[Congressional Record Volume 144, Number 113 (Tuesday, September 1, 1998)]
[Senate]
[Pages S9800-S9802]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     REPORT OF THE SPECIAL INVESTIGATION UNIT ON GULF WAR ILLNESSES

 Mr. ROCKEFELLER. Mr. President, today the Committee on 
Veterans' Affairs released the final report of its Special 
Investigation Unit (SIU) on Gulf War Illnesses. The report represents 
the culmination of the unit's year-long, 20-member staff investigation 
into issues surrounding the illnesses that have affected many veterans 
of the 1990-91 Persian Gulf War.
  The Gulf War ended over seven years ago, but the aftermath of this 
military victory will remain with us for years to come. This brief war 
represented a critical turning point in our concept of modern warfare. 
For the first time since World War I, we faced the possibility of 
widespread use of chemical warfare agents. Previously, concerns about 
the use of ``weapons of mass destruction'' focused on the threat of 
nuclear warfare, increasingly possessed by the more developed nations 
of the world, but still limited in availability. But in the Gulf, we 
came face-to-face with the threat of the ``poor man's atomic 
weapons''--chemical and biological weapons.
  Chemical and biological weapons have been around for a long time. The 
United States and its allies abandoned the use of chemical weapons many 
years ago. In April 1997, the United States Senate ratified the 
Chemical Weapons Convention, joining many other nations in the 
international disarmament of chemical weapons. But for terrorists and 
rogue nations, chemical and biological weapons remain the weapons of 
choice, and they are likely to play a significant role in the 
battlefields of the future. According to Secretary of Defense William 
S. Cohen, just as we faced this threat in the Gulf War, we are likely 
to face it again.
  In hearings before the Committee on Veterans' Affairs, military 
heroes such

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as General Norman Schwarzkopf and General Colin Powell recounted their 
fears about the potential use of chemical or biological weapons in the 
Gulf War. They described the dilemmas they faced as they realized that 
vaccine supplies were inadequate to protect the 697,000 men and women 
who were deployed to the Gulf, forcing our leaders to decide who would 
be protected and who would not. They recalled the anguish associated 
with making those decisions. But fortunately, the widespread use of 
chemical weapons and the massive casualties that had been predicted for 
that war did not occur.
  After the Gulf War, it was generally agreed that we must be better 
prepared to meet this threat in the future. We needed to develop new 
technologies for the detection of chemical and biological weapons in 
the battlefield; to make sure that we had adequate supplies of vaccines 
and medical antidotes, and other protective equipment, especially masks 
and suits; and to ensure that our troops received adequate training to 
carry out their mission in the event of use of chemical/biological 
warfare. Given the crisis our military faced during the Gulf War as our 
leaders realized that we were not well prepared then, you might expect 
it would be high priority to make sure we are not caught unprepared 
again. Sadly, this has not been the case.
  The SIU report finds that almost eight years after the Gulf War, our 
military is still not prepared to fight in a chemical or biological 
warfare environment. The Inspector General of the Department of Defense 
corroborated these findings in a recent report which states that with 
the exception of Navy surface ships, our armed forces are unable to 
assess unit chemical and biological defense readiness because unit 
commanders have not made this training a priority. Of the 232 units 
reviewed by the Inspector General, 80 percent were not fully 
integrating chemical and biological defense into unit mission training. 
This is completely unacceptable.
  The SIU also found that training for chemical and biological warfare 
is still inadequate, and that the technology for battlefield detection 
of chemical warfare agents has not improved since the Gulf War. 
Although the threat of chemical and biological warfare has increased 
since the Gulf War and hangs heavy over the potential battlefields of 
the 21st century, the military still has inadequate supplies of 
vaccines and chemical/biological protective equipment. It is imperative 
that we be prepared to face these very real risks. Moreover, we must be 
ready for the possibility that the next terrorist attack on U.S. 
civilians may include such weapons. The task of domestic defense and 
preparedness poses an even greater challenge.
  Recent events underscore the need to make this defense and readiness 
issue a national priority. Eight years after the Gulf War, United 
Nations inspectors still have not been able to fully assess Iraq's 
chemical and biological weapons capabilities. We have all seen the 
roadblocks that Saddam Hussein has succeeded in placing in the path of 
this international effort to inspect for these weapons. Fortunately, we 
did not have to send in military personnel in the recent U.S. attack to 
destroy the chemical plant in Sudan. Had we needed to, however, and if 
these terrorists had chemical and biological weapons, I fear our ground 
troops would have been ill-prepared to function in such an environment.
