were showing signs of illness or
who were worried about any aspects of the Gulf War to attend a
meeting that was arranged at a local venue. They expected
roughly about 50-100 people to turn up. 500 turned up, not only
from the local area but from around the country. Those people
that attended from around the country also came with
information that there were other people in their own local
areas suffering the same condition.
Mr. Sanders. Let me interrupt you. My State is in the
northern part of our country where people from the military are
not very happy to come forward. ``I was not shot, I was not
wounded but I'm feeling pretty sick.''
Mr. Cammock. That is exactly the same. It is only today I
spoke to a senior officer who is still serving and he has got a
condition that other veterans have had. He has spoken to his
medical officer and his medical officer says it is his age.
Mr. Sanders. You suspect there are still people in the
military not coming forward?
Mr. Cammock. Yes, they are feeling shoved away by their
medical officer saying there is not a problem, the MoD is
telling them there is not a problem and there are other things
to look at. It could be stress, it could be age, it could be
all kinds of thing.
Mr. Sanders. Thank you. Let me go to Mrs. Thompson and
thank you very much for your testimony. I don't know how to
phrase this--let me phrase it this way: Mrs. Thompson, if you
were in the US now and were an American citizen, your husband's
condition would have been acknowledged as having been caused by
participation in the Gulf War. You are a British citizen and
that is not the case. How do you respond to the fact that in
the US finally, I should say after many, many years, we have
finally acknowledged the condition that your husband passed
away from but that is not the case right now in the UK?
Mrs. Thompson. It is very sad for the people suffering not
to have the condition recognized as attributable to Gulf War
service because I believe there are several servicemen who died
from Motor Neurons Disease and that it is way above the amount
that should have come back. I think obviously the news is
welcome from America that progress has been made and I can only
hope the Mod and other people will follow the progress made.
Mr. Sanders. Since the acknowledgement in the US that ALS
is attributable to service in the Gulf, has there been a
response from the British government to you and other families?
Mrs. Thompson. Not that I am aware of to me and other
families which is quite sad. You feel forgotten most of the
time.
Mr. Sanders. You are not forgotten. Let me ask Lieutenant
Nichol and Mr. Rusling, both of you were appropriately in
office and let me tell you we have heard almost exactly the
same testimony in the US time and time again of American
veterans who were frustrated, angry and disappointed by the
lack of response of their own government to their particular
problems. Given the fact that so many people have been hurting
and in some cases dying in the UK, why is the government so
reluctant to say ``Yes, we understand you have a problem; yes,
we will spend the money to find the cause of the problem; yes,
we will compensate veterans. How can we be of help to you?''
Why do you think the government has not responded in that way?
Flight Lieutenant Nichol. I have no idea and I think
perhaps a public inquiry might help to establish that, if there
is nothing to hide, nothing to worry about, nothing to cover
up. We are told so many times we are paranoid, then have a
public inquiry, have an independent inquiry so people like Sam
don't have to go through what they suffered. Larry should not
have to suffer as he is suffering. Veterans should not have to
come begging for help 11 years after the end of the conflict.
It really is a tragedy that we treat our veterans in this way.
Mr. Rusling. I think though that that will set a precedent
to look at other war veterans and do likewise with them, look
at them in another manner.
Mr. Sanders. You think there is a financial aspect?
Mr. Rusling. Yes. I believe the matter would have been
dealt with a long time ago.
Mr. Sanders. Thank you all very, very much, Mr. Chairman.
Mr. Shays. I would say in some cases it is a physical
element but also we rejoice that there were so many that came
back safe and so few who were killed or wounded and I think
that it is difficult for us to come to grips with the fact that
more came home wounded than we wanted to acknowledge.
Mr. Rusling. I think also it is the position of
accountability and certain decisions had to be made at the
time. Some were errors that were made and perhaps they have to
be accountable for their actions. That is very sad for us
because we are carrying that back now.
Mr. Shays. A nice point. It is not dissimilar as Mr.
Sanders said. Your testimony could almost be made in the US.
There is not much difference. Mr. Putnam, you have a point?
Mr. Putnam. Thank you very much. This testimony is
virtually identical to the US. Two weeks ago I had a similar
forum in my constituency where I had over 200 of my
constituents meeting this group of National Guards come back
with very built-in illnesses. Young men in the prime of their
life who came back with the illnesses of 80 year olds. Live
conditions, neurological diseases. In their case we cannot
identify what it was. They had to use a certain paint to
prepare the equipment and they were ordered to abandon all
procedures, to abandon all safety equipment to expeditiously
complete their task. Chairman, Ross, you are the heads of your
respective organizations. In similar organizations there are
other coalition partners and do they report similar stories?
Mr. Rusling. Yes there is a similar organization in Canada
and Australia. The numbers are far smaller but they have
exactly the same problems as we have.
Mr. Cammock. The Norwegians and French, they have the same
sort of problems.
Mr. Putnam. What about the Kuwaitis, do we know anything
about that?
Mr. Cammock. They used to acknowledge it initially but it
sort of tailed off but the last report we had was that there
was a large amount of illness in the Kuwaiti population,
certainly with lung cancer.
Flight Lieutenant Nichol. I think Lord Morris has got the
most information on how the Kuwaitis are suffering as well. As
I understand it they are suffering in high numbers in very
similar if not identical conditions to what our veterans are
suffering.
Mr. Putnam. Those of you who were given a range of vaccines
and injections, were they administered evenly throughout the
services or did different Commanding Officers take different
processes to dispensing those treatments and vaccines?
Flight Lieutenant Nichol. Larry and Shaun can talk about
the large numbers but from my perspective as an RAF officer we
were given the option of taking the vaccine and I remember
specifically turning down having anthrax injected into my body.
It was a procedure, it was your own decision if you wanted it
and at my level a large number of people chose not to take
these inoculations.
Mr. Rusling. We received no choice in the matter. We were
given a time to parade for our vaccinations and we did so and
at the time we were vaccinated, a couple of days later some
more vaccine. Two days later, some more vaccine and we were not
given a choice at all.
Mr. Cammock. Lt. Nichol is quite right there about the RAF
giving the option about the inoculation, the reason being that
they realized that a flight crew, you could not afford to have
a flight crew ill through inoculations and, therefore, it is
entirely up to the individual if he accepted; but on the
service side, it was compulsory. On the first day there were
twelve inoculations all at the same time. A few days later then
you went to a different barracks for other inoculations and as
far as the Gulf was concerned, if you were in a transport combi
half-way up the MSR, there is a refuelling base run by the
Americans. If you were unlucky enough to get there before 4:00
o'clock and if you got no pump and out by 6 you got what the
Americans got so you could have had one in the morning and
another at the base in the afternoon.
Mr. Putnam. Of those twelve you had no choice?
Mr. Cammock. None whatsoever.
Mr. Putnam. And there was no informed reason?
Mr. Cammock. No.
Mr. Putnam. But, with the RAF it was different?
Mr. Cammock. I have seen American air people who were ill
and they decided they could not afford to have our air crew the
same.
Mr. Putnam. Did the Service keep records of who accepted
certain vaccines and who rejected them?
[Laughter.]
Mr. Rusling. In 1996, Mr. Putnam, I wrote to the MoD asking
for a copy of my medical documents and I received a letter back
from Brigadier McDermott advising that the inoculations I had
been given in the Gulf were classified secret and that has
remained the same, nothing has been recorded.
Mr. Shays. That could conspire in the US, to give you that
as an explanation: Top secret.
Mr. Putnam. That is not a term we use in the South, Mr.
Chairman.
[Laughter.]
Mr. Putnam. Were you outfitted for chemical launch?
Mr. Cammock. Yes.
Mr. Putnam. Did they ever go off?
Mr. Cammock. Constantly.
Mr. Rusling. All the time.
Mr. Putnam. And were they all positive?
Mr. Cammock. Yes.
Mr. Rusling. Allegedly. We don't believe so.
Mr. Putnam. It was the MoD--
Mr. Cammock. One of my colleagues, in 1996 he died of
chemically induced leukaemia and he was one of the guys who had
to unmask and do the screen test and I can't really believe
there was nothing at all. Can I make a point. On first March,
1991, all of our MPC equipment was removed. Our chemical suit
was taken off us, given to the Iraqi prisoners of war. On 1st
March we had no chemical ability of protecting us at all and
from 4th-10th March one of the alarms went four times. So we
were walking about in shorts and flip flops when munitions were
being blown up. You could not put them on because they were no
longer there. It is absolute madness. Some troops went into a
minefield at the end of the battle, the battle had been won, it
is just madness, absolute madness.
Mr. Putnam. Lieutenant, has the BCE equipment, the alarms,
the sensors of any of those names changed in 11 years since the
war?
Flight Lieutenant Nichol. I am not an expert in chemical
weapons but I can tell you on the first day of the war when the
sirens went off and we were based at Bahrain, some considerable
distance from the conflict itself, the chemical sirens went off
as well and the answer was, ``Well the batteries are flat.''
So, the warning for the flat battery is the same as for a
warning of a chemical attack. I don't know if one can say
procedures have changed in the on-going 11 years but I am
certainly not aware that they have.
Mr. Rusling. Our systems are still the same alarm systems
and we have contacted a company near Nottingham who advised
they were not allowed to speak to us because it was a matter of
secrecy.
Mr. Putnam. Let me ask you one final question. When you
mentioned the presence of testing for depleted uranium and the
presence of 236, could you elaborate on that?
Mr. Rusling. Well, I don't know if you have these on the
table. Do you have the test results which have come back into
the UK from the last hearing in the US?
Mr. Shays. We have it.
Mr. Rusling. What actually happened is we sent samples off
to Canada to identify CPUs and we sent them to a gentleman
called Harry Sharma. He carried out tests and he recommended
that we should have tested from gastechtomotery and he
recommended that that be done also in Canada. So we sent the
phials off to him. Dr. Sharma reported back depleted uranium.
The MoD here in the UK said, ``Okay, fine, you have done these
tests. However you have no control room and you have not had
them done in the UK'' so we now have a laboratory accepted by
the MoD and we have them tested in the UK and here are the
tests and the results.
All I can say as a soldier I have been exposed to depleted
uranium and I would be pleased to speak to Dr. Haley with
regard to neurotoxic properties because I was cutting the
equipment on the casualties with shears in recent succession
and I was breathing all that stuff in off the casualties. So
most certainly I would like to know.
Mr. Sanders. Let me see if I understand. Mr. Rusling, you
and a number of other veterans sent your urine off to a
laboratory in Canada?
Mr. Rusling. Yes.
Mr. Sanders. As of a month ago, it reported that you had
depleted uranium?
Mr. Rusling. No, we sent the samples in 1998 to Canada and
we progressed between the two laboratories, Waterloo University
and Memorial University, testing out samples which were
positive.
Mr. Sanders. In 1998?
Mr. Rusling. Yes. What we needed to do then was get a
laboratory in the UK. There is an oversight committee in the UK
set up. The MoD have only just got around to getting this
going. We are not prepared to wait for the MoD to bring itself
kicking and screaming.
Mr. Sanders. Tell us again. You told the MoD you have an
accredited laboratory saying you have depleted uranium in your
urine, seven years?
Mr. Rusling. 11.
Mr. Sanders. Well now, what did they say?
Mr. Rusling. We have had Dr. Jacob to speak from the
States, Dr. Harry Sharma. Dr. Sharma spoke in 1999 at the
Defence Committee and pointed out to the Defence Committee that
the MoD could not refuse the findings in the Canadian
laboratories because they had not done any tests whatever.
Mr. Sanders. So they confused--
Mr. Rusling. They confuse everybody about the vaccines,
spinning.
Mr. Sanders. And they will not do the same tests?
Mr. Rusling. No testing, none at all, nothing.
Mr. Shays. Thank you. At this time we will go to Lord
Morris and then Ross Perot and then we will come to myself and
we may come back a second round just briefly and then we go to
the next panel.
Lord Morris. I am very moved by your presentation, Samantha
Thompson, with Hannah here this morning and I am also most
grateful to Larry, Shaun and John for the compelling case you
have made for the Association you represent. I am sure they are
very proud of the evidence you have given.
Samantha, on 25th February in answer to a parliamentary
question of mine about Nigel's death, the Defence Minister told
the House of Lords and I quote:
``Mr. Thompson was a man of immense courage, humanity and
great cheerfulness in the face of considerable adversity. Our
thoughts are with his widow, family and friends.''
What initial reaction did you receive to the opinions you
voiced on what might have caused Nigel's illness? Were you
surprised by the reaction? Did you receive adequate help from
the NHS during Nigel's long illness and when did you become
aware that Motor Neurons Disease among American Gulf veterans
is now accepted as war-related by the US government? Again,
were you told that the prevalence of Motor Neurons Disease
among Gulf veterans in the US was twice as high as the general
population? In other words, the reason, the very strong reason
why the US took that decision?
Mrs. Thompson. We felt also concerned about Nigel's ill
health from 1995. We did not know whether or not we ought to go
public with out fears. We took a long time because we knew the
ramifications of that. One of the reasons we thought it
important to voice our concerns was that every time a doctor
and specialist dealt with Motor Neurons Disease, the same word
kept creeping up all the time, a symptom and we kept asking
why, why and we were told that Nigel being 36 and diagnosed
with Motor Neurons Disease was very young and the doctors were
perplexed. Obviously there are cases where young people have
the illness but it is very, very rare and because it was so
soon after returning from the Gulf you could not refer to that.
Nigel died on 23rd January and I believe it was the day
after that it was announced about the prevalence of ALS and the
Gulf and I only hope now that the same research can be done
here.
Lord Morris. Turning to John, Bernie asked about my
question about the government's reason for delay in recognition
of Motor Neurons Disease as Gulf War related. The answer to my
question in February said:
``The government is aware of the recent US government
announcement regarding the prevalence of Motor Neurons Disease
in US veterans of the Gulf conflict which follows preliminary
evidence from the comparative study. The research findings are
yet to be published within scientific literature. When they are
produced we will consider carefully their implications for
facultative veterans.''
That was on 20th February. I have heard nothing further. I
think also that probably answers your question, Bernie about
government standards. Have you any comment on that?
Flight Lieutenant Nichol. I think it is part of the
prevarication for whatever reason about the suffering that Gulf
War veterans have been going through for 11 years. I wrote to
the Prime Minister in January 2000 on behalf of the veterans
and by the British Legion to ask him to set up a public
inquiry. He replied:
``The public accepts some veterans have become ill and
sadly some have died. Many believe this ill health is unusual
and directly related to participation in the Gulf conflict.''
He, however, as the Minister explained in his letter, said:
``There is still no medical or scientific consensus on this
subject and important research is in progress.''
That is two years ago. That continuing important research
was going on in January when Nigel died. It will go on this
year and next year when more veterans die. There needs to be
more acceptance and less heel-dragging.
Lord Morris. Shaun, your case became a test case and you
referred to your case before the Appeals Tribunal. It decided
in your favor; as you say it took you nine years to get there
but what indication have you had from the government's reaction
to the decision of the pension Appeals Tribunal?
Mr. Rusling. Nothing whatsoever. Nobody has written to me
other than the Appeals Tribunal themselves to advise me Gulf
War Syndrome was accepted. Could I concur with Sam: I myself
had excellent care from the NHS. The doctors who have been
diagnosing Gulf War Syndrome, there has been about 28 of us in
my small area in East Yorkshire in England. They have diagnosed
Gulf War Syndrome. They don't argue the fact, Yes, it is Gulf
War Syndrome and whether they explain the diagnosis, it is the
same. It is all the Gulf War veterans are suffering illness
from the Gulf War and it is madness that we have had to break
it down to each compartment, chronic fatigue, bowel syndrome.
It is quite ridiculous and some veterans have committed suicide
because it is too much.
Lord Morris. Larry, I think the inquiry would like to hear
more about the suffering you have had and also your opinion on
why it is so important 11 years on that we should have a public
inquiry. What the government said, as you know, is that there
is nothing to be served by a public inquiry just as they have
said for a long time. There will be nothing to be served by
appointing a minister for veterans' affairs. They have said
more recently and I will be quoting their words tomorrow, that
they do not rule out a public inquiry now. Is there anything
you want to say?
Mr. Cammock. I think the need for the public inquiry is
extremely urgent. Going back to Motor Neurons Disease, the
national statistics are 85,000; people over the age of 55 you
can expect three people suffering from Motor Neurons Disease.
From the 53,600 inoculated to go to the Gulf, the Gulf veterans
in this country, 8 of them have Motor Neurons Disease and all
under the age of 55. Four of those men have now died.
Lord Morris. Even the US findings understate the
seriousness of the problem. They found that Motor Neurons
Disease, ALS as the Americans call it, is twice as prevalent
among American Gulf War veterans as in--
Mr. Shays. Allow me to say, what our government was saying
was that it was consistent with ALS in the general public but
they were using older population but when you compared it to
the younger population it was double, more than double.
Lord Morris. Gulf veterans emphasized by John and others,
they were ``A1'' when they were deployed?
Mr. Cammock. That's correct.
Lord Morris. They were for the most part between 20 and 35.
There were some outside that of course but it is with that
section of the population, the general population that the
comparison should be made and I think, as I say, that even now
the full seriousness is not appreciated. I do not know how you
approach that.
Mr. Cammock. The actual figures go a lot further if you
take the aspect of 48,400 people actually served on the ground
in the Gulf and if you look at the illness amongst the people,
the figures are a lot higher percentage-wise.
Mr. Shays. Thank you. Mr. Perot, you have the floor for ten
minutes to ask questions.
Mr. Perot. I would like to ask the people who took the
vaccinations, did they ever show you what was in the phial?
Mr. Cammock. No.
Mr. Perot. It was ``Come in and have a shot'' and never
read the detail. The anthrax vaccination in our country is not
approved by the Food and Drug Administration and under our laws
it would only be administered with consent; but some people had
a shot and that was it. It was the delay between the
inoculations and I assume were you ever informed of all of
this?
Mr. Rusling. Nothing. In fact we had nicknames for them.
The MoD had nicknames for them.
Mr. Shays. By the way, we cannot answer by a nod of the
head, it has to be vocal.
Mr. Rusling. There were nicknames for the vaccine which was
``gutter'' and the anthrax was, I can't remember biologically,
sorry I can't remember the other one but we had nicknames. When
I was advised in 1996 that things were classified secret, Mr.
Perot, I did not give my consent to it, being classified.
Mr. Perot. You took some of them with the American troops?
Mr. Rusling. That's correct.
Mr. Perot. And, like everyone else, you stood in line and
took the shot?
Mr. Rusling. Yes.
