Special Briefing by Dr. Rostker, Special Assistant to the Secretary of Defense
(Special briefing on Gulf War illnesses by Dr. Bernard Rostker, special assistant to the Secretary of Defense for Gulf War Illnesses, Medical Readiness and Military Deployments. Also participating: Navy Rear Adm. Craig R. Quigley, deputy assistant secretary of Defense for Public Affairs, and Army Col. Michael Abreu, director, Investigations and Analysis.)
Quigley: Good afternoon, ladies and gentlemen. We'll break our briefing this afternoon up into two parts.
To begin, I'd like to introduce someone who's very familiar to you, the under secretary of Defense for Personnel and Readiness, Dr. Bernie Rostker. And he's here to announce the release of two studies that contribute to our understanding of issues concerning the Gulf War illnesses some of our veterans have experienced. And when he has completed that and taken your questions, I'll be back up to make a few more announcements and then take your questions on other topics.
Rostker: Well, this is -- you will all, I'm sure, remember that the Office of the Special Assistant was created initially around the issue of Khamisiyah. And in July of 1997 the CIA and the Defense Department released a projection of a possible plume of sarin gas that was our best projections at the time of where and how our troops may have been exposed.
At that time, that model and that work was reviewed by a number of organizations -- the General Accounting Office, the president's advisory committee, and independent reviews, and we were requested to extend the methodology. We set about doing that, and we now have a new set of projections. Those sets of projections are based upon updates in data, updates in troop location, and I'll show you those in a moment.
We'll be doing a new round of notifications, based upon the new projections.
In addition, we sponsored a review of the scientific literature as it pertained to chemical and biological weapons. We wanted to understand what medical literature was telling us about possible effects of exposures consistent with the kinds of exposures we were projecting through these simulations.
The RAND Corporation undertook that review, and they're releasing today their study. It's volume five in their series on Gulf War illnesses. The results of this study are extremely consistent with the results of a study that was released about six or eight weeks ago by the Institute of Medicine on the same topic. The Institute of Medicine [IOM] was charged by Congress to look at possible health effects from depleted uranium, sarin, pyridostigmine bromide, and vaccines. Their chapter on sarin correlates very closely with the RAND results in their study. [The RAND study is available on line at http://www.gulflink.osd.mil/library/randrep/bw_paper/ . The IOM study is available on line at http://books.nap.edu/books/030907178X/html/ .]
So let's take a look at the projections that we had in '97 and how they have changed.
(To staff) Can we get that up on the screen? There we are.
[Slides used in this briefing are available on line at http://www.defenselink.mil/news/Dec2000/g001205-D-0000C.html ]
This introductory slide actually has as its background pictures of the explosions that we had at Dugway when we went to recreate the events at Khamisiyah. And in this picture's background you can see the boxes exploding, the rockets being thrown out. What we found in those tests was that the vast majority of the simulant, simulations for sarin, were not released into the air; were either in the rockets that broke open and leaked, were driven into the ground, or were driven into the wood of the various boxes. So only a small amount of the sarin was actually released. What happened, then, over about a three-day period is sarin was leached out of the boxes and out of the soil. And so instead of a large, instantaneous event, what we actually had was a much smaller event that lasted over about a three-day period. And our simulations were able to demonstrate that effect.
This chart shows the comparison -- the reasons we undertook the simulations. The simulation today represents much greater detail of the event. It incorporates the comments by a number of reviewing organizations. We have improved models. We also have refined data in the form of unit locations and the actual, what we've called (inaudible), the release of agent. In 1997, we were projecting that the only agent that was released was sarin. We now believe that both sarin and cyclosarin was released. Cyclosarin is a much more toxic agent than sarin. CIA believes now that less rockets -- fewer rockets were involved in this event. The cumulative effect of a more toxic agent with less agents is to have an event that's approximately the same size as the one we were projecting occurred in 1997.
The biggest change we have between now and 1997 is a much finer understanding of where our troops were located.
In the intervening period, we worked with the Army and initiated a number of conferences with former S-3s and G-3s, in which they brought their diaries and their war journals and we recreated where all of our companies -- all of our units were, down to the company level, on every day of the war. And from that, we have a much better understanding where troops were likely. So you put all of that together with the improved models, and we have a number of improved simulations.
Now, let me emphasize that these are still simulations. This is not ground truth. We never had a sensor, we never had a collector on the ground that we could correlate directly with what the computer is telling us versus ground truth. These are the best that we can do based upon an understanding of the weather and understanding where troop headquarters were and understanding from UNSCOM [United Nations Special Commission] of what the weapons were and their level of toxicity. This is provided to our veterans so that they can make informed decisions about their health, but this is not absolute ground truth.
