A. LISTENING TO GULF WAR VETERANS

Among Gulf veterans testifying before the subcommittee were Steven Wood, Barry Kapplan, Chris Kornkven, Julia Dyckman, and Brian Martin, all of whom reported health complaints typical of the range of maladies often called the "Gulf War Syndrome."
Army S/Sgt. Steven Wood testified that during the first week of March 1991, he drove through ammunition storage sites destroyed by U.S. forces. Near a bombed out bunker, he inspected artillery rounds on the ground which he identified in an Army manual as chemical weapons. "Later that day," Sgt. Wood stated, "I started to get very sick with symptoms I suffer still today. I sought medical assistance that day . . . [and] . . . never once received any comprehensive, much less compassionate, treatment from the Army. I was told it was 'all in my head.' "
Transferred back to Germany following the war, his symptoms continued. In 1994, Sgt. Wood, unable to get treatment from Army doctors and unable to perform his duties, contacted a German physician. "This German doctor did more tests in 2 hours than the Army did in 5 years. When my wife and I left the [German] doctor's office, we were told that I 'had been poisoned.' These findings were immediately dismissed [by Army doctors] as being worthless since they did not come from a military doctor. Then it was stated to me by this military doctor that they did not like Gulf War veterans [complaining] with health problems."¹²
Major Barry Kapplan, a career Army pilot who had passed 15 flight physicals in the 11 years prior to deployment to the Gulf War, "began to feel increasingly ill" in April 1991 but dismissed the symptoms as related to the harsh desert environment. On May 8, he reported "violent nausea, vomiting, diarrhea attack." On May 28, now back in Germany, he was admitted to a military hospital with "cardiac arrhythmias . . . severely bleeding gums, cough with sputum production, shortness of breath, severe fatigue, diarrhea, hair loss, skin rashes/lesions, and abdominal discomfort." Military doctors diagnosed Major Kapplan with "just post traumatic stress." With severe brain, nerve, heart and gastrointestinal problems but still being diagnosed with "somatoform disorder," he was given a discharge by the Army "due to unemployability" in October 1995.¹³
Major Kapplan's wife Nancy, a registered nurse, testified about "the medical issues facing our family" since her husband's return from the Gulf. Her four children have suffered from continual chronic infections and one child has ". . . esophagitis, gastritis and gastroesophageal reflux disease . . . with little relief of her symptoms." Mrs. Kapplan reported that she has similar chronic symptoms since her husband came home from the war.¹⁴
S/Sgt. Chris Kornkven, an Army Reservist, reported, "While still in the Gulf I began experiencing symptoms that continue to this day. I had difficulty remembering significant events that happened days earlier . . . my knees and shoulders [were] especially painful . . . and fatigue stayed with me constantly." After the war, his symptoms worsened and included intestinal problems and headaches. He sought treatment in 1992 from VA doctors who -- without any physical exam, testing or treatment -- referred him to the mental health clinic where he was diagnosed "PTSD."¹⁵
"I reported blinding headaches with only offers of aspirin. I reported memory loss . . . dismissed as stress. I reported skin problems . . . and was told 'it's not cancer yet . . . come back as needed.' I reported breathing problems . . . no diagnosis. I reported intestinal problems . . . and rectal bleeding . . . dismissed [and] no follow-up. I reported joint pain . . . diagnosed as fibromyalgia . . . no treatment other than Motrin. I reported chest pains . . . and racing heart beats . . . [and] was told it was due to an abnormal heart valve . . . [which] was hereditary," a point which S/Sgt. Kornkven says "nicely avoids VA's rating guidelines."¹⁶
During the war, thousands of troops, including S/Sgt. Kornkven, climbed on Iraqi vehicles destroyed by depleted uranium [DU] rounds which leave a residue of dangerous radioactive dust particles when inhaled or ingested. He was tested by the VA and told he "had a higher DU count than those [troops] carrying around [DU] fragments in their bodies . . . [but] it was nothing for me to worry about."¹⁷
"My wife had a miscarriage in which the fetus had to be surgically removed. She has as much trouble with fatigue as I do. She was diagnosed by a private physician as having fibromyalgia. My son, who is 2 years old, has not slept a complete night since being born. He appears to have intestinal problems, his stools are very acidic, he is VERY light sensitive, and has the exact same rashes on his legs as I do."¹⁸
As far as the VA's emphasis on stress as a cause of Gulf veterans' illnesses is concerned, S/Sgt. Kornkven stated that while stress may play some part in his malady, he believes that ". . . veterans are subjected to much more stress by trying to navigate the bureaucracy of the VA, and with worrying how to cope with medical conditions that are ignored. All the while being unable to work, and wondering how to feed or house a family."¹⁹
