Tuesday, November 12, 1996 - 1:20 p.m.
(Also participating in the briefing are Dr. Steven Joseph, assistant secretary for health affairs; Dr. Bernard Rostker, special assistant for Gulf War illness; and Mr. Kenneth H. Bacon, ASD [PA]).
Mr. Bacon: Good afternoon.
I'm sorry we're late. I gather there was other excitement today, as well.
Today we're announcing an expansion of the Persian Gulf Illness team. On September 25th, as you recall, Deputy Secretary White announced the establishment of an action team headed by Dr. Bernard Rostker who is Assistant Secretary of the Navy for Manpower and Reserve Affairs. Today Dr. White will name Dr. Rostker as Special Assistant for Persian Gulf Illness, and announce some other measures to help us get to the bottom of this problem.
After Dr. White talks, he'll take three or four questions, and then Dr. Rostker will speak and take more questions, and also Dr. Steve Joseph, who has been handling the health affairs side of Persian Gulf Illness will also make a statement.
Dr. White: Thank you, Ken.
Yesterday, the President said, "I want to assure all of you that we will leave no stone unturned in our efforts to investigate Gulf War Illness, and to provide our Gulf War veterans with the medical care they need. There are mysteries still unanswered, and we must do more."
I want to assure the American people, and particularly the men and women who served in the Gulf that we, the Department of Defense, are totally committed to the Secretary's guidance to finding out everything we can in terms of these issues around Gulf War Illness. It is one of my highest priorities. I work on it every day.
Our approach to Gulf War Illness has to be far-reaching, inclusive, and comprehensive. As the President said, we must leave no stone unturned.
First and foremost, we're taking care of those who served in the Gulf and are ill. In addition, we have another major focus in terms of this program. We have an extensive medical research program around Gulf War Illness.
Secondly, we are asking veterans of their experiences in the Gulf, trying to learn from them what went on.
Thirdly, we have a major investigative effort to learn more about the events that occurred in the Gulf and the implications of those events for our veterans.
So we have a very broad-based program.
Just as importantly, we have to be concerned about putting our troops in unfamiliar environments in the future. As a consequence, we have a major program underway to learn from what went on in the Gulf and from other deployments, including Bosnia, and use what we learn for the future to assure the health of the men and women who serve.
Today I'm announcing the establishment of a new office of the Special Assistant for Gulf War Illness. This office will be headed by Dr. Rostker, the Assistant Secretary of the Navy for Manpower. He will build on our prior work, but he will refocus and substantially increase the level of our effort. Much of that increase will be focused on incidents in the Gulf during the Gulf War, the exposure that may have occurred from those incidents, and the implications of such incidents. This, then, will particularly build on the major program we already have, around health.
We will make additional resources available to him. In fact, we will increase the size of the investigative team by some ten-fold -- from about 12 to over 100 people. This is an office that will report directly to me.
Furthermore, we will continue to monitor our efforts and the resources that we have committed, and if they are not sufficient, we will increase them.
As you probably know, when I ordered this reassessment which Dr. Rostker headed, we also looked at a number of other issues. First of all, the problem at Khamisiyah, which was discovered, as you know, and was reported to you earlier this year, was a watershed event from our point of view. It provided us with new evidence in terms of possible exposure to troops in the Gulf. In this case, of course, because of detonations made by our forces after the war.
I wanted this reassessment for a number of reasons. First of all, I wanted to make sure that we had sufficient resources available for this effort. And in fact, we've determined that we did not and we substantially increased those resources.
Secondly, I wanted to make sure that the focus of our efforts was correct, and we have found that while we have, we think, the appropriate focus in terms of health care, clinical and related medical research, we did not have sufficient emphasis with respect to the operational aspects of the war and the implications of those operations for this problem.
I also wanted to make sure that we had sufficient communications programs underway to reach out to the veterans -- those who served and fought in the Gulf. Again, we have found that we have ways that we ought to beef up those programs, improve them, emphasize two-way communications over one-way communications, and we can tell you later about some of those details.
So the Department is committed in this regard, then, to expand the program under this reassessment, with a new office, with substantially increased funding, and with a major reorientation so that in addition to the health concerns, we're looking more at incidents.
Let me speak for a minute about the extensive work we have with respect to health care. We have done, under Dr. Joseph's supervision, a comprehensive clinical investigation program--some 25,000 people in DoD, and with his colleagues in the Veterans Administration where they have done some 60,000. We are funding additional research on the potential causes of this illness, including an additional $5 million for research on the possible effects of low level exposures; and an additional $10 million research on chemical hazards; and $12 million on general research. That's a total of $27 million for this fiscal year -- over double what we spent last year.
