[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 ______ U.S. GOVERNMENT PRINTING OFFICE WASHINGTON : 2003 89-074 PDF For Sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpr.gov Phone: toll free (866) 512-1800; (202) 512-1800 Fax: (202) 512-2250 Mail: Stop SSOP, Washington, DC 20402-0001 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:] [GRAPHIC] [TIFF OMITTED] T9074.001 [GRAPHIC] [TIFF OMITTED] T9074.002 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. 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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:] [GRAPHIC] [TIFF OMITTED] T9074.037 [GRAPHIC] [TIFF OMITTED] T9074.038 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:] [GRAPHIC] [TIFF OMITTED] T9074.039 [GRAPHIC] [TIFF OMITTED] T9074.040 [GRAPHIC] [TIFF OMITTED] T9074.041 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:] [GRAPHIC] [TIFF OMITTED] T9074.042 [GRAPHIC] [TIFF OMITTED] T9074.043 [GRAPHIC] [TIFF OMITTED] T9074.044 [GRAPHIC] [TIFF OMITTED] T9074.045 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 raise250,000 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:] [GRAPHIC] [TIFF OMITTED] T9074.046 [GRAPHIC] [TIFF OMITTED] T9074.047 [GRAPHIC] [TIFF OMITTED] T9074.048 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:] [GRAPHIC] [TIFF OMITTED] T9074.049 [GRAPHIC] [TIFF OMITTED] T9074.050 [GRAPHIC] [TIFF OMITTED] T9074.051 [GRAPHIC] [TIFF OMITTED] T9074.052 [GRAPHIC] [TIFF OMITTED] T9074.053 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:] [GRAPHIC] [TIFF OMITTED] T9074.054 [GRAPHIC] [TIFF OMITTED] T9074.055 [GRAPHIC] [TIFF OMITTED] T9074.056 [GRAPHIC] [TIFF OMITTED] T9074.057 [GRAPHIC] [TIFF OMITTED] T9074.058 [GRAPHIC] [TIFF OMITTED] T9074.059 [GRAPHIC] [TIFF OMITTED] T9074.060 [GRAPHIC] [TIFF OMITTED] T9074.061 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:] [GRAPHIC] [TIFF OMITTED] T9074.062 [GRAPHIC] [TIFF OMITTED] T9074.063 [GRAPHIC] [TIFF OMITTED] T9074.064 [GRAPHIC] [TIFF OMITTED] T9074.065 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:] [GRAPHIC] [TIFF OMITTED] T9074.066 [GRAPHIC] [TIFF OMITTED] T9074.067 [GRAPHIC] [TIFF OMITTED] T9074.068 [GRAPHIC] [TIFF OMITTED] T9074.069 [GRAPHIC] [TIFF OMITTED] T9074.070 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:] [GRAPHIC] [TIFF OMITTED] T9074.071 [GRAPHIC] [TIFF OMITTED] T9074.072 [GRAPHIC] [TIFF OMITTED] T9074.073 [GRAPHIC] [TIFF OMITTED] T9074.074 [GRAPHIC] [TIFF OMITTED] T9074.075 [GRAPHIC] [TIFF OMITTED] T9074.076 [GRAPHIC] [TIFF OMITTED] T9074.077 [GRAPHIC] [TIFF OMITTED] T9074.078 [GRAPHIC] [TIFF OMITTED] T9074.079 [GRAPHIC] [TIFF OMITTED] T9074.080 [GRAPHIC] [TIFF OMITTED] T9074.081 [GRAPHIC] [TIFF OMITTED] T9074.082 [GRAPHIC] [TIFF OMITTED] T9074.083 [GRAPHIC] [TIFF OMITTED] T9074.084 [GRAPHIC] [TIFF OMITTED] T9074.085 [GRAPHIC] [TIFF OMITTED] T9074.086 [GRAPHIC] [TIFF OMITTED] T9074.087 [GRAPHIC] [TIFF OMITTED] T9074.088 [GRAPHIC] [TIFF OMITTED] T9074.089 [GRAPHIC] [TIFF OMITTED] T9074.090 [GRAPHIC] [TIFF OMITTED] T9074.091 [GRAPHIC] [TIFF OMITTED] T9074.092 [GRAPHIC] [TIFF OMITTED] T9074.093 [GRAPHIC] [TIFF OMITTED] T9074.094 [GRAPHIC] [TIFF OMITTED] T9074.095 [GRAPHIC] [TIFF OMITTED] T9074.096 [GRAPHIC] [TIFF OMITTED] T9074.097 [GRAPHIC] [TIFF OMITTED] T9074.098 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:] [GRAPHIC] [TIFF OMITTED] T9074.099 [GRAPHIC] [TIFF OMITTED] T9074.100 [GRAPHIC] [TIFF OMITTED] T9074.101 [GRAPHIC] [TIFF OMITTED] T9074.102 [GRAPHIC] [TIFF OMITTED] T9074.103 [GRAPHIC] [TIFF OMITTED] T9074.104 [GRAPHIC] [TIFF OMITTED] T9074.105 [GRAPHIC] [TIFF OMITTED] T9074.106 [GRAPHIC] [TIFF OMITTED] T9074.107 [GRAPHIC] [TIFF OMITTED] T9074.108 [GRAPHIC] [TIFF OMITTED] T9074.109 [GRAPHIC] [TIFF OMITTED] T9074.110 [GRAPHIC] [TIFF OMITTED] T9074.111 [GRAPHIC] [TIFF OMITTED] T9074.112 [GRAPHIC] [TIFF OMITTED] T9074.113 [GRAPHIC] [TIFF OMITTED] T9074.114 [GRAPHIC] [TIFF OMITTED] T9074.115 [GRAPHIC] [TIFF OMITTED] T9074.116 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:] [GRAPHIC] [TIFF OMITTED] T9074.117 [GRAPHIC] [TIFF OMITTED] T9074.118 [GRAPHIC] [TIFF OMITTED] T9074.119 [GRAPHIC] [TIFF OMITTED] T9074.120 [GRAPHIC] [TIFF OMITTED] T9074.121 [GRAPHIC] [TIFF OMITTED] T9074.122 [GRAPHIC] [TIFF OMITTED] T9074.123 [GRAPHIC] [TIFF OMITTED] T9074.124 [GRAPHIC] [TIFF OMITTED] T9074.125 [GRAPHIC] [TIFF OMITTED] T9074.126 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. 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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:] [GRAPHIC] [TIFF OMITTED] T9074.153 [GRAPHIC] [TIFF OMITTED] T9074.154 [GRAPHIC] [TIFF OMITTED] T9074.155 [GRAPHIC] [TIFF OMITTED] T9074.156 [GRAPHIC] [TIFF OMITTED] T9074.157 [GRAPHIC] [TIFF OMITTED] T9074.158 [GRAPHIC] [TIFF OMITTED] T9074.159 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.] -