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Digging for Clues: Illness Investigation Stretches On

By Douglas J. Gillert
American Forces Press Service

WASHINGTON, Aug. 21, 1998 – When Gulf War veterans began showing up at hospitals and clinics complaining of chronic headaches, memory loss and a host of other maladies, physicians were baffled. Eventually, many of them speculated the illnesses were stress-induced.

Other people, however, espoused more sinister causes. Backed by reports from U.S. and foreign medical researchers, veterans groups and others began suggesting Iraq used chemical and biological weapons against the Americans, and these weapons were now causing health problems among tens of thousands of Gulf War veterans. Lacking any proof Iraq had used chemical or biological weapons, DoD continued to deny such incidents had occurred.

By the time declassified reports revealed the strong possibility of chemical contamination -- not from aggressive Iraqi actions but as the result of U.S. destruction of Iraqi weapons -- the Pentagon took numerous direct hits in salvo after salvo fired by irate veterans and a suspicious press. A growing number of Americans wanted to know, what is DoD hiding?

Pressure from veterans, Congress and the White House, and a growing awareness within DoD, combined to launch a full-scale investigation of these illnesses. In November 1996, DoD established a special investigative unit to explore causes of the mysterious illnesses Gulf War veterans were reporting.

"Initially, we didn't provide veterans the information they needed to answer their questions and alleviate their fears," said Bernard Rostker, DoD special assistant for Gulf War illnesses. "We weren't fast enough to understand all of what went on, so some people decided we must have been involved in a huge conspiracy."

For some, the cause seemed cut and dried: Iraq had released chemical weapons, in particular, the deadly nerve agent sarin, on unsuspecting American service members.

Did Saddam Hussein's army use biological warfare agents? If so, where and to what extent? Did pesticides or the uranium-tipped weapons used by our own forces cause the illnesses? These are among the questions for which Rostker and his staff have sought answers.

Since the DoD investigation began, Rostker's group has grown from a dozen to more than 100 full-time investigators. The leap in size parallels the escalating numbers of veterans -- from a few thousand to more than 100,000 -- who may have been exposed to depleted uranium, sarin and other chemical or biological agents.

Throughout 1997, Rostker's team reached out to veterans through town hall meetings, one-on-one interviews and numerous conferences as they tried to piece together the Gulf War illness puzzle. Rostker demanded scholarly research and output in a series of case narratives that described suspected chemical-biological events.

"Completeness and accuracy outweigh timeliness," he told his team. Despite the sometimes turtle-like pace of the investigation, Rostker now looks back on 1997 as a productive year and noted the progress in his first annual report.

"We are systematically investigating and reporting on possible chemical and biological agent exposures," he continued. "This includes substantial field testing to determine the likely level of exposure resulting from the detonations of sarin-filled rockets at Khamisiyah, Iraq."

Now in their second year, investigators are focusing more attention on other possible causes for Gulf War illnesses. "We will continue to do research on potential chemical and biological exposures, but we're also going to be more active in the area of environmental concerns," he said. "This year, particularly, we're looking at oil well fires, depleted uranium and pesticides."

Piecing together what happened on the battlefield seven years ago isn't easy, Rostker admitted. Much of the missing information must come from veterans no longer in uniform, so his liaison with veterans organizations is critical. "We put a high priority on making sure we communicate and try to keep them informed," he said. "More importantly, we want and need to listen to them if we are ever going to fully understand what went on."

Besides reconstructing old and often confusing events, Rostker finds himself arguing the case for scientific evidence over emotionally clouded eyewitness accounts. "An observation doesn't confirm a chemical-biological incident. Good people telling you exactly what they saw and what they believe happened is not necessarily what actually did happen," he explained.

Rostker said he understands how difficult it is for a soldier who felt burning sensations after a Scud missile attack to believe he wasn't a victim of chemical warfare. "Yes, he had a burning sensation, but it was most likely from propellant released from the breaking up of the missile, not from a chemical attack," Rostker said. "Having to convince individuals that there are alternative explanations to what they felt or saw is tough."

More frustrating, however, are "outrageous accounts you see on the Internet, for example, those that blame severe birth defects on the Gulf War," he said. "We have a very good handle on birth defects, and we have a good understanding of mortality. So when I read on the Internet that tens of thousands of babies have been born with defects and thousands and thousands of veterans have died, it's very frustrating. It's just geared to inflame the issues, so that there are many people who don't know what to believe."

Perhaps the town meetings proved to be the greatest boon to the DoD investigation. Rostker and his staff met with veterans groups in 15 cities last year and at several military installations this year. The meetings provided forums for frank, open discussions and served not only to let veterans know what DoD is doing for them, but to give the defense team a chance to hear from the vets.

"These town hall meetings can be fairly painful," Rostker admitted. "But it's important we don't hide behind the Potomac River, that we hear their concerns. Because believe it or not, we come back and act on those concerns -- not in terms of 'By God, we're never going out there again!' but rather in terms of 'Wait a minute. This is a concern they have. How do we address that?'

"If we're not doing something to address that concern, let's do something. If we are doing something but not getting the information out, how do we get the information out? We need to be responsive to their questions."

GulfLINK, DoD's Gulf War illness site on the World Wide Web, provides a virtual history of the investigation. The site (www.gulflink.osd.mil) offers a running account of research, meetings and investigators' findings on specific events during the war. "We don't [categorically] dismiss any possibility," Rostker said. To date, however, no case investigated has yielded clear evidence of chemical contamination.

"People should understand that the investigation is a learning experience for those involved," he said. "We are desperate to understand what went on in the gulf so that we can change our procedures, policies, equipment and doctrine to minimize the possibility that these adverse events will occur again."

The investigation has revealed a need for better record-keeping, medical surveillance, environmental sampling and forward-deploying biological detection units -- "being able to account for what went on," Rostker said. Since the Gulf War, DoD has fielded a new gas mask, tested medical dog tags and begun developing improved chemical alarm systems. "I can't take direct credit, but the importance of these issues is consistent with what we have learned."

As his investigation continues without an established end-date, Rostker is reflective about what he's accomplished and what remains to be done. "I wish we could clearly say, 'This is what veterans are sick of, and we know exactly how to treat them,'" he said, "but the answers are elusive."

Rostker places much of his hope for success on more town hall meetings and conferences with veterans and more than 100 research projects cosponsored by DoD and the departments of Veterans Affairs and Health and Human Services. He hopes these activities will help the federal government "better understand what happened in the gulf, and commit to changing things as we go forward."

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