Mr. Perot. Then you found out later that was the attitude
in our country. We had to do that because I do not think the
military, the line officer is not the medical officer who
understood the risk of the mercury and so on and so forth. Now
how about pyridostigmine bromide?
Mr. Rusling. Yes, I certainly stopped taking pyridostigmine
bromide, I could not stop passing water every twenty minutes
and I was doing twelve hour shifts.
Mr. Perot. Did anyone tell you exactly how you were
supposed to take it and when?
Mr. Rusling. We were supposed to take 50 mgs three times a
day.
Mr. Perot. Alarms go off and they start taking it?
Mr. Rusling. Well, what I don't understand, we were told to
take it once or three times a day, but the alarm would go off
and officers would come into the tented areas, mealtime or
whatever, saying ``Take that now.'' The junior ranks were
taking 30 tablets on top of the prescription of what they are
advised to take so they were overdosing.
Mr. Perot. What pesticides were used in your groups?
Mr. Rusling. Yes it was pentiphylon.
Mr. Perot. We say Weslon D.
Mr. Rusling. Dytoxin.
Mr. Perot. Your uniforms were impregnated also with this?
Mr. Rusling. Yes.
Mr. Perot. So, you had the same basis--
Mr. Rusling. And there was mylithium in the casualties
which again we did not know.
Mr. Perot. Was there much incidence of wives who became ill
shortly after the husbands came back?
Mr. Rusling. A lot of wives complain of gynaecological
problems but we do not know the extent.
Mr. Perot. But, they started after Desert Storm?
Mr. Rusling. Yes, I have a lot of wives complaining of
burning semen and gynae problems which started after the
husbands returned from the Gulf War.
Mr. Sanders. Just for the record, maybe you can help me and
see what kind of information we have on this. This is my
understanding in terms of ALS. We have 700,000 troops and my
understanding is that 16 of our veterans have been diagnosed
with ALS out of 700,000. Here you had 60,000 people in the Gulf
and you have eight diagnosed which suggests that
proportionately the number here is greater than the US.
Mr. Cammock. It is possibly true but not all of the
veterans in the US, not all 700,000 have actually been checked.
Mr. Sanders. Sure, but as it stands right now, the
proportion of ALS victims in the UK is substantially higher?
Lord Morris. Yes.
Mr. Rusling. I think Professor Hooper will speak about
that.
Mrs. Thompson. I was going to say the number of ALS/Motor
Neurons Disease is very small so although there may be some
veterans who are perfectly well now there may be something
going on and in a few years' time they will show Motor Neurons
Disease. Nigel was diagnosed in 1993. He had various tests. It
was not this, that or the other, so unfortunately it must be
Motor Neurons Disease.
Mr. Sanders. And the point you made earlier, this is an
older person's illness.
Lord Morris. Yes, it is not a young person's illness.
Mr. Perot. Do you receive any benefits at this point?
Mrs. Thompson. I receive a widow's pension. They recognized
it was for war service. I receive a Gulf War pension.
Mr. Perot. I have one suggestion in terms of how to get
from where you are to where you want to be because our
government was exactly in the same position. Since our
countries are very close and we continue communications all the
time, I think if there were ways to link your Prime Minister
and our President in a conversation on this subject and your
Head of what we call the Veterans Society--what do you call it?
Flight Lieutenant Nichol. We don't really have one, not in
the same way you have in America.
Mr. Perot. It is the MoD?
Flight Lieutenant Nichol. Yes.
Mr. Perot. We are moving forward now in a very powerful and
constructive way to solve this problem and I think if they
shared the experiences this could do a lot to get things moving
quickly. I think if your group understood it is a great
opportunity to say that is good we should do it and understand
what we are now doing in our country in terms of research and
that sort of thing; it was postponed for some years. You have
problems here and I know this is right in your hearts. You do
not want it left, you risk your lives to go out and get them
and in this case it is a subtle thing, we want to be back. I am
certain once people fully understand that and you take the
proper actions and the tremendous benefits that will come to
the world and the people of Great Britain from knowing how to
protect people and how you have that sense with vaccines and
all the rest, I challenge that really you say what is the
nature; whatever the status quo is, we maintain the status quo.
We have to head for change and that is what you are working so
hard to do and anything we can do to help in a constructive way
we will. I cannot tell you how much I admire you for your
integrity and your courage and I salute you on behalf of
America. These people gave their lives for their country and we
are so depressed and defeated by the fact that our country
turned their back on the people that they committed suicide.
That was terrible, because they were wounded, left behind and
we won't do that and I'm sure your country won't do that and
because of you we want to make it better. God bless you.
Mr. Shays. Are you all done? Thank you, Mr. Perot. It is
helpful those questions were put in the record. Mr. Sanders,
you want to make a point?
Mr. Sanders. I am unclear how the British government is
compensating those people made ill. In general if somebody has
ALS now in the UK, are they compensated? Is it a compensable
illness or just an individual situation, the government makes a
judgment?
Mr. Rusling. From what I have seen, if there is something
that is not right for the people and they can get away with
paying them 20 percent pension, they will do so. That is one of
the saddening factors.
Mr. Sanders. So they are fighting for their rights?
Mr. Rusling. Many people are so tired mentally and
physically, many have committed suicide and attending MoD
assessment programs was the final straw.
Mr. Cammock. Even when you have been diagnosed and
compensated with a war pension you still have to have a two
year review and that is a complete new medical from scratch and
the person who does the medical on you has no indication what
your previous medicals were or previous documents. He comes
with a blank piece of paper. You can be fine one day and the
next day dying.
Lord Morris. I think Congressman Sanders' question as well
is about our arrangements for war pensions, the war pensions
legislation. If a condition is accepted as war-related, if he
dies, his widow is a war widow. It is that kind of thing you
want to know more about.
Mr. Rusling. Only if he dies of the illness attributable to
service. He must die of conditions or he won't get that grant.
Mrs. Thompson. You don't get a war pension unless it is
over 80 percent.
Lord Morris. In my own case my father died, he was very
badly gassed, he lost a leg and he lost an eye. He died of
heart failure and my mother was told she was not a war widow
because he did not die from a war-related condition. I changed
the law to the effect that anyone who died of a cardio-thoracic
illness who had served in a conflict where gas was used as a
weapon of war would be given the benefit of the doubt. In other
conflicts, going back to the First war, benefit of doubt has
been given. How much benefit of doubt has there been recently?
Mrs. Thompson. The benefit of doubt only the last seven
years. After the date of your first claim. After that seven
year period it goes to prove that your illness is relative to
your service and with the amount of documentation we have from
the Gulf there is no chance.
Mr. Rusling. Everything has been destroyed. All the
vaccinations records have been destroyed, where you went from A
to B. Everything has disappeared mysteriously.
Mr. Sanders. Many of these illnesses take many, many years
to show the symptoms.
Mr. Perot. We had all these problems in the United States.
When I first had a person with ALS, you call it Motor Neurons
Disease but it is the same thing, contact me, I went to
retrospective researcherrs and they said, ``We need to look at
this.'' I said, ``We will do the research, let's just have the
records.'' ``We can't do that it would be a violation of
confidentiality.'' I said, ``Right, go to everybody who has
this and ask them to volunteer.'' ``Oh no, we can't do that.''
We have been through this phase. Here is the exciting phase.
You have to have people at the top who understand the real
world and once they see, when it starts happening in our
administration replacing the people who had been so stressed
ever since the war was over and then you have people with open
minds to look at the fact even those papers have all the same
problems, it is really heartbreaking that we do not have all
the detail but we can have vaccinations, real patterns there
but I am an optimist and obviously you are because you keep
fighting for what you believe in and I really believe with the
things going on here in parliament we are going to see, if you
continue the good fight, you are going to see some very, very
positive things happen.
Mr. Shays. I am going to claim back the floor. Usually what
we do in Washington is when somebody else takes the floor we
call it a deal but I am interested to know about Khamisiyah. We
were told in the US that our troops were not exposed to
offensive chemical weapons and we kept hearing the word
``offensive''. We had a witness coming to testify that troops
were exposed to chemical weapons at Kyamisiyah, he had a video
of our troops, taken shots of the shells and rockets. When our
Department of Defence learned that, on Tuesday the week before
that we were going to have this hearing and have his video
tape, on the Friday at 12:00 o'clock they announced there would
be a press conference at 4:00 o'clock. They said our troops
were never exposed to offensive chemical weapons but might have
been exposed to defensive chemical weapons. In other words we
had blown them up and the fact was our Department had known
this for a period of time and had not disclosed it.
We tried to imagine who it originally was, it was 2,000 and
5,000 and then potentially close to 100,000 of our troops and
by the way when I say ``our troops'' I mean our coalition of
troops exposed. I thought in one sense we can't be here. We are
here trying to help veterans and particularly our American
veterans but also those veterans who fought side by side with
us and we fought side by side with them. So do you ever have
that feeling when you walk out on ice and you think it is
rather thin? Are we treading on thin ice in terms of our
injection of what we have learned and sharing it with what you
are learning in your country?
I would say in our country we are a little ahead. We think
we have gone to the point where the momentum is turning to the
veteran; I am not sure that is the case in the UK, but it will
be the case if you continue to speak out. I am struck by a
comment we had in the United Air Force, Major Michael Donnelly.
He is a gentleman who is still alive with ALS. He came before
our Committee and recounted a now all to familiar litany of
official refusals to connect his illness with military service
and he was at one time a robust military pilot and there is a
previous picture of his two children on either side of the
wheelchair. He is not robust anymore. He came before us hardly
able to speak, his wife one side and father the other. He
looked at us and in a quiet voice said, ``I am not the enemy.''
You triggered that because you almost with you and your husband
were deciding whether to in a sense, to challenge your
government; it was almost if you did you would be viewed the
same as he was. Imagine a witness of any country coming to his
elected officials and saying, ``I am not the enemy.''
I am interested to know, Mrs. Thompson, if there is one
thing that could happen in the UK that you would like to see
happen in your country, what would that one thing be?
Mrs. Thompson. I think it would be if we could have
complete honesty from now on. Right from the beginning people
in the MoD did not want to listen to us. We would not go there
and be a pain to them, but we continued to fight and gradually
we have made tremendous progress. As you said yourself, we feel
that it is turning in the veterans' favor in America and I
think it would be really something if we could feel that it was
happening that way over here and maybe if we continue, that
will happen.
Lord Morris. On your point about Khamisiyah, I was told by
the then Minister for the Armed Forces, I think in 1995 in the
House of Commons that only British servicemen could possibly
have been exposed to the plume after the destruction of the
Iraqi chemical arms dump. Paul Tyler was told fairly recently,
last month, that the MoD now estimate it could be as high as
90,000. That is an enormous difference. That is the position
here. It could be as high as 90,000 people exposed to those
nerve agents because of the bombing of the Iraqi chemical arms
dump in South Iraq.
Mr. Shays. I am going to conclude my questions and if no
one else has questions, we are going to the next panel; but as
with each of the panels, is there something that you wish we
had asked that you are prepared to answer, something you want
to put on our record? Is there any final point that you think
needs to be made?
Mr. Cammock. I would like to say one thing with reference
to the bromide tablets that were talked about earlier on. One
of the problems in the Gulf was the bromide tablets. You were
given a handful of tablets and ordered to take them on a
regular basis. When it came to people working on shifts,
working 12 on, 12 off and if they happened to be sleeping at
the time, they would probably, as in most cases happened, took
their bromide tablets prior to going to sleep. When the alarm
went off and they jumped out of bed, the order came from the
NCO or officers, ``Take your tablets now'' and they would be
taking tablets again. In some cases it could only be a matter
of hours before they took the previous one. So, the three doses
a day did not occur on a regular basis.
Mr. Shays. My theory was if two, three or four would be
better, I tried that on my lawn and ended up with a pretty
brown lawn, but that was not my life and we do know we have
testimony that when the alarms went off, some of our military
personnel did more than was required and they did as you
pointed out, Mr. Perot, at the wrong time in the heat of the
battle. Any point you wanted to make?
Mr. Rusling. I would like to confirm what has happened
during the Gulf War, our soldiers from both sides need to know
if they go to war they are going to get proper medical care and
proper assistance should they be ill. This should not happen to
the next generation of servicemen, the war on terror and we
need to know that there are proper ways for medicals and it
won't happen again.
Mrs. Thompson. I would just reiterate Nigel maintained he
would not be alive to see the results of an independent public
inquiry. I just fear how many more veterans will also not be
around to see the beginning of this public inquiry, let alone
the conclusion of one.
Flight Lieutenant Nichol. I think it has all been said,
Congressman Shays. So, thank you, Mr. Perot, thank you as well.
I hope in five or ten years we are not still talking about it.
Mr. Perot. You won't be. We were exactly where you are
today. Is that a fair statement?
Mr. Shays. That's a fair statement.
Mr. Perot. But once our leaders solve a problem and you
say, Who is keeping this going? It is career employees. Once
our leaders saw what was really happening they took the
leadership role. You can do the same thing but you need to keep
up the good fight, make sure they get all the information that
you see.
Mr. Cammock. In 1997 I spoke to your Committee in
Washington. Since that date nothing has changed, not one iota
has changed of any research or any of the government.
Mr. Shays. If it is any consolation to you, what you said
to the Committee made an impact in the US and had an impact on
the veterans in the US and we were grateful for those points. I
am going to conclude by saying to you all that tomorrow I have
an opportunity to address some members of parliament. I am
going to repeat your requests of all the things you could ask
for, you ask for honesty. What a beautiful thing to ask for and
what an easy thing to comply with. This part of the hearing is
over and we will have a break with the panel. We will take a
two minute recess.
[Recess.]
Mr. Shays. I would like to call the Inquiry to order and
welcome our guests, our witnesses as well and I am requested we
speak as loudly as we can. To welcome and introduce our second
panel we have Patrick Allen, senior partner of Hodge Jones
Allen, leading solicitor on compensation payments for Gulf War
veterans. We also have David Laws, Liberal Democrat MP with
constituents who have suffered many serious illnesses they
attribute to serving in the Gulf. We were going to have the
Countess of Mar, I think she is not as well as she needs to be
to be here today and we have Paul Tyler, a member of parliament
on the effects of organophosphates and other issues relating to
Gulf War illnesses.
We are going to invite each of our witnesses to submit
whatever statement they want for the record. It will be
submitted and made on the record and if they want to make
additional comments they should feel free and we thank you for
your patience and are grateful that you are here. Mr. Allen,
you have the floor as we say in the US.
STATEMENT OF PATRICK ALLEN, SENIOR PARTNER, HODGE JONES ALLEN;
HON. DAVID LAWS, LIBERAL DEMOCRAT MEMBER OF PARLIAMENT; AND
HON. PAUL TYLER, MEMBER OF PARLIAMENT
STATEMENT OF PATRICK ALLEN
Mr. Allen. Thank you for this opportunity of addressing you
this morning. I have prepared a memo which I have submitted
which I hope you have and I will try to summarize the main
points of that memo in a few minutes.
My law firm in Camden, London has a contract with our
government, with the Legal Services Commission to carry out
investigations into Gulf War Illness compensation claims. The
legal position in this country is that UK servicemen and women
have a right to make a claim against the government for
personal injury or death by negligence or other torts in
relation to events which take place after 1987. This followed a
change in law after that time. Claims are made in the normal
way through the courts and there are many claims.
My firm acts personally for about 600 veterans and we
coordinate the compensation claims for about 2,000 veterans
altogether. We have a team of two full time advisers and they
carry out all the relevant research and look to report papers
from all round the world relating to the Gulf War. We have
carried out a limited number of tests and we have considered
and are considering all the suspected causes of Gulf War
illness which you mentioned this morning.
Recently the MoD has set up an investigation into depleted
uranium and there is a DU Oversight Board which meets in order
to oversee those investigations and we have a member on that
Committee. Obviously, we cannot disclose the results of our
inquiries because that is covered by legal professional
privilege but no proceedings have been issued in the English
courts at this moment against the MoD, with the general
extension of time given by the MoD.
There is limited no fault financial compensation available
to Gulf War veterans in this country. They are entitled to
apply for a war pension under the War Pensions Scheme
administered by the War Pensions Agency if they are injured or
become ill in the course of military service. There has to be a
causal link between injury or disability and service in the
armed forces. For claims made within seven years of leaving the
service, the burden is on the Secretary of State to show the
disability is not linked to service but I think you will see
the benefits under the scheme are very modest and for 100
percent disablement the payment shows 6,250
disability level.
Around 53,400 member of the UK armed forces served in the
Gulf War conflict. About 2000 of these have notified the MoD of
their intention to claim compensation for Gulf War illness and
as at September, 2001, 1231 applications had been made for war
pensions by Gulf veterans and of those 1038 had been granted.
In my paper I summarize the international state of
epidemiology in the Gulf War illness which I think we are all
aware of. There have been many studies carried out in the UK,
Canada and US that have all roughly come to the same
conclusions. They have studied Gulf War veterans and compared
them with those who have not been in the Gulf and found that
those who served in the Gulf suffered two to three times more
than those who did not. It is remarkable how many of them come
up with incredibly similar results. Simon Wessely has reviewed
the cases in a paper in January, 2001 and he says and I quote:
``There is a health effect and it is not trivial. It is not
due to selection bias.''
The fact that people are coming forward and filling out
their own questionnaire, there is a general health effect. Our
approach recently has been firstly to attempt a mediation of
Gulf War claims against the MoD and with the time and expense
involved in a full-blown court case. We therefore made an
approach to the MoD to consider setting up a mediation which is
the form of alternative dispute resolution which will be on a
local basis and consider not just compensation claims but all
the matters of concern to veterans.
Now, unhappily, that approach was eventually rebuffed.
There was considerable correspondence with the Prime Minister
and his Ministers. Lord Morris assisted us with that
correspondence. At one time we thought the matter was going to
be considered favorably but at a meeting with Dr. Moonie in
March, 2001, he said there would be no discussions along these
lines, this despite the fact at about the same time in March,
2001 the Lord Chancellor issued a press statement on behalf of
the UK government saying all departments would use mediation
and dispute resolution as a means of settling claims brought
against government departments.
However, the Prime Minister clarified the matter in May,
2001 in a letter to Lord Morris:
``The MoD is very happy to discuss these issues (DU) or
other issues with veterans or their legal representatives. I
know that HJA attach importance to dealing with matters of
dispute which go beyond the issue of liability and
compensation.''
--and that they would be happy to have discussions with us
on the basis that there is no legal liability for Gulf War
veterans. We embarked on some meetings on issues. It appeared
as long as we did not talk about compensation and we had two
meetings, one was to highlight concerns about the veterans
about the administration of the pension scheme itself, there
were great worries, it worked in a slow unreliable way,
inconsistencies with the decisionmaking and we discussed this
with the Head of the Pensions Agency and that did result in
some helpful moves and some of the problem cases were dealt
with.
