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Witness Testimony of Anthony Hardie, (Gulf War Veteran Member, Research Advisory Committee on Gulf War Veterans' Illnesses), Madison, WI

Chairman Mitchell, Ranking Member Roe, and Members of the Subcommittee:

Thank you for inviting members of the Research Advisory Committee on Gulf War Veterans’ Illnesses to testify today regarding the implications of the U.S. Department of Veterans Affairs’ limited scope of Gulf War Illness research.  I am honored to fulfill the Subcommittee’s request to testify today as a Gulf War veteran regarding my own personal experiences, observations, and recommendations on these issues. 

My experiences are far from unique, and I am sharing them in the hope that it will help to better inform the Subcommittee and in turn assist the countless thousands of my fellow Gulf War veterans who, like me, have been injured and ill for nearly two decades following the war without effective treatment.

Like 175,000 to 210,000 of my fellow Gulf War veterans, I have had significant health issues that began during my deployment to the Gulf more than 18 years ago, and like them have experienced a profound negative impact due to the sharply limited scope of VA’s heretofore Gulf War Illness research program. To put things into perspective, in 1991, I was a young, fit, 22-year-old special operations soldier tasked to the multi-national Coalition-led Joint Forces Command-East when the war began, and I turned age 23 while in Khafji, Saudi Arabia (near the Kuwaiti border) just days before we moved across the border into Kuwait.

PB.  In mid-January, my team of about 30 men was directed to begin taking the PB (Pyridostimine Bromide) nerve agent protective pills that we had all been issued.  We were told that they were experimental, not FDA-approved, that we had no choice in consenting and were ordered to take them, and that we would probably experience symptoms similar to mild nerve agent poisoning.  Like tens of thousands of my fellow Gulf War veterans, I experienced significant side effects, including watery eyes, runny nose, confusion, dizziness, muscle twitching, diarrhea, weight loss, and generally feeling quite ill. For me, like so many others, the acute symptoms lasted for at least as long as I took the pills, which was for a number of weeks. 

Today, science has shown that these experimental pills we took, along with the industrial-strength pesticides so many of us used and overused are implicated as causes for our lasting Gulf War Illness.  Yet, despite research showing the negative impact of PB in combination with pesticides at least as early as a 1990s Duke University study funded not by VA, but by Ross Perot, VA’s limited scope GWI research has yet to develop effective treatments, diagnostic tests to assess the damage, advisements on what to do or not to do, or even informational materials in order to help improve the health and lives of the one-fourth to one-third of us Gulf War veterans who have been and remain ill.

Fog of War.  Because of the much vaunted technological advances of the 1991 Gulf War displayed around the clock on the nascent CNN, it is easy to understand why that there seems to be a persistent belief here in U.S. that for the first time in history, there was no “fog of war” during the 1991 Gulf War.  On the ground, it was a different story.

When the first SCUD missiles were fired, ground troops near the border like me were concerned about them hitting our locations because the Iraqi political-military strategy was not yet understood. 

When more than 700 of Kuwait’s oil wells were lit on fire, Islamic and non-Islamic forces alike quietly discussed whether the midnight-darkness at noon was some sort of cataclysm, before the unprecedented cause of the unnatural, midday inky blackness became known. 

When chemical alarms sounded or silkworm missiles came in, a denial cycle between forward and theater command levels led to a widespread belief that the tens of thousands of alarms – even those double- and triple- verified as accurate—were simply faulty.  During the war, my team’s chemical alarms went off a number of times.  Like most other Gulf War troops, we were told that the Iraqis had not used or even forward-deployed their chemical weapons and the alarms must have been sand or some other false alarm.  After the war, it was publicly revealed that tens of thousands of alarms went off throughout the Gulf War theater of operations.  One day in particular, I remember receiving communications that nearby unit at R’as al-Mishab had been hit with chemicals [chemical warfare agents].  We later received communication that the chemicals had been confirmed.  Later, it was discounted as a false alarm, despite the second confirmation.  This story is far from unique, with Gulf War veterans having echoed similar stories in previous public testimony. 