Some of you may recall that when we announced this reassessment back in September, we took a number of other steps. I asked the Army Inspector General to look into the events surrounding Khamisiyah to provide a full accounting of what went on there. I also asked the Assistant to the Secretary for Intelligence Oversight to conduct an investigation as to what happened to the intelligence information that was provided to the Department in '91, and yet not resurfaced until '95 for our use.
I also asked the National Academy of Sciences, in conjunction with the Institute of Medicine, to undertake a major multi-million dollar, multi-year program with a focus first on Gulf illness, on everything that we are doing around Gulf illness, to assess what we're doing, to critique what we're doing, to give us advice. Then secondly, to look forward into the future and give us advice to build on our efforts in terms of preparing for the next unfamiliar environment in which we may have to send our servicemen and women. Like all activities done by the Academy, this will be all open to the public.
Let me say a few words about what we are doing about Khamisiyah in particular. First, we are trying to contact every one of the individuals who participated in the demolition operations at Khamisiyah. Secondly, we are sending out letters to everyone within 50 kilometers of Khamisiyah at the time of these incidents, in order to determine whether or not they have data that can help us, whether or not they have health complaints, etc. That's over 20,000 additional people. We will provide whatever medical support these people need, and of course we will make our investigations and its results public.
In closing, let me say that one of the strongest proponents of this expanded program as we worked on this reassessment is Dr. Steve Joseph, our Assistant Secretary for Health Affairs. Dr. Joseph believes, as I do, that success depends on a broad-based, open program. The action team that we're talking about today will focus strongly on the non-health issues and future force protection issues, while Dr. Joseph will continue to be in charge of all of our health-related programs, not only for Gulf War illness, but across the Department. Dr. Perry and I are deeply pleased that Dr. Joseph has agreed to continue in these efforts and lead these new initiatives that we're announcing here today.
Before I turn the rostrum over to Dr. Rostker and Dr. Joseph, I would be happy to answer any questions you may have.
Q: Dr. White, many veterans and some veterans groups have been critical about the program, claiming, in effect, that the Pentagon and the CIA know more than they're telling; that there's been a cover-up; and the reason implied is that the cost of such a liability, if there is a smoking gun and it's being covered up, would be prohibitive. How would you react to that, sir?
A: There is no cover-up. We are not hiding anything, we're not keeping anything. We're putting all of the resources we can that we can effectively use to uncover what information we have, and we will continue to do that. The CIA has made the same pledge. These are, first and foremost, our people. They are people whom we rely on and you rely on for your national security. We have a responsibility to make choices with respect to these people and committing them to operations. They're the most valuable asset we have. We will do anything possible to make sure they get all of the care that they need.
Q: We've been asking some very basic questions about what happened at Khamisiyah since June, and we have not gotten any answers from this podium or from this institution. Perhaps you could tell us, were there any reports of chemical detections at Khamisiyah by the officers of the enlisted men to higher headquarters?
A: Not that I know of. I think what we ought to do on Khamisiyah is tell you everything we know today, and I'm going to turn to my colleagues to do that, because they have much more detailed information in terms of what's going on. Let me make one other comment, if I may.
This is an ongoing investigation. We are identifying people, we are bring them in, we are interviewing those people to learn what happened at Khamisiyah, so we're not through with that investigation.
Q: These additional investigations you announced today sound like the results of your investigation are going to be delayed for months.
A: We're not delaying anything. The Khamisiyah investigation has been going on since we announced it to you several months ago. What I'm talking about today is substantially increasing the total effort to make sure that not only Khamisiyah but other events or incidents that may have occurred in the Gulf are also aggressively being investigated.
We found in the reassessment that because people were focused so much on Khamisiyah, other incidents were not getting investigated. We don't want that to happen. So instead of having a small team do it, we're going to have a very large team do it.
Q: When you talked about the change in the focus of the investigation, you said up until now it appears there has not been sufficient emphasis with regard to operational aspects of the war. What does that mean?
A: That means what happened operationally in terms of the conduct of the war at the time. Much of our focus has been on the issue around people who said they were ill, treating them, and then trying to find out why they were ill. Khamisiyah makes you look, more importantly, at what went on at that time, what happened, what was there in terms of munitions, what forces were there, what did they detonate, how did they detonate it, how were they protected from it, and so on. We have other incidents of that sort, and we're going to investigate all of them.
Q: Focusing mostly on U.S. conduct during the war?
A: Yes, we're focusing mostly on U.S. conduct. We have cooperation underway with other countries. We've been meeting with the Czechs and the Brits in particular in the last several weeks, and we will be meeting with others.
Q: How do you respond to the suggestion in the draft report of the Presidential Commission that this Department should not investigate, itself, in regard to Khamisiyah or any of these health effects, and it should be left to an independent body?
A: I'm not going to respond to a draft report. But let me address the question of the investigation, which is the fundamental question.