This picture is of the first day of the three-day event as we were depicting it in 1997. The events occurred at about 4 o'clock in the afternoon. This is the computer simulation of the cloud to the end of that day. And the line you see is at a level of concentration called the general population limit. That is a level that EPA would require a chemical company in this country to report a chemical event. It is a level that assumes that a person would be exposed to this agent for 70 years, and it is at that point EPA, even after being exposed for 70 years, would say there is no problem. Our soldiers, people in the area were exposed a much shorter time, potentially only a few minutes, but we use the general population limit as the furthest-out point that we are required to report to the Environmental Protection Agency.
Q: Excuse me. Could you, using the legend, give us an estimate of how big that cloud is?
Rostker: That cloud is probably 600 kilometers by 100 kilometers.
Is that about right, Mike?
Staff: Yes, sir.
Rostker: And that will be very important, because the last chart we'll show you is the area of lethality and the area where there would be sufficient concentration where our alarms would go off. And that area will be like three kilometers by eight kilometers. So we're talking about an area for reporting that is hundreds of times greater than an area where someone would become ill, would even know they were exposed through myosis of the eyes, or where any of our chemical alarms would go off. But this is the level required for reporting to the EPA and is the standard which we have consistently used.
Q: The brown dots are the American units? Is that --
Rostker: The brown dots are the American units as we understood them from the S3-G3 conferences on March 10th.
Now, that is where the company headquarters were. People would be dispersed around those headquarters. People could have been on detail -- truck drivers, additional personnel assigned to units that would not be captured in the registries or the rosters of those units.
Q: I'm sorry, I don't want to pull us off track, but I thought that the S3 and G3 journals were brought together after that chart. Wasn't that the one that was produced in '97?
Rostker: This is the --
(To staff) Are these the originals?
Staff: The '97 units.
Rostker: These are the '97 units as best we understood them in '97, yes.
Q: And since then you've had that conference report.
Rostker: Since then we've had about 20 conferences. And that is -- accounts for about 80 percent of the change in our understanding of where people are, are based upon a better understanding where units were down to the company level.
Q: And we haven't seen that yet.
Rostker: You will see that.
This is the picture of the plume as we now understand it. There have been improvements in the modeling techniques both in terms of the modeling of the weather as well as in terms of transport and diffusion; in other words, how an agent would enter a cloud and move forward.
Now, models like this are used contemporaneously in things like assessments of weapons of mass destruction, assessments of chemical accidents. Our teams have smaller versions of these models where they can take the weather in a given day and project where a cloud would come, and that would be the basis for an evacuation order.
We're using that type of technology here.
Q: And can you give us the same estimation of how large that plume is?
Rostker: It doesn't go as far to the south or as far to the west, but it goes a little further east, and it's moving further east where it's capturing additional people. So I would say that it's probably 400 kilometers at the most, and probably 80 to 100 kilometers at its width.
Now, we actually used five different simulations, and this is the outer trace of all five simulations. So we're trying to be as encompassing as we can. If you took any given simulation, it in fact would be a smaller area than this. So this is an outer area on the second day, based upon the five simulations. This is not uniform exposure during the second day. This is like watching a cloud pass by, and if it passed by at all during that day, then you would be in that green area. That doesn't mean you're under that green area for the entire day. The computer simulations operate on 10-minute clicks. So the assessment is done by the simulation every 10 minutes during the day.
This is the simulation for the second day, and you can see that it has swung down and to the west. And this is the original simulation. And this is with the improved model. And effectively, what you see here in the second day are really two clouds. The first cloud to the south and west are the remnants of the first day cloud, and then the second-day cloud breaking up as it's being fed from the sarin and cyclosarin leaching out of the sand and out of the wood at Khamisiyah.
Purple area on the third day. We were looking at a cloud moving away from our troops up towards Baghdad.
And the projections now are of a smaller cloud, much more concentrated, around Khamisiyah.
And then there was still in the simulation some leaching, some sarin that the model said would be there at the limits that we projected on a fourth day. And here is the projection for the fourth day, based upon the 2000 estimates.
Now this chart is very important. This is the area immediately around Khamisiyah. And you look at the scale. It says 6 miles or 10 kilometers. And this is the area, in blue and in dark blue, where troops, if they were in the area, would have felt something or our alarms would have gone off. And the great enigma of Khamisiyah was, if we had a large chemical event, why is it that no one reported it at the time, why is it that we had no alarms going off, why is it that we had no sick people? And this accounting through the simulation suggests why, because you can see where the brown dots are, and you can see that we did not have troops in an area that would have been exposed either where the troops would have felt something or the alarms would have gone off.