Gulf War and Vietnam War veteran Reserve Navy Captain Julia Dyckman is a registered nurse who was in charge of the emergency room and the out-patient clinic of Combat Zone Fleet Hospital 15 near Al Jubayl, Saudi Arabia, an area often under SCUD missile attacks. Her unit took care of 8,211 out-patients, 697 in-patients, and 90 combat admissions. In her hearing statement, she identified the following medical conditions reported by troops in-theater and treated by her hospital personnel: respiratory problems; unexplained fevers; vomiting; diarrhea; various rashes; numerous reactions to immunizations; unexplained stomach and abdominal pains; and cardiac problems.²⁰
On returning to the United States, Captain Dyckman was assigned to interview returning Gulf veterans. She stated: "Many personnel voiced concerns over long term health effects, current health conditions, and numerous pay and family situations. The Readiness Commander did not like the results of my interviews . . . interfered with my medical care . . . [and] . . . records of interviews I conducted were discarded. For most Gulf reservists, the only avenue available for medical care was civilian or possibly the VA. Some veterans were too ill to hold down a job and therefore had no medical insurance to cover civilian care."²¹
"During this time my health continued to deteriorate. I was released from active duty even though my medical problems were not resolved. I sought care at the VA [for the following]: hearing loss; bronchitis; chronic cough; hypertension; rashes; foot and joint pain; stomach ulcer; diarrhea; headaches; abdominal pain. I was diagnosed with gout (although the gout test was negative); offered Tylenol; and told, 'Nothing is wrong with you, get it through your head!' "²²
"For over 2½ years I was shuffled from one VA clinic to another, each investigating a different body system. No coordinated treatment or diagnostic effort was ever experienced. It has been a problem with records [needed] for disability claims . . . [which were] . . . lost in the VA system. Disability and claims procedures are complicated and time consuming. In order to obtain VA treatment for Gulf illness, you have to first have a service connected illness or injury which is difficult to prove even when you were treated in-theater. Also, the VA only considers military and VA medical records for service connection, excluding expert civilian records. Additionally, they only use selected parts of records that agree with the VA and disregard any positive findings."²³
"You might ask what it is like to be a Persian Gulf war veteran after 6 years. Each day starts with uncertainty. When you eat you are constantly sick and have intermittent diarrhea. Mobility is difficult due to swollen joints and muscle aches. Severe headaches are intermittent. Sometimes you forget what you are doing and what you were going to do. Pain and fatigue are constant companions. You are forced to deal with constant denials from the Pentagon that 'nothing happened' during the war. These statements confuse medical providers who then doubt your credibility. What is needed is recognition, though not coded by the CDC, that Gulf war illness is a combination of unique symptoms and outcomes. This is why specific protocols need to be run before the VA says that this illness 'doesn't exist' or is 'all in your head.' "²⁴
Sgt. Brian Martin was a former member of the 37th Airborne Engineer Battalion, a unit which detonated and destroyed the Iraqi ammunition depot at Khamisiyah containing 100 bunkers and 43 warehouses. He videotaped the event and made it available to the subcommittee and television networks in the summer of 1996. Sgt. Martin testified: "On March 4th, 1991, we entered the depot area, placing explosives in and around 33 bunkers. We set time charges for detonation, then moved south 3 miles to what we considered a 'safe zone.' At no time whatsoever did we fear . . . chemical exposure. We were told . . . there were no chemicals in the area. Our commanders knew nothing about chemicals in the bunkers. Seven minutes later the destruction of Khamisiyah began."
"Witnessing these awesome explosions was a remarkable sight. The explosions blew straight into the air, then would spread at the top . . . [it was] . . . the closest thing to a nuclear mushroom we would ever see. Our excitement quickly turned to fear when 'cook-offs' or fallout from the explosions began showering down on us. Several missiles landed underneath our trucks, spinning and taking off until blowing up. Men were running everywhere for cover. Giant clouds . . . were covering us. The 82d Airborne [12 miles away] asked us to stop the detonation because of 'cook-offs' penetrating their area. Our battalion moved into convoy formation and proceeded to vacate the area. Twenty miles later we found an area with no signs of 'cook-offs.' "
"For the next 3 days it rained harder than any of us had seen in the 6 months we were there. Our commanders joked about us 'putting something into the air to change the weather.' For the next 5 days it was unsafe for us to return to Khamisiyah to finish destroying the remaining 67 bunkers. The skies were dark, gray and cloudy for those 5 days."