This is a big, complicated issue. We're looking at an operation that took hundreds of thousands of people--there are literally millions of pages of documents. It is operationally complicated. We think that the Department of Defense is effectively the only place you can do that in an effective way, in a relatively short period of time.
Then the issue becomes one of oversight. We would welcome and are exploring ways to identify and establish public, outside, objective, not related to the Department of Defense, oversight efforts.
Mr. Bacon: Ed, you want to ask the last question?
Q: You speak of other incidents. What other incidents are you talking about, other than Khamisiyah?
A: We have some, a number of incidents where we've had detection devices that have gone off, where people have donned their protective gear and so on. We've identified those incidents, we've talked to soldiers who say they were there. Now we're going to go and more aggressively get at the information in each of those cases.
Q: Are you talking about incidents that are of the caliber of Khamisiyah in which you know there were chemical munitions?
A: No. We do not know of any other incident of the caliber or the character of Khamisiyah. None at all.
Q: Are these dozens of incidents?
A: These are dozens of incidents. So far, that we know of. Yes. But from my point of view, it's open-ended. As long as there are the identification of other incidents, we will look at them.
Thank you very much.
Dr. Rostker: My name's Bernie Rostker. I'm, in my full time job, the Assistant Secretary of the Navy, and now reassigned to take on this added responsibility as the Special Assistant for Gulf War Illnesses.
Let me try and put in perspective the activity that we will be starting.
It was in September that Dr. White asked me to take on this additional assignment as part of a number of activities that he was doing to reassess where we were. I think he's talked about the fact that Khamisiyah is a watershed experience, and he wanted to make sure we were doing all that was possible in the context of Khamisiyah and he asked me to reassess our total activity.
I put together a team made up of outsiders from the departments -- people who had knowledge of medical affairs, epidemiologists, military operations, and chemical and biological warfare specialists. We systematically started to interview the various organizations and the various people who had supported our activity. It was about three weeks ago that we told John we thought there was a need for substantial expansion of the resources and a refocus. We were concerned that with the high emphasis on Khamisiyah that we were not giving attention to other possible instances, and most importantly, that we were not involving the veterans in the process. When I say veterans here, I mean those on active duty, reservists, as well as those who have separated from DoD, the people who served in the Gulf.
John asked me to put together an organization that would correct these deficiencies, and we have done that in the guise of a new office for the special assistant.
The mission of that office is three-fold. First and foremost is to make sure that all of the people who served in the Gulf get the care that they deserve and that they need. So we will be working with veterans groups to make sure that they understand our activities and if there are people who are sick, that they come in to either the DoD activity or the Department of Veterans Affairs activity to get the help, checkups, and get the medical treatment they need.
The second thing we're engaged in is to follow on what the President said in terms of leaving no stone unturned. We now will put in place the resources necessary to ensure that we can investigate all of these potential instances and do it with the help of those who were in the Gulf.
Third, and importantly for the future, we need to make sure that the Department takes on those activities, makes those changes that will preclude the circumstances in the Gulf that we find ourselves in the Gulf from happening in the future. Much has already taken place in terms of changes that have been implemented for Bosnia. More can be done.
Let me tell you that the changes we've talked about here are, in fact, underway. We took the first increment of 12 additional investigators and added them to the team this morning. We're expanding our physical space. We will be growing the entire organization that you see here from the 12 people in the Persian Gulf investigation team to approximately 110 people, and we will be increasing the budget from approximately $2 million to $12 million. We're absolutely committed to starting this and moving forward in an expedited fashion, to working with our veterans and working with those who have the information that will help us explain what went on in the Gulf.
The organization that you see here has, most of the additional resources will be in the investigation and analysis cell. We put additional resources in public affairs and outreach to work with our veterans. The box marked medical and benefits represents our commitment to oversee the full range of health issues that are going on and to work with Dr. Joseph and his people in the design and implementation of the medical research program that will allow us to move forward.
With those comments, I'd be happy to take any questions.
Q: Is this just a coincidence that this is being announced the day before the Presidential Task Force is going to be holding their open session and criticizing the Defense Department?
A: No, it's not a coincidence. We set this as a goal, as it became clear that we needed to put more resources in this. The Deputy Secretary asked that we coordinate our efforts and bring our efforts to focus on his testimony tomorrow before the President's Commission. So we identified these, we've been working on it for about three weeks, but our point of focus was, in fact, tomorrow's testimony.
Q: Do you know anything about what happened at Khamisiyah?
A: I am not the Department's expert on Khamisiyah, but I'll be happy to take any question you have.
Q: No, I'll ask them later...
Q: How long will it take you to get to 110?