Now we've corroborated this by surveying some 20,000 troops that were within 50 kilometers of Khamisiyah. We did this before we had any of the these simulations, when we wanted to see if there was any grouping of soldiers who had symptoms that might point to which way the wind was blowing or which direction the cloud was forming.
And in surveying the 20,000, we got back something like 8,000 responses, and it finally turned out that we had about 26 soldiers that had some kind of a sniffle or some kind of a reaction that we could not explain. And we interviewed those 26 soldiers. We -- I'm sorry. We had about 50 soldiers we interviewed. We had 26 we couldn't explain from the interviews.
We plotted where those 26 soldiers were, and no more than two were in any given unit, and they were scattered throughout the area. So we did not have a concentration of soldiers with symptoms. That would be inconsistent with our expectation, based upon these simulations, of where the area of concentration would have been that would have been heavy enough for people to have felt something or to have been exposed at a level where our alarms would have gone off.
In 1997 we notified almost 100,000 soldiers that they may have been exposed to sarin as a result of the explosions at Khamisiyah. Based upon these new simulations, we now would suggest that something like 32,000, 33,000 soldiers may not have been exposed that we previously thought might have been exposed, and something like 35,000 soldiers who we thought might not have been exposed may now well be exposed.
We are sending letters to all of these soldiers explaining what we did with the new simulations; that they may still -- we now believe they may still have been exposed; they may not have been exposed, even though we told them previously they might have been; or now we believe they have.
At the president's advisory -- the president's oversight board meeting, one of the members, when we were talking about this, said, "Doesn't that raise credibility of the Pentagon again?" And Senator Rudman, the chair of the board, answered that he felt that it showed that we were being honest and letting the analysis go where it may. And I think there are some quotes that are available from the question and the answer.
As always in this, we've called it as the data has suggested. We think this is, as far as we're concerned, the end of the Khamisiyah analysis. But if there is any additional information that is brought forward, we'll be happy to continue our inquiries. These are computer simulations. They are mathematical representations of what the scientific community believes is the physics of weather and the physics of dispersion and transport. We have a better understanding of where the troops were on those days. All of that leads to better projections, and that's what we're providing the veterans.
There is no benefit to the veterans in terms of treatment or compensation from the Department of Veterans Affairs, whether they are or not under the plume.
VA, based upon the studies of the Institute of Medicine, do not associate individual symptoms or illness with exposures to low-level chemical agents, and so we provide this information for the future for the veterans to have a full accounting of what happened during the Gulf, but it has no practical value in terms of getting compensation or getting treatment. We owe that to our veterans based upon their service and their illness, not upon whether or not they may or may not have been exposed at Khamisiyah.
Q: First, did you say you sent out two letters, a letter to the 32,000 and a letter to the 35,000?
Rostker: And to the 66,000.
Q: And to the 66,000.
Rostker: They're separate letters.
Q: Okay. And is there -- have you tracked, since the 1997 98,900 that were notified, have many of those have self-reported Gulf War illnesses?
Rostker: There has been a study. I don't have it here. But there has been a study by Dr. Gray at the Navy Research Center in San Diego, which correlates hospitalization and illness, reported illness, through the registries with the Khamisiyah plume. That study is going to have to be redone because we now have a different plume.
Q: Do you remember the results of that?
Rostker: There was no correlation. And we can provide that study to you.
Q: Do these simulations assume that the transportation of this plume is at ground level? I mean, that would vary substantially by all kinds of weather conditions.
Rostker: The simulations actually have 30 different levels that they calculate. We take the level at 1.5 meters above the ground, at basically the height of the average person. So we tried to accommodate that. And you're exactly right, depending upon how far you're up, the weather patterns will raise this and blow it. We're looking at the concentrations at ground level.
Q: Is cyclosarin, the presence of cyclosarin, one of the new things you found? I was confused about that.
Rostker: That's one of the new things the CIA has told us; that there was -- they believe cyclosarin was present. I think they get that from UNSCOM. Previously they had told us, and we had modeled this with them as if the entire chemicals were sarin. The other thing is we did not have good toxicity information about cyclosarin, and we do now.
Q: Does this represent some type of Iraqi weapon or weaponry being at Khamisiyah that you did not previously know about?
Rostker: I don't think so. But let me ask Mike.
Q: And then I have one other quick follow-up.
Abreu: I'm sorry, the question?
Q: Does the presence of cyclosarin represent some type of Iraqi weaponry being there that you did not previously know about? How new is this?