Since Khamisiyah, I suffer from . . . blood in vomit and stools, blurred vision, shaking and trembling . . . muscles weakening . . . chest pounding like my heart was going to explode. My symptoms were simply written off [by Army doctors] as a 'stomach viral infection of unknown origin.' My medical conditions were ignored. In December 1991, I put in for an 'early out' from the military. I did not receive an exit exam nor did I know I was supposed to."
"I suffer from excruciatingly painful headaches, memory loss, and severe diarrhea . . . mood swings . . . I violently vomit if I smell perfumes, vapors or chemicals. I get lost and forget where I am sometimes. I am an ex-paratrooper who needs a cane and wheelchair to get around. My joints . . . swell, burn and hurt."
"Today . . . I have some clearly defined diagnoses from the VA of multiple chemical sensitivity, inflammatory bowel disease with scarring of the colon and stomach due to chemical exposure, temporal lobe brain damage also with scarring due to chemical exposure, Reiter's Syndrome, chronic fatigue syndrome, and tinnitus. I have abnormally high platelets around my blood cells, and recently I began testing for Lupus and Alzheimer's Disease. I am worn out all the time, yet I am an insomniac. For all of this, except [for] the chemical injuries . . . the VA rated me in 1994 at 100 percent compensation . . . then in 1996 added Permanent and Total [disability, following DOD's announcement about Khamisiyah]."²⁵
Other Gulf veterans testified before the subcommittee about life-threatening illnesses such as cancers, heart and lung problems, and Amyotrophic Lateral Sclerosis [ALS].
Colonel Gilbert Roman, U.S. Army Reserve, volunteered for active duty in the Gulf War and was named Deputy Commander of the 311th Evacuation Hospital, Army Medical Service Corps. He stated [in spite of profuse nasal bleeding from pre-cancerous polyps during testimony]: "I arrived in Theater on January 6, 1991 . . . [and] . . . during official visits to strategic military cities there were frequent SCUD attacks during which I heard chemical alarms sound. When I asked if these alarms meant chemicals had been detected, I was told that the chemical alarms had malfunctioned. I [soon] became ill and was treated for nausea, headaches, vomiting, diarrhea and high temperature. Rashes I had over my body I thought were normal and expected since I spent most days in the sand, wind and sun with all the attendant fleas, flies and desert parasites. Headaches I attributed to fatigue and lack of sleep."²⁶
"The symptoms . . . continued after I returned home and got progressively worse. In 1993, I registered at [a] veterans' hospital after receiving an invitation from the VA to come in for an examination if I was a Gulf veteran. They recorded all of the ailments I indicated . . . [but] . . . no treatment was offered. The VA hospital billed me for my supposed 'free examination' and they ended up attaching my next year's meager tax return."²⁷
"To date, although I have now had three official examinations since 1993, I still continue to receive requests for more and more information from the VA claims office. Materials sent are never acknowledged as received, phone numbers given are not to any VA recognized exchange, and the name given for contact is not a true VA employee. Frustration . . . [I've been] in the VA 'system' 4 years with no real contact from a person; just requests for more information."²⁸
"In 1996, I was hospitalized three times and treated by my private physician for a respiratory ailment. I could not walk more than 25 steps without having to stop, out of breath and fatigued. This ailment, which was life threatening, would not allow me to lie on my back to sleep as I would begin to drown . . . as my lungs filled with fluid. I was forced to sit up for sleep and was constantly fatigued due to lack of sleep and no energy." ²⁹
"My [private] cardiologist, Dr. Peter Steele, diagnosed me as having 'cardiomyopathy with congestive heart failure.' Dr. Steele stated [in a letter]: 'What is clear is that he served in the Middle East and that he has a cardiomyopathy. I would submit that this may well be part of the Gulf War Syndrome.' "³⁰
Major Michael Donnelly, USAF retired, who flew 44 combat missions during the Gulf War, often flying through plumes from bombed Iraqi munitions manufacturing and storage facilities, stated: "Upon return from the Gulf, I was reassigned to Florida . . . [where] . . . I first started to experience strange health problems. I didn't feel as strong as I once had or as coordinated . . . [and] . . . always fighting a cold or the flu. By the summer of 1995 . . . [and] . . . stationed in Texas . . . I was exposed to malathion fogging, an organophosphate pesticide used for mosquito control, while jogging in the evenings. I started to have serious health problems."
