Special Assistant for Gulf War Illnesses
Mr. Chairman, I appreciate the opportunity to appear before the Subcommittee on Human Resources to report on the progress of the Department of Defense investigation of Gulf War illnesses. In previous testimony presented before the Subcommittee on January 21, 1997, I outlined the mission of my office and described the full extent of the commitment of the Department of Defense. It is imperative that we find out everything we can to determine the possible causes of these illnesses while providing the best possible care for those who are ill. We also have an eye toward the future as we learn from our Gulf experience and make the necessary changes in policies, doctrine, and technologies.
With an increased level of resources and redirected efforts, we have focused on the goal of conducting as thorough an investigation as possible into why many of our veterans who served in the Gulf War are ill and have entered into a broader dialogue with them as we proceed in our investigation. We remain committed to our veterans who served our nation so willingly and committed to the mutual trust upon which the military contract with our service members depends. We know full well that if that commitment doesn't express itself in action - it doesn't exist.
That commitment was demonstrated in the recent Presidential decision to extend the presumptive period for compensation for Gulf War veterans with undiagnosed illnesses. As you know, the government compensates for disability, not exposure. In the case of symptoms that may be attributed to Persian Gulf veterans' illnesses, the benefit of the doubt regarding service connection is in favor of the veteran. We welcome this because it completely eliminates any argument that our actions are driven by concerns over government liability. Our inquiry never has been, and never will be, directed by such concerns. Our only interest is to support our veterans by vigorously searching for the causes of Gulf War illnesses.
During the course of our investigation, we have worked to communicate with our veterans to explain our efforts and to gain an understanding of their personal concerns. Since December, our activities in the area of risk communication have intensified. We have eliminated the backlog of calls from veterans who call our 1-800 Incident Reporting Line. This one-on-one contact with veterans has helped our investigators obtain valuable information that is incorporated into our investigation. Approximately 90 percent of the people who have called have been fully debriefed by a trained investigator. Their insights have increased our understanding of various events and incidents before, during, and after the war.
We launched an outreach effort in January mailing surveys to approximately 20,000 Gulf War veterans who may have been within 50 kilometers of the Khamisiyah site when bunker demolition took place. Veterans were asked if they witnessed chemical detection from indicators such as M8 alarms, M256 kits, or Fox vehicle detections; if symptoms were experienced or observed; and, if they saw or heard anything that may be helpful to the investigation. To date, more than 6,000 veterans have responded; of that number, approximately 300 commented that they experienced some symptoms associated with Persian Gulf Veterans' illnesses; approximately 300 provided information on recollections they had regarding the site. This latter group is receiving follow-up calls from our investigators for a full debriefing of their experiences. This response has provided our investigation and analysis team with many new leads which are being followed up with telephone interviews.
Communication with veterans, Congress, and the American people is a high priority for our investigation. To this end, we have improved our GulfLINK Internet website to include a news article format to explain what we are doing on a week-to-week basis. A hyper-text capability on the site will provide supporting information to the more technical case narratives as they are released. Our GulfLINK website is now interactive. Veterans who have questions about our investigation can now e-mail the Defense Department with their concerns and get answers. We hope this will allow us to hear from the public and be even more responsive to Gulf War veterans.
To strengthen our relationship with veterans services organizations (VSOs), I have held two monthly roundtable meetings with VSOs -- one in February and one in March. I consider feedback and participation from veterans' organizations in this investigation to be a critical element in answering questions pertaining to the relevant Persian Gulf War issues that concern them. Nationwide public forums have been scheduled. At the invitation of the Veterans of Foreign Wars and the American Legion, I am participating in nine town hall meetings throughout the country. Last night I was the guest of the American Legion in Atlanta and tonight I will be in Boston. These meetings have been productive opportunities to have one-on-one conversations with our Gulf War veterans. I have been to Cleveland and will be traveling to Denver, San Diego, Seattle and Chicago in May.
The DoD investigation is organized around a formal case management system.
Cases include examination of incidents like Khamisiyah or other environmental hazards and issues such as the use of pyridostigmine bromide (PB) tablets and pesticides. Case managers direct the efforts of many teams that review events and issues that occurred before, during or after the war to assess how events relate to potential causes of illnesses or to the need for future changes in policy.
The Investigation and Analysis Directorate (IAD) comprises the largest element of the Office of the Special Assistant and directly supports the analytical effort. The Chemical and Biological Warfare Agents Team is presently the largest team within the directorate investigating 25 cases of suspected or reported chemical detection.