Abreu: The presence of sarin and cyclosarin, we knew about the presence of sarin and cyclosarin in '97. It was said -- we said that in our report. Dr. Rostker is correct. What we didn't have in 1997 was toxicity data on cyclosarin. We had to run laboratory tests to get that and develop that information at Edgewood Arsenal. So in 1997 the assumption was made that the toxicity of sarin and cyclosarin were equal. And so that's how we modeled it.
Q: I wonder if there --
Q: Can you quantify in any way how much more toxic cyclosarin is?
Q: Yes. And how much more cyclosarin was there?
Abreu: Let me answer the second question first.
The ratio of sarin to cyclosarin was three to one. The -- and cyclosarin is -- there's some issue and there's some debate of whether it's two to three times, depending on the resources that you look at, two to three times more toxic than sarin. We always try to be deferential in respecting the welfare of the veteran. And so consequently we used three times more toxic.
Q: And what was the -- what is the revised estimate of the number of sarin-filled rockets that were there? You said you got a new number on it. What was the old number, and what is the current number, and how was that arrived at?
Abreu: The amount of agent released was -- originally in 1997 was 715 kilograms. The new estimate as provided by the intelligence community through the Central Intelligence Agency was 320 kilograms.
Q: But it included this --
Abreu: At a 3-to-1 mix of sarin and cyclosarin.
Q: As I recall in 1997, the CIA said that there were approximately 500 rockets that were filled with sarin. Is there a different number believed that they were --
Abreu: In 1997 we modeled -- the modeling was based upon that 500 of the 1,250 estimated rockets actually released their agent. Based on information that the CIA has acquired through the intelligence community, that number was revised down based on what was found through inspections in the area.
Q: Down to what?
Abreu: 225. To 225 rockets, I'm sorry, from the 500. It was cut in half.
Q: Of the 1,250 --
Abreu: Of the -- there was an estimated total of 1,250 rockets in the pit.
In 1997, we modeled that 500 of those rockets released their agent, and this time it's 225.
Q: Can I clarify something? Certainly two years ago you had WMD modeling; you knew how to model all of that. Why back then didn't you model the same way you are now?
Rostker: It turns out even two years ago we were breaking ground. You'll remember the original CIA plumes were straight-arrow plumes. They did not, in a sophisticated way, bring in weather. And that was the original recommendations from the panel of wise men that the Defense -- IDA, Institute of Defense Analysis pulled together.
Give you just a little history.
CIA modeled the explosions at Bunker 73, which were an enclosed explosion, the first explosions that the UNSCOM called our attention to. The pit was always the tough issue because it was in the open and many more rockets. And we were waiting for the CIA's modeling, and Director Deutch was so unhappy with the quality of that modeling he said we're not going to publish. John White, who was the deputy secretary at the time, asked IDA to put a panel together to review the state of methodology, the state of these models, and they came out with some recommendations mainly to increase the fidelity through better weather models. And that's what we and the CIA put together. So we were really breaking very much new ground in the spring of '97.
The President's Advisory Commission was quite insistent that we get them numbers immediately, and we finished the simulations in July of '97 and provided them with these estimates very quickly. We knew at that time that there were some issues that we would have to revisit in terms of the modeling. Those were reinforced with reviews from the General Accounting Office, a Senate special investigative unit, the PAC itself, and then the Rudman Presidential Advisory Panel. At the same time, the quality of the data was improving, particularly on troop locations. Putting that all together is the basis for these new simulations.
Q: So do you think that, in retrospect, you were pressured just by the circumstances to put out not the best quality of --
Rostker: They were the best quality we knew how to put out, but there was certainly pressure to put out a number.
It's a matter of public record, but the president's advisory committee was telling us to notify everybody in a 500-kilometer ring around Khamisiyah that they were exposed to sarin, and their estimate was 100 percent of everything and the most pure sarin. And we said, "Wait a minute. You're going to be scaring people. We need to make a better assessment." And the PAC said, "Yeah. Well, you have until our next meeting, and then we're going to make this demand." And we tried very hard to be both responsive, in terms of good science, and meet the demand.
We stood behind and continue to stand behind the '97 estimates as reasonable estimates, given the state of the art and the limitations of the data. But they were not the definitive estimates, as we've been able to come forward now.
And as you'll remember, there was a lot of speculation that the number would be about 10,000 and then about 20,000. And I think when we came in with a number of 100,000, that was much, much greater than anybody had expected. But that was based upon the best science that we understood at the time.
Q: Dr. Rostker, you said that studies have shown no correlation between health problems and location of troops under this plume. And you also said that this new information doesn't really have a practical effect in terms of obtaining medical care or benefits.
Have you therefore ruled out, essentially, exposure to low level of nerve agents as a possible cause for the illnesses suffered by some veterans?