"Schetoma, or blind spots, in front of my eyes and my heart would beat irratically. Palpitations, night sweats, sleeplessness, trouble concentrating and remembering, and trouble taking a deep breath. Extremely tired much of the time. By December, I had trouble walking and experienced weakness in my right leg. In January 1996, I explained my symptoms, and mentioned I had been in the Gulf War, to a flight surgeon who immediately talked about the effects of stress. I was referred to a neurologist."
"During the first visit with the neurologist, I heard the line that I would hear throughout the whole Air Force medical system: 'There's no conclusive evidence that there's any link between service in the Gulf and any illness.' "³¹
Major Donnelly, in his 20's during the war, was diagnosed in January 1996 with ALS or "Lou Gehrig's Disease." ALS, a rare fatal disease which generally affects people between the ages of 40 to 70, is "a progressive wasting of muscles that have lost their nerve supply."³²
DOD's Special Assistant for Gulf War Illnesses Dr. Bernard Rostker, an economist, has admitted that nine cases of ALS among Gulf veterans have been confirmed, and stated under oath that "for the population that served in the Gulf, we would expect to see roughly between 7 and 11 cases of ALS. And we're looking at nine cases of ALS."³³
However, [in response to Dr. Rostker's claim] the director of the Cecil B. Day Laboratory for Neuromuscular Research at Massachusetts General Hospital and an ALS expert, Robert H. Brown, Jr., M.D. and Ph.D., stated in a letter to the Human Resources Subcommittee:
"The incidence of new cases of ALS is about 1/100,000 individuals in our [overall] population. Thus, it is true to say that a group of 700,000 individuals might, in the aggregate, be expected to show 7 or so new cases of ALS over a year's time. However, these statements about aggregate populations must be interpreted carefully. IN particular, they assume an age-spread that reflects an entire population [emphasis added]. If one looks at the age of onset of ALS, the mean onset age is 55 years. The number of cases showing onset below the age of 40 [emphasis added] is probably no more than 20-25 percent or so of the total. Thus, one might expect 0.20-0.25 cases/100,000 individuals [or an estimated 1.4- 1.7 cases of ALS in the 18-40 age range]. As I understand it, there are now 9 or 11 cases of ALS in the Gulf War veterans population. This seems excessive to me [emphasis added].³⁴
According to a study by Dr. Will Longstreth, professor of neurology at the University of Washington School of Medicine, people exposed to organophosphate compounds, such as pesticides and other chemicals, may be at twice the risk of developing ALS.³⁵
Another Gulf veteran with ALS is Marine Major Randy Hebert, also a subcommittee witness, who testified that he may have been contaminated from a reported exploding chemical mine near his vehicle when the Kuwait invasion began in February 24, 1991. Major Hebert stated: "I recall my right hand feeling cool and tingling"³⁶ as he struggled into his protective clothing and gear. After removing his mask when told it was a false alarm, he received another radio message: "Your lane is dirty, chemical mine has gone off, go to MOPP 4 [full protective equipment]." Major Hebert testified, "I now feel that [removing his mask] was a mistake." Shortly after, Major Hebert said, "he felt funny" and had trouble breathing.³⁷
Returning home in May 1991, Major Hebert reported symptoms of memory loss, mood swings, vomiting, diarrhea, depression, and severe daily headaches. By the fall of 1994, he experienced uncontrollable coughing, throat muscle constriction, and atrophy in the right arm and hand. In October 1995, after more than 4 years of undiagnosed symptoms, he was finally diagnosed with ALS. "I believe the medical problems I have discussed are due to low level chemical exposure over an extended period,"³⁸ Major Hebert concluded.
Nick Roberts, a subcommittee witness, was a Seabee with Naval Mobile Construction Battalion 24 stationed near the Port of Al Jubayl, Saudi Arabia -- an area reportedly hit by SCUDs. He stated: "On January 20, 1991, I was awakened by a loud explosion. Running to the bunker, I heard a second explosion and noticed a large fireball. I put my gas mask on. We sat there for approximately 20 minutes and then the all-clear was given. We went outside. I estimate that half of the unit returned to their tents and the other half remained outside talking."
