[Congressional Record Volume 149, Number 47 (Monday, March 24, 2003)]
[Extensions of Remarks]
[Pages E553-E554]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




           TROOPS SHOULD RECEIVE REQUIRED MEDICAL SCREENINGS

                                 ______
                                 

                           HON. DENNIS MOORE

                               of kansas

                  in the house of representatives

                         Monday, March 24, 2003

  Mr. MOORE. Mr. Speaker, with our country's troops now entering into 
active combat in Iraq, I want to bring to your attention and to the 
attention of my fellow Representatives an issue made even more timely 
by the events of the past twenty-four hours.
  On March 13th, I sent to Defense Secretary Rumsfeld a letter which I 
am including in the Record with this statement. I encouraged the 
Secretary to assure that all troops entering the Iraqi area receive 
medical examinations before and after deployment. The Kansas City Star 
recently carried an informative article, also included here, 
summarizing a law enacted by Congress in 1997 that requires such 
physical and mental screening of our troops, due to the many 
unexplained illnesses that followed service in the 1991 Persian Gulf 
War.
  Our fighting men and women serving in the Middle East face a genuine, 
immediate threat of biological and chemical weapons. We owe them no 
lesser level of service and dedication than they are providing in 
defense of our country. I hope all members of Congress will join with 
me in ensuring that the commitments made to the members of our Armed 
Forces in 1997 are kept in 2003 and afterward.

                                     House of Representatives,

                                   Washington, DC, March 13, 2003.
     Hon. Donald Rumsfeld,
     Secretary, Department of Defense, The Pentagon, Washington, 
         DC.
       Dear Mr. Secretary: I am writing to express my concern 
     regarding a recent article I read in the Kansas City Star 
     March 5, 2003, entitled: ``Troops are not receiving medical 
     screenings required by 1997 law.'' I have enclosed the 
     article for your review.
       The article asserts that troops entering the Iraqi area are 
     not receiving medical examinations before and after 
     deployment. As you know, Congress mandated in 1997 that all 
     troops receive such tests to help in identifying future 
     ailments such as Gulf War syndrome which has been extremely 
     difficult to document and treat following the 1991 Gulf War.
       I strongly urge the Department of Defense follow the 1997 
     mandate and if the DOD needs help fulfilling this mandate to 
     accept the Veterans Administration's offer of help to collect 
     and maintain medical information on all troops entering 
     southwest Asia.
       I look forward to your response on this important matter.
           Very truly yours,
                                                     Dennis Moore,
                                               Member of Congress.

             [From the Kansas City (KS) Star, Mar. 5, 2003]

     Troops Are Not Receiving Medical Screenings Required by 1997 
                                  Law

                          (By David Goldstein)