When we moved forward to the evacuated Kuwaiti border city of Khafji, a nighttime missile sounding like a train overhead killed about a dozen Senegalese troops where we had just left.  Another night, we were the target of a multi-volley Iraqi artillery raid.  Given the unexplained, severe, painful skin rash all over the exposed skin on my face and hands on one of those nights as I had slept under the only open window in the building, I have long wondered about its cause and effects. 

When we launched into southeastern Kuwait with Coalition forces, unlike further to the west, we encountered no resistance.  We were able to quickly move into Kuwait City, where we took over the former Iraqi command center, replete with a room-sized sand-table map of Kuwait covered with chemical warfare and other symbols that was the object of great interest to the CENTCOM officers who flew in the following day, before the facility was closed off permanently for the remaining nearly two months I was in a neighboring building near the Kuwaiti International Airport. 

HD/L/HL.  In the days that followed the informal end of the ground war, small teams from my “unit” combed through former Iraqi sites in Kuwait and Iraq, assessing them, gathering information, and even picking up the occasional souvenir. 

In one bunker complex north of the Kuwait bay that a handful of us went through, I was captivated by the lovely fragrance that smelled just like the large red flowers that filled my grandmother’s garden back home and pervaded Iraqi bunkers so hastily evacuated that plates of half-eaten food and loads of personal gear had been left everywhere. 

Along with the lovely, captivating geranium fragrance was the pervasive odor that I thought was wet onions.  I found this very odd at the time because there were no onions to be found in even the emptiest of the bunkers. 

If I had been looking at a watch, I could have told you shortly thereafter what the time and date was when my severe, chronic cough began. Like many Gulf War veterans (and Iranian veterans of the Iran-Iraq War who preceded us), it has never subsided.  For years, I believed that my black sputum that I coughed up for three months, and the never-ending cough that continued thereafter, was the result of the oil well fire smoke.

Years later, I was horrified to learn that what I smelled that day were the characteristic odors of Lewisite and Mustard, a classic mixture used heavily by the Iraqis during the Iran-Iraq war.  Even still, I discounted that my severe respiratory illness that began very shortly thereafter could have been because of these blister agents, not knowing until more recently that while the damage is immediate, the symptoms of mustard agent exposure don’t show for as long as even 24 to 48 hours after exposure, and that the vapors I inhaled that day—by the fact that they were strong enough to be smelled—were also strong enough to do immediate and lasting damage to my entire respiratory tract that corresponds with my symptoms at the time and since.

After talking with my doctors, the soft, blackish chunks I coughed up at the end of the Gulf War, some as wide across as a dime or larger, were almost certainly not oil well fire residue, but instead soot-tinged lung tissue being sloughed off after being blistered by these Iraqi chemical warfare agents.  And notably, because there were only two or three of us in those bunkers, with me in them the longest, and because none of us were well trained enough to ever recognize these characteristic odors, they were never reported—except to my family, as ironically I searched after the war in Arab shops for the uniquely fragrant, geranium-scented perfume to buy for my mother that I was certain the retreating Iraqi troops had been using so heavily that it had left its scent behind in those bunkers.

I have heard enough first-hand accounts from other Gulf War ground troops about coming across chemical mines, being hit with isolated chemical attacks, and more that I now firmly believe that the CIA and DOD has no basis for their long-held statements that Iraqi ground commanders never possessed or used chemical weapons during the war.  The extent and impact of intelligence failures were widely discussed on and off the battlefield, and if there is further interest and a proper request to do so, I would be happy to provide more information in a closed setting on this issue. 

Sadly for at least 175,000 of my fellow ill Gulf War veterans, VA’s limited scope of GWI research has not even begun to address the health outcomes associated with widespread chemical warfare agent exposures, let alone treatments, information, or advisements that might help improve our health and lives.

Sometime following my redeployment to Ft. Bragg, I sought health care at the Troop Medical Clinic (TMC) on “Smoke Bomb Hill.”  After explaining during triage that my “Kuwaiti cough” was unrelenting and often led to vomiting, I overheard a discussion about me just outside the exam room, “He’s another one those Gulf War veterans who ‘thinks’ he’s sick.”  I vowed to myself to never seek treatment again until after I was out of the military, assuming that the VA would be able to fix me up in no time.  Meanwhile, based on my cough, which was the worst in the mornings and after running, I was “diagnosed” with “post-exertional asthma” and given an inhaler, which one of my similarly diagnosed, fellow Gulf War veterans and I nicknamed our “Kuwaiti badge of pride.” 