  My concerns here are not new. In 1994, when I was chairman of the 
Committee, my staff issued a report that called attention to many of 
the long-term health concerns arising from our soldiers' exposures to 
environmental hazards. Many of the concerns raised then remain today.
  Senator Specter and I will call upon Secretary Cohen to carefully 
consider the findings of this report and provide an emergency action 
plan to address these shortcomings. I am confident that he is as 
concerned about our military's preparedness for this threat as we are, 
and we look forward to his response.
  Our military men and women must be protected and they must be 
prepared to fight in a chemical/biological warfare environment. That 
means that they need ongoing, quality training in chemical/biological 
defense and detection systems that will work quickly and reliably on 
the battlefield. It means that they need adequate supplies of the 
required chemical protection masks and suits, and training in how to 
properly use them under battlefield conditions. It means they need 
sufficient supplies of vaccines, antibiotics, and medical antidotes. 
And it means that they need well-trained medical personnel who are 
prepared to respond to chemical and biological warfare casualties, and 
the medical equipment needed to care for such casualties.
  All of this means a commitment of time and funding across all the 
service branches, and the support and leadership of commanders 
everywhere to guarantee this commitment. Most of all, this requires a 
solid commitment from this Congress and President Clinton.
  We have had enough talk of readiness--it's time to make it a reality 
if we are to fight on the battlefields of the 21st century.
  Mr. President, I request that a summary of the report's findings 
prepared by my staff be printed in the Record.
  The summary follows:


                             Report Summary

       The report of the Committee on Veterans' Affairs' Special 
     Investigation Unit (SIU) on Gulf War Illnesses is 
     thematically divided into 4 major sections or chapters.
       Chapter 1 addresses DoD and CIA intelligence operations 
     during the War and the destruction of the Khamisiyah 
     munitions depot. It reviews some of the communication 
     problems that existed with poor transfer of critical 
     intelligence information between DoD and CIA on the locations 
     of Iraqi chemical weapons facilities. It also critically 
     reviews DoD's efforts to ``model'' the events that transpired 
     at the U.S. demolition of the Khamisiyah munitions depot in 
     March 1991. The SIU report is particularly critical of the 
     Office of the Special Assistant for Gulf War Illnesses' 
     (OSAGWI) efforts to research the weather conditions that 
     existed on the day of the demolition, as it related to 
     estimates of the numbers of U.S. servicemembers who would 
     have potentially been exposed to low levels of chemical 
     warfare agents, such as sarin.
       The report points out that the OSAGWI modeling report does 
     not integrate crucial weather information provided by a 
     division of the Air Force that is typically viewed as expert 
     on such issues. Further, the OSAGWI report was largely an 
     internal document, and it was not subjected to the scientific 
     rigors of the peer review process. The Special Investigation 
     Unit (SIU) also contracted with a scientific consultant who 
     supported these criticisms and found that the estimate of 
     approximately 100,000 servicemembers who may have been 
     exposed to be a grossly overestimated figure.
       The defense and intelligence chapter also details the SIU's 
     investigation of the question of whether there are additional 
     Khamisiyahs or chemical weapons exposures to be found. On the 
     basis of extensive review of classified and unclassified 
     documents, interviews with military officials in Great 
     Britain, France, the Czech Republic, and our Arab allies, and 
     an interview with inspectors of the United Nations Inspection 
     Team, the SIU found no evidence to either prove or disprove 
     that the Iraqis offensively used chemical weapons during the 
     Gulf War. The SIU did find that during the Gulf War, our 
     military was not adequately prepared to deal with the threat 
     of chemical or biological warfare, and our military continues 
     to be inadequately prepared today.
       Chapter 2 is an ``Assessment of Gulf War Veterans' Health 
     Care Services and Compensation at the Department of Veterans 
     Affairs.'' The SIU team found that VA has often inadequately 
     monitored a number of Persian Gulf War health and benefits 
     programs. As a result, VA demonstrates inconsistent 
     compliance with their own regulations and policy directives, 
     and inadequate implementation of services and benefits for 
     Gulf War veterans. This chapter concludes that too many Gulf 
     War veterans are dissatisfied with the health care that they 
     are receiving from VA, and too few are receiving timely 
     responses to their compensation benefits claims.