Rostker: Well, I go back to the IOM, and it's repeated by RAND. We have very little information about low-level exposures. We even have less information about very short exposures. That cuts both ways. There is nothing in the literature that would suggest that there is a causal relationship, but there is no robust literature to suggest that it's not possible. And that the IOM used, and it's very similar to what RAND has suggested.
I can't rule it out, and it's a matter, in terms of exposure, that a veteran needs to be treated and seen based upon his symptoms and his condition, not receiving -- the VA has determined, not receiving compensation on the basis of an exposure where there is effectively no data that makes the link. But then there's no data that says it's impossible.
Q: If I may follow up --
Q: -- it's now been almost 10 years since this event happened. Why is there not sufficient data to make a more definitive -- every review of this has the same conclusion: no evidence now, but can't be ruled out, because there's insufficient data.
Why haven't you gotten sufficient data, especially since you apparently have a base of approximately 100,000 people who have experienced a very low-level exposure?
Rostker: Well, on the basis of those exposures, we're seeing nothing. We've funded epidemiological studies of Gulf War veterans. We've correlated it to the plume. There are no correlations. That work will have to be duplicated, correlated to the (inaudible) plume. So in that regard, we have done what you've asked. What we are engaged in is more animal testing of low-level sarin exposures, very low level and transitory. We have a charge from Congress to investigate the impact of low-level chemicals on a battlefield. It's not something that we have focused on, but it is important.
We're very lucky here. This was one event, less traumatic, less of a large event; a smaller event than we had originally expected. But if we are in a dirty battlefield where chemicals are being used, there will be leaching from all kinds of events, and accumulation that we need to take cognizance of, and we are doing the research to do that.
Q: It's still been 10 years since this happened. I know it hasn't been 10 years since this intensive review has taken place. But when will there be answers to some of these questions? How many research projects do you have under way now, and when might they likely provide some answer about the mystery of Gulf War illnesses?
Rostker: We can address the problem. We can use the best scientific methods we have. We have done that repeatedly. We've done it here. It's been done overseas. We have ruled out things, but we have not been able to show a definitive link.
Now, you can say that's the Pentagon, but the IOM, the Institute of Medicine, which is the blue-ribbon panel for these kinds of issues in the United States, just published -- what, six weeks ago or so? -- a volume, "Gulf War and Health." And they looked at depleted uranium, sarin, pyridostigmine bromide and vaccines. The only thing they were able to say in a definitive sense in terms of sarin is that if you have a large dose of sarin, you might die.
Well, we know that. And what they said in terms of the issue here of Khamisiyah is, and I will quote, "The committee concludes that there is inadequate, insufficient evidence to determine whether an association does or does not exist between exposures to sarin at low doses insufficient to cause acute signs and symptoms and subsequent long- term adverse health effects." And that's what we're talking about. That's the description of what happened at Khamisiyah. And we have done the epidemiological studies. They're cited here. RAND in 250 pages provides quite an encyclopedia of what we know worldwide about exposures to chemicals at various levels, including low level. And I'll read their conclusion on what it would relate to in Khamisiyah:
"Very little of the literature treats long-term effects of exposures to doses below that which would cause acute clinical symptoms. Considerably more research is needed in this area before even preliminary suppositions can be formulated."
Q: The answer in both of those studies is, We don't know, we don't have the research we need in order to make --
Rostker: And that's why we're engaged in that research.
Q: Then why isn't that -- when is that research going to be completed? When might we get some answers to this?
Rostker: The most important part of that research has been the epidemiological research. And that research has shown that there are no associations.
Q: Do you have any data that might indicate how many in that group of 35,000 who may have been exposed under the new plume may have reported any symptoms akin to Gulf War Illness?
Rostker: That's what the Navy Center will have to do in revising their study. And that's why it's important to give them the best possible plume that we can. But again, this is a computer simulation. This is not ground truth.
Q: Well, but were there people who were not included even in the original plume reported Gulf War Illness symptoms, and wouldn't you know that just based on the --
Rostker: Well, they will have to do that in an appropriate construct of model. But I would point out to you that there are people who are reporting problems and some of the classic problems that were never near Khamisiyah, that were out of theater by that time.
If we're looking for an event that correlates closely with the complaints, the unexplained complaints, of veterans, it's not the Khamisiyah event.
That doesn't mean there can't be people who are ill and might be suffering from that. We don't see it yet in the literature. In our reviews, it is not in the literature.
In the IOM study, the only definitive thing that the IOM ruled out was depleted uranium at levels we saw in the Gulf. Everything else, they said: more study. And that's a terribly difficult standard that they set, because we're talking about hypotheses that have not been assumed to be relevant. If you have a whiff of sarin, and it's only for five minutes, are we going to go study it? Well, that's the issues raised here. But it has not been the issue that generally has been raised, and that's why you see a lack of formal research on it. We are funding some of that research now.