Like many of my returning fellow Gulf War veterans, I did my best to deal with the chronic cough, fatigue, abdominal pain, diarrhea, nausea, dizziness, and cognitive impairment that began before returning home and just wouldn’t subside.  Some of my fellow soldiers also suffered from skin rashes and a variety of other symptoms. 

I only just began to realize how wrong I about finally getting proper health care from the VA,  when at one of my earliest VA appointments in Milwaukee shortly after leaving the military, I tried unsuccessfully to put words to what was wrong with me, and was told by the clerk, “Well, we’re all confused.”  Like many of my fellow veterans from Somalia, I was diagnosed with PTSD.  A few months after my discharge, I had a recurrence of malaria as well, though I could get no treatment for it from VA because I had been denied service-connection.  Instead, I called a buddy back at Ft. Bragg, who gladly mailed me the pills, and I haven’t had a recurrence since—no thanks to VA, which to this day has denied my service-connection for malaria as well. 

A year or two later, having moved to Madison, the designated Gulf War coordinating doctor’s agitated words burned forever into my memory when she told me, “There’s nothing wrong with you Gulf War vets.  It’s all in your heads, you just need to forget about it, get on with your lives, and get past it.”  Even if it were “just” PTSD or TBI, which it clearly wasn’t, these words still ring in my ears as one of the most commonly cited examples of VA’s history towards Gulf War veterans that has yet to be fully remedied, because the answers lie here in Washington, in creating the political will to find effective treatments that doctors in Wisconsin and across the country can implement with their still-ill Gulf War patients.  Like other Gulf War veterans I have spoken with, what was most effective in finally getting taken seriously was when mental health referred me to other medical specialties because my chronic cough and other symptoms were clearly unrelated to any known mental health condition.

However, by then, I had been in the VA system for about three years, and it was now about six years after the war.  I had served my country for more than seven years, much of it in sharply austere conditions in highly underdeveloped countries, not to mention two tours under harsh combat conditions.  I found it unconscionable was treating my brothers- and sisters-in-arms with such flagrant, caustic disregard. 

Gulf War Illness.  Like some Gulf War veterans, my chronic, widespread pain and MS-like neurological symptoms have been diagnosed and service-connected as fibromyalgia.  Like a few Gulf War veterans, my post-Gulf chronic, painful bowel disorder has been service-connected as irritable bowel syndrome.  Like many Gulf War veterans, my debilitating chronic fatigue has been well documented.  But, like nearly all other ill Gulf War veterans, I am not service-connected for Gulf War Illness or Gulf War Syndrome.

Despite special provisions in the law, Gulf War veterans have had unique and special challenges due to the currently medically undiagnosable nature of many of their health conditions.  In fact, the data from VA’s most recent, December 2007 quarterly Gulf War Veteran Information System (GWVIS) report—which it inexplicably discontinued thereafter—shows that of the 272,215 claims filed by the 696,842 veterans of the 1991 Gulf War (a filing rate of almost 40 percent), only 3,149 undiagnosed illness claims, equaling about one percent of all claims filed, have been approved.   The fact that only one percent of all Gulf War veterans’ claims filed have been approved for “undiagnosed illness” violates both the letter and the spirit of the Persian Gulf War Veterans Act of 1998, which was clearly intended to help ill Gulf War veterans receive expedited service-connection for their Gulf-related chronic multi-symptom illness. 

Like many Gulf War veterans, I have had chronic sinusitis and chronic cough since the Gulf.  Since my discharge, I have requested again and again for VA to do a lung scope to go into my lungs to see what it looked like, but at every turn was put off, told there were other tests to do first, told there was no reason to do so.  Again, my cough has never subsided since it began in February/March 1991.  This Spring, after 18 years I was finally able to get a bronchoscopy, and its results were yet one more bittersweet revelation—“red, irritated, and angry-looking”, with a diagnosis of one type of chronic obstructive pulmonary disease (COPD), chronic bronchitis.  Due to VA’s limited scope of GWI research, I found this bittersweet victory on my own, having gotten the test done privately after having found no support from the VA for getting this test done for my 18-year-old chronic cough, despite having firmly and repeatedly requesting it since my very first VA encounter in 1994. 