The Environmental and Occupation Exposures team is investigating all cases relating to environmental and occupational exposures including depleted uranium, pesticides, and similar potential causes of illnesses.
The Medical Planning Issue Team is investigating the medical planning, policy and relevant exposure issues relating to immunizations, pyridostigmine bromide, stress, infectious diseases, and any other similar potential causes of Gulf War illnesses.
Also central to our investigation is the Veterans Data Management team who work practically around the clock calling veterans for their input and observations. We are asking these veterans to share with us any logs, journals or photographs they might have in addition to eyewitness accounts to further the investigative efforts.
The results of each investigation will be released to the Congress and the American public. The Khamisiyah narrative published in February was the first in a series of reports intended to open up a dialogue with Gulf War veterans. We intend to publish narratives related to incidents or issues involving Camp Monterey, Fox Vehicle capabilities, Marine Breaching Operation, Czech/French detection, Mustard Exposure, and Al Jubayl in the next 60 days.
During the demolition operations at Khamisiyah on March 10, there were no reports of chemical munitions nor were there reports of anyone experiencing symptoms consistent with exposure to chemical agent. Subsequent inspection by the U.N. in late 1991, early 1992, and then again in May 1996 suggested that there were chemical munitions stored at Khamisiyah during the time in which U.S. forces destroyed the depot. It was not until late 1995 that the evidence led CIA, and later DOD, to suspect that U.S. forces could have destroyed these munitions and possibly been exposed to chemical agents. This was confirmed in a U.N. visit in May 1996 and announced by the Department in June 1996.
The recently released Khamisiyah narrative is an interim report which portrays our best understanding of what occurred as we know it at this point in time. The narrative does not represent a final product. It was released with an appeal to individuals who were in the Khamisiyah vicinity to contact us with any information that would help us better understand the activities at this facility after the war. As we receive additional personal descriptions from veterans as well as survey results, the Directorate will continue to refine the case narrative.
I know the Committee is concerned about the missing portions of the U.S. Central Command (CENTCOM) nuclear-biological-chemical (NBC) log. The investigation of this log has been turned over to the DoD IG. My office had taken the investigation to a point where the assignment of additional resources was appropriate.
Our inquiry, which will be expanded by the ongoing DOD IG investigation, indicates that the chemical log pages that survived were extracted from the full set of log entries. We believe they survived because they were used to prepare testimony for the Defense Science Board. In other words, these were the pages that carried significant chemical events.
With the exception of Khamisiyah, almost every chemical event we are investigating, such as the Czech/French detections and the Marine Breaching Operation, is entered into the log. Moreover, we would not expect to see Khamisiyah on these pages because it was not viewed or reported by the troops as a chemical event. At this time, my best assessment is that the missing pages did not contain any information about chemical exposure. In addition, we have the Corps situation reports (SITREPS) for these days; specifically, the 4th of March and the 5th of March, the day of and the day after the detonation of Bunker 73, and they do not mention destruction of chemical weapons at Khamisiyah. We also have obtained the SITREPS for March 10 and 11, the day of and the day after the detonation in the pit. Those documents are classified and we are asking that they be declassified.
There are a number of other collateral investigative efforts underway to obtain more detailed information which is supportive of the work of my office. The Army Inspector General (IG) is also conducting an investigation into the events surrounding the demolition of the ammunition storage facility at Khamisiyah. The Assistant to the Secretary of Defense for Intelligence Oversight is undertaking a further investigational effort that deals with the intelligence aspects of Khamisiyah. All of these investigations are well-coordinated and we welcome them.
Efforts to determine potential exposure at Khamisiyah are ongoing. Because of the difficulties inherent in modeling the Khamisiyah pit area, Deputy Secretary of Defense White requested that the Institute for Defense Analyses (IDA) convene a panel of experts in meteorology, physics, chemistry, and related disciplines to review all of the modeling efforts. IDA also reported continued concern about the inability to describe the many variables of the agent-munition release mechanism. IDA agreed with the CIA that huge uncertainties remained in attempting to estimate key variables such as the number of rockets present for destruction and the number of those destroyed, total quantity of agent released, mechanism of release, and purity of agent. Both the CIA and IDA presented testimony on this issue before the March 18, 1997 public meeting of the Presidential Advisory Committee on Gulf War Veterans.