We then had a meeting with MoD officials to talk about the
Gulf Veterans Medical Assessment Program. You may know the
GVMAP was set up by the MoD to make an assessment of Gulf
veterans who were not well and this has been going on since
1994. Something like 2000 Gulf veterans have been seen and they
h ave found that many are not well, in fact about 20 percent
are not well. What we have been concerned about is there is no
follow-up for those who are not well. This is simply an
assessment and the results of the assessment are sent to the
veteran's doctor and it is up to the British NHS to take over
any relevant treatment at that point.
We are aware that the Americans have taken a different tack
on this and we have been carrying out a detailed search to
discover the best treatment for Gulf War veterans. There has
been a lot of research into this issue and the IOM have issued
a paper highlighting what they think are the best treatments
for the symptoms which Gulf veterans display, including chronic
fatigue syndrome, depression, fibromyalgia et cetera and they
remark on the use of behavioral therapy and exercise. I have
quoted in my paper what the IOM say they believe the Veterans
Agency should:
``Provide specific training to health care providers caring
for Gulf War veterans to ensure that they are skilled n the
principles and practice of patient-centred care and ensure that
healthcare practitioners serving Gulf War veterans are allowed
sufficient time with patients to provide patient-centred
care.''
No such advice has so far been given to us and this is a
matter of great concern to us. The NHS is the treatment area
and there is no military expertise, no coordination, only
fragmentation and variation across the country and we consider
that the option of treating veterans in the NHS is likely to
fail. They are not likely to have the expertise or resources to
tackle the problems of behavior therapy.
We consider that the way forward is for the MoD to set up a
Veterans Assessment and Treatment Center working with the NHS
which will provide the treatment needed. I quote in my paper
what Bruce George said in January:
``Therefore we have to look to treat, largely in a
sympathetic and symptomatic manner. Symptomatic treatment where
there is no identifiable cause is all that is available to
us.''
We thought we should call for a public inquiry. We believe
that only a public inquiry will allay the fears of veterans and
the public that all relevant evidence has been properly
examined. There has been a history of delay and secrecy on the
part of the government in the investigation and treatment of
Gulf War illness which has resulted in a loss of trust and
confidence among veterans. Conspiracy theories are common. We
hope that a public inquiry will establish where the truth lies
in relation to facultative illness and the alleged causative
factors and will highlight the best way forward for treatment.
We made a formal request to the Prime Minister recently. That
was rejected too.
[The document, ``Memo by Hodge Jones & Allen,'' follows:]
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Mr. Shays. Thank you, Mr. Allen. I was going to call you
the Right Honorable but I understand that would be giving you a
title you don't yet have?
Mr. Sanders. We are very generous about those things.
Mr. Shays. The Honorable Mr. Laws, it is wonderful to have
you here and you have the floor.
STATEMENT OF HON. DAVID LAWS
Mr. Laws. Thank you very much for the invitation and for
the boost to the campaign your being in the country has given
us. I have prepared a paper which has been given to you but to
bring you up to date I would like to not talk entirely to that
paper.
Mr. Shays. The entire statement will be put in the record.
Mr. Laws. I think I should make it clear firstly my reason
for involvement in the matter of the Gulf War and that is I am
the constituency Member of Parliament for Mrs. Thompson who was
here giving evidence this morning and any constituency MP with
such a case would take an interest, but I take a particular
interest because Mrs. Thompson is such an effective
spokesperson over this issue and speaks not only with great
passion but great balance and common sense and I am pleased to
support her today. There are four points:
The first point is why do we need to get to the bottom of
this issue? For Sam it is to get to the bottom of the issue and
what caused the death of Nigel. I think the other reasons have
been touched on. Knowing the causes of Gulf War illnesses would
assist in treatment, on compensation and help us avoid these
problems in the future for serving members of our forces, for
British and US who are at present serving in such places as
Afghanistan.
Secondly, to highlight the very poor record of successive
governments in getting to the bottom of the issue. This is not
a party political issue in the country. Successive Defence
Committees in the House of Commons have commented on the very
poor record of the MoD in getting to the bottom of this issue
and the year 2000 report of the Defence Select Committee
summarizes the very poor record of the MoD and it draws
attention to the 1995 report of the Defence Select Committee
and that report stated:
``In responding to the allegations of a Gulf War syndrome
MoD has been quick to deny but slow to investigate...MoD's
response has been reactive rather than proactive and
characterized throughout by scepticism, defensiveness and
general torpor.''
In the Defence Committee's 1997 report, concern about the
way in which the MoD was pursuing the matter was reinforced
when the Committee stated:
``We do not feel that the Ministry of Defence has been
dogged in pursuit of the facts.''
Even the recent report expressed concerns about the way
this matter was being dealt with and drew attention to the fact
that veterans and veterans' families do not have confidence in
the way the MoD is pursuing this matter and does not have
confidence in the department which had overarching
responsibility for British troops in the Gulf War investigating
its own behavior and responsibility towards the troops. We have
a problem we are leaving the department responsible for what
happens in the Gulf to investigate its own abilities and that
is not a very satisfactory state of affairs.
One other point is relative to recently and that is the
experience of Shaun Rusling. You referred earlier on to what
was needed from politicians in relation to these issues is
honesty, but we see in relation to Shaun Rusling there is a
lack of honesty from the government. Mr. Rusling had his appeal
by the War Pensions Agency upheld and they proved the fact that
he is suffering from Gulf War Syndrome and they criticized very
clearly the MoD for amending the diagnosis to change the words
Gulf War Syndrome to symptoms and signs of ill-defined
conditions. They said in their summing up:
``We know of no basis under legislation which entitles the
Secretary of State effectively to withdraw an appellant's
appeal by replacing a rejected condition with accepted one.''
Therefore, I took a question to the MoD asking them the
reasons that they changed the appeal papers of Mr. Rusling and
why they ordered them and after a delay, the answer came back
that it would appear not all the appeal papers of Mr. Rusling
had been presented at the Appeals Tribunal in 1999 and at that
tribunal further diagnoses for appeal were identified and this
required a new set of papers. This is the kind of obfuscation
which gives the MoD a very bad name and we are making in
relation to Mr. Rusling's own decision to find out because of
the decision of the War Pensions Agency Appeal Tribunal the
government will accept the diagnosis of Gulf War Syndrome and I
asked the Secretary of State for the Defence whether he would
make a statement on that issue as to what issue the government
is going to take as a result of that fundamental ruling.
I tabled it some weeks ago and on 13th June I received an
answer back from the Minister which just said, ``I will answer
shortly'' so we are still left waiting for what the
government's response to this very key area is and frankly
after 11 years you would have thought we would be more together
than that.
The other issue is whether there should be a public
independent inquiry on the matter and I think all of us giving
evidence think there should be because it is the only way we
can get to the truth. In 1994, the Minister of the Armed Forces
told the House of Commons he did not want to have an inquiry
and the excuse was:
``In the absence of any confirmed scientific evidence that
there is a health problem resulting from Gulf service, I do not
believe there are any grounds at present for such an inquiry.''
So, the argument was that there was no evidence to have--
Mr. Shays. Just to interject, if you don't open the door to
see what is in the room, you are not going to see the evidence.
Mr. Laws. Exactly and earlier this year the position of
Ministers is still there should not be a public independent
inquiry but I was told by Mr. Ingram at the MoD that a public
inquiry could not help to answer the question why some Gulf
veterans are ill, only continuing scientific and medical
research can do that. In fact, there seems to be an acceptance
that there is an unusual illness for people who served in the
Gulf but the argument is now the inquiry itself could not do
the scientific and medical research. That is obviously true but
it is wilfully misleading to the person producing that research
to make sure it gets done rapidly and on time.
To finish, the Minister for Veterans Affairs in the House
of Commons and the MoD also wrote on 8th April and he said:
``The Prime Minister does not believe that an independent
public inquiry into this matter is appropriate at this time.''
Then I pressed the Minister further to answer in what
circumstances would it be appropriate to hold such an inquiry
into this matter and I am afraid in relation to the lack of
honesty of the MoD, the answer came back:
``If the circumstances were to change, a public inquiry may
become the appropriate mechanism.''
I don't know if you have civil servants like we have in
this country.
Mr. Sanders. Oh, no, none whatsoever.
[Laughter.]
Mr. Laws. This is the real equation of the issues.
Lord Morris. Since then, David, I have been told that the
possibility of a public inquiry being appropriate is not
excluded. Those words were chosen with clinical care.
Mr. Laws. I think you are absolutely right. They are the
same words as in 1994. ``I do not believe there are any grounds
at present for such an inquiry.'' So, whether it is a door we
can kick in or whether it is a form of words to say we should
not have an inquiry now is delaying it indefinitely, but thank
you for highlighting the issues and rather than ending on a
sour note, quoting the MoD, you may have noticed Britain's
leading newspaper had an article in which it backed the call
for a public inquiry and that is a helpful opportunity.
[The statement of Mr. Laws follows:]
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Mr. Shays. Thank you.
Mr. Tyler?
STATEMENT OF HON. PAUL TYLER
Mr. Tyler. Can I echo the thanks of my colleagues to all
your team for giving the opportunity for us to give evidence.
As with colleagues here I do not intend to go through all my
statement.
Mr. Shays. Your statement will be part of the record.
Mr. Tyler. Thank you. What I would like to do is highlight
one or two points but in addition I have provided for your
counsel something from Hansard, our official record, which I
hope may be helpful and I will come to that in a moment.
I am not a medic nor a scientist, I am, like you, an
intelligent layman. I happen to be a member of the Royal
British Legion Gulf War Group and I became that because of my
long-term campaign because of the damage done to so many people
by organophosphates and it was through that route I came to the
issue of the Gulf War veterans and the Gulf War syndrome.
I start from the position that I do not know whether there
is a connection between organophosphates and the symptoms that
have been exhibited by some of the people you met today and
many, many other veterans on the other side of the Atlantic.
That is not the issue. The issue is that nobody seems to know
and 11 years afterwards somebody ought to be really certain.
That is the real scandal, real tragedy.
In my statement I refer to the symptoms that are common
from acute organophosphate poisoning and I took this from
Health & Safety guidelines note MS17 which was not intended to
guide those who went to the Gulf. Had it been available to
those who went to the Gulf we may have had a different
situation. It reveals a huge range of symptoms. This diagram is
taken from your own Environmental Protection Agency which
illustrates everything from the top, memory loss to muscular
loss at the bottom and many of those are similar to those
exhibited by Gulf War veterans.
The chronology ran roughly like this on this side of the
Atlantic: In early 1994 it became apparent that some
organophosphates had been used in the Gulf and as a result of
that later in October, 1994 I tabled a parliamentary question:
``How many British troops were exposed to organophosphates
pesticides, including malathion, during the Gulf War, and what
research his Department has undertaken into the links between
the use of these pesticides and Gulf War Syndrome.''
The then-Minister was due to reply on 3rd November:
``I am aware of only 10 British service personnel who would
have been involved.''
And he went on to explain they were simply involved in
spraying some 50 Iraqi troops, delousing them. However, despite
the fact that that was used, a MoD memorandum produced later
demonstrated that in fact that was not the true position. It is
all here in my statement I will not go through it all for you
but the true position was that many troops were exposed to
organophosphate pesticides. Their equipment was sprayed. The
basic precautions that should be taken when using these
extremely dangerous pesticides which I am sure you know were
originally developed in the last World War as a germ warfare
agent, that these pesticides were used extensively, warnings
were not noted, indeed such was the necessity to increase the
supply that they were bought locally when, of course, the
instructions were not in the language the operators could
understand.
As a result of the admission, the information given to me
in the House of Commons was completely inaccurate; the then
Minister apologized to the House and to the Select Defence
Committee that the mistake had been made. As a result of that
the Royal College of Physicians was asked to investigate this
particular issue. Again, I quote their conclusions which were
basically to say that far greater resources had to be made
available in the efforts to discover the causal links behind
the suffering of many Gulf War veterans.
Two major concerns were highlighted by the Royal College.
First, it did not seem and this has come out from all your
witnesses this morning, that the government was taking
seriously the concerns of service personnel who went on our
behalf, on behalf of the free world to the Gulf. As a result of
that lack of interest, not nearly enough resources were being
given to this particular issue.
In March this year I asked a parliamentary question again
of the Armed Forces Minister that he would give:
``a list of international studies of the effect of exposure
to organophosphate pesticides with particular reference to the
1990-1991 Gulf conflict.''
I have provided for you his answer to that request. That
request I put before the Royal British Legion Group on 21st
March and with the help of Professor Malcolm Hooper from whom
you are going to have a witness statement this afternoon, we
have been able to identify a huge range of discrepancies in the
answer given by the Minister on this very specific issue on the
relevance of organophosphates to this particular problem. That
is in my supplementary pack for you but no doubt you will wish
to talk to Professor Hooper about that. Obviously, his
expertise is far greater than mine in these matters.
As a footnote I want to make a quick contribution on the
continuing saga referred to already of Shaun Rusling's appeal
to the Appeals Tribunal. This morning in Hansard I have got
another statement back from the Armed Services Minister, Dr.
Lewis Moonie. Again I need not read that into the record but I
think it displays a continuing failure to understand the
severity of the problems faced by the veterans and perhaps even
more serious the MoD seems to be in denial when it comes to the
actual use of the words Gulf War Syndrome. Even when the
Pensions Tribunal in making its award to Mr. Rusling as you
heard this morning, even when there on the official paper it
referred to the Gulf War Syndrome, the MoD refuse to
acknowledge that there is such a thing and that as a starting
point for a really rigorous inquiry seems to me and I am sure
many others, to fail dismally when it comes to answering Mrs.
Thompson's point which she made at the end of her submission to
you this morning: Will the government now be honest about this
particular problem?
I have on a number of occasions pressed the government,
both through the Leader of the House whom I shadow in the
Commons and in terms of questions to the MoD to try and get
that degree of clarity into their performances.
Mr. Chairman, I think this issue is not just important in
terms of looking back. As Mr. Perot has already said this
morning, it is possible that our troops may again be engaged in
a similar conflict, perhaps even in that particular war theater
in the Middle East. If so, it is critical, it seems to me, that
we are better prepared, we know what is involved and we protect
those who serve on our behalf in a more effective way.
At the end of my statement I have made a very short
submission and perhaps I should read that to you. First, I
believe that the MoD and the operational command structure for
UK service personnel in the Gulf War were either misinformed or
negligent in the way in which they authorized, organized and
monitored the purchase and use of organophosphates. Secondly as
a result, the MoD failed to acknowledge and investigate the
potential role of organophosphates in causing significant
illness amounts UK service personnel (especially those directly
exposed to risk from OPs). Thirdly, even when the mistakes were
discovered and admitted, MoD failed to investigate with
sufficient urgency and resource the significance of this
connection, or for example, the remarkable coincidence that
other allied forces, not exposed to OPs, experienced less
symptoms of illness. I think there is evidence that the French
are in that category.
Four, the recommendations of the Royal College of
Physicians report (commissioned by the Government) have not
been followed through in terms of increased emphasis and
resources, or even taking advantage of the more extensive and
effective US research program. Finally the Shaun Rusling appeal
case raises alarming new concerns about the MoD's true
commitment to a full and fair investigation of the Gulf War
Syndrome; the determination of the US Congress to achieve an
exhaustive investigation should prompt the UK government to
take a more proactive stance, and to fulfil its obligations to
especially deserving British service personnel.
One final point--
Mr. Shays. Please do. Can you make it brief?
Mr. Tyler. Lord Morris referred to the fact that originally
a question elicited the answer that only one person amongst our
troops was affected by the blowing up of the chemical dump, the
plume and I established in a recent question that there were at
least 9,000 individuals who were affected. That degree of
mistake is more than a discrepancy, it is a disgrace.
[The statement of Mr. Tyler follows:]
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Mr. Shays. I would say it is a real issue where the plume
went because our numbers were much smaller but go into 50,000.
Mr. Sanders?
Mr. Sanders. Thank you again for your testimony. My Tyler,
as I understand it, you came to this issue because of your
general concern about the impact organophosphates might have on
human health. One of the themes that has also interested me is
the fact that many of the illnesses being suffered by the
veterans are not new illnesses. They are illnesses that we see
in civilian society every day. We have heard what you call
Motor Neurons Disease we call ALS, this is not a new illness.
It is something in the civilian society. We are also looking at
problems like chronic fatigue syndrome. That is what we call it
in the US; memory loss or failure to concentrate is a common
symptom for a Gulf War veteran, irritable bowel syndrome,
depression or mood swings. We heard testimony from people who,
if they were exposed to perfume would become quite opposed to
it.
My question is: Given the fact that many of these symptoms
have been seen for many years and associated with many
organophosphates in chemicals, why has that connection not been
made more quickly in terms of Gulf War illness? Why has someone
not said, ``This is nothing new, this is what happens when
people are exposed to organophosphates?' Why has there been the
reluctance on the part of the government or some of your
researchers?
Mr. Tyler. I think your experience must be the same as
mine. I think it is quite extraordinary that it took a question
from me, a mere layman with no experience apart from my
interest, why was it the symptoms were so similar? When I got,
``Well, so very few people were exposed so that can't be the
connection.'' It was months and months later that the admission
came out of the MoD saying the answer was entirely wrong and
thousands of our troops were exposed to organophosphates. So,
the only answer I can give is the lack of information in our
various departments, after all, the experts here in London were
very knowledgeable about the effect of organophosphates and
were beginning during this period as a result of campaigners I
have been associated with, to be aware of the very considerable
dangers of people's exposure, the fact that people went to the
Gulf without that information was in fact a scandal without
what happened later.
Mr. Sanders. Where are these experts, these medical people,
researches now? How can they evade the issue? I have spoken to
hundreds of physicians in one room who treat people who are
made ill by exposure to chemicals and then I believe that the
AMA medical organization have diagnosed this does not exist.
So, this is a very hotly debated issue in the US. Many people
do not believe it. My question is, I presume, is there at least
a body of thought within the UK whether it is health department
people, people in agriculture who understand the potential
danger to organophosphates and say, ``This is nothing new, we
have seen this for dozens of years and of course this is what
it is about.'' Where are those people, where are the voices?
Are they working with the veterans organization to pressure the
government?
Mr. Tyler. The answer to your question is, yes, yes, yes,
yes. Professor Malcolm Hooper is a leading expert and he is
coming this afternoon. I think it will be better if he gives
you the detailed information you are seeking rather than me as
a layman.
Mr. Putnam. Mr. Allen, your firm has retained two
scientific bodies who are working on the Gulf War symptoms we
have referred to today.