Q: What is your current best estimate of how many Gulf War veterans have unexplained health complaints? How many people are we talking about?
Rostker: We have always said that there's about 120,000 that have come the registries. About 10 percent of those have come and are well, just come to be assessed. About 80 percent of the remaining 90 percent get some diagnosis. And so we're talking about somewhere between 10(,000) and 20,000 that have an unexplained illness.
Now the VA has recognized a lot fewer of those with unexplained illnesses, something on the order of 3(,000) to 4,000.
Q: And is there any research yet that indicates whether or not service members who served in the Persian Gulf War are sicker at any greater rate than those who didn't serve?
Rostker: There are consistent studies that show those who served in the Gulf report symptoms at a considerably higher rate. When you turn that into objective measures -- days of hospitalization, mortality, days off the job -- there are no correlations.
There is no question, though, that the Gulf War population is reporting more symptoms than are the control populations.
That's been consistent through this entire period.
Q: But you say they're not reporting extra job losses or --
Rostker: That's right.
Q: But just if I -- if I just can follow-up on that one point. But that doesn't answer the question about whether we know from some objective or blind study or controlled study whether or not in fact they are sicker, whatever these illnesses are, at rates greater than the general populations.
Rostker: Just reported symptoms. The VA has undertaken a large random survey of families, because there's been issues about families, that has gone through or is going through a series of questionnaires to be then sorted down to -- I want to say 5,000 -- (aside) -- is that -- does anybody know the right number?
Staff: The last group will be a thousand in each.
Rostker: A thousand controls, a thousand not controls who will go through full batteries of tests. And so the VA is trying to answer that question.
Q: A couple of questions. When did these letters go out?
Rostker: They're going out today.
Q: They're going out today. And will that list of the 35,000 new people be released? Is that public?
Rostker: This gets into privacy issues, and I doubt that -- I'm not sure, but I don't think we're going to release that.
Q: Okay. One of the things that one of the reports mentioned is that the Army moved in quickly and didn't have explosive ordnance disposal experts doing this work. Do you, in your position, are you advocating any policy changes that would prevent a situation like this from happening again, saying you can't do this where chemicals might be present?
Rostker: We have a whole lessons learned directory, and we're involved in a whole range of things. One of the early papers that we had the Institute for Defense Analysis work on for us was the issue of field expedience explosions and different ways of destroying weapons in the field. I think we've learned some lessons, but I would be -- I can't tell you exactly how we would handle it in the future. And that's one of the reasons.
I think you know that the Gulf War Office has been expanded to be able to deal with all deployments; some past deployments where people have raised issues, as well as potentially future deployments. And one of the things we're engaged in is working with the CINCs -- CENTCOM -- (inaudible) -- or Korea -- to get their focus. It's not just a matter of setting policy here, it's a matter of getting the commands out in the fields focused on the kinds of things we need to do better, if we were to have a similar situation.
Q: And one more question on the 3,000-4,000 folks that VA recognizes as having Gulf War Illness, are they treated any differently? Do they get any benefits that the 10,000-20,000 that I guess DOD classifies as possible -- what's the difference between those two?
Rostker: The basic difference is one of establishing service connection. If you have another illness, and let's say they decide that your symptoms are related to arthritis, then you have to establish service connection to both be seen in a VA hospital or be compensated if you can't work. For the people who are presumed to have whatever illness they have for the Gulf War, they do not have to establish service connection. They will be treated in the VA hospital and they can be compensated based upon the degree of disability. We do not compensate for the presence of something; we compensate for the consequences in the form of the disability.
Q: Compensation is different from medical care?
Rostker: Yes, ma'am.
Q: So the 3,000-4,000 get compensation in addition to medical care?
Rostker: If they are unable to perform work, then they would meet certain standards --
Q: And the 10,000-20,000 just get medical care.
Rostker: And the people who are presumed to have illness caused from the gulf just get medical care. The people who have other diagnoses have to establish service connection to be treated.
Q: What does it mean, the fact that you have halved the number of rockets that released, but you've actually, you know, increased the amount of chemicals that was released?
Rostker: The numbers are what the numbers are. My staff is tired of hearing me. They bring me simulations. They say, "Is this good or bad?" I say, "It is what it is." I have no notion of good or bad.
Q: Is there a number you can put on it?
Rostker: Well, if we were dealing with the same level of rockets as before with the increased toxicity because of cyclosarin, the cloud would have been bigger.