       The SIU report states that ``although VA purports to 
     operate as a single entity on behalf of veterans, in practice 
     it is a loosely linked group of bureaucracies that operate 
     largely in isolation from one another.'' This organizational 
     structure contributes to problematic communication and 
     bureaucratic hurdles that affect VA's ability to provide 
     effective and efficient service to Gulf War veterans. The 
     greatest problems were seen in VBA's handling of Gulf War 
     compensation claims, and their processing was characterized 
     as ``inconsistent and counterproductive.'' While the report 
     notes problems with the health care provided to Gulf War 
     veterans, the SIU staff also found a number of very caring 
     and competent health professionals who were delivering 
     appropriate health care, despite obstacles such as limited 
     information and resources.
       Chapters 3 and 4 focus specifically on health concerns and 
     health research. This chapter reviews the chronology of 
     health-related events, the assessment of the range of 
     possible exposures in the Gulf War, the nature of the health 
     problems that have

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     emerged, and the government research response on this issue. 
     This information is presented in Chapter 3, ``Evaluations of 
     Wartime Exposures, Gulf War Veteran Health Concerns, and 
     Related Research, and Unanswered Questions.'' Chapter 4, 
     ``Possible Long Term Health Consequences of Gulf War 
     Exposures: An Independent Evaluation,'' contains the brief 
     reports of scientists the SIU contracted with for independent 
     reviews. These prominent scientists reviewed scientific 
     literature on a variety of exposures including pesticides, 
     PB, chemicals, stress, and other wartime and environmental 
     hazards, and the health consequences that follow such 
     exposures.
       Both health chapters conclude that there is no single 
     ``Gulf War Syndrome'' characterized by a single disease 
     entity or diagnostic label. Instead, there is a significant 
     proportion of Gulf War veterans who returned home with a 
     number of chronic, poorly understood symptoms such as 
     headaches, joint pains, rashes, fatigue, gastrointestinal 
     difficulties, and other symptoms that are potentially 
     disabling in some cases. In studies that have compared the 
     rate of these symptoms among Gulf War veterans to the rate of 
     symptoms in veterans of the same era who were not deployed to 
     the Gulf, significantly more symptoms are reported by the 
     Gulf War veterans. It is clear that many veterans are ill, 
     and it is also clear that we may never know why.
       There are many reasons why the question of ``why are Gulf 
     War veterans ill?'' cannot be answered.
       First, DoD deployed many reservists and active military 
     personnel to the Gulf without adequate pre-deployment medical 
     evaluations; as a result, we do not know what preexisting 
     illnesses or health conditions they may have had. In any 
     health investigation, such information would serve as an 
     important baseline from which to assess the pattern of 
     emerging illnesses.
       Second, DoD's medical recordkeeping for the Gulf War was 
     grossly inadequate. There are no clear records of even basic 
     information, such as the vaccine records of the men and women 
     who served in the Gulf. It is unclear whether such records 
     were ever kept or whether they were destroyed because they 
     were not felt to be a high enough priority to warrant space 
     on the military cargo planes returning to the United States 
     after the war. Many of the medical records from the war are 
     also missing, hindering any efforts to review information on 
     the numbers of troops who were hospitalized or received 
     medical care in the Gulf. Finally, there was no DoD 
     recordkeeping on the range and extent of exposures present in 
     the Gulf. All these factors seriously hinder any research 
     efforts to establish a cause and effect for the health 
     problems that followed the Gulf War.
       Also, in addition to the broad range of possible 
     exposures--heat, pesticides, PB, smoke from oil well fires, 
     petroleum products, ultra-fine sand particles, stress, and 
     others --and their individual health effects, there is also 
     the issue of the potential effects of an almost infinite 
     number of possible combinations of such agents. Health 
     research today is often not designed or conducted in ways 
     that allow us to fully understand the interactive effects of 
     such agents and their subsequent health consequences. All 
     these issues complicate, and in fact hamper, current 
     examinations of the events of the Gulf War while trying to 
     answer the question of ``why are Gulf War veterans ill?''.