A: We're shooting to do it within about a four-week period. We've involved contractor resources rather than DoD in- house resources, because, frankly, we can expand the contractors much more quickly, and these are contractor resources that have the security clearances we need and have the operational experience in the Gulf. We think this is the way to expand the organization much more quickly than we could if we had to do it through the normal bureaucratic process.
Q: What kind of investigators will these be? Medical, forensic...
A: No. These will be mainly people with backgrounds in operations, intelligence. As the Deputy Secretary said, we need to expand our focus to a much more complete look at the operational aspects of what went on in the Gulf.
Q: If I understand the Department's position, it is that there was no use of chemical weapons by Iraq, but that there may have been exposure due to episodes like Khamisiyah or U.S. ordnance dropped on supplies. Is that still the position?
A: That's my understanding, yes.
Q: The Gulf War's been over for a long time. Why did it take so long to reach this point?
A: I think this process has grown, an awareness of the process has grown over time. Khamisiyah certainly was a watershed event for us and refocused our efforts to make sure we completely understood what went on in terms of our own operations. It was very clear as we got into Khamisiyah that the resources that were available were not adequate to do the job. It was in September that Dr. White asked me to look at it, to make the assessment. It was just last month in October that we came to him with a recommendation, and here we are in the beginning of November, substantially standing up a team.
Q: Do you concede that the Pentagon has been, at the very least, slow to react? How do you think the Pentagon has mishandled this?
A: I think that, and Dr. White has said this, that we wanted to make sure that we had adequate resources, and upon examining that, we came to the conclusion that we did not have adequate resources on this. That's why we're increasing this by ten-fold.
Q: Do you anticipate that the team now could revisit theories about fallout from production, for instance, storage facilities...
A: Yes, very much so.
Q: ...early days?
A: Yes. There's nothing that has gone on that's a closed book at this point. We will reexamine all of it. We will, hopefully, make better use of the vets in understanding that, but we take nothing that has been done before as definitive.
Q: Do you understand why the Defense Department has not taken the testimony of the people who were standing there more seriously over the course of four years?
A: We've been in a receive mode. We've not been in a mode of communication. The testimony has been received, it's been sorted, it's been used to analyze, but we haven't involved the vets in a two-way communication, and I think we have lost the opportunity to gain insight in that. Part of it is the limited resources we had on the problem. They were trying to understand the instances in the Gulf, were overwhelmed by Khamisiyah, and now we're trying to correct that situation.
Q: The question is, why would the Pentagon not have adequate resources to begin with, and why weren't you in other than a receive mode from the very beginning? Why take four years? That's the bottom line question.
A: I don't think we fully understood the problem. I don't think we fully understood the problem, I'm sure the people who were involved thought they were adequately doing their work, but upon reflection, it is clear that we could have done things differently and better, and we're prepared to make that investment now.
Q: The reflection being tomorrow is this critical task force?
A: No, the reflection was the Deputy Secretary's asking me in September to take a look at this from a complete reassessment. And frankly, me coming to him weeks ago and saying we needed to do things differently, we needed to have a different outreach program, we needed to substantially increase the resources. My concern that we were so fixated with Khamisiyah that we were not working the other instances and we were not adequately expanding the inquiry. This occurred well before the draft report of the Presidential Commission or looking towards their event.
Once we decided on the magnitude of this response, it was important to bring that to the attention of the Presidential Commission, and that's what we're doing today and in Dr. White's testimony tomorrow.
Q: The bottom line is for the past four years, you haven't had the adequate resources, and you haven't done it the way you should have...
A: I think in retrospect, that's clear.
Q: From what you've seen of the medical evidence, does there appear to be any particular medical problems among the men who were at Khamisiyah?
A: We don't have an adequate base for drawing that conclusion at this point. As you know, we went out to Khamisiyah in the form of a press announcement, we're not going out in the form of a letter to the 20,000 people around Khamisiyah. We're asking them to come in and to participate in the medical protocols that we have, and that will give us a much better base to understand it than we previously had.
Q: Back in June when Khamisiyah first was disclosed to us, it was said that you would go out then and contact the men who were there to find out what happened to them. Do you know if there's any initial sense that there's any particular medical problem these men have?
A: The initial sense from those who were at the pit during the detonation, as compared to others in the 82nd Airborne who were not at the pit, was no difference in their reporting to the CCEP. But we want to make sure and go out and get the full medical evaluations for all of those who were around Khamisiyah, and that's what we've been encouraging.
Q: I'm sorry, back in June, though. Do you know of any subsequent conversations with these men there's been any official...
A: No, I don't.
Q: What are the other instances, the other issues that you worry about most? And can you describe the dozens of other potential instances that have come up already?
A: Most of these have been, as I understand it, already reported in the press. The Czech instances, SCUDs and fuming nitric acid and the like. We're going to go back over all of those, and we're going to involve the vets to an extent we haven't in the past. So they're out there. Many more may be out there. I don't know. But each one of those will be reassessed with much more involvement of the vets than we have had in the past.