Q: But now that you have fewer rockets, for the greater proportion of cyclosarin, have you --
Rostker: The cloud turned out to be roughly the same. If we had modeled this on straight sarin and with the fewer rockets, the cloud would have been much smaller.
By the way, I would tell you that we have shared this with our allies. And the British believe that we are overly cautious. And there's no right or wrong here. They believe we are portraying the cloud as too toxic and it is larger than they would have done running their simulations. And that's just -- it is what it is.
Q: But they believe that you have made a worst case scenario --
Rostker: It's worse, if I can say that.
Q: Are there British troops in that --
Rostker: Yes, there may be some British troops. We've shared with this with the French and the British, and we will continue to -- we will do that in the future, also.
Q: One clarification on the maps. The first series you showed was presumably very light concentrations, and then the very last one you showed, which looked kind of like an inverted V, that inverted V was the area of high concentration, of concentration sufficient to set of alarms to cause --
Rostker: Remember, the scale changed dramatically.
Q: Yeah. The smaller one was about six to 10 --
Rostker: Exactly. Exactly. And this helps at least me explain the paradox of Khamisiyah. Everybody's saying we have a major event here, UNSCOM is saying we have rockets here, and in the middle of this, the company commanders of the companies around Khamisiyah, they were at school in Leavenworth, held a press conference, and said, "We don't believe there was sarin there, we didn't see any." How do you put the two pieces together? Well, the simulation helps you put those two pieces together, both the company commanders who said there was nothing there, and UNSCOM who said we found the rockets. If the simulation is correct, we can explain both statements.
Q: Were there no soldiers who went up to inspect?
Rostker: No, not afterwards.
Q: Not afterwards?
Rostker: No. They set this off and headed south. That's very clear. So there was nobody that went back to Khamisiyah. Now, there were people after the Bunker 73 explosion that went back into Khamisiyah and no alarms went off, and that was about four days earlier.
There's another thing, which we have not modeled, and that is, this is stormy, this was a raining period. We have pictures of depots from CBS of the depots right near Khamisiyah, and the troops were in mud, up to their boots in mud. And mud, water, will hydrolize sarin, will break it down. So again, these are conservative estimates because we haven't fully accounted for the degree of water in the atmosphere and on the ground at the time.
Q: One more question just about the general health. Presumably, since the Persian Gulf War you've done a better job of tracking the health of U.S. personnel serving in missions abroad. Has there been any similar phenomenon in terms of higher reported illnesses among U.S. troops who've served in Bosnia or Kosovo or anywhere else?
Rostker: No. And in fact, we've tracked the health of U.S. troops serving in the Gulf.
Our medical departments have done wonders, compared to the traditional sickness of deployed soldiers. We have reports on -- by symptoms and by days lost, and our deployed troops are doing just fine.
But I would tell you that the Canadians have had a Khamisiyah or a Gulf War-like complaint about their troops that were bivouacked, were camped near a chemical plant in Croatia and having unexplained illnesses.
The British -- as soon as they were in Kosovo, people were complaining about -- sick, and they charged there was depleted uranium.
So that there is a long history of people having illness and trying to -- and I don't say this in a pejorative way -- associating it with an extraordinary event. And deployment can be an extraordinary event. That's why we now have an office that can be a focus -- focal point of trying to get answers for our service members and provide them with the best information they can.
Q: Did you --
Quigley: One or two more, please.
Q: Yeah. Did you indicate how the modelings worked with the explosions? You've said you assumed that the explosions sent the sarin into the ground, and it's --
Rostker: We don't assume --
Q: I'm sorry. Can you just clarify that?
Rostker: Yeah. What we did -- it was quite clear we needed to understand what this event was. And we built stacks of 122-mm rockets. We fabricated boxes down to the hinges, because there was an issue of the metal in the hinges blowing around. We brought rockets from around the world. We fabricated heads and plastic bursting compartments that were identical to Iraq, and then we set them in stacks, as we understood the stacks to be in the desert, at Dugway Proving Ground. And then we brought in the soldiers who actually wired the Khamisiyah stacks and had them wire it with the same amount of explosives that they had used at Khamisiyah.
It was on an instrumented range. So above the range was collectors -- above the stacks were collectors, so you could see -- measure the cloud on the ground. All around it were collectors, so you could watch stuff come out. And we blew these stacks up. And you've seen, I think, in the past the pictures of these. We certainly can make these pictures available again.
Q: When did you do that?
Rostker: In '97, in June. I think it was June of '97.