Mr. Allen. They are not collecting the work. We are
analyzing the work. We cannot put the resources you need to
conducting your own research and the Americans have spent many,
many dollars and I know the MoD have spent over 1m.
We are a law firm funded by public funding.
Mr. Putnam. That is in a review capacity?
Mr. Allen. It is a review of the many articles and papers
which are published on the Internet.
Mr. Putnam. Mr. Tyler, the focus of your work has been on
the role of organophosphates. Do you believe the vaccines and
the treatments are not contributing factors to the Gulf War
illness?
Mr. Tyler. I don't have the expertise to rule it out. It
could be that those who were exposed to organophosphates and
had those vaccines, that may well have triggered the sort of
symptoms that we have been witnessing. I think that those you
will speak to later will give more detailed scientific evidence
on that point. I think looking at the most limited point there
could well be an interaction as we indeed have found with other
people in other walks of life who have been exposed to these
pesticides.
Mr. Putnam. You referred to French evidence. I am not
familiar with that. Can you elaborate on that?
Mr. Tyler. I understand that organophosphates were not used
amongst any of the French troops at all and there seems to be a
much lower level of reported ill health which would suggest
that that may well have been a negative factor, a double
negative. That is anectodal, I don't have any direct evidence
from the French government or any inquiry in France. It may be
Lord Morris can add to that.
Mr. Shays. At this time, Lord Morris.
Lord Morris. Christopher, I think you were extremely
fortunate in having such an impressive panel of witnesses for
the bereaved and those who are chronically sick due to the Gulf
War and I think we are very fortunate again that we have
Patrick Allen, David Laws and Paul Tyler. Perhaps I could first
of all ask David Laws, why does he think the government now,
you said successive governments have been resisting a full
public inquiry. Why does he think that against the mountain of
evidence of direct links between the illnesses of Gulf War
veterans, they are still resisting? Why is it so important to
pursue this matter after the Gulf War ending and what is the
MoD's reaction to the decision by the Appeals Tribunal in the
Shaun Rusling case?
Mr. Laws. Well, not only do people who have lost loved ones
want to get to the truth but we can sort out compensation, the
treatment of those people and make sure servicemen we are
sending out now to do the same tasks, to make sure they won't
have the same type of health problems in the future.
In the MoD we have three problems. In just talking about
the very nature of the MoD, it is used to the culture of
secrecy and not seeing very much as being part of the mentality
of the health department. There are a few other issues, the
issue of compensation but for the MoD to accept direct
responsibility, I don't think that is the overwhelming factor.
I just used what we are expecting the MoD to do as a department
is to take responsibility to get to the bottom of a problem
which may have arisen as a consequence of failures whether
understandable or not; failure of the people accountable in
1990 and 1991 and no one likes to mount a great searching
investigation into issues likely to reflect badly on
themselves.
Lord Morris. My approach was to go to the Prime Minister on
the grounds that more than one department is involved and that
the case, the centrally important point in the case was that a
departmental inquiry is not good enough. So, that is why I
approached and Patrick knows all about this, the Prime Minister
to say that only the Prime Minister could arrange a wide-
ranging inquiry with all the departments across Whitehall.
Mr. Laws. I think you are right and it may take momentum
from someone outside the Prime Minister looking at the issues
to get an independent inquiry. When the government came in in
1997 it did not have the historical baggage so it started off
more interested in getting into office; however, Ministers come
and go but our servicemen remain the same. So, the culture is
not to get to the bottom of the situation so I think you are
right, it may take the Prime Minister to force the MoD to think
again.
Lord Morris. Patrick, you are a highly respected lawyer in
this field who said that you support a public inquiry. I think
it might help our American colleagues if you could tell them
about the kind of issues, tragedies that have been looked into
by public inquiries like Paddington, Alderhay, the sinking of
the Marchioness and the scale of those tragedies compared to
this one.
Mr. Allen. Sadly, we have had quite a number of national
tragedies, mainly concerned with transportation disasters and
generally speaking there has been a public inquiry. Sometimes,
the government has tried to save money by not having one. That
is not the case with the Marchioness where a pleasure boat sank
in the river and the public inquiry only took place ten years
later. They want to save money but getting to the truth can be
quite expensive. You have to really assemble in public all the
relevant evidence with witnesses and then those concerned, the
injured and bereaved, can see issues are being got at
responsibly and can be satisfied there is no stone unturned.
With the Gulf War it is the opposite. There is suspicion
that things are covered up and delays and the MoD have a lot of
the facts. They control a great deal of the information. Most
of us do not have the information. They have information about
which vaccines were used; some medical records were destroyed
inadvertently, we understand, but only by having a public
inquiry can the injured, the bereaved get their hands on the
information. In the past we have got to the truth, sadly a lot
of the recommendations have not been implemented but at least
the public links have taken place and that is what we need with
Gulf War illness.
Lord Morris. You point out that 100 percent for disability
pension is not a king's ransom. I know Ross Perot's favorite
quotation from Kipling is as follows: ``Look where he's been,
look what he's seen, look at his pension and God save the
Queen.'' But, I am very glad that you point out we are not
talking here of creating millionaires.
Can I just turn to Paul. Paul, I think it was John Major, a
constituent of John Major's who said he was spraying in the
tents and, of course a great many people who were not mentioned
in answer to you were very closely involved in that they were
spending all day every day spraying the tents where our
soldiers lived, with organophosphates and it was reported that
some of them were soaked to the skin with organophosphates. How
can it possibly be thought by anybody that that would not have
very serious consequences against the background of our
experience in the farming industry in this country?
Mr. Tyler. That is absolutely right and it was indeed not
only that that was revealed much later which meant, of course,
there was a delay in anybody taking very effective remedial
action, but it became apparent as I did mention, that some of
the organophosphates that were used were purchased locally,
presumably in a bazaar, who knows where, with Arabic
instructions on them so there was no possibility of those using
them understanding the very considerable dangers, the
precautions they should have used nor provided the basic advice
then available here in London in other departments for those
manufacturing organophosphates and for those using them in
other wars.
Lord Morris, you are absolutely right some of the people
were absolutely saturated. Then of course the question was
raised and the MoD has tried to use this as a way of trying to
explain why they did not follow this. In those circumstances
why didn't all those people concerned go down with a very
serious illness and it may be members of your team have seen
this illness. It would appear some people are more genetically
vulnerable to organophosphates than others and this has been
proved in the agricultural field alike. It shows again the lack
of medical follow-up.
Mr. Shays. Let me just say that is a wonderful statement
that after lunch we can introduce those in the medical
community and academic community who will speak to the issue.
Mr. Perot you have the floor for ten minutes.
Mr. Perot. I would like to thank you for your honesty,
integrity and courage for taking these issues to parliament for
the armed services. I know how much that meant to them and God
bless you for what you are doing. All the studies on the
organophosphates I can truly say from World War II where the
question was did you have flat feet, if we get all the things
going you are trying to get done, genetic makeup, our
vulnerability to many of the chemical and biological weapons
out there, I would like to ask you, our government is now being
very aggressive, looking at all these issues. Our real
challenge is to get the British government take the same
aggressive attitude. Let's find out what the problem is, so on
and so forth. What is the realistic way to get the British
government to react? We had the same problem. We had all these
people in place saying ``this is not right'' so on and so forth
and now we are really starting to move. It's late but better
late than never. But, in terms of protecting our troops and
population in the future it is important to get it done. What
would be your advice for the best way of getting it done?
Mr. Tyler. Rather than giving you advice we are taking your
advice because you are one step ahead of us. There are three
elements critical to us. We as representatives don't give up
and don't intend to give up as you have not else you would not
have been here. Second, media interest. I don't know to what
extent it has happened in the States but here on television,
radio and written media there is a continuing concern to the
way we treat our veterans and I pay tribute to the way the
Daily Express has taken up the case and done a grand job. The
third thing is we learn from one another. It is absurd people
who stood shoulder to shoulder in the Gulf can't stand shoulder
to shoulder about the work being done with their veterans.
Mr. Shays. If I can just interrupt, that key point is why
we are here. We are shoulder to shoulder, we are trying to
learn from you and you can do some learning from us.
Mr. Perot. Anything that we can do that would be helpful we
are right there. Again, my question has already been asked but
I want to thank you because I understand this is a lonely
mission but the military troops are on long lonely missions all
the time with their lives at risk and it takes time and energy
to stay on top of it. Thank you so much.
Mr. Shays. Thank you, Mr. Perot. I won't take my full ten
minutes but just respond, Mr. Tyler, to your point about
organophosphates. We also want to respond to you, Mr. Laws. You
were almost having to explain why you were here because of a
constituent and I think that is important to continue to
emphasize we are laymen in our field. We are members of
Congress, members of Parliament but it tends to be onerous. It
is like going to a large university, getting a passing grade
but then we specialize in a few areas and we respond to our
constituency. All of your constituents would want you to
respond to the few and in the case of my work in Connecticut I
have already mentioned one gentleman, an air force pilot who
served in the Gulf War. There was another one who was told his
job was to spray the Iraqi prisoners and he did it in a large
tent with no ventilation with no air conditioning and he spent
eight hours a day, give or take, day in and day out spraying
prisoners, tens of thousands of prisoners with lindane which is
an organophosphate. Shortly after he contracted pancreatic
cancer and died and there was incredible effort on the part of
the government to say no connection.
We went out and came back with this answer, but what amazes
me is we focussed on the workplace. We would never have allowed
lindane to be used in that way without preventive gear,
ventilation, so on. Probably what we have learned as well, you
all in Great Britain have this same practice as we have in the
US and that is we can order our troops to do something that
would be against the law to do.
Finally I want to say there will be more wars and it is
incredibly sad we have not learnt from previous wars. I also
had a constituent who had lung cancer. He had sprayed British
airplanes involved in nuclear tests in the US. Listen to this
answer. He was denied benefits because he was not cleaning an
American plane so the view was it was not a US airplane. We had
to come back and say ``But he was under US command to clean and
wash down that airplane.''
So, I don't have questions because you all have done a
wonderful job. I would just finally conclude by saying is there
anything we should have asked you that we should make part of
the record, anything you feel needs to be put in the envelope?
Mr. Allen. I think the government should set up a Gulf War
compensation scheme; they should set up a proper treatment
program similar to America and there should be a public inquiry
into Gulf War Syndrome.
Mr. Laws. I would like to say finally in response to Ross
Perot's question, what will get a public inquiry. It is clearly
going to require an independent external force on the
government rather than a response to the veterans who for many
years have been fighting this case. That is why it is so
important that the Shaun Rusling case got such a high profile,
but you came to the country and that gave a terrific boost to
put it back on the agenda.
Mr. Tyler. I think your words about the necessity to take
advantage of some of the specialists I hope will be partially
fulfilled this afternoon. Not only have we got Malcolm Hooper
but also Dr. Goran Jamal who has already given evidence to you
and I have worked with him on the neurological effects of
organophosphates and I am sure you will find that extremely
helpful.
Lord Morris. Can I say how sad the Countess of Mar was not
to be able to come. I am sure Margaret, had she been here,
would have been very proud of our witnesses.
Mr. Shays. I can say for the record we met with her in the
US and we met with her here. She was a very compelling person
who argued that both the US and Great Britain do more to deal
with this issue.
We are going to be on recess for three-quarters of an hour.
We will begin fifteen minutes earlier and I would encourage the
staff to see all the witnesses are here. I believe all our
witnesses are invited to lunch. Do get some lunch and then we
will reconvene in 45 minutes. I thank you Mr. Laws, Mr. Allen
and Mr. Tyler. Thank you very much.
Mr. Shays. I would like to call our inquiry to order and
welcome our panelists and guests. Note for the record that we
do like the sun, specially in London, but we are probably going
to want to see the screen a little better and when we are
looking at the screen the members will sit on the chairs over
there.
I will announce our witnesses for this panel this afternoon
in the order that they will speak. Professor Malcolm Hooper,
President of the National Gulf Veterans and Families
Association. Second speaker, Professor Graham Rook on vaccine
hypotheses relating to multiple immunization programs. The
third speaker will be Goran Jamal on neurology relating to Gulf
War veterans. The fourth speaker will be Dr. Mike Mackness on
paraoxonase and finally number five will be Chris Busby on the
effects of depleted uranium. We have the five very respected
panel members and we are delighted that you are here and we
will start with you, Professor Hooper.
STATEMENT OF MALCOLM HOOPER, PRESIDENT, NATIONAL GULF VETERANS
AND FAMILIES ASSOCIATION; GRAHAM ROOK; GORAN JAMAL; AND MIKE
MACKNESS
STATEMENT OF MALCOLM HOOPER
Professor Hooper. Thank you very much, sir. I think it is
time for you to move now.
Mr. Shays. I feel very nervous not having a microphone.
Perhaps I'll take the gavel. You aren't going to get too
technical on us, are you?
Professor Hooper. I hope not.
First of all, thank you very much, Chairman, Lord Morris
and all the other members of the Panel for inviting us to
speak.
[Slide presentation.]
Professor Hooper. This is who I am and the point I want to
make here is what we are seeing is the most toxic war in
Western military history was fought in the Gulf War. The bottom
line for me and I think many people is truth, justice and our
shared humanity in common relationship with the land on which
we all have to live. It involved soldiers, people, military and
government and the debt of honor which is recognized by the
Select Committee 2000.
There are syndromes of uncertain origins described in the
Merck Manual 1999, 17th edition. It is known as Gulf War
Syndrome and also known as the ME of the military. All this
group of syndromes includes ME, chronic fatigue syndrome and
others, chemical sensitivity all of which have been diagnosed
on Gulf War veterans. In addition we heard earlier this morning
about organophosphates. All these clusters of syndromes give
rise to a large number of disorders of the various systems in
the body: neurological-ans, pns, cns, cardiovascular immune
system, gastrointestinal, respiratory, endocrine system.
Anything left? They are all disturbed in one way or another,
but the comment that you see very often is that patients
complain of disabilities; despite the wider range of
disabilities the routine laboratory tests are strikingly
normal. That is the reason for doing a number of routine tests
in my book.
But, one explanation is that this is all in the mind; it is
in the mind. That is one explanation. This is another
explanation we have been working with where all these
overlapping syndromes have dysfunctional states which cover
many systems. The brain immune system, the gut, the endocrine
system. So we have tryptophan, sulphate and lipid metabolism as
being part of that story. We have heard about that today.
I want to quickly go through this. Too many vaccines given
simultaneously. The MoD admits to 10 but you heard this morning
that it went to 14--
Mr. Shays. Can you talk a little slower and we are going to
ask you to look at the transcript and see the words are put in
a way that would be helpful.
Professor Hooper. Okay, 10 vaccines were admitted by the
MoD but you heard this morning some people had 14. One Gulf
veteran whose record we managed to reconstruct, had 18 in one
day. Another had 14 in two days in the Gulf. USA troops in fact
had 17 vaccines they received. They were given too close
together, in wrong combinations, live vaccine, cholera and
yellow fever negate their response. In defiance of established
protocols which are well written up in medical reference text
books and three UK studies have found 2-3 fold excess of
symptoms among Gulf War veterans and an association of symptoms
with vaccines.
The evidence against vaccines now is overwhelming in my
judgment. The study by Kings College is the first DOD report,
then Cherry and other colleagues at Manchester funded by MRC/
MoD. MRC approved the study and I think one of the most
important studies was done by Steele in the Kansas State study.
I think this is a very definitive slide because what it shows
is if soldiers were not given the vaccine only 3.7 percent came
up with symptoms like the Gulf War Syndrome. People who were
vaccinated but did not go to the Gulf, 11.5 percent of these
people showed Gulf War Syndrome. People who were vaccinated and
went to the Gulf showed 34.2 percent. This is clear evidence
that the vaccine played a clear role. The Rook-Zumla hypothesis
was in 1997, not 1999. Graham Rook is here to provide a deeper
understanding of what that means but he recognized that the
vaccine could provide some information.
The government independent panel has this title, it is not
my summary, it is its full title. All it does show is animal
studies. It has not looked at human beings at all. Guinea pigs,
mice and marmosets. The mice study will not be finished till
later this year; marmosets in 2003 and this is 12 years on and
then it is only with marmosets. The panel has been excluded
from conducting or recommending any studies of sick Gulf War
veterans. This has been challenged three times in its meetings
and three times the answer has been no.
Another important point is the cholinergic triple whammy
which includes pryadostigmine bromide which you heard so much
about, organophosphates, carbonates and sarin tabun vx agents
and possibly mustard gas. The inhibition of AchE leads to
increased levels of acetylcholine in all four systems and the
consequence is synergism. There is synergism between the two
compounds causing multiplication of something like 10 x 200
fold. Paraoxonase is being looked at by Mike Mackness and Goran
Jamal who present on the new role solely of the consequences.
Pyridostigmine bromide. PB cannot be ruled out as a
possible contributor to the development of unexplained or
undiagnosed illness in some Gulf War veterans. I raised this in
a paper to the Select Committee in 1999. The use of PB may
reduce somewhat the effectiveness of post-exposure treatment
for non-soman nerve agents. So you are into an issue of trading
off uncertain health risks against uncertain gains which is not
helpful.
Pesticides or organophosphates. These were extremely widely
used. It was denied then there was an apology. Diazinon,
malathion, some unknown from local sources. No proper
protection for the operatives or the troops. 1 HSE trained
operative diagnosed by MAO as organophosphates poisoned. It is
highly contentious and political because these were used by
agriculture, fish and other civilian usage. Pyrethroids and
lindane were also widely used and deet also very widely used in
large quantities. In addition, synergy has been demonstrated,
see Abou Donia et al in the States and you are familiar with
that work.
Chemical warfare nerve and mustard agents. Sarin, Tabun,
VX, no soman. Work in the States suggests there was no soman so
we need not have used PB at all. What was the source? Opening
air war, demolition of Khamisiyah and possibly some scuds.
Frequent alarms, all false, disabled, ignored and there was
persistent low level exposure not at a killing level. Eye
witnesses repeatedly confirm the presence of nerve and mustard
agents and we have had news from the Czech teams about this.
They have dismissed equipment as faulty not credible now
recognized as reliable. Does low level exposure give rise to
chronic damage? Yes from 1970 onwards.
This is the DU story and Chris Busby is going to talk about
this. This is a depleted uranium penetrator. A depleted uranium
shell equal to a dirty bomb using nuclear waste; 350 tons at
least were fired in the Gulf War and the hazard has been known
and understood since the 1970s. Health risks are impossible to
quantify according to a 1994 report and remedial action was
required--
Mr. Shays. Let me interrupt you. I am not asking you to
shorten this but how much more time do you need?
Professor Hooper. Just one more.
Mr. Shays. Please proceed.