       Some of the scientific experts the SIU contracted with were 
     able to provide very sound criticism of some of the 
     hypotheses about Gulf War illnesses, such as discounting the 
     role of a possible infectious agent, such as mycoplasma. They 
     were also able to clarify issues such as the possible health 
     effects of PB or pesticides, as well as the links between 
     stressful exposures, such as combat, and long-term physical 
     health. These experts also made a number of important 
     recommendations regarding future research directions and 
     better prevention of unnecessary health risks which were 
     integrated into the report.
       A number of the report's recommendations will be used to 
     develop additional legislation. Many of the major legislative 
     issues have been covered already in S. 2358, the legislation 
     that was introduced by Senators Rockefeller, Byrd, and 
     Specter. Specifically, S. 2358, the Persian Gulf War 
     Veterans' Act of 1998:
       Calls for the Secretary of VA to contract with the National 
     Academy of Sciences (NAS) to provide a scientific basis for 
     determining the association between illnesses and exposures 
     to environmental or wartime hazards as a result of service in 
     the Gulf War;
       Authorizes VA to presume that illnesses that have a 
     positive association with exposures to hazards during the war 
     were related to service even if there was no evidence of 
     illness during service;
       Extends VA's authority to provide health care to Gulf War 
     veterans through 2001;
       Requires the Secretary to task NAS with the identification 
     of additional research issues that the government should 
     conduct to better understand the adverse health effects of 
     exposures to environmental or wartime hazards associated with 
     Gulf War service;
       Tasks NAS with assessing potential treatment models for 
     chronic, undiagnosed illnesses that have affected Gulf War 
     veterans;
       Establishes a system to monitor the health status and 
     health care utilization of Gulf War veterans with chronic, 
     undiagnosed illnesses within VA and DoD health care systems;
       Requires that VA, in consultation with HHS and DoD, carry 
     out an ongoing outreach program to provide information to 
     Gulf War veterans;
       Extends and improves upon VA's Persian Gulf Spouse and 
     Children Evaluation Program, and;
       Requires the Secretary of VA to enter into an agreement 
     with NAS to study the feasibility of establishing, as an 
     independent entity, a National Center for the Study of 
     Military Health. Such a center would evaluate and monitor 
     interagency efforts and coordination on issues related to 
     post-deployment and would look at issues of how to better 
     prevent and treat post-conflict illnesses.
       In addition to these important issues addressed by S. 2358, 
     the report highlights further a number of shortcomings within 
     VA's and DoD's current policies. They include:
       The need for DoD to place a higher priority on training and 
     preparedness for the threat of offensive use of chemical and 
     biological weapons (CBW) in today's warfare scenarios, 
     including better CBW detection systems, adequate supplies of 
     protective masks and suits, adequate numbers of vaccines for 
     protection, and medical isolation units for treatment of such 
     casualties;
       The need for greater prevention of unnecessary health risks 
     in the battlefield (and on domestic military bases), such as 
     unnecessary exposures to inappropriate use of and inadequate 
     monitoring of environmental agents such as pesticides, 
     solvents, depleted uranium, and other identified health 
     hazards, to include coordination and consultation with EPA 
     and CDC on identifying and managing such risks;
       The need for DoD to participate in the proposed national, 
     state-based birth defects registry in order to better assess 
     the relative risks of birth defects in military populations;
       Given VA's history with environmental health issues such as 
     Agent Orange, atomic veterans, and Gulf War veterans' health 
     concerns, the need for VA to create the position of an 
     Assistant Secretary of Veterans Affairs for Deployment-
     Related Health Matters, with responsibilities to include 
     oversight of issues such as battlefield illnesses;
       The need for DoD and VA to improve monitoring of health 
     care to Gulf War veterans, to include identification of any 
     barriers to care currently in the system and the need to 
     develop methods for early detection of illnesses with delayed 
     onset, such as cancer;
       The need to ensure comprehensive pre- and post-deployment 
     medical examinations of Reservists who are placed on active 
     duty for deployment for military operations; and
       The need for the Secretaries of the Departments of Defense 
     and Veterans Affairs to implement doctrine that reflects and 
     builds upon the lessons learned from the Gulf War in order to 
     avoid repeating many of these same mistakes with future 
     military deployments and veteran populations.

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