Q: Are you going to seek any input into the CIA wind modeling to see which way the wind really was blowing? They testified in September that it was going toward Iran, and then they backed off of that and are restudying it.
A: The Center for Naval Analysis is engaged in looking at all of the various wind and what's known as plume models to see their applicability to this particular problem, and the issue very much is the validity of the data that supports the models. There's a great deal of uncertainty as to many of the parameters that get plugged into this model, these models, and CIA is engaged in doing that.
Q: To follow that, the wind. Do you know what the gasses released from these weapons would do? Would the rise up into the atmosphere and dissipate? Would they stay low to the ground? Do you even know that?
A: I don't personally know that. I'm not the expert on these plume models, and that's what the Department has asked IDA to do, is pull together and look at the validity of the CIA models and other models as to the applicability of this particular problem.
Q: Wouldn't that be a basic, a fundamental physical fact here to know if we have gas disbursed on the ground level?
A: Absolutely, and we don't know. But let me say that what we have done is to go to people who have been, as best as our records can tell, within 50 kilometers of Khamisiyah. That is more people than we believe would be identified in any analysis of a plume. We will follow that up within the next several weeks with a survey of those people within 50 kilometers to make sure that we've identified all of the units. We will be asking those people do they know of chemical sensors that went off? We will be asking them whether they know of any instances themselves or observed any instances, where people had any reaction that can be attributed to chemical agents, and we will ask them about the general operations in Khamisiyah. So we think that that expanded base, working with the veterans, will allow us to better understand the effects of any release at Khamisiyah.
Q: Secretary Rostker, can I just ask you, some of the people claim there was an attack at [Al] Jubayl that they believe involved gas. You've heard the story, I've heard the story. Have you looked into this, and what did you conclude?
A: I have not looked in it. It is one of the instances we will look at in detail.
Q: But you're not denying that it was...
A: I just don't know.
Q: I have one more for you, if I could. What have you done so far about looking into studies that might, hopefully, were done before any of these weapons were destroyed? Studies to tell whether it was safe to do anything at all.
A: I think one thing is clear in the Khamisiyah setting. None of our troops who were there who engaged in the detonation of the weapons realized that they might well have been working with chemical weapons. That's clear from all of the reports from people who were there, who were in Bunker 73, who were in the pit. The issue of chemical weapons in Khamisiyah only starts to arise with the UN exposures.
If we knew they were chemical weapons at Khamisiyah, they would have been treated differently. There are procedures in place to treat them differently. When the UN found out that there was mustard gas, for example, at Khamisiyah, those rounds were taken away and were destroyed in incinerators. We would not have blown Khamisiyah if we knew there was gas there.
Q: What commander was responsible?
A: I don't know.
Let me turn the podium over to my colleague, Steve Joseph. In standing up this new organization, we really are carrying through what Steve said to me in our first meeting, that he was very comfortable in our health aspects, but felt that we needed to have more resources in the area of operational analysis. My team confirmed that, and so we now have a partnership. I am responsible on the operational side. I'll be responsible in an oversight. Steve continues to be responsible for the health programs that we have. Steve?
Dr. Joseph: Good afternoon.
Let me make just three points, and then I'd be happy to respond to any of your questions about the clinical or medical issues and turn the others over to Bernie so we can go back and forth.
First, I want to express my appreciation to the Secretary and the Deputy Secretary for their strong and continuing support for our health efforts, and if I may say so, for me personally. I look forward to continuing the aggressive health agenda in the DoD.
Second, as John White said, I have been a strong proponent for some considerable time now, for this expanded Department-wide agenda. I welcome it and I welcome Bernie's arrival.
I think this now gives us the opportunity to divide the question, and that has been a problem since we began. Dividing the question between the operational and intelligence look and the medical, the clinical and research look, so that then we can put it back together.
On the health front, my third point, I believe we're making major progress and major validation with the directions we've been going on. I think you will see later in this week some very strong validation in the peer reviewed scientific literature of what we have been finding with regard to the illnesses experienced by veterans; but we can't stop now. And as I've said every time we have been here together, we've got to pursue the remaining uncertainties -- Take off, piece by piece, the things that we either do not understand or do not know about yet.
I began this really in the first days I came here, and I think I said to you the first time I came down that our primary objective was taking care of our people. That's what we have done, that's what we will continue to do, and we will learn through that and from that some of the larger issues of the health-related effects. But now we have an opportunity to really have a line into the operational and intelligence spheres and put that together with what we are learning clinically.
So I'd be happy to respond to your questions, and I'm sure Bernie will be, as well.