Professor Hooper. There were no orders to the troops about
this, no advice, the troops were knowingly exposed because
people knew the material was being used. This resulted in
thousands of unnecessary exposures. The response by the
government was last year and the depleted uranium oversight was
discovered in 2001. So, nothing was done for twelve months.
This is an American veteran, he came back with his child,
you can see the damage to the child. This is an Iraqi child,
the photograph taken in Iraq, taken by Professor Guenther and
you can see the damage to the structure of the limbs.
The Medical Assessment Panel has seen some 3000 Gulf War
veterans. Papers and letters have been written by the various
teams since 1996. The latest paper is extraordinary in claiming
that of the last 1000 veterans seen by the panel 80 percent
were well but well with symptoms or organic disease which is
not my definition of well. They have turned to somatization,
war syndromes and explained Gulf War Syndrome and this was
roundly rebuffed by your Committee as I understand it--
Mr. Shays. Our Committee?
Professor Hooper. In Washington. The letter was
contemptuously rejected which said war syndromes were the cause
of the problem. We have also got now three categories of the
disease, not contentious: Motor Neurons Disease-2-3 times;
cancer of kidneys found in large excess and chronic lymphocytic
leukaemia ten times.
Mr. Sanders. That is ten times more for Gulf War veterans
than civilians?
Professor Hooper. Yes, from the three determined in the
medical profession. There appear to be no records of these or
any other diseases kept in the central program so we often
don't know what is going on. This is a quote from a letter from
a medical assessment panel:
``Very substantial progress has been made on Gulf War
related illnesses...the most telling feature being that they
are primarily psychological dysfunctions...recorded since at
least the American Civil War. Not unique to Gulf conflict. No
illnesses specific to participation in Operation Grancy. He has
a psychiatric illness. I hope he will not waste his time,
energy, aspirations chasing after non-existent organic
explanation that will never be found.''
That is the official line. Conclusions. It is not a result
of somatization or a manifestation of a general war syndrome.
It is not primarily a result of PLSD. It has multiple causes
not a single cause. It is an organic illness affecting multiple
systems resulting from the unique multiple exposures suffered
by Gulf War veterans.
[The statement of Professor Hooper follows:]
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Mr. Shays. Thank you. A wonderful job.
STATEMENT OF GRAHAM ROOK
Dr. Rook. First I would like to thank you for this
opportunity to address you on this question. I want to start by
making the point that Gulf War illnesses are going to have
extremely complex causation and we must not think of the
different hypotheses being in competition with one another. The
effects seen in individual veterans will be an ``integration''
of all the usual exposures to which they were subjected in the
context of individual histories and genetic backgrounds.
Now, you have heard a little bit from Malcolm about the
epidemiological links which seem to exist between vaccines and
Gulf War illness, so I do not need to go into those in detail
but you will remember that it appears even if not deployed,
there were more symptoms and it also seems there was a dose-
response relationship with symptom scores and the experimental
vaccines, plague and anthrax administered with pertussis seems
to be to blame. As well as that epidemiology there is a study
which has been submitted for publication from Dr. Mark Peakman,
a study of immunology superimposed on the epidemiological
studies which Simon Wessely and his department has undertaken
so there is a balance with the appropriate control groups and
that study is showing significantly increased expression by
peripheral blood lymphocytes, particularly interleukin 4 and
interleukin 10. You might want to remember those two because
they will turn up again.
Now, the hypothesis that we put forward in 1997 was that
long-term changes in the balance of the immune system could be
caused by multiple vaccinations. This would be exacerbated in
psychologically and physically stressed individuals and also by
the chemical exposures and this could lead to a diverse range
of symptoms including mood changes. So, I am going to show you
in the five years new types of information have come forward to
show the hypothesis was not as crazy as it was thought
originally and it is within the epidemiology and the immunology
done.
Here is a slightly complex diagram. There are three
players. On the left you have a bacterium and a list of
components, it could be a vaccine, for instance. In the middle
you have the antigen-presenting cell and on the right
lymphocytes. Starting with the uncommitted lymphocytes which
can turn into attaching lymphocytes, Th1 or Th2 or the green
fellow there called Treg, the antigen-presenting cell is the
one that tells ThO what to become, what pattern of immune
response is actually needed, but it makes that decision on the
basis I have drawn it, rather fancifully as a kind of keyboard,
a large number of signals it gets from the bacteria, it is
exposed; it is trying to decide which sort of organism it is
and which sort of response is appropriate in response to that
organism.
Say you played the chord of C sharp, you arrive at Th2 and
with B flat you get another lymphocyte. With others you get
regulatory cells. In the last few years it is clear that these
are unrelated to alogens in the atmosphere or air zone cut
content or because once these cells have picked up those
signals they wander up into your spleen or other lymphoid
tissues where they now have a different way of presenting what
other antigens they receive.
What sorts of evidence do we have that bacterial components
such as we find in a vaccine do indeed exert long-term systemic
effects on immulogical responses? Firstly there is the animal
model work. Much of it happened since 1997. Experimental models
of ``diseases of immunodysregulation.'' There is the immune
system which has gone wrong. There the body is attacking itself
where allergens are in the air and inflammatory bowel diseases
attaching to the bowel. There are many listed in the statement
showing you can block or enhance allergic disorders and
autoimmune disorders by vaccines and microbial components and
showing the induction of the regulatory T cells by the single
injection of a bacterial component. With the regulatory T cells
they turn off the response to something entirely unrelated to
the bacterial vaccine itself.
The first author there is from a large pharmaceutical
company and I will mention why that is a relevant point later.
When we wrote the paper it was already known that from the
consequences of routine vaccination of the public we could
already suggest that certain vaccines were having an effect on
the public, causing death in children, switching to Th2 status.
The guy who announced that lost his job until a group in
Baltimore proved him right and now it is no longer used. These
are non-specific effects on overall survival from all causes.
Then if we--
Mr. Shays. Can I just add to this. Tell me why what you are
saying is important? I need to put this into context.
Dr. Rook. It is important because it was saying that giving
a massive load of vaccines in the Gulf War could have systemic
effect on their overall immune systems for many years after. It
is important to show that we see it in the ordinary public;
just by giving ordinary vaccines we have an effect on the
systemic system. The exploitation of beneficial effects of
microbial components in clinical trials for treating diseases
of immunodysregulation is going ahead at a great rate in
allergic disorders-mycobacteria, lactobacilli, CpG motifs; DNA
has been the subject of an $18 million deal by Pasteur. Here we
have a type of effect of microbial components regulating the
immune system, getting pharmaceutical companies to put hundreds
of millions of dollars in it and yet we still have the problem
of persuading war departments to accept it.
Now we have the Gulf War vaccination schedules. There is a
huge amount of evidence given in my statement. This is an
example of the overall child survival. You can see the blue
line in children not given the vaccine; the dotted line, the
BCG increased survival from all causes, partially offset by
giving DTP as well. This is nothing to do with the diseases to
which the vaccines are directed. They are non-specific
vaccines.
The next element from the hypothesis was the effect of
stress. What is so neat about all this is pretty much tending
to become Th1 or Th2 or a regulated cell. But if you stress
people they turn out more cortisol, more noradrenaline from the
sympathetic system and cortisol and noradrenaline tell the
system to turn off the Th1 cells and to turn on the Th2 cells
and regulatory cells. Also, within the last couple of years
Kevin Tracey in New York has realized that in fact
acetylcholine is also a major regulator of these cell types.
So, if you give them that you will also be accelerating the
acetylcholine and curiously I do not think Kevin Tracey has
been brought into the dialogue on the matter but he is the one
that knows more about this in the world.
[The statement of Dr. Rook follows:]
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Mr. Shays. Give me a sense of how many more slides you
have.
Dr. Rook. Maybe two. I think it is two.
Mr. Shays. Well, you can have three slides.
Dr. Rook. It is only two.
Mr. Shays. Take your time.
Dr. Rook. This is the question of how could changes in
cytokines affect mood. There are a number which cause sickness
behavior: Sleep, diminished sexual activity, fever, appetite
control. They are not fanciful animal experiments, they are
certain now. If you give them to cancer patients or patients
with hepatitis or immunological mediators you get profound
depression. Goats get depressed but become manic upon
withdrawal of the material. Similarly, it is now clear that
twin studies relate Th2 disorders to depression. We can see
that from studies coming out of Denver.
So, the balance of the immune system affects moods in some
extremely subtle ways and I come to my summary slide which puts
all of this together. Over on the left there we have some of
the influences to which the Gulf War veterans were exposed:
Extreme stress, AChE inhibitors and vaccines. The evidence to
suggest that the effect would have been to take them away from
Th1 and towards an unbalanced response with too many regulatory
cells, the evidence there is extremely powerful.
The next result will be an unbalanced immune system. It is
exactly what has been found by Dr. Peakman's study and one
would expect such things as poor response to infection and
rather subtle effects on mood. That is all I want to say.
Mr. Shays. Thank you very much. Two very, very interesting
presentations.
STATEMENT OF GORAN JAMAL
Dr. Jamal. Thank you, Mr. Chairman and honorable members. I
am absolutely delighted to be here, again to give evidence. I
am going to talk about the nervous system and why it seems to
be the target area in the Gulf War veterans. This is the
nervous system-I will come to them, the nature of the symptoms
actually reflects on each internal organ, kidney, liver, you
mention it. So, the apparent multi-symptom is really not a
multi-symptom at all. It is a reflection.
This was the original study, which was multi-factorial. It
is not one factor it is a cocktail of a lot of factors. The
organic system has many patterns. It involves all the internal
organs. It is very illusive to clinical examination. That is
easily overlooked. The assessment is easily overlooked.
Everybody knows that, but also the symptoms of the system is
extremely incapacitating with the patient and it is not
measurable by any standard of clinical protocol.
We have looked into this system by looking at about 13
different approaches. Most people use one or two, we use 13 to
cover most of the aspects because it is a multi system organ
and this is the frequency of the abnormalities we found in the
Gulf War veterans.
Again, if you look at the profile and pattern of this,
there are 13 different examinations and this is the frequency,
60 persons and if you take 80 persons they produce exactly
identical profiles. That profile has been compared with the
chronic organophosphate one where we found similarities but not
identical. It was the different profiles you could see despite
the similarity of the symptoms but when you look at the
different components of the system they are not similar.
This slide shows we have three patients. It is not Motor
Neurons Disease but in these patients we found both brain stems
and pharmacological involvement. Here is the guy telling me
they have not had anything similar to that in that department
at all. `This was not similar to anything. We have not been
able to carry this through, we don't have funding.' This is
about 5,000 each. We have proposals for the
research. I think I will stop there except to say one important
thing:
I have one other side to this one. This is a slide which
shows pharmacological works. We publish on organophosphates and
this was funded by the government. This is one example. If you
look at the red dots, the red diamonds versus the blue, the red
ones are those with acute poisoning and we followed them up
while the blue ones are those with no acute poisoning just
continuing long-term effect. There are farmers and the black
ones are the control. You see the departure between the acute,
the chronic and the others but these were just some slides.
We looked at more than 600 farmers in a cross-sectional
epidemiological study following this particular study and we
have demonstrated in that population that the incidence of
disease were normal farmers with illness. They were cross-
sectional of farmers in the North of England and Scotland. In
the North East it was 18 percent in this normal population
compared with 0.5 percent in the phosphates--
[Alarm bells ring.]
Mr. Shays. Could you make the last point you were making
when the bells came on?
Dr. Jamal. I think the point I am trying to make is when we
looked at a normal population cross-section of the entire
farming population in Scotland and North East England, the
study was more than 600 farmers with neurological symptoms and
then we took a section of them for more toxic examination, we
found a normal healthy-looking population but they were just
farmers. We found the incidence of neuropodia was 18 percent in
this population versus a normal incidence of neuropodia in the
general population of 0.2 to 0.5.
Mr. Sanders. Normal healthy-looking farmers are being
poisoned, is that what you are saying?
Dr. Jamal. Yes. Just to summarize what I am saying, what I
mean in a nutshell, in summary, if the nervous system--the
nervous system is a different component including the central
nervous system the brain cells and seems to be primarily
involved in the Gulf War syndrome and there are perfectly
reasonable explanations as to why and what the patterns are and
how the injury has happened to the nervous system.
The other thing is that what looks to people as apparently
multi-system involvement might not really be a multi-system
involvement although there is more than one factor culminating
in the production of the injury.
Mr. Shays. Thank you, excellent presentation as well. Dr.
Mackness, are you next? I am going to ask you to talk to Ross
Perot and we might hear you better through the microphone.
STATEMENT OF MIKE MACKNESS
Dr. Mackness. I would like to thank the Committee for this
opportunity to speak to you. I work primarily on an enzyme
called paraoxonase which occurs in human plasma and serum and
we have heard a lot today about organophosphates and this
enzyme is the link perhaps between organophosphates and
illness.
If I could just summarize the worldwide use of
organophosphates, they are used for many things: insecticides,
plasticizer, fire retardants nerve gases and in some cases
medicines. Of 7.5m kg of organophosphates, just three types of
organophosphates are used annually in the US alone, not
wordwide, this is just the US. Worldwide production is
estimated at 150m kg/year and deaths about 200,000 a year from
organophosphates poisoning in agricultural use.
[The statement of Dr. Mackness follows:]
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Mr. Sanders. Where are you getting that number from, sir?
Dr. Mackness. The World Health Organization.
Mr. Shays. Because it has come up and we have a question:
Is that because of people who have no knowledge how to use it?
I am not trying to be funny.
Dr. Mackness. Can you define ``how to use it''?
Mr. Shays. Among sophisticated users.
Dr. Mackness. That is tending to be less frequent in the
industrialized world. Suicides through organophosphates are
much more frequent in the non-industrialized world.
Mr. Perot. Are the instructions with the farmers? Let's say
it is made in the US, are the instructions in the language?
Dr. Mackness. The instructions should be in the language of
the country.
Mr. Perot. If the farmer can read.
Mr. Shays. I am going to ask you to talk a little louder.
Mr. Sanders. Having started the interruptions, we are rude
Americans! You mentioned suicides. We heard earlier today that
some 98 British veterans committed suicide but it seems a large
number. What is the connection between suicide and the
organophosphates poisoning?
Dr. Mackness. What I meant was when people drink
organophosphates to commit suicide.
Mr. Shays. We are going to try and get back on your target.
Dr. Mackness. Of course there are some instances of extreme
use of organophosphates. I do not really need to go through
this. I think we all know what the problem is, but the one big
problem with these compounds is that you can actually make the
organophosphates in your garden shed which is twenty times more
toxic than cyanide gas. Some acute toxicity symptoms are rather
undefined at the moment, in fact they are not defined at all.
In the 1950s Norman Aldridge discovered a classification of
esterases which he called A-esterases which detoxify
organophosphates. This distinguishes from the B-esterases which
are inhibited by organophosphates. They inhibit the nervous
system and prevent nerve transmission.
Work on paraoxonase began in the 1960s by a gentleman
called Russell Main in the States. He actually injected
partially purified paraoxonase into rats and showed that it
reduced the toxicity of organophosphates. If you compare the
thickness into four divisions for mammals and birds you can see
the birds are more susceptible to organophosphates poisoning
and that is because they have no paraoxonase. Further evidence
from GCLA, if you actually knock out paraoxonase gene in mice
they are extremely susceptible to organophosphates. So, all the
evidence is that serum paraoxonase is extremely important in
mammalian metabolism of organophosphates.
This is a background about the enzyme, this is the
important property of the enzyme for humans. It actually has
what are called polymorphisms. They are in the coding region of
the protein, position 55 and 192. They are only found in humans
and it means genetically you can inherit four or a combination
of four possible isotopes of the enzyme. They all differ in
their speed of hydrolysis of any given substrate but they also
differ in what substrates they are more active to.
So, if we simply take the 192 and the Q is more active to
diazoxon sarin and soman there is no difference in activity
with phenylacetate, chloropyrifos oxon and 2-naphthyl acetate,
but the R form is more active with paraoxon, methyl paraoxon,
chlorthion oxon, EPN oxon and armine. So, not only do you have
those forms that differ in the rate of say, diazoxon, they are
actually coming the opposite way round. So, the question that
we were asking, myself and my wife have done a lot of this
work, is what is the role of PON in OP toxicity in man?
So, we hypothesized that different PON isoforms may be
important in determining OP toxicity. These are the different
isoforms. The red one is the LL and this is hydrolysis of
paraoxon and you can see that is far more active towards
paraoxons and the MM/QQ is far less. So, this illustrates the
difference in rates of hydraolyses you can get in the different
isoforms.
We have actually conducted a study of sheep farmers who had
done dipping. Some had become ill and some had not. That is
cases in red, the ones that were ill, reference in yellow of
those who were not and basically if you look at the right-hand
three columns, these show there is an increased frequency for
these particular increased isoforms. These particular isoforms
happen to be the ones least able to hydrolyse the active
component of sheep dip used in the UK which is diazoxon. In
fact, the odds of you actually having symptoms of
organophosphates poisoning were 2.4 times greater in the lower
print out, in other words the least effective your ability to
get rid of paraoxon, the more likely you were to have symptoms
of organophosphate poisoning.
That said, we conducted a study with the Gulf War veterans
where we actually looked at paraoxonase in Gulf War veterans
compared to healthy controls. It is the two top panels you want
to be looking at here. You can see the veterans and I apologize
for the abbreviation of 'vets', have much less ability to
absorb and they also have a very much lower paraoxon
concentration. That means independent of any of the isoforms no
matter what isoform they have, they have lower paraoxonase
activity.
Again, it does not matter what isoform they have, they have
lower concentration. So this is in an effect that is
independent of any of the generic effects on--
Mr. Shays. That is on all veterans, general?
Dr. Mackness. Yes.
Mr. Shays. Not just sick veterans?
Dr. Mackness. No, all veterans. This just shows you that
the PON 1 allele were not fit for distribution between the two.
So you have an independent genetic list. This illustrates that
in that.
In summary, low paraoxonase in Gulf War veterans does
require much further investigation as it may be involved in the
aetiology of the Gulf War syndrome complex. If you want me to
put that into context, low paraoxonase activity is associated
with cardiovascular disease, particularly in diabetes. People
who are prone to the development of diabetes tend to all have
low paraoxonase activity. So, there is a link between actually
having low paraoxonase activity and development of some major
diseases. Thank you.
Mr. Shays. Thank you. We will go to you, Dr. Busby and we
can go up front. Dr. Busby, I think you are our last speaker
and then we will proceed with the questions.
Dr. Busby. Thank you very much, all of you, for inviting me
here to talk about what is effectively an effect of the Gulf
War low dose radiation. I have prepared a statement here and I
am sure you have copies of that and I am not going to just read
it out but I hope to cover the major issues.