"I was one of the men outside talking. Within just a few minutes, my arms, neck and face were stinging, my lips felt numb and I had a strange taste in my mouth, like a copper penny . . . a metallic taste. Some say a mist came over the camp . . . [it seemed] more of a fog. Chemical alarms began sounding. Alarms going off everywhere. Marines camped nearby began to yell, 'Go back to your bunkers. We have been gassed.' We were ordered to MOPP level 4. Radio transmissions were coming in, 'Confirmed gas attack. Repeat, confirmed gas attack.' "
"We were given the all-clear once again. Afterwards, many of us went to the water tank and washed ourselves down to stop the stinging. My first symptoms were redness of the skin and welts on my chest that afternoon."
Petty Officer Roberts reported that "in the days and weeks that followed my symptoms began to grow in number: rashes and small blisters, fever, night sweats, and flu-like symptoms, just to mention a few. After a mont, my lymph glands were swollen and my joints hurt. Once home . . . we were turned over to the VA . . . the Navy said they were not set up to take care of our medical needs. I never got any medication from the VA, nor was I ever diagnosed by the VA."
Petty Officer Roberts reported that after 1½ years of no help from the Navy or VA, "I sought private medical help. Within 6 weeks of testing and a biopsy of my lymph gland, I was diagnosed with non-Hodgkin's lymphoma, a cancer, in stage three. I started on chemotherapy 2 days later."
"The cause of my symptoms is very obvious. I stand by my charge -- as I have from the very beginning -- of chemical [warfare] exposure, not to mention the overall exposure from fallout due to intensive [United States] bombing of [Iraqi] chemical and biological plants, radiation fallout from thousands of depleted uranium rounds used by the United States, exposure to vaccines and nerve gas pills, and months of breathing smoke from more than 300 oil well fires. I don't see how you can call it anything else. Gulf veterans are suffering [from] chemical poisoning."³⁹
Petty Officer Roberts concluded: "By the end of 1993, [there were] 399 men out of 758 [in Battalion 24] who had been put out of the service because they were medically unfit."⁴⁰

B. CHEMICAL DETECTIONS AND EXPOSURES

[NOTES]

12. Statement of Steven Wood, Human Resources Subcommittee hearings, No. 2, pp. 49-50, 52.
13. Statement of Barry Kapplan, Human Resources Subcommittee hearings, Nos. 1-4, pp. 328-330, 332.
14. Statement of Nancy Kapplan, Human Resources Subcommittee hearings, Nos. 1-4, pp. 337, 339.
15. Gulf War Syndrome: To Examine New Studies Suggesting Links Between Gulf Service and Higher Rates of Illnesses, 105th Cong., 1st sess., pp. 268-269 (1997) ("Human Resources Subcommittee hearings, No. 1") (statement of Chris Kornkven).
16. Ibid., p. 271.
17. Ibid., p. 270.
18. Ibid.
19. Ibid., p. 272.
20. Statement of Julia Dyckman, Human Resources Subcommittee hearings, Nos. 5-6, p. 192.
21. Ibid., p. 194.
22. Ibid., p. 195.
23. Ibid., pp. 196-197.
24. Ibid., p. 198.
25. Statement of Brian Martin, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 1-4, pp. 320-322.
26. Status of Efforts to Identify Gulf War Syndrome: Multiple Toxic Exposures, Human Resources Subcommittee hearing of June 26, 1997. (Statement of Gilbert Roman, p. 2) (in subcommittee files).
27. Ibid., pp. 3-4.
28. Ibid., pp. 4-5.
29. Ibid., p. 5.
30. Ibid.
31. Statement of Michael Donnelly, Human Resources Subcommittee hearings, No. 2, pp. 39-40.
32. Report by the National Organization for Rare Disorders, ALS Report #57, April 1997 (in subcommittee files).
33. Statement of Dr. Bernard Rostker, Human Resources Subcommittee hearing, No. 2, p. 100.
34. Letter from Robert Brown, director, Cecil B. Day Laboratory for Neuromuscular Research, Massachusetts General Hospital, to Mr. Robert Newman, subcommittee staff, September 15, 1997 (in subcommittee files).
35. Reuters News Service, "Gehrig's Disease Tied to Chemicals," June 24, 1997.
36. Statement of Randy Hebert, Human Resources and Intergovernmental Relations Subcommittee hearings, No. 5-6, p. 109.
37. Ibid., pp. 110-111.
38. Ibid., pp. 112-113.
39. Statement of Nick Roberts, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 1-4, p. 345.
40. Ibid., p. 346.