Our efforts to estimate exposure are directly linked to two key factors: estimates of the extent of any chemical agent dispersion and determination of actual troop locations. We are working with the CIA to reduce some of the uncertainties associated with the demolition. We will be conducting a series of small scale tests at Dugway Proving Ground in Utah using inert chemicals to provide insight into numbers of rockets destroyed, mechanism and quantities of agent release, and initial agent behavior. As we have discussed with the Presidential Advisory Committee in Salt Lake City, preliminary estimates regarding potential exposures are premature until we review the test results.
Our second ongoing effort involves improving our knowledge of unit locations throughout the war, including the time frame of the Khamisiyah demolitions. Later this month, the Army will assemble Desert Storm brigade and division operations officers from XVIII Airborne Corps, the major command in the Khamisiyah area, to help us identify unit location already in our database. We are asking these senior officers to locate their units down to at least battalion level for days not previously identified from existing records. In subsequent months we intend to extend this methodology to other corps to improve our knowledge of troop locations throughout the theater of operations.
The Department of Defense believes that our search for answers to the question of who may have been exposed to chemical agents requires aggressive inquiry. Therefore, having discussed these concerns with the Presidential Advisory Committee at their last meeting, I am going forward with an analysis of participation rates for personnel registered in the CCEP and VA medical registry programs that were examined prior to July 1996 with regard to time and unit locations relative to Khamisiyah events.
We believe that our measures of the relationship between relative unit location and registry participation, while having extremely serious scientific limitations, may help further our understanding and generate hypotheses. In time, when modeling yields its best estimate of where chemical agents may have affected troops, we can observe whether different kinds of participation and symptoms are in some meaningful way associated with the dispersal of chemical agent.
To ensure that we fully understand the existing state of science on a variety of issues related to the health of Gulf War veterans and to help focus our future efforts, we have asked the RAND Corporation to prepare extensive medical literature reviews in nine areas including: pesticides, immunizations, chemical warfare agents, pyrdostigmine bromide, stress, biological warfare agents, depleted uranium, infectious diseases, and environmental exposure to oil fires. The literature reviews will examine published articles, books and government reports. This will give a clear picture of the existing knowledge base, identify gaps, and allow analyses of future research needs.
Research will help us understand the long-term effects of exposures to a number of factors present in the Gulf War. As I reported to the Committee in February, the DoD has strengthened its research program to study a wide range of medical issues related to Gulf War illnesses. For fiscal year 1997, we will spend up to $27 million in Gulf War-related research. The Department's research program is conducted with extensive collaboration with the Departments of Veteran Affairs and Health and Human Services through the Research Working Group of the Persian Gulf Veterans Coordinating Board.
We are actively pursuing solid research proposals examining the consequences of possible exposure to low levels of chemical agent. In late 1996 and in early 1997, requests for proposals were published in the Commerce Business Daily to solicit proposals investigating the causal relationships between illnesses and symptoms among Gulf War veterans and possible exposures to hazardous material; chemical warfare agents; stress; and combinations of inoculations and investigational new drugs during military service in the Gulf War. Proposals have been received and they are undergoing external scientific review.
We continue to seek the advice of oversight organizations for recommendations throughout this investigative process. The Department of Defense has taken guidance in many matters from the Presidential Advisory Committee on Gulf War Veterans' Illnesses. In March, the Departments of Defense, Veterans Affairs and Health and Human Services submitted to President Clinton an action plan in response to the recommendations contained in the Committee's Final Report.
Our investigation is one that deals concurrently with the past, the present and the future. We are attending to the health needs of our veterans, seeking them out and responding to their concerns. We are examining the past through a very thorough, painstaking investigation to find out what occurred that could be affecting the health of many veterans. We are also looking to the future and applying what we learn to ensure that the Department implements necessary changes to military doctrine, procedures, and equipment to ensure that we protect our troops in the future. Having complete records, such as the CENTCOM NBC log, would certainly have made make our job easier. We must improve our systems of collecting and retaining information from the battlefield - operational, intelligence, personnel location, and health records. As we discover new leads, we will use every resource at our disposal to move our investigation forward. We will "widen the net" with outreach, communication, town-hall meetings and any other vehicle that maximizes the dissemination of vital information and provides further insights into our investigation.
We are conducting an open investigation. We are actively declassifying documents and making them available to the public. The Army as the executive agent for declassification has pursued every lead and recently visited numerous installations facilities, and commands to ensure the most complete compilation of documents pertaining to the Gulf. This very pro-active approach has recently produced another 66,000 additional new pages of information. We will fully disclose everything we learn, when we learn it.
You have my commitment that we will aggressively pursue all of these issues. No effort will be spared to determine the causes of these illnesses and to provide the medical care our Gulf War veterans need and deserve.
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