And then we assessed the sand and its characteristics and the wood. And we measured the amount of material absorbed in the wood and its leaching characteristics. We actually did that with live sarin at Aberdeen. And we used sand that I would tell you is -- was characteristic, shall I say, of the sand at Khamisiyah, so we would understand the characteristics of the sand and its attempt to -- its ability to absorb the chemical. So these were direct tests that we did in '97.
Q: Dr. Rostker, is it possible that there is no correlation between any of these events and the complaints of Gulf War veterans, that there is in fact no Gulf War Illness, that there's no Gulf War syndrome?
Is that possible, as you look at this 10 years later?
Rostker: Everything is possible. We are committed to working with our veterans to, as the president said, leave no stone unturned. And so we have --
Q: (Off mike.)
Rostker: Yeah. Well, Senator Rudman said those stones are getting pretty small. They're getting like pebbles. And with his guidance we called off a number of investigations because in his judgment and the board's judgment the stones were too small. But I told him at those hearings, I said, "I can't make that call. I will go after the littlest pebble, because this department's credibility is at stake. I need your help, Senator Rudman, in deciding whether or not this pebble is too small." And they gave us guidance, and we have done -- if you go to the web site [ http://www.gulflink.osd.mil/ ], you'll find a whole number of close-out reports where we said, "It looks a dry hole; we've been advised by outside authorities that it's a dry hole, and here's what we know about that subject to date. But we're calling off the investigation." And in our -- as is our way, we said to the population, the veterans population, "If this is a problem, if you have additional information, again, come forward." But we have so far not had somebody request us to open up, re-open an investigation that we've called off.
Q: And the book is not closed on Khamisiyah?
Rostker: Nothing is ever closed. We're calling it a final report. If you have additional information that would cause us to do more work, we'll be happy to do more work. And the office is not going away.
Q: Sir, if tomorrow you were able to put your finger on -- "Hey, we found it, there is a cause for Gulf War Illness and it is an actual, real thing," what are the legal, financial, moral implications for DoD? There's a feeling out there that the Pentagon doesn't want to find a cause for this because of -- then it'll be held to blame or something. But what would the real ramifications be?
Rostker: Basically for DoD, nothing. Responsibility for treatment of the veterans is the responsibility of the Department of Veterans Affairs. We have a responsibility for our active duty soldiers and retirees. But that is incorporated within our system. We have no -- nothing, no ax here except getting the best information for our veterans, getting the best information so we can change and learn from what happened in the gulf. The most important thing is to learn from this experience. And part of that learning, incidentally, is having somebody like me stand up here and be able to talk to you and to veterans about what we know. And that was one of the lessons we learned in the gulf, and that's why the OSAGWI office has become a permanent office to be able to deal with veterans over issues like this into the future.
Q: Can you talk about low-level exposure research that you have, in terms of how much money DoD is spending and what you have on the table in terms of actual projects?
Rostker: We can get you information on that. That is handled through the under secretary for Technology and Acquisition -- Acquisition and Technology. So -- but we can provide that information to you. I don't have it here.
Q: Since there is no definitive link, then what are you telling these veterans to do, you know, in this letter? Just telling them that you might have been exposed to a plume, but -- you know, what?
Rostker: But we don't know, and if you are concerned about your health, and haven't, go to the VA, go to DoD and we'll give you a full physical exam and we will work with you. And if you want to come back for a physical exam because it's been some time, we will do that, too. We're not close to our veterans -- I know the VA is not close to the people that they have a responsibility for. But I have to tell you what we have. This is our best assessment of exposures. In today's world, this is what we're required to do. This is a new generation; we lay it all out, and we commissioned -- the Congress commissioned the Institute of Medicine to advise them as what do we know about this exposure? And before that, we commissioned the RAND Corporation for the same thing, because we didn't feel we had enough information to make those judgments. And as I said, the research is what the research is. I can't invent a cure for something or I can't go further than what the scientists tell me in terms of making an association.
Q: I'm sort of confused at the difference between -- in the letters here it indicates that you believe that low-level exposure is probably not significant enough to be causing any health concerns. But yet you guys are still funding research in low-level exposure. Can you --
Rostker: Because there's uncertainty in all of this. Because we're guided by the strict words of the scientists here, which says do more research. And we believe in that. But --
Q: Is there a possibility that you would --
Rostker: There's always a possibility.
Q: Well, I mean that is there a possibility that later on you might find that there's going to be bigger problems than you anticipated, just like you have had in the past with numbers changing, and so forth?
Rostker: There is always the possibility. I can only tell you what the literature tells us. We chose to put the words in the letter in the most positive terms, actually, which says there is no literature that suggests there's a problem. That can be thrown right back in our teeth and saying yeah, but there's no literature says there isn't. We would have to say yeah, that's right. And we're committed to continuing to work with the veterans.
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