In the last five years there has been increasing
understanding that there is something very wrong, risks
associated with estimating the health consequences of exposure
to the low dose radiation, in particular internal radiation. By
internal radiation I mean radiation inhaled or ingested,
particularly man-made isotopes or new forms of natural isotopes
and uranium. Uranium is one example of this. As a result of
this and persuasive evidence, there is a problem in the
understanding of these health effects, the British Government
has now set up a committee called Cherry, examining the risks
from radiation.
This is a major step and implies the British government is
sufficiently concerned about the issue to investigate it. It
covers a very wide area and exposure to places like Sellafield
and the nuclear industry and this has been a discussion that
has been around for a very long time, during the Cold War and
atomic weapon testing in the 1960s which was banned, as you may
recall, in 1963.
Well, I am on this Committee and I was actually responsible
for the acronym, I suppose you would say that led to this being
set up but the European parliament is also asking for similar
investigations and the well-known organization called Kyoto
also did so because I believe that the question of DU, the
question of Gulf War syndrome, where we have the problem is
consequent upon exposure to the uranium. Of course, there are
other agents that are involved in Gulf War syndrome and if I
had to choose between the various syndromes that there were and
trying to lay the cause of it in some place, I would say the
neurological syndromes were probably consequences of chemical
poisoning but there are a whole range of effects associated
with mutation and I think a lot of these effects are caused by
the exposure to the radioactive particle produced when uranium
weapons hit the target.
The uranium, as you know is a very dense material that is
used because it enables tanks to be taken out, but when it is,
the armor turns into very small microns of uranium oxide
particles and they are very active and very mobile and very
long lived in the environment. Also, in sunny weather they can
be suspended.
I visited Iraq and Kosovo with measuring equipment and I
have been able to go in both those places some years after the
war and there is a considerable amount of uranium activity in
particles. So, the idea that these particles somehow magically
dissipate after the war and are not harmful is quite wrong. I
could have brought you particles and shown you.
So, the main danger from internal radiation, the health
effects of radiation have been traditionally tests on external
radiation, external acute radiation from Hiroshima so people
standing outside at the time of the Hiroshima bombing, there
was an enormous flash and they would receive a large dose and
in terms of cancer in these people they have decided through
international commissions on radiology that these low dose
cases are reasonably safe and on this basis the routine reports
like by Sellafield which is the nuclear site in the UK, have
been discounted. In other words, the radiation or the cancer is
because the dose is too low but it is only the external dose
that is considered.
The internal dose from the particles ingested or inhaled is
dealt with as if it were an external dose. It is diluted into
the whole body and this is essentially the problem with the
radiation logical assessment and why it is in error. Recently
we were able to show, my colleague and I, as a result of an
investigation of infant leukaemia following Chernobyl and
particles following Chernobyl, they were measured between 100
fold and 1,000 fold and some Israeli people have also looked at
genetic mutation in the offspring of Chernobyl and come to
similar conclusions.
There is a very large error in the assessment of the risk
from internal radiation. A good way to show this to you, it is
rather like assuming the same from sitting in front of a fire
to warm yourself or reaching into the fire and eating a hot
coal. It is exactly the same dose, the amount of energy is the
same. In the case of uranium also you have very, very large
quantities.
Now, 350,000 tons of uranium was dropped on Iraq and when I
went there I could measure a lot of the environment in relation
to cancer and, of course, the particles there are still air
borne in the atmosphere and going into the system and from
there they take a very high dose of the tissue resulting in
lymphoma and leukaemia and any other cancer or mutation. There
is an increase in genetic mutation and inheritable genetic
damage so you get children born with inheritable conditions
and, of course, it continues on.
What evidence is there of these effects? One of the pieces
of evidence is the Gulf War syndrome but leaving that aside,
very recently there is a study of the Italian Military
stationed in Bosnia and Kosovo. This is one of the first pieces
of evidence. The data shows eight-fold increase in lymphoma
after their period of duty there from Sarajevo. There has been
20-fold increase in leukaemia and lymphoma. Other evidence was
from the Iraqi cancer register which you may not believe but I
have been there and looked at the figure and it does seem to
show the children born around the time of the Iraq war have a
high incidence of leukaemia.
There is also chromosome damage, 13 Gulf War soldiers
showing chromosome damage which you can approximate equal to
the sort of damage the Russians measured on the Chernobyl
liquidator at the time. Basically, I suppose what I am saying
is that there is now sufficient evidence to suggest that the
uranium is causing the genetic mutation which will result in
increasing cancer and genetic damage.
Is the material measurable in people? Well, actually it is.
A number of studies have shown that Gulf War veterans contain
significant high levels of uranium as estimated by isotonic
radiation and very recently, only yesterday I learnt of a test
done in this country of 11 Gulf War veterans in which all of
them were shown to have significantly increased levels of date
of loss in their urine but two of them had highly increased
levels of enriched uranium and this raised lots of interesting
questions about enriched uranium.
When I was in Iraq I was taken to an area which was
extremely radioactive. There was yellow material on the ground.
I tried to bring samples back but they took them away. It
seemed there was some deployment of crude radio-active weapons
from the Iraqis or an attack on some facility there but it was
extremely radio-active there. So we do have a lot of evidence
that first of all it is out there in the environment. Secondly,
it is there in the people. Thirdly, that concentration of
uranium on the people can cause cancer because there are those
areas of errors in the radiological risk. Fourthly, I believe
the authorities do not want to open up the reasons of these
effects because of the financial and political implications.
Once you go into the radiological implication of what they
consider to be very low radio-active material then it will
raise all sorts of questions about people who are exposed for
further reasons.
[The statement of Dr. Busby follows:]
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Mr. Shays. I have a feeling we all have accumulated a
number of questions we want to ask you and we are going to
start with Mr. Sanders. We are going to go to Adam Putnam and
then we are going to go to my colleagues and then Mr. Perot and
then I will ask questions. It has become a long day but this is
a very important part of this day. Mr. Sanders, you have a lot
of questions there, don't you?
Mr. Sanders. I do. First of all let me thank this panel,
Mr. Shays, I and Mr. Putnam have been involved in many, many
hearings and I have to say certainly this panel has been one of
the most informed we have heard from. I have to tell you my
emotional reaction and this is a general question that I would
like anybody here to respond to. In the US we have a saying
`It's like ships passing in the night'. All of you have done
very specific evidence. You have done studies, you have done
tests which show the extremely harmful impact of
organophosphates of vaccines of the DU. You have your charts,
you have your concrete evidence and you have presented that
today. We go back to the US and we have a panel of government
scientists and representatives from our veterans
administration, or Department of Defense who are telling us
after hundreds of millions of dollars being spent on research,
`Well we just have no evidence that there is anything called
Gulf illness. We have no concrete evidence at all.'
So, the first problem that we have is either you are all
totally crazy which I do not think, needless to say, or
something is very, very wrong with the state of government both
in the US in terms of the government and here in the UK. So, my
very first question to you and you can talk about the UK, is
what the hell is going on when you have done this research and
your government is still claiming they do not know if there is
a problem. Something is crazy here. it's either you or them.
What's going on?
[Laughter.]
Dr. Busby. Well, I have to say, this new committee, the
Cherry Committee examining the radiation, the reason that came
about was because of the BSE affair. It is a very large mistake
that was made in this country and there was a science advisory
committee set up by the government on BSE. It was chaired by--
Mr. Shays. This is `Mad Cow' disease?
Dr. Busby. Yes, `Mad Cow' disease. This committee advised
the government that BSE could not cross the species and no way
it could cause any harm and in fact that is entirely wrong and
so as a result the government became a bit concerned and
thought an advisory committee might be biased or self-
selecting. So we suggested that they set up a new kind of
science advisory committee in opposition but set it up to be
opposition like parliament, like Her Majesty's loyal opposition
and under those circumstances you had two opposing sets of
scientists. One from the industry and the others from citizens'
representatives or from the NGOs and they were brought in but
the report would include both their positions and then the
politicians could take evidence from them.
The reason we did this is in the last years, 20 years,
anthropologists have turned their searchlights on society and
primitive people but now they have decided scientists are fair
game, or ran out of people to study and were surprised that
scientists are no different from anybody else. If you want to
go down a particular road, you just accumulate the right sort
of scientists who allow you to go down that road and this
potentially is the answer to your question. Science is not
something handed to us from heaven as nature sees it. It is
what we put in ourselves and some of the people who put things
in are not exactly morally honest or people I trust.
Mr. Sanders. We thought only politicians were political.
Professor Hooper. The science that has been commissioned
and done is often poor science designed not to get the right
answer and there was the study on birth defects showing no
birth defects among Gulf War veterans' children. it ignored
whole strands of evidence and was completely biased. Dr. Hans
Khan from the Gulf War veterans shows there is birth defect
among them so the initial science was badly flawed.
The Medical Assessment Panel is working with animals. We
have the ``animals'' walking round or in bed. They are
suffering. Why don't they take samples and examine their
immunology? We have these people who are sick and ill,
organophosphates have been looked at. Farmers who were working
but ill. No one looked at the farmers who were too sick to
work. This is an example of bad science designed not to get the
answer and this is what happens again and again.
Dr. Rook. Let me emphasize what Professor Hooper said. The
problem is getting to the veterans to do any work on them at
all. The panel here, money is only scanned towards animals and
epidemiology. It makes sense to do the epidemiology, but it
makes sense to get the samples as early as possible.
There is a series of phase one clinical trials and in the
civilian sense, if you have been subject to phase one trials,
there will be set up a stringent series of tests and sampling
and follow up. We tried to get money to work on the Gulf War
veterans. Having tried a pilot study with the medical
assessment panel which was based a few hundred yards from our
own laboratory, we were unable to, the MoD would not let us.
Then when we put in an application to do a large study piggy-
backed on a large epidemiology study, we were told we could not
because we had not done a pilot study. A simple old-fashioned
trick of `blocking'.
Mr. Sanders. My last point. In my view the most significant
point that every one of you has made is that what we call Gulf
War illness is not something just unique to people who served
in the Gulf. Everything that exists in Gulf War illness, their
problems one way or another exist in millions of people
throughout the world. That is the significance. Every illness,
whether it is ALS or chronic fatigue syndrome, all exist also
in the civilian society. In many ways our Gulf War veterans
were canaries. People thrown into an enormously toxic climate,
greater concentration. They came out of that more ill than most
civilians would be.
Given that if you agree with my perception, do you think
that in the back of government's mind you have a chemical
industry, you have a nuclear industry which is not necessarily
enthusiastic about people learning of a negative impact of
chemicals or nuclear powers? Is that a factor in the reluctance
of British and US governments to go forward?
Dr. Jamal. I think my experience, I believe that is one of
the important reasons; coming back to the question of
organophosphates in 1992 when we started there was a confusion
in the literature. Some of the studies, epidemiological
studies, some of the studies went that way, but when you really
looked at them you found that some of them were not based on
the science. Epidemiology is good if it is directed with good
science. We did the first study to define what is it you will
look for in the epidemiology. So if you don't define what you
want in the epidemiology based on good basic science, not
necessarily in hundreds or tens of thousands of people, then
when we designed the cross-sectional epidemiological piggy-back
on the first one we found what we found and it was found by the
scientific community; but that is an important point.
Professor Hooper. if you look at organophosphates, they
have been withdrawn now. We were warned about toxic compounds.
51 stringent safeguards were to be used, people, crofters were
to be advised before the spraying was done and the whole thing
has got lost and fewer and fewer of the compounds have been
withdrawn because they are too toxic. But, it has been too slow
and far too many passengers.
Dr. Jamal. The Gulf War veterans, as far as I know and at
least the British veterans were exposed to organophosphates
which were bought locally but most of these were not licensed
to be used in the western world, not in the UK not in the US,
not in Europe. So, that is also to be borne in mind.
Mr. Shays. Mr. Putnam?
Mr. Putnam. Dr. Hooper, you said that the Gulf War was the
most toxic war?
Professor Hooper. Yes.
Mr. Putnam. You went on to elaborate on the general
hypothesis, vaccine/no vaccine, cholinergic triple whammy as
you put it which talks about pyridostigmine bromide and the
sarin vx but not DU?
Professor Hooper. DU came at the end. I picked up, I have a
slide which I did not show you, Chairman, because I was
conscious of your timeframe. The Institute of Medicine in the
States has identified 33 toxic exposures of Gulf War veterans.
I was picking out what I had been given, ones affecting people,
those were vaccines, the triple whammy and DU and I think the
plume smoke as well played a significant part. Studies have not
been done in this country in that area although there has been
a very good study in the States.
Mr. Putnam. So, DU is one of them?
Professor Hooper. Yes.
Mr. Putnam. Dr. Jamal, you are focussing solely on
organophosphates?
Dr. Jamal. It was on the slide but right at the bottom. The
slide did not show completely. It is chemicals and pesticides.
Multiple vaccinations, DUs.
Mr. Putnam. Dr. Busby, you say the main cause of these were
the cause of Gulf War syndrome?
Dr. Busby. Basically the new serum is in the chemical
industry and the cancer people talk about the nuclear and
everyone gets hung up in the middle. So without more money, and
meanwhile everyone dies, and this is why I was cautious of
saying if you had to take a view it would be the neurological
symptoms, with agents which are discovered but what radiation
dose causes mutation, generic mutation and inherited damage. So
you can see the damage we saw after Chernobyl and all of these
symptoms here have been recorded in the people who were
radiating at Hiroshima and also the people living in the
contaminated regions.
Nevertheless I think the neurological symptoms could be
placed at the door of the organophosphates and to the
vaccination program but the mutation-based illnesses I don't
think they are more than that, they are radiation damage,
damage with genetic material.
Mr. Putnam. So everyone is on the same basis?
Dr. Busby. I think so. If you shoot 100 people with
different colored bullets then you find dead people with lots
of different colored bullets but they will all be dead and if
you try to look for a similar cause you might say, `This is
dead person syndrome' and then it is a complex reason but I
don't think the cancers and leukaemia and lymphoma are caused
by organophosphates.
Professor Hooper. I did not show it but I have a slide in
the statement showing the various examples that can be done by
the different exposures on the body and it has crosses all over
it. They are all capable of creating the genetic damage that
can be done by nerve agents as well as DU. It produces free
radicals and you can cause damage quite extensively. So, there
are established mechanisms which can cause damage and many of
them overlap and can be provoked by different agents. So the
cocktail effect is troublesome. First of all are you adding or
are you multiplying?
Dr. Busby. There were none of these in Kosovo.
Mr. Putnam. You said 350,000 tons?
Dr. Busby. Yes, 350,000 in Iraq and about 10 tons in Kosovo
but although 10 tons might sound less than 350,000, I
calculated about 3m particles for the whole of every person in
Europe which is a lot of particles.
Mr. Putnam. None of you received any government funding for
the studies?
Dr. Busby. Unless you go onto the DU committee.
Dr. Jamal. Not on Gulf War illness.
Mr. Shays. Can we clarify something. Are you free to go
after US studies? You are not inhibited being based in Great
Britain? The answer is any of you can go after any study,
nationality is not a factor or location is not a factor.
[Witnesses indicating in the affirmative.]
Mr. Shays. Do any of you have US funding for projects?
[Witnesses indicating in the negative.]
Mr. Shays. I interrupted, I am sorry.
Mr. Putnam. You have not received any. How many of you have
applied?
Dr. Mackness. I received some from the MoD.
Mr. Sanders. British MoD?
Dr. Jamal. I have applied to the British MoD and did not
get any funding. I applied to the American DoD jointly with two
others who were turned down.
Dr. Busby. The Goldsmith Foundation, the Government of
Ireland, anywhere but the Government of England.
Dr. Rook. I did apply to the MoD but was turned down.
Professor Hooper. I have not applied to the MoD or the DOD.
[Laughter.]
Professor Hooper. Ours is done on a shoestring by the
courtesy and generosity of the university where I have now
retired from but I still do what I can.
Dr. Rook. In view of this discussion, whether there are
competing hypotheses or not, I made the point at the beginning
of my talk--
Mr. Putnam. No, I spotted that.
Dr. Rook. But I think the epidemiology study by Cherry in
Manchester is where they cluster different types of symptoms
together. What we might be seeking to see is three types of
cluster. We have Dr. Busby on mutation, the central nervous
system clusters and then the peripheral mal-functions to do
with the immune system and put that way it makes quite a lot of
sense--
Dr. Busby. The multi-vaccine work study is based on the
British work--
Dr. Rook. I have not done work on the Gulf veterans at all.
My work was on the rest of science where the notion that
bacterial components have powerful regulatory effects is now
well established but I have not worked for the Gulf War
veterans.
Mr. Putnam. Are you aware of someone, all of you made
reference to environmental factors, psychological and physical
stress. Is there someone out there who is the primary focus?
Professor Hooper. I think the Cherry/McMahon study which
you will hear a little about next from Mr. Wessely has picked
up vaccines and pesticides with suggestions of PB and that
database is not publicly available to interrogation or at least
it was not, so it makes it difficult to follow up. i think it
is worthwhile saying at this stage that I think we all owe a
great deal to Ross Perot and Bob Haley because without that
work that was a pattern of work I wanted to see carried out in
this country through epidemiology and we are getting down to
some investigations but what Bob Haley did was to go through
and show clear damage which is indisputable and I am sure we
would find the same thing with other veterans. He took a lot of
stick not just from politicians but from proper scientists as
well but we owe him a great debt for it and we owe you a great
debt as well. Thank you.
Mr. Putnam. Dr. Jamal, your work on the effect of
organophosphates on the farming population, that was only in
northern England and Scotland, is that correct?
Dr. Jamal. It was Northern England and Scotland. I based it
on Scotland.
Mr. Putnam. Is there similar evidence from the US that
would reflect the equivalent rate of neurological damage among
the farming population?
Dr. Jamal. There are some studies made from california,
people who spray, there is literature. There are others here
and there but I don't really think US farmers dip sheep in the
same way. We looked particularly at farmers dipping sheep and
using these compounds in that context.
Mr. Putnam. Thank you, Mr. Chairman.
Mr. Shays. Lord Morris, you have some questions?
Lord Morris. Quickly, Mr. Chairman. My first question is to
you. I understand you asked the US General Accounting Office,
the GAO, to look at plume models used by the US Defence
Department to determine who might be exposed to the plume
panacea?
Mr. Shays. That is correct, we did that.
Lord Morris. Can I ask should locations be included in
those studies?
Mr. Shays. That would make a lot of sense. We will make
sure that is done.