Q: You've already mentioned a look at the health conditions of the 37th Engineers -- 150 guys there we heard about in June. Where are you in ascertaining their health? And a bigger question, are you going to try to correlate the 20,800 who we think were in the area so far? Find out what their health is?
A: When Khamisiyah came upon us, the first thing we did is we went back and pulled all the health records. This relates to a prior question as well that was asked. We pulled all the health records in the CCEP of people who we could identify at the time as being in the immediate area of the demolition. That was the 37th and some other units.
We first ascertained that there was no higher representation of those units in the CCEP than of soldiers as a whole in the Gulf.
The second thing we did was that we asked medical experts from inside the building and some medical experts from outside the building to go over those records. I think there were 46 or 47, to go over those records now with the knowledge of Khamisiyah and see if there was anything with hindsight looking at those records that might show any pattern, any difference from what we were seeing as a whole in the CCEP. Both the inside and the outside experts agreed that we had not.
The third thing we did was we looked at all autopsy, all deaths in the theater during the period of the Khamisiyah demolitions. There were nine. And eight of those deaths were autopsied. The ninth was multiple injuries from a motor vehicle accident. We looked at those autopsy records and found nothing in any of those autopsies -- these were theater-wide -- that could be related to chemical exposure.
The next thing we did is we talked to the physicians who were in charge of the facilities in the area -- battalion surgeon, division surgeon, other medical personnel -- and looked at the medical logs that we had to see if there was anything unusual reported in the Khamisiyah area during that period. And again, we found nothing in the way of acute symptoms.
Now the answer to your second question will depend on what we get back from the surveys and from our increasing knowledge of those soldiers who are out concentrically from the center of the demolitions at Khamisiyah. But as far as we have to date, with those steps that I've related to you, we find nothing that indicates any acute instance of reaction to chemical agents at the site itself or out from it.
Q: The 150 that were at the site, you haven't individually talked to them to see what their situation is, their health is.
A: Yes, we have. Of the 450 in the units around Khamisiyah, excuse me... We keep getting in the businesses of how many we're talking about because of the concentric circle. You keep describing that as increasing the number. It really is just an increase in the radius that we look at.
Of the 1,100 people who were in the closest in radius, we have talked by phone, the investigative team has talked by phone with almost 600 of them, and it's the other 500 who we have not been able to contact by repeated phone attempts that are now the subject of the registered letter that went out.
From those conversations, and from the survey which will be going out in the next few weeks, we will ascertain whether there are individuals with health problems that need to be revisited, and then take the appropriate steps.
Since the events of the last several weeks, our hotline, which we set up back in '94 for the CCEP, has been getting a record number of calls. Since the 20,000 press conference, whenever that was two weeks ago, that hotline has been getting a record number of calls, and many of those people who have called have registered now for CCEP. So I think we've gotten an additional 3,000 or so registrants just in the last two weeks. Many of those people will come on through the medical exam, and obviously, we will find what we will find in examining them.
Q: But you're correlating with people there and their health effects?
Q: From the medical exams that you've done so far, doctor, are you getting any correlations, indications of any kind of chemical poisonings of these people?
A: I think the answer I can give you from the... Remember the pieces of information that I mentioned a few minutes ago, the answer is to date, no. Whether we will get any indications from the people who now come in as a result of the increased calls to the hotline, increased registrations, I do not know. There's no indication so far that we will. One might have thought that if these were people with significant symptoms, they would have come into the CCEP in the last two years, but perhaps not. We'll just have to see what we get and go from there.
Q: You've tested the ones that were closest and they are negative.
A: I don't know what that means, we tested the ones who were negative....
Q: .First, you have tested the ones that were closest to Khamisiyah.
A: The people who were closest to Khamisiyah, we have contacted by telephone as many as we can. We have no significant information from either those telephone calls and the further surveys which will go out.
The only actual medical work that has been analyzed to date is that we went back into the medical records of those who we now know were at Khamisiyah, and before we even knew about Khamisiyah had come into the clinical evaluation program. We pulled those records and said first of all, are there more of these people than we would expect? No. Second of all, when we look at their medical jackets now, with the hindsight that they were at Khamisiyah and something happened at this place called Khamisiyah, do we see anything different than we otherwise had seen? The answer to that has been no.
Q: So you're not getting any complaints from any of the people you've talked to on the phone that would indicate some kind of chemical or nerve gas poisoning?
A: No. Not to date.
Q: How many of those have reported being affected by Gulf War Illness?
A: How many of those who have called in?
Q: How many of those you have talked to who were in that perimeter, of the 600, have complained of Gulf War Syndrome?
A: I don't know because we didn't ask the question. What we've asked them is do you have concerns and want to come in and register in the program, so that we can do exactly what you've said. I think that's a question best not asked over the telephone, but best asked between the patient and the physician when you can pursue that.
