Statement by Dr. Bernard Rostker, Special Assistant to the

Deputy Secretary of Defense for Gulf War Illnesses

Before the Senate Veterans' Affairs Committee

January 29, 1997

Mr. Chairman, on November 12, 1996, the Deputy Secretary of Defense, Dr. John White, appointed me Special Assistant for Gulf War Illnesses. The action was part of a broader set of initiatives undertaken on September 28, 1996, to assess the Department of Defense�s Gulf War Illnesses program in view of recent events, to include the reports that soldiers may have been exposed to chemical agents during the destruction of the storage site at Khamisiyah.

As special assistant my first priority is the health and welfare of our Gulf War veterans. My mission as the Special Assistant for Gulf War Illnesses is to serve as the DoD coordinator for all issues relating to Gulf War illnesses. I see this mission in three parts. First, to ensure that DoD does its part to ensure that all who served in the Gulf receive appropriate medical care; second, that we conduct a complete and thorough investigation to determine why so many of our veterans are ill; and third, to apply our findings to future deployments.

Two vital aspects of this mission are to ensure that we learn everything possible about the potential causes of service-related illnesses, including events during and after the Gulf War and to promote improved communication with Gulf War veterans on the relevant health care issues. This mission is critical. Not only do we have a moral duty to our veterans, but we must also understand what is making our people sick so that we make the changes necessary to protect our people in the future. Our efforts here must have long-term effect. We must ensure that DoD puts into place all required military doctrine, personnel and medical policies, procedures, and equipment to prevent recurrence of the problem. And we must work cooperatively with DVA to coordinate all issues critical to their program responsibilities.

The guidance from President Clinton is clear: "I want to assure all of you that we will leave no stone unturned in our efforts to investigate Gulf War Illnesses, and to provide our Gulf War veterans with the medical care they need. There are mysteries still unanswered and we must do more." I will make it my business to leave no stone unturned.

To carry out the mission entrusted to me by the Deputy Secretary of Defense, I have expanded by an order of magnitude the Department of Defense�s investigations organization. The original team of 12 is now more that 110-people strong and I have completely revamped the way we do business. We have the investigators and analysts necessary to perform a full review of currently known exposures, and I have the authority to search out and pursue reports of any new incidents.

My expanded efforts build on earlier work by refocusing and substantially increasing the level of commitment. Much of that increase is focused on incidents which occurred during the Gulf War, the hazardous exposure that may have resulted from these incidents, and the broader implications of such incidents. In coordination with DVA, we are doing this with renewed dedication to communicate with all veterans who served and fought in Southwest Asia in 1990 and 1991, including those veterans who are on active duty, served in the Reserve or National Guard, and those who have returned to full-time civilian life.

I have expanded into new areas to initiate a pro-active, risk communication strategy with the two-way communications between DoD, the VA and the Gulf War veterans as recommended by the Presidential Advisory Committee on Gulf War Veteran�s Illnesses (PAC). Today, when a veteran calls our telephone hotline to offer information, the veteran receives a follow-up call and is interviewed by a trained investigator who ensures that information is incorporated into our case files. These return calls not only provide an in-depth debrief, but for the future, establish a dialog between a single point of contact in my office and the reporting Gulf War veteran. The process involves the veteran in the investigative process in a significant and meaningful way. This information becomes an essential part of the case management process. It is recorded and forwarded to an investigator for analysis. The analysis becomes part of a larger picture as we examine the incidents and theories associated with Gulf War illnesses. It also serves as a springboard for veteran outreach. Our call back team works in two shifts, from 7am to 11pm Monday through Friday. The responses from the veterans have been extremely positive.

We also collaborate very closely with veterans service organizations (VSO). For example, on December 11, 1996 we hosted the VSO�s at a demonstration of the protective gear and chemical equipment used during the Gulf War, particularly the M8 alarm, 256 test kits, and the FOX chemical reconnaissance vehicle. They appreciated the opportunity to become more familiar with the equipment that has often been written about in the media and was the subject of Congressional debate. I plan to host another similar demonstration mid to late February.

We have initiated a formal structure for our incident investigations. We are preparing a series of narratives that summarize what we know about such incidents as Khamisiyah, the Marine breaching operation, operational logs, Fox alarms, pyridostigmine bromide (PB) tablets and every other issue under investigation. The narratives will be a status report to the American people of what we know , when we knew it, and what actions we plan to take to address the concerns of Gulf War veterans and their families.

We are building on the major health program initiated by the Department of Defense to care for those still on active duty, or otherwise eligible for DoD care. A comprehensive clinical evaluation program was established to provide in-depth evaluations of health concerns of Gulf War veterans who are on active duty or serve in the Reserve or National Guard. We are asking all personnel who want to be evaluated to contact the program to schedule an appointment for a medical evaluation. To date, more than 38,000 Gulf War veterans are registered and of those, 30,000 veterans have requested a medical examination. Also, as reported by Dr. Kizer, The Department of Veterans Affairs has completed exams for 63,000-plus veterans. We will coordinate our efforts with DVA as appropriate.

In addition to forming my organization, the Deputy Secretary of Defense generated a number of other important initiatives. In the area of research, the DoD has committed to spend $12M to study a wide range of medical issues related to the Gulf War. Further, DOD is prepared to spend another $15M to study the long-term effects of chemical and other hazardous exposures, including low-level chemical exposure. Again, we will coordinate this research program with HHS, and DVA through the established Persian Gulf Veterans� Coordinating Board.

As you may know, last week I withdrew the DoD staff paper published on the GulfLINK homepage which discounts low-level exposure as the cause for Gulf War illnesses. In doing this, I noted that the PAC concluded and current scientific evidence does not support a causal link between low-level chemical exposures and undiagnosed Gulf War illnesses. However, the PAC also recommended that additional research is warranted. We concur with this assessment and plan to fund the appropriate research. I approach this subject with a completely open mind. Our research agenda is clear evidence of this.

Dr. White also initiated a review by the Institute of Medicine of the DoD clinical health examination protocols in light of the possibility of chemical exposure; a review by the Army Inspector General of military operations at Khamisiyah; and a review by the Assistant to the Secretary of Defense for Intelligence Oversight of the circumstances surrounding the handling of intelligence data concerning Khamisiyah and similar facilities.

Further, Dr. White requested that the National Academy of Sciences provide a mechanism for oversight to meet the President�s call for an independent, open, and comprehensive examination of health-related issues and assessment of the multiple issues related to the protection of our forces. This initiative is in addition to the PAC�s oversight of the investigation into low-level chemical exposure events and monitoring of government-wide implementation of its recommendations.

I would like to take a moment to comment on concerns raised by several members of this committee. At the request of the committee and with the support of General Schwarzkopf, DoD has made available to the Congress the so-called Schwarzkopf logs. These logs have also been made available to the CIA, the PAC and my office. I also know how frustrated the committee has been about our inability to produce a complete set of the USCENTCOM NBC logs. I am frustrated also because the existing logs have proven to be very valuable indeed. Accordingly, we are now establishing a chain of custody for the logs from Riyadh to Tampa and beyond. I welcome the committee�s review of these verbatim interviews to establish the true record concerning these important logs.

In conclusion, we are whole-heartedly committed to finding out everything we can about any factor impacting on Gulf War illnesses. This is absolutely necessary, not only because it is right for our veterans, but also because it is imperative for the future safety of our troops. The results of our collective effort will be a better understanding of the illnesses facing our Gulf War veterans, a better way of caring for our troops and their families, and new strategies for protecting our troops in the future. Thank you.

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