       Washington.--Troops heading for the Iraqi theater are not 
     getting health screenings, especially blood sampling, 
     mandated by a law Congress enacted in 1997.
       The law, which grew out of concern about unexplained 
     illnesses that followed the 1991 gulf war, required that 
     troops receive mental and medical examinations before and 
     after deployment overseas. The tests are intended to provide 
     clues in case the phenomenon known as gulf war syndrome 
     should recur.
       Instead, the Pentagon requires only a brief, one-page 
     questionnaire asking for general health-related information. 
     A top Pentagon health official said blood tests would not be 
     especially useful.
       About 300,000 American personnel are now at jumping-off 
     points near Iraq or on their way. Many consider U.S. troops 
     much more likely than in the 1991 war to face biological and 
     chemical weapons.
       ``The majority of the troops have already deployed . . .  
     and therefore we're not going to have a good picture of their 
     health,'' said Steve Robinson, a gulf war veteran and 
     executive director of the National Gulf War Resource Center.
       ``Once again, if soldiers are exposed, we do not have 
     baseline (medical) data required to document their status. 
     You're looking at gulf war illness 2.''
       The Pentagon insists that it has followed the law.
       ``If the intent was to make sure we had better 
     documentation--yes, we are in compliance,'' said Michael 
     Kilpatrick, a physician who is deputy director of deployment 
     health support at the Pentagon.
       Veterans affairs activists, health care expects and 
     congressional watchdogs are unconvinced.
       The law, signed by then-President Bill Clinton, was enacted 
     in response to a chorus of health complaints from gulf war 
     veterans. Many reported a variety of ailments, including 
     headaches, memory loss, rashes, equilibrium problems and loss 
     of motor skills.
       The causes were unknown, despite numerous medical studies. 
     Some veterans pointed to the release of chemical or 
     biological agents when Iraqi stockpiles were bombed, the 
     military's hurried vaccinations against those agents, desert 
     diseases and parasites or pollution from burning oil wells.
       The syndrome has caused a bitter battle between veterans 
     and the Pentagon, which has refused to recognize it, and the 
     Department of Veterans Affairs, which has had to decide 
     whether claims for medical compensation are valid.
       Democratic Sen. John Kerry of Massachusetts, a former 
     veterans affairs activist, called the Pentagon's program 
     troubling.
       ``What's the message we're sending to our troops around the 
     world today and those prepared to fight in Iraq?'' he asked. 
     ``The message seems to be, `Do your duty to country, but your 
     country won't fulfill its duty to you if you're lucky enough 
     to return home.' ''
       Kerry, a candidate for the Democratic presidential 
     nomination in 2004, has asked the General Accounting Office 
     to investigate whether Defense has met its requirements.
       In addition, leaders of the Senate Committee on Veterans' 
     Affairs have asked for a detailed account of Pentagon efforts 
     to track medical data on battlefield troops.
       Last month, Veterans Affairs Secretary Anthony Principi 
     wrote to Defense Secretary Donald Rumsfeld and said the VA 
     wanted to work closely with the Pentagon to collect ``health 
     and exposure data'' on those deployed in southwest Asia.
       ``Much of the controversy over the health problems of the 
     veterans who fought in the 1991 war with Iraq could have been 
     avoided had more extensive surveillance data been 
     collected,'' Principi wrote.
       Mark Brown, a VA toxicologist who has been investigating 
     gulf war illnesses, said Principi's letter was intended to 
     put the VA ``on the public record'' about its concerns.
       The Pentagon's approach, he said, ``certainly wasn't 
     adequate in the first gulf war. Have they learned their 
     lesson and done better? Maybe we'll be pleasantly 
     surprised.''
       The law requires the Secretary of Defense to ``establish a 
     system to assess the medical condition of members of the 
     armed forces,'' including reserves, deployed outside the 
     United States for combat, peacekeeping missions or 
     humanitarian operations.
       Kilpatrick said the Pentagon's program was ``an evolving 
     process'' and part of a concept called ``Force Health 
     Protection'' that was put in place during the Kosovo conflict 
     in 1996.
       Some health officials with the Defense Department appear 
     not to have known what Congress required.
       Some gulf war medical researchers proposed a study to the 
     Pentagon a year ago that would track some troops in post-
     Sept. 11 military operations. The proposed study unknowingly 
     mirrored the elements of the law, and a medical official 
     wrote back, ``This sound like something we need to 
     investigate further as something we could like to support.''
       The project involved studying the Rhode Island National 
     Guard. David Haines, an immunologist affiliated with George 
     Washington University, said he discovered a month ago that 
     the Department of Defense was supposed to be doing the blood 
     sampling that he and his colleagues had proposed to do on a 
     small scale.
       ``We will do the right thing and step back if DOD is doing 
     great things, but we don't believe DOD has anything like that 
     in place,'' he said.
       According to Kilpatrick, a brief questionnaire is basically 
     the military's response to the congressional mandate because 
     it has other steps already in place.
       In the questionnaire troops are asked how they would rate 
     their health, from excellent to poor. They are also asked 
     whether they have any medical or dental problems, whether 
     they have any health concerns, whether they wear glasses and 
     whether they have concerns about possible ``exposures or 
     events during this deployment.''
       Anyone answering ``yes'' to certain questions will be 
     referred for further examination. Rick Weidman of the 
     lobbying group Vietnam Veterans of America, calls the 
     questionnaire ``absolutely useless from an epidemiological 
     point of view.''
       ``There's nothing about susceptibility to skin rashes or 
     any of the derivative diseases that are due to some of these 
     kinds of exposures,'' he said, ``and there is no 
     psychological exam. Nothing.''
       According to Kilpatrick, troops are asked whether they have 
     sought mental health counseling within the past two years, 
     but the military has to rely on personnel being truthful.
       ``If people say, `My mental status is fine,' we are not 
     stopping to engage in a three-hour survey to assess people's 
     mental status,'' Kilpatrick said. ``If we are preparing to 
     deploy 20,000 troops, it's physically impossible.''
       A key element of the 1998 law is the taking of blood 
     samples to establish a medical baseline and help identify 
     possible subsequent exposures to toxic materials. The absence 
     of

[[Page E554]]

     such tests on veterans of the 1991 gulf war has handicapped 
     researchers.
       Blood is always taken for HIV testing, Kilpatrick said, and 
     those samples are in storage. But fresh samples will be taken 
     only if the serum on file is more than a year old, he said.
       He disputed the idea that additional sampling would be 
     helpful because the biological markers of many toxic agents 
     disappear from the bloodstream within hours or days of 
     exposure.
       Also, Kilpatrick said, troops are physically evaluated 
     every five years, except for pilots, who are tested more 
     frequently. Medical histories were more valuable to 
     researchers than ``hands-on'' physical exams, he said.
       But gulf war medical researchers said the Pentagon's plan 
     is a missed opportunity, especially considering the threat of 
     weapons of mass destruction.
       ``We can run into the same thing all over again,'' said Lea 
     Steele, a Kansas Institute of Health epidemiologist who has 
     studied gulf war veterans. ``One of the difficulties of the 
     gulf war was we didn't have any evidence prior to the war. It 
     was hard to link illnesses.
       ``Now that we're becoming a second time deeply involved in 
     Iraq . . . there is no established protocol that would be 
     very valuable. Some people say Saddam Hussein has less to 
     lose now. He may be more likely to use these things.''

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