Obviously, anybody who says they want to come into the program has concerns about something.
Q: And their medical records would not automatically show that...
A: No, they would not.
Q: ...that they were complaining of something like that?
A: No. I don't believe so. We wouldn't pull their medical records until they come in for the exam.
Q: Sir, what is your latest estimate of the number of people who may be suffering from Persian Gulf Illness?
A: I think to date we're up in the 30,000 thousands of people who have registered for the comprehensive clinical evaluation program. About ten percent of those register and don't want a clinical exam. Whether that really represents those who may be suffering from one are the illnesses that affect people who were in the Gulf is hard to say, but I think I'd best answer your question by saying we have some 30,000 people who are concerned about their health related to their experience in the Persian Gulf. I assume you have, or we can provide you if you haven't, looked at what happens when we look at those people carefully and extensively through the clinical evaluation program.
Q: If you're widening the radius now and one of the things you're looking for is elevated levels of certain ailments that might be linked, aren't you creating a risk by widening the radius in that you'll have such a big pool that the elevation won't show up because it might be lost, if there was a fairly say, a narrow wind band or whatever, there was some narrow exposure?
A: That's a very useful question. It gives me a chance to say something that's important.
We do not yet know, and perhaps we're going to find out with expanded operation and intel delving, but we do not yet know whether or to what extent there was a significant exposure to nerve agent at Khamisiyah. No one knows the answer to that question.
We know there was a demolition. We have very high probability that there were chemical agents there. But we have no knowledge of how much was actually released, in which directions it was released, and in what concentrations, which numbers of troops may have been exposed. Similarly, we have no evidence to date from the medical probes that we have done that there is any illness at the time associated with those demolitions. But we can't be sure. That's why we've taken these progressively larger radii, I guess is the word, radii of distance from Khamisiyah and said now we're going to look more closely at everyone in that radius.
The specific question is really the statement that's been made by everyone who's looked at the issue from myself to the Institute of Medicine to the other groups, that the data so far on this large group of people in the comprehensive clinical evaluation program show no single unique illness overarching across that group. But they all say, and I say as well, we can't be sure that within that large group there may not be some small clusters of individuals who may have become ill as a result of exposure to one thing or another, so we have to keep looking and probing.
Q: Sir, I hear you saying that you have no complaints of illness from Khamisiyah, and yet I covered a House Government Oversight Committee just three weeks ago in which a Brian Martin, and Frank Caplin, and members of the 37th said they've been sick ever since. They swore under oath that to be the truth. Are they lying?
A: No, I don't think they're lying. I've always said from here that I'm not a believer that any significant number of the veterans who have come forward with illnesses are lying, to use your words. I think these are real illnesses, and in real people. We have 50-some-odd-thousand of them now in the comprehensive clinical evaluation program.
What I said was that we cannot associate any unusual pattern compared to the overall pattern in the comprehensive clinical program, nor can we associate any unusual clinical incidents with the demolition incident at Khamisiyah.
Q: When exactly did you become convinced that you needed to spend the resources for the operational analysis, and what action did you take?
A: Are you asking me that question personally? Or as the Department? You're asking me that question?
A: I've been convinced of that for some considerable period of time, and over time we've discussed that issue within the Department, with all the individuals concerned, and through the mechanisms that we've had and the Deputy Secretary.
Q: For a year? Two years?
A: I think, just as Bernie said before, I think in retrospect, you would find everyone in the Department feel that we well could have gotten on this issue, particularly with respect to the information and the operation and intelligence sources right from day one. We began the clinical program in March of 1994. Certainly it would have been better to have a parallel strength in the other areas.
I shudder to think where we would be now had we not begun the clinical program.
Q: If there ever is some link established between these illnesses and events in the Gulf War, what would change in terms of health benefits for veterans, disability claims, and so on?
Mr. Rostker: I think we are absolutely committed to making sure that people have access to all of the health resources that they need, and if they qualify for any form of compensation, any other benefits, that they be granted those benefits. I think the issue is the medical condition of people. That's what drives the health program, and that's what drives the benefit program.
Q: You said veterans who are complaining of these illnesses now will get coverage at VA hospitals? Or is that a case by case question?
A: The Congress substantially in 1994, changed the whole presumption for getting treated in Veterans hospitals. If there are systems that developed within two years of the Gulf and if they're undefined symptoms, there's no diagnosis, then there is no presumption, there's no problem of presumption. They don't have to prove that they had these symptoms in the Gulf. They are entitled and have full access to Department of Veteran Affairs programs.
Q: Is that to say that there would be no increased cost to the government associated with the link...
A: The issue is not the link. The issue for benefits is the health status of individuals. And if individuals are sick, then they can get treated in Veterans hospitals, and we've been encouraging them to come in.