Lord Morris. My second point is I understand that the MoD
has now agreed to fund the study of cancer in Gulf War veterans
but there are very strong indications as has been said today,
the Italian peace-keepers in Bosnia had cancer clusters
discovered. There is no reported intention to undertake a
similar study among our troops who served in the Balkans. If
you are a veteran, that is a serious omission. I wondered if
the Panel can comment?
Dr. Busby. When the Mod were putting together their data on
what course of studies they would fund, they sent me a draft of
this to comment on and I took up a number of these points and
suggested that they did fund epidemiological studies on cancer
and made a number of other suggestions to them but they have
always been blocked. I just get a rude letter back saying
effectively `Sod off' really and I always find them extremely
hostile. There is no discourse whatever, who do you think you
are, where is the army and then when of course it was finally
published it was published and you know the results.
Another thing, they are not going to look at, for example,
is the connection with uranium dust. They say DU goes into the
dust and becomes one with the content of the earth and if we
suggest otherwise they say, no it does not. You just get no
further.
Mr. Shays. Mr. Perot?
Mr. Perot. First I would like to thank all the Panel for
what you have been referring to. We have had similar problems
to the ones you have had--
Mr. Shays. Mr. Perot, it may be that you are further away,
but we can't hear you.
Mr. Perot. We have had problems like you have. We had
problems getting to the Defense Department. This is back in the
earlier period of time?
Dr. Jamal. Yes.
Mr. Perot. Ours has changed its position and is working
hard to solve this problem and if we get that we can get a
strong alliance between our two countries, get the same thing
over here. Nothing could be more important than that we all
work together as one team. So, that is something. We certainly
would give the highest priority to you. My question really is
have you looked at lead?
Dr. Busby. Yes. Certainly there is a question of having
metal.
Mr. Perot. It could have toxins?
Dr. Busby. Yes, it is toxic to the kidney, that is the
particular organ.
Mr. Perot. I guess my question, you have answered my
fundamental question. To attract the best advice you have to
have government facilities, otherwise you have other options,
where to go at the time. It appears that so far you have not
been formally received when you come in with concepts. Is that
a fair statement?
Dr. Busby. The reason I did it is essentially because I
can't bear the idea of all these children dying. So, I don't do
it for money.
Mr. Perot. That was very clear. You take the risk of going
to Iraq.
Dr. Busby. That was scary.
Mr. Perot. Yes, I'm sure it was. Those are my questions.
Dr. Jamal. We have been in contact with Dr. Haley for many
years now and I am so glad, absolutely delighted, that he was
able to do those absolutely first class studies and I think we
very much welcome the idea to have collaborated today and will
continue with Dr. Haley.
Mr. Perot. I would love to see Great Britain involved in a
collaborative activity. The very reason if for no other reason
that our government wants to bring in the best man among our
allies to collaborate to come up with answers to these
problems, that would be wonderful brain power. That is all I
have.
Mr. Sanders. If you don't get to the Gulf, move to Texas.
Mr. Perot. You can stay right here. It's a small world.
Anywhere in the world we can get together and collaborate. Once
you collaborate you get something done.
Mr. Shays. Depending on how you do the numbers we have two
to five thousand doctors in the Department of Affairs, defense
affairs; when we asked who had specialty in the workplace
handling materials they could think of no-one and eventually
got back to us and gave us two names so it was not surprising
that when veterans came to talk to them that they had no lid on
it and it was not their field, it was not their interest and
our veterans felt like when they were talking to doctors, they
looked at them, well you know the story, so it's not surprising
to me--well, it is surprising. I would think what would have
happened is that our department of special affairs and
department of defence would work overtime to find doctors with
those specialties and even though we raised it as a question,
we still did not see it happen.
My first question to all of you and I know you might find
this discomforting, but I need to satisfy my own curiosity on
this: Is there anything that was said by one of you by someone
else that you may disagree with or say it is overemphasized or
under-emphasized. Mr. Mackness, is there any one thing Drs
Jamal, Rook, Busby or Hooper said you would want to say `Yes,
but'?
Dr. Mackness. No, but while I have been sitting here
listening to the discussions I have interestingly come across
another thought. It was about the uranium causing membrane
damage and organophosphate produces damage that is done to cell
membranes so if it protects against organophosphates and it
protects against theoretical damage in uranium we may have a
universal link because the enzyme is low in the veterans.
Mr. Shays. In your work have you done any genetic pre-
disposition?
Dr. Mackness. To what?
Mr. Shays. In other words, basic genetic make up makes them
more susceptible to Gulf War veterans?
Dr. Mackness. No, not genetic.
Mr. Shays. Anything, Dr. Jamal that the others said that
you want to put in a different light?
Dr. Jamal. Well, I think if I may summarize I think there
is a link in a combination between all of what has been said. I
would agree with the proposal it seems to be neurological but
there is a radiological risk, the links being enhanced by the
chemical because they are genetic as well as toxic to the
chromosomes and cause mutation. So there may be an association
there. For instance, the blood barrier alters when immunology
alters and I think there is a linkage between all the
approaches and there is one way to find out, by doing further
studies.
Mr. Shays. That question I asked the first two, any
comment?
Dr. Busby. I don't know enough about their areas to be able
to really comment sensibly. From looking at their results, a
lot of them seem to me quite persuasive. There seem to be some
elements of their presentation that I would call arm-waving but
we all do that and it is a shorthand for ourselves to say we
know we have an easy way of communicating. So, I am not taking
them to task but there are areas where I would say, `Exactly
what do you mean by that and how do you know that is true'?
Mr. Shays. We only gave everybody ten minutes--
Mr. Sanders. You are speaking for the audience--
Mr. Shays. They knew their audience. I am going to come
back to you because I have a theory. Dr. Rook?
Dr. Rook. I think there has been a problem in many studies
due to the fact that the ministries have been unwilling to let
people examine the bases themselves and unwilling to get
clinically-based studies superimposed on the epidemiological
studies. There have been a lot of studies of Gulf War veterans,
a small number of veterans have been looked at. One of the
studies Mr. Busby mentioned about uranium in the Gulf War
veterans, maybe we are all being exposed to uranium in the
modern world but it is not the fault of the world. If people
are not given ready access to the patients, to do private
studies, then it is very difficult to do and another point Dr.
Jamal made, it is helpful to do pilot studies because it helps
epidemiologists to know what to look for.
The idea epidemiologists can do wonderful studies is not
true. Every epidemiologist needs to know what they are looking
for. It is not the different questions you ask but what to look
for. So we have been hindered in a sense.
Mr. Shays. Professor Hooper, anything you would put in a
different light?
Professor Hooper. No, I think I have been rather
reinforced, rather than different lights. On the first slide I
put in about the new endocrine immune system and I think that
is not a novel concept and it ties together the diverse system,
the nervous talks to the endocrine system and all this cross-
talk going on in the body and this shows that these messages go
not just to the cells that you want to talk to but other cells
as well that you need to unscramble. So, I feel we have a
conceptual framework for our thinking which allows us to
understand the different insults which have come to the Gulf
War veterans and they are formidable and very extensive.
Mr. Shays. It strikes me that you have a lot of goals. One
is that you are not getting funding, the other is it strikes me
that your theories are not exclusive, let me put it this way:
It strikes me in many cases you are complementing each other,
not working in competition. That is the way I felt. I would be
interested to know, I think with DU in the US we have not moved
forward that way and maybe because the implications are quite
significant, we used DU in the structure of a tank and we used
DU to penetrate. We use it in a lot of different ways and if it
was found to be harmful to the people, who would be looking at
it afterwards? It puts into play a lot of questions about what
were you doing and what were you using?
I am struck by that but I would like to know the cost of
your project. If you did a study on this, what kind of dollars
are you talking about?
Dr. Busby. What kind of study are you talking about?
[Laughter.]
Mr. Shays. What kind of studies did you ask for? let me be
more clear. You have made requests for funding. What kind of
dollars are we talking about?
Dr. Busby. I am looking to do two years' study and in
pounds about 80,000.
Mr. Shays. In my way of looking at it that is not a lot of
money in the framework of the context that I have--
Mr. Sanders. It's too small a sum of money, we can't give
it to you, sir.
Dr. Busby. I'll make it four years.
Mr. Shays. I am not being reckless about the question. I
did not know if you would say 8m.
Dr. Busby. The truth is these studies are not difficult.
They require somebody to do a certain amount of work for a
certain amount of time. I am not looking to become rich, I am
just interested in the work, but I can't do the work because I
am not funded.
Mr. Sanders. I think Dr. Busby raised an interesting point
about the British government. I think there are, it is like a
political issue, these guys and we look at the world in Gulf
War illness in a particular way. Then there are another group
of people who have access--
Mr. Shays. 300m in the US.
Mr. Sanders. Which has not given us a tiny fraction of the
information revealed to us today. So, we have to say, okay,
there are two ways of looking at the world. Let's continue to
fund, but let's give these guys half the money and see what
they can do with a few hundred million dollars and see where we
proceed. But, there are two world views out there and one world
view is getting all the money.
Mr. Perot. I suggest that the best thing that can happen is
that you address Mr. Blair and I think you will see a sea
change in activity in this country. We can still collaborate
but you will have the opportunity to collaborate with our
science we have in the US but I feel very strongly the first
step would be if you had the man to hear what we heard today
direct from you just sit down and give, in little over an hour,
present to him, I think we will see all the collaboration will
still take place between the US and Great Britain. But,
suddenly, if we start funding your work and have Great Britain,
they are moving along on the dollar, I would like them to have
the opportunity to do it and get this one theme.
Mr. Shays. If I may suggest it is a very fine idea. We are
going to find a way to intensify in the US in a seminar type
opportunity where we can call in some of the DoD folks, have
you all make a presentation a little longer than you have done
now and then ask for there to be some response and dialogue. We
might do it on an informal basis. I have more questions I could
ask you but I have a feeling you all should come before a Panel
again.
Mr. Sanders. Would you come to the US and confront the DVA?
Mr. Shays. Can you use a different word?
Dr. Busby. 'Confront' is an important word.
Mr. Sanders. Let us help you while your research is not
done.
Mr. Shays. We have other questions but I think what we are
going to do is we might ask for you all to submit some
responses for the record before we close the record and then we
are going to find a way to get you to the US to be able to
continue this dialogue and so unless there is some last
comments--
Dr. Busby. There is something I meant to say when you were
talking. You should know that the World Health Organization and
the International Atomic Agency have an agreement not to
research, or the WHO is constrained by this agreement not to
research the relationship between radiation and health which
has to be left to the atomic people which is nuclear power.
Mr. Shays. Is that your theory or fact?
Dr. Busby. No, it is fact.
Mr. Shays. I have never heard that to be true and it would
be pretty stunning.
Dr. Busby. It is true, it was done in 1969. I could show
you the document.
Mr. Shays. I would like that submitted to our Committee. We
are running a little behind on time and I am concerned about
that but you all were an excellent panel and we thank you. Dr.
Jamal, for the record you were already before our committee and
you were an excellent witness and we would love to get you back
there again.
Mr. Shays. Our final speaker today is Professor Simon
Wessely from Guy's, King's and St. Thomas' School of Medicine
and author of epidemiological studies relating to Gulf War
illness
STATEMENT OF SIMON WESSELY, AUTHOR OF EPIDEMIOLOGICAL STUDIES
Professor Wessely. This has been a very large study group,
you have already heard them. The basic thing of what we have
done in working on this problem since 1996, our approach is
that there were 53,000 British armed forces in the Gulf and we
cannot study them all so we have run a random sample of one in
ten. We are absolutely adamant that it is worth the effort
because at the end we want to say something not only to the
small number of veterans we studied but the whole veteran
community. So we can say. `Yes, you have a problem you should
worry about or no, you don't.'
I just walked in at the end with the epidemiological
studies and then I want to go on to clinical studies which we
are now doing generally for the whole UK government.
We traced 4,000 UK armed forces in the Gulf and we compared
them with 4,000 UK armed forces who went to Bosnia so we
compared them with people fit for active duty and went off on a
very nasty and hazardous deployment in 1992 and compared with
4,000 who did not go to either conflict. That took me about 30
seconds to say, two years to do and it was extremely difficult.
I give you a list of bullet points and we found compelling
evidence of the evidence of the UK armed forces in the Gulf. It
is not found in those that went to Bosnia. There is an
undisputable rise in and a decline in physical health, a two or
three-fold rise in symptoms and because we have the random
sample that is representative of the entire appointment we can
say without any shadow of a doubt there is a serious problem in
the forces that went to the Gulf and I think we have shown that
definitively in the UK armed forces and it has been confirmed
by the Cherry Group.
We did not find evidence of a Gulf War syndrome on a
statistical analysis, there was no difference between that and
the Gulf era. It was a relatively academic point of interest to
relatively few people.
Most important is we found a Gulf War health effect but no
evidence of a unique illness. That is what McFarlane and others
groups have shown. We found these were symptoms which were
associated with certain specific exposures and key ones using
records that were available in about one third of the personnel
who were receiving multiple vaccines, not any singular vaccine,
but multi-vaccines which was a clear cut relationship, the more
vaccines you received the more likely you were to have symptoms
some years later and we thought that was because they were
given only when you were serving in the Gulf.
In Germany there was not an association but I have to say
that is a more tricky analysis and there is some dispute how
valid that is, if it is valid, for reasons we will come on to.
It is difficult to look at other exposures and we found
generally sick people reported more of the exposures we could
not report independently and it is difficult to know what to
make of that.
So, we did that and then we went on to clinical studies you
have heard about which are now concluded and we got 400
veterans who were sick from the Gulf, well from the Gulf, sick
from Bosnia and well from Bosnia and we got them to come to
King's. What did we find there? Some things were good, some not
so good. Their neurological health, concentration, memory and
so on and also some had symptoms and complained of problems and
generally they were good so the findings were reassuring.
Psychiatric examination showed there was an increase in
depression and anxiety, not substantial but it was there. The
most particular interest was post traumatic stress disease
which was quite small, from 1 percent to 3 percent in Gulf War
veterans which signified the Gulf War veterans who did not have
post traumatic stress disease. It does not exclude the
situation, it means psychiatric diagnoses are not the answer.
We have carried out neurological studies, I am not a
neurologist but that is currently under review.
Looking at the systems concentrating with the single fibre
genes so on and so forth, it is a little difficult to talk on
that. We have also done immunological studies and you have
heard from Graham Rook. We can say we have already on
epidemiological grounds confirmed the brand of this hypothesis
and being immunized after a condition of stress which is why I
emphasize the finding of the vaccines only seems to have had
the effect in the Gulf.
[The statement of Professor Wessely follows:]
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Mr. Sanders. You effectively agree with what he said?
Professor Wessely. Yes, that is only an association. We
have done that in the laboratory and Graham has given some
hints on that and we partially confirmed some of the
hypothesis. That is also under review in the journal but as
Graham has already mentioned it I can mention it again. we have
had replication of the hypothesis. I do not think it can be now
as time has passed.
We have also done in collaboration with Dr. Mackness, we
have sent him all our examples. He has done analyses there.
Again, it is under review. By using collaborators we found
something interesting and we are now in the middle of further
analyses of data, doing follow-up studies to see what has
happened to people over time. The trend is looking slightly
more encouraging but there is still a difference between the
Gulf and Bosnia.
In the one minute I have left I would like to pay tribute
to a couple of things: To the veterans who took part in the
study, there were 12,000 and the difficulty was trying to find
them but once we found them, the amount of cooperation was
remarkable. We are grateful to the veterans who came up to
King's for the study and the key group there was not the sick
ones but the well ones. They gave two days of their time, we
did not pay them and we didn't half mess them around for
altruistic reasons. I would like to thank also, we have had
funding from the DoD originally; also I would like to thank the
MoD in the UK, we have had cooperation from the MoD and I would
like to thank the officials there I have worked with over the
years. So, I would like to place on record our thanks to them
as well. That is where I will conclude. I am sorry I do not
have a presentation.
Mr. Shays. Professor, we appreciate you coming. You flew
in?
Professor Wessely. Yes, just got in.
Mr. Shays. So you have hardly had a chance to take a
breath. You have before you Congressman Bernie Sanders,
Congressman Adam Putnam and Lord Morris. My name is Christopher
Shays and we will all ask you questions; we will start with Mr.
Sanders.
Mr. Sanders. Mr. Shays and I suffer from this syndrome: We
have been to many, many meetings and heard from many, many
government officials who have studied this year on year. So, we
have a unique syndrome of listening to this. I don't know when
you came in but you had five people up here who in various ways
have told us that organophosphates and DU, without any doubt in
their minds at least, causes very serious, not mental but
physical effects on people. We have people in the US who have
come to that same conclusion.
One of the problems that I have when I hear from
government-funded people is they are still studying this and
you have other people now documenting and demonstrating the
actual damage done by assaults of organophosphates and DU. They
seem to be twelve years ahead. So let me start off with the
easy question that is:
If these people are making demonstrations that they are
showing us on a screen of various brain scans, actual damage
done, why is the British government, you think, not funding
those people?
Professor Wessely. I don't represent the government,
Congressman. I have absolutely no idea. I can't answer that. I
can say our work is collaborated with Rook and Mackness who I
saw at the end of the list. So, we have been collaborating with
scientists. As for other questions, I can tell you I have got
money and I have failed to get money. We got turned down and we
originally were turned down with Graham for the new
application. Some grants we had and some we had not, but I
don't think I can answer why others did not.
Mr. Sanders. In your opinion is the British government
funding the most significant research that may help explain the
Gulf War syndrome?
Professor Wessely. Any scientist is going to say yes. I
have run out of money now and I am on record as saying I am
disappointed with this. I think we should have taken a more
long-term strategic approach, much better monitoring of our
soldiers past and present and there is much more work to be
done. I would also say it does not matter how much money you
throw at us and I would like more thrown at me, but we need
time to get to the position to test the hypothesis, to test Dr.
Rook's hypothesis and to test Dr. Jamal's hypothesis. It takes
time to recruit sick and well veterans. It took us two years to
find these people. It is not easy and to find representative
samples. You could have given ten times the amount you gave us
but it would not really have been enough to get genuine
clinical representative samples, there is not a real short cut
to that.
Mr. Sanders. In your particular judgment, is exposure to
organophosphates and DU and the various vaccines and anti-nerve
agents given to the soldiers one of the causes of Gulf War
syndrome?
Professor Wessely. I can speak to the work we have done. It
is convincing that the particular schedule in multi-vaccines
has been associated with Gulf War illness. We never looked at
DU so I don't know.
Mr. Sanders. Has there been any government-funded study
that has looked at DU?
Professor Wessely. I can't answer that, I don't know.
Mr. Sanders. The answer is no?
Professor Wessely. No.
Mr. Sanders. After 11 years there is none?
Professor Wessely. Again, it is very difficult to know who
is exposed to what. We use the same techniques as Dr. Jamal so
we have done that. To explain the large health effect we found,
it has to be quite wide spread which is why we are interested
in vaccines which are given to most of the groups rather than
DU which it is hard to explain why that would have affected
Admirals in the Navy so we prepared the hypothesis around
mental and psychological factors as well. They would have
affected large numbers of people across the entire performance
which is what the epidemiological tests showed. If you look at
battle fatigue, that was particularly mentioned in relation to
World War II and people remained affected by that for many,
many years, indeed their entire lives.
If you send men to war there is no such thing as a `free
lunch' and people have always been damaged by war and there are
changes. We see things in the Gulf but things that are common
to the experience of war--
Mr. Sanders. 'They are neither physical nor psychological
but somewhere in between'?
Professor Wessely. Well, I think I am doing what we do
which is a slight bit of spin. If you look at the First World
War records you find--
Mr. Sanders. Is there something in between physical and
psychological?
Professor Wessely. I think I am trying to say the end
stages look quite similar. You can find stages in the First
World War which sound like Gulf War syndrome, but they could
not have been exposed to what they were exposed to in the Gulf
War; but you find extremely moving descriptions which sound
like what we are hearing as well.
Mr. Sanders. You say:
``As there is little evidence that individual vaccines are
associated with long-terms side effects, but the association is
context dependent, the conclusion is that routine vaccination
is preferable to, say, `on the spot' measures.''
Professor Wessely. That would be a political interpretation
you have put on what I said--
Mr. Sanders. It was in the context of being given a lot of
vaccines in a short space of time and the hypothesis of the
high stress situation. If you think those vaccines are
important, then clearly you should be giving them on a more
routine basis, not in the heat of the day. The results of what
Dr. Rook identified are the results of taking too many
different vaccines in too short a period of time or too many of
the same vaccines; if two is good, four is better while the
bombs are falling?
Professor Wessely. It is difficult to come up with that
very fine plain analysis but in general the pattern we found
which was indeed as Graham predicted, it was a small number of
vaccines rather than the nature of the individual vaccine but
it is difficult to be serious about that.
Mr. Sanders. You did not identify how many of each person?
Professor Wessely. Yes, we did. Where we had records we
did.
Mr. Sanders. What was the range?
Professor Wessely. It was from 1 to 10 I think.
Mr. Sanders. The future implication, not just the field
application or civil applications we are talking about mass
vaccinations and inoculations?
Professor Wessely. I would be very careful not to do that.
I am a very pro vaccination person and it is the particular
circumstances of the Gulf War. In relation to civil policy I
don't have any, to be frank. I can only look at what we have in
front of us.
Mr. Sanders. The prophylaxis said between the UK and US was
different?
Professor Wessely. Yes.
Mr. Sanders. Is there any research out there that
demonstrates the impacts the different schedules have?
Professor Wessely. I think the only person who has looked
at that is Steel. I think you knew far more, we were pretty bad
with the records. You will know more about this than me but I
understand there is no contemporary fact database. I may be
wrong on that but that is what I think is the case. You talk
about everyone has to agree that record-keeping was very poor.
Mr. Sanders. What does ``Neurological studies do not
suggest major deficits'' mean?
Professor Wessely. We did a complicated neurological test
looking at memory retention and so forth and those findings
were generally normal. There were some changes that tended to
be related to mood but we did not find evidence of strong
neurological deficit.
Mr. Shays. Thank you. Lord Morris?
Lord Morris. Time is at a premium now so I must be brief.
You heard me earlier refer to the incidences of Italian peace-
keepers in Bosnia and finding there the true cancer costs?
Professor Wessely. So I heard.
Lord Morris. I know that you are very familiar with what
has been done from Britain vis a vis Gulf War veterans. There
is concern that there is to be no reported intention now of a
study of cancer in people who served in the Balkans. Could you
comment on that?
Professor Wessely. We are cooperating with the McFarlane
Group and Hygiene group looking at cancer in the color format.
We would like to look at cancer in the Bosnian veterans and it
is no secret that I think that could be studied and I believe
that members of the Armed Forces should have particularly their
mortality and cancer incidence routinely monitored. We are in a
good position to do that because we have good epidemiological
bases and cancer bases that cover the whole of the UK. I think
we should be routinely looking at those databases.
Mr. Shays. Mr. Perot?
Mr. Perot. Have you had a chance to present these findings
to the Prime Minister?
Professor Wessely. No, not normally.
Mr. Perot. Is your specialty psychiatry?
Professor Wessely. Psychiatry and epidemiology.
Mr. Perot. How much money in your research have you
received from Great Britain?
Professor Wessely. In Great Britain we received a grant
from the MoD to study the epidemiology and from the Medical
Research Council to study the outcome of the Gulf War report
and that is what we have received.
Mr. Perot. How much have you received?
Professor Wessely. We received 300,000 for
neurology and about 140,000 for the follow-up
study. We failed to get other monies.
Mr. Perot. When did you start going to the government?
Professor Wessely. We went in 1996 and at that time they
were not very keen on funding these kind of studies. Then we
went to the MoD and most of it is paid for by you and that cost
you $100,000 and I think that is very good value, but there we
go. Then we went back to look at a similar epidemiological
study also funded by DoD and that cost around $300,000.
Mr. Perot. Who were you dealing with in the US?
Professor Wessely. Oh dear. That's a good question. It
would have been, you are going to have to help me on this one.
Mr. Perot. Boston?
Professor Wessely. I know who he is but on the individual
level we never really saw them. Nicholls' name I recall, Simon
Checks but we were over here. It was a rather faceless process.
Mr. Perot. Is that funding still coming?
Professor Wessely. No.
Mr. Perot. Roughly when did that stop?
Professor Wessely. The last of funding we had was probably
two years ago.
Mr. Perot. Can you talk about World War I? You are not
aware of the chemical weapons involved in World War I?
Professor Wessely. Indeed. I am afraid I should have said
as well DoD also funded that historical study. We made a
historical database at the time; we are very, very aware that
chemical warfare was not invented by Saddam Hussein. You spend
time reading the records from World War I. Not to be moved by
them, means you have no heart at all. They are remarkable
stories told in a familiar, amazing language.
Mr. Shays. I have a few questions. I want to make sure I
have not misunderstood you. You said you found Gulf War
illness?
Professor Wessely. We have not found a Gulf War syndrome
which would be a particular combination of scientific symptoms
associated with the Gulf. We found the same pattern of symptoms
as possible, the difference being the Gulf people. They had
more of them, were more intense.
Mr. Shays. So, it is not your testimony you did not find
Gulf War illness. Do you believe that a disproportionate number
of Gulf War veterans be they from the UK or from the US came
home sick?
Professor Wessely. I don't have to believe it. Our evidence
shows clearly for the UK that that is the case. There has been
a significant increase in ill-health with Gulf War veterans
which must be due to serving in the Gulf because they did not
occur to those who served in the Balkans.
Mr. Shays. So you are not taking the position because you
did not find something that something does not exist?
Professor Wessely. That's true. We did not find a unique
syndrome but I think it is a bi of an academic sideline. The
important thing is we found an important health situation.
Mr. Shays. When I look at this research you have to know
what you are looking for. When you go into that room you have
to make sure you went into the right room and you have to make
sure that you actually opened the door and looked in. If
someone does a study and says, `We did not find a problem or
did not find this or that' it does not mean it does not exist.
It may mean they did not know what they were looking for or
they did not go in?
Professor Wessely. We looked at all the doors, we went in
and what we found what was behind them.
Mr. Shays. In looking at the relationship of
organophosphates and Gulf War illness, most DoD and MoD studies
did not attempt to measure nerve gas in organophosphates. This
is my question: In your survey did you attempt to ask questions
about organophosphates?
Professor Wessely. Yes.
Mr. Shays. If yes, what are your findings?
Professor Wessely. In terms of the reporting, people who
reported exposed to nerve gas we asked were those with
organophosphates more likely to be ill. The problem with that
as a statement is it is not very informative. They were sick,
they remembered more of everything which is why I put more
emphasis on the immunological data and vaccine data where we
had independent verification. On the organophosphates, we found
people exposed to organophosphates but to be honest most people
commonly did not know. We asked about the DU. The commonest
response was `I haven't a clue.'
Mr. Shays. In one of your earlier published papers you
concluded . . . resulted in so-called post war syndrome,
described by different medical changing terms?
Professor Wessely. Yes.
Mr. Shays. For example, if this had been in Vietnam Agent
Orange and that was probably only particular to Vietnam, would
you agree various post war syndromes might be due to different
causes?
Professor Wessely. Absolutely. That is the point we are
making. This is a classic example. Agent Orange and Gulf War
veterans are very similar in their symptoms as I am sure you
know.
Mr. Shays. What about your conclusions on so-called stress.
Explain that to me.
Professor Wessely. Again, it is not as you would say,
rocket science, but clearly going to war is a stressful
business and I can't believe in this day and age anybody denies
that and some people will come back with visible wounds and
some with invisible wounds.
Mr. Shays. But stress can change your biological make-up?
Professor Wessely. Of course, yes.
Mr. Shays. And stress can perhaps let certain things
penetrate your body?
Professor Wessely. It can indeed. Just to reiterate what I
have said, we looked at that and the classic symptom is PTSD.
That does not account for the rates of disability in sick UK
Gulf War veterans. It has increased, but not by very much,
nothing like enough for the explanation of what we found.
Mr. Shays. When people imagine PTSD, they judge that like
judging the unified symptom and it could be a whole host of
things caused by a whole host of different causes.
Professor Wessely. Well, actually I agree with you
completely and in much broader terms than we intend to use it
but I said if we use it in the way the US are using it in
diagnostic manuals, that is not the explanation. Funnily enough
I am on your side but PTSD is mentioned. We have found that to
be increased which you would expect but not by very much. 1-3
percent.
Mr. Shays. It has been pretty well established that the
epidemiological research allies with case definition. I think
of it how Dr. Haley made some pretty great discoveries using
the case definition when you compared the sick veterans from
the well. It seems that that would confound the results. Is it
true you avoided a case definition and if so, why?
Professor Wessely. I have not avoided a case definition
because we did not have one. We started out in 1995 where we
had patients having very different things. There was nothing
agreed as to what was the Gulf War problem, was it a
psychological problem. So we first of all we went very broad
indeed and then we decided where are you most likely to find
the problems and we decided where people who had physical
disabilities and the second case was the physical disability
two standard deviations below, which was Bosnia and Kosovo. We
looked at those where you are likely-to continue your analogy-
we looked behind the door, where we were likely to find it
which was the physically disabled.
Mr. Shays. It strikes me one of the most difficult things
for you to develop your theory, why it happened and then you
test it and find your theories wrong. You learn as much by
learning it is wrong as if it is right. Then you go in a
different direction. What I found with Mr. Haley's work and
some of the people here, they might have been locked into a
better theory of what might have occurred but they have deemed
to not get the funding so we as a Committee are struggling with
the fact that some of the people in our country we think it has
all been vetted in a certain area and ignored certain elements
we saw on the table before us. Your work should have been done
but in addition the work of these men should have been done in
our opinion and it would have given a better complement to sort
out, a better view.
Mr. Sanders. Let me pick up on the point. I don't mean to
be rude, Professor Wessely--
Professor Wessely. That usually means you are about to be
rude.
Mr. Sanders. You weren't here today when we heard from the
veterans. They are angry, frustrated; they believe your
government has not been responsive to their pain and that is
what the veterans are saying exactly about the US government.
One of the frustrations that they have in the US is that we
have spent several hundred million dollars on studies and on
studies and on studies and they go nowhere. What these guys
want to know is what is causing their illness and how we can
treat their illness. Having said that I regard that leading us
in the wrong direction when you say the symptoms are neither
physical nor psychological but somewhere in between.
We have five prominent scientists who were here a moment
ago telling us that they are physical, that exposure to the DU,
organophosphates, exposure to a variety of vaccines including
vaccines with PB, that this is nothing to do with psychology
and I don't argue with you that stress affects everybody in
war. If a guy gets hit over the head with a hammer, we are not
talking about a psychological--
Mr. Shays. You might have--
Mr. Sanders. But the results are quite physical in his body
and have to be treated in a physical way and I think when you
write they are neither physical nor psychological, what you are
doing is saying the evidence we heard here for an hour is
irrelevant and when you say that, veterans are going to get
very, very angry.
Professor Wessely. First of all, I have not said that.
Mr. Sanders. I read you the exact quote--
Professor Wessely. I said they are physical and
psychological.
Mr. Sanders. ``They are neither physical nor psychological
but somewhere in between.''
Professor Wessely. I have said that I believe this is a
complex story with many strands to it. I have said you cannot
send men to war and not expect psychological problems but I
have also said we made a substantial contribution to the
answering of the points you made, to the work we have done with
Mackness and Rook. You have to take what we have done by what
we have done. We have taken a large view and I am closely
allied to the people you were listening to an hour ago. You
take us as you find us, Congressman. We are there on the record
with the literature and I take some pride in what we have done
to develop and understand Gulf War illness and we have
collaborated with scientists and you have heard about them an
hour ago. It is the same people, Congressman.
Mr. Sanders. If I might conclude, the war has been over for
11 years. The truth of the matter is that the amount of
research and understanding and treatment that has been
developed despite hundreds of millions of dollars have yielded
relatively little. If you compare that to AIDS research and
treatment you would find Gulf War treatment sorely neglected.
So, I say we should not be proud of government's role and we
have a lot of work to do and I just wanted to get that out.
Mr. Shays. You did. The problem we have is we think it has
been a story of failure of government to deal with the issue.
Professor Wessely. I agree with you. We went to the UK
government in 1995 or 1996 and we were told to, as the last
speaker said, to `Sod off'. So, I am completely au fait with
that and repeatedly on record as saying I do not think handling
veterans now, I don't think we have a very good record in this
country of looking after the veteran community. I have said
that on many occasions as Lord Morris will confirm.
Mr. Shays. Mr. Putnam, do you have any questions?
Mr. Putnam. A gentleman from Vermont made my point very
eloquently. We have already heard your statement that the
historical studies reflect the syndrome is neither physical nor
psychological but somewhere in between. That is not acceptable
to our veterans, it is not acceptable to those who are overseas
now being exposed to the same risks they were exposed to years
ago. While you did clearly say that PTSD is not the cause, most
of this discussion has focussed on the psychiatric rather than
the physical and it is the physical that causes people's livers
to shut down and intestinal and endocrine systems to shut down
and reproductive health to be destroyed, so in that regard I
would agree with everything Mr. Sanders said which is we have a
long way to go and we learned more in the previous panel of
entrepreneurial researchers.
Mr. Shays. We are delighted to have a point or two if you
want to put anything on the record.
Professor Wessely. Well, I think the points have been made
but I believe it is a complex disorder. It is like a large
jigsaw. I have the people round the table put some pieces in
that jigsaw but there are large areas that remain dark and I am
as committed as anyone else is and you are preaching to the
converted on that one.
Mr. Shays. We thank you for your work, where your heart is
as well as all the other people here before. We collectively
are in this together to make a big difference and we look
forward to making a difference.
I would like to say, Lord Morris, this has been a unique
experience to be your guest in this magnificent chamber and to
be in my forefathers' home country and I would like to present
you with a gavel we have used in our hearings for a number of
years and I am going to part with it because it has a home with
you.
[Applause.]
Lord Morris. I shall treasure this gavel. I promise not to
use it too frequently for purposes other than those for which
it was made.
Can I in turn pay very high tribute to our American guests.
I think Christopher, as Mark Twain, who if he did not ought to
have said when he was asked about Wagner's music. He said
``Wagner's music is not as bad as it sounds.''
[Laughter.]
Lord Morris. Christopher, because of your work and your
fellow Congressmen and that of Ross Perot whom we all admire
and those who have been working behind the scenes with you,
this occasion has been far more successful than any of us could
possibly have hoped. If I can say so, the Royal British Legion
has been very much involved in our affairs. What we have
achieved here today and yesterday and hope to achieve tomorrow,
could not even have been contemplated but for the support of
the Royal British Legion.
I pay a tribute to Terry English, to Lorna Rudkins, to
Jeremy, to others here today from the Legion. All of us look
forward to being their hosts later today. We are deeply
grateful, Terry. Please accept that on our behalf.
Again, Chris, can I thank you very much for inviting us. I
think we have done a service to everyone involved. I say
tomorrow in the Royal Robing Room. We are not saying that
people in executive government here or in the US want to see
stricken veterans and disadvantaged. What we are saying is
their problems are our problems. They are the problems they
should not be bearing, the costs of the Gulf War but I thank
everyone who has helped in any way in the making of what for me
has been a very memorable experience.
Mr. Shays. Thank you very much. I don't have a gavel to
close. Can you use the gavel?
[Gavel by Lord Morris.]
[Whereupon, at 4:28 p.m., the hearing was adjourned.]
[Conclusion of transcript insert from July 18, 2002.]
Mr. Shays. At this time the chairman would recognize the
most distinguished and articulate vice chairman of this
subcommittee.
Mr. Putnam. Thank you, Mr. Chairman. I continue to be
appreciative of your work and Mr. Sanders' work in this field.
I came late to this cause and have been proud to participate in
it, having had a number of constituents impacted by it.
The lessons we learned in London were tremendous and I
sincerely hope that our Pentagon and our Defense Department
apply the lessons of the last war to the pending one.
Mr. Shays. I thank the gentleman.
I would also say that it was an extraordinary privilege for
you and Mr. Sanders and myself to address members of the House
of Lords and the House of Commons during our 2-day experience
in London.
We would also note for the record that we have the most
distinguished chairman of the International Relations
Committee, Mr. Ben Gilman, and unless he has something to say,
I am prepared to adjourn this hearing. [Laughter.]
Mr. Gilman. Looks like I came at the right time.
Mr. Shays. I do have one order of business.
I ask unanimous consent that all members of the
subcommittee be permitted to place opening statements in the
record, and that the record remain open for 3 days for that
purpose. Without objection, so ordered.
I ask further unanimous consent that all witnesses be
permitted to include their written statements in the record.
Without objection, so ordered.
Any comments that the most distinguished gentleman from New
York would like to make?
Mr. Gilman. No, I just want to commend you once again for
your great work in making certain that we follow all of the
needs of our personnel overseas and our military personnel. I
am very distressed to read in the morning papers about the
testing of nerve gas in some of our areas, and I hope our
chairman will take a look at all of that.
Mr. Shays. We definitely will.
Mr. Gilman. Thank you, Mr. Chairman.
Mr. Shays. Thank you.
If there is nothing further, we will now adjourn this
session.
[Whereupon, at 9:42 a.m., the subcommittee was adjourned,
to reconvene at the call of the Chair.]
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