I understand on the Department of Veterans Affairs side, it needs to be manifested with some physical condition within two years of their service and above. On the Department of Defense side, there is no, in a sense, such thing as a service-connected. Any one of our people who are sick or are treated in defense medical treatment facilities, and if they are so sick that they can't continue and they're on active duty, then they are entitled to a disability program. We're going to be looking at that applicability for the reserve community to make sure that we treat everyone fairly. But the most important thing is if a person who served in the Gulf is ill, they need to come in and we will take care of them.
Q: I have one more for you, Dr. Rostker. On the issue that I was raising with you, is it standard military operating procedure to examine, to determine, what is being decimated, what is being destroyed before such a detonation occurs? Can you check on that?
A: I can, and I've also seen the videotapes, the home videotapes that were taken of people who were in those bunkers. They were dark, they looked at the material. There was no special marking, there was no indication that these were chemical bunkers. They were not carried on our intelligence list as chemical bunkers. And to the extent that we can reconstruct it at this point, they followed normal procedures.
If there was any additional indication that there were chemicals present, they would have followed different procedures.
Q: Is it not kind of a standard, common sense procedure before detonating anything big like they were detonating, to get upwind?
A: If you look at the, again, the videotapes from the bunkers, they retreated away from that, and that's why you see these plumes going in the other direction. Apparently they didn't retreat far enough because there were some offset that exploded and they moved further down. But they did not go downwind of the explosions. They retreated away from the explosions. But that was normal procedures, as I understand it, had nothing to do with anybody suspecting that there were chemical... Again, if you've seen the home videotapes of the troops when the explosions went off, they weren't in MOP and they showed no indication that they thought there was any chemicals there.
Q: You said there were no, on the intelligence list that there was no indication of chemical bunkers. But one of the issues is that an intelligence report has languished for years that exists, without the CIA noticing it, without you noticing it. The CIA had a press conference and they said they finally found it.
Is there anything, my question, in this Persian Gulf Illness action team, that would prevent that from happening again? Are you going to look at other intelligence reports from other sites that were bombed?
A: Absolutely. And we're not the only one looking. You'll notice on that other chart that the Assistant to the Secretary for Intelligence Matters is also doing a review of all intelligence information, and the Army IG is doing a review of the events around Khamisiyah. We will be looking at all sources of information and trying to expand our sources of information.
Q: Dr. Joseph, what about sub-acute exposures? Sub-acute levels of exposure? What's your view on that?
A: There is some scientific research that bears on the question. It is not complete or definitive. What scientific evidence there is, and the current -- if not universal, the current orthodox scientific view is, that with exposure to a chemical agent, nerve agent, if you do not get enough exposure to become ill at the time, you will not have chronic symptoms or symptoms down the road. The nature of the interaction is such.
Proving that question one way or another is difficult, for a whole number of reasons -- especially once you get beyond animal models. So it's not New England Journal research. That's why we've put additional monies -- now that we've learned about Khamisiyah and this issue of low level has been raised, we've put this additional $5 million into this particular topic.
There really is no basis at the present time, beyond cocktail chatter, to say that a low level exposure at Khamisiyah below the level that would give acute symptoms, is responsible for a whole series of symptoms that we're seeing now five years later, but we can't tell for sure. That's why we have to do the research.
Q: Is your personal view that there's no connection or that research might prove a connection?
A: My personal view always is that further research and further information may tell us tomorrow what today we don't know. In my business, you never say never. You sometimes get close to it, but you never really say never. I think we need to do this research, but all I can say, I can just repeat to you once again, there is no basis now for expecting such a connection. We need to continue to look, and what we find, we will find.
Q: And you don't see a correlation, Gulf War Syndrome and this chemical destruction presently?
A: Let me remind you that we've drawn a 50 kilometer ring around Khamisiyah, and we drew it out that far so we would be sure to get kind of anything. That 50 kilometer ring covers a period of approximately ten days. Our people were in the Persian Gulf for almost a year and there were 700,000 of them. In that 50 kilometer ring for ten days, were 20,000 people. So even if I was to be totally wrong in what I said to Pat Sloyan a moment ago, and there might be something in the chronic low level, no acute effects that affected all of those 20,000 people -- that's a quite extraordinary proposition -- but even if that were true, it would extend at most to 20,000 out of 700,000, and most of those 20,000 are not represented in the clinical program that's been going on for two and a half years.
So the Khamisiyah incident by itself cannot explain the wide sweep of symptoms in the still DoD beneficiaries and VA beneficiaries. Might there be something in it that can explain something for some of them? It is possible. That's why we have to continue to look and to provide care to all of them.
Q: Especially in the geographic sense there's not enough...
A: Geographic or temporal.
Press: Thank you.