A reasonable person would conclude that all of these conditions, which are anecdotally very common among Gulf War veterans, should be presumptively service-connected and treated by VA under—take your pick—“Gulf War Illness,” exposure to Kuwaiti oil well fire smoke, or exposure to sarin, cyclosarin, or blister-agent vapors.  Yet despite all the scientific evidence, VA has not yet made any of these and so many more presumptive conditions for the tens of thousands of ill and ailing Gulf War veterans whose struggles are at least as bad as my own, and due to VA’s limited scope of GWI research, there was not and still is not help, or even an understanding of what to look for in us Gulf War veterans.

The decline.  Given the prevalent “warrior” mentality that pervaded every aspect of military life, years later I would find it extremely disingenuous that one early government study showed low rates of hospital stays by Gulf War veterans, with the implication that there really wasn’t a problem and appeared to be one of the earlier attempts to discount that anything was wrong with us.  Like me, many of us Gulf War veterans battled health issues and struggled to stay in the workforce for years.  As I have often said, if it weren’t for the military, I wouldn’t have been able to keep on struggling, but then again, if it weren’t for the military, I wouldn’t have had to. 

Before the military, I was seen as a bright and promising boy, with achievement test scores nearly always in the 99th percentile, being academically recognized at an early age for reading hundreds of books each year, being selected to represent my high school in high quiz bowl, and so on.  That factor, combined with my enduring warrior mentality, has meant that my cognitive losses and challenges haven’t always been as visible to others who didn’t know me before the Gulf War.  But for me, it has been extremely painful, with great difficulties in even finishing a book, and short-term and working memory loss that is much worse than my most elderly relatives and has required major adaptation over many years and reliance on new skills, devices, and assistance. 

Submitted with my written testimony is a statement written by my mother more than a decade ago in support of my VA claim. It could have been written by any Gulf War veteran’s mother, describing what she saw in her son—all the symptoms, all the changes for the worse.  These observations are hardly unusual—spend a little time with any of us 175,000-plus ill Gulf War veterans and you’ll see much the same thing.

Things have only gotten worse since then.  For a few years, I believed that my symptoms would just hold steady, and I kept working harder and harder on veterans issues in a variety of roles, always seeking to help find treatments and assistance for my fellow Gulf War veterans.  As things got worse, increasing amounts of caffeine and energy drinks kept me going at about the same pace.  I began to need accommodations to continue working, trying to make a difference for others.  Finally, even all that didn’t help, and like many other Gulf War veterans, I kept getting worse, until finally this March, after a fairly major thoracic surgery, I was simply unable to return to a normal working life, and I’m now largely at home—not a fun thing when you’re only what you thought was mid-way into your career.

IOM Issues.  Last November, the Research Advisory Committee issued its exhaustive, definitive scientific report.  In essence, the report said in scientific terms what we ill Gulf War veterans have been saying all along – that our Gulf War exposures made us ill, and that we’ve been ill ever since.  This final government acknowledgement was truly a bittersweet victory.

Yet, more than 18 years after the Gulf War, VA has essentially nothing to show for its efforts on behalf of ill Gulf War veterans besides acknowledging that Gulf War veterans really are ill and that it is the result of our military service.  The VA has nothing new to offer our Gulf War veterans to help improve our health and lives besides procedural excuses.  Like me, many of us have battled Gulf War related health issues for that entire time.  Today, there are no effective treatments.  It is time for this Congress and this Administration to truly leave no stone unturned in helping our nation’s countless thousands of ill Gulf War veterans, who served their country, were injured in war, but have yet to be taken care of as promised.

It is true that VA has retained an open door for Gulf War veterans not yet enrolled in VA to be seen at VA medical facilities for priority health care for Gulf War related conditions.  And, the VA has made great stride in reducing wait times for VA health care appointments, and should be commended for this herculean achievement.  Restoring  Gulf-War related (“enhanced”) enrollment in VA healthcare under Priority 6 should be an immediate, no-brainer priority and continued in perpetuity.  I wonder if I’m alone in finding it absolutely stunning that VA allowed this provision to expire.  Thankfully, Congressman Glenn Nye (D-Virginia-02) has been successful in including this restoration for Gulf War and Agent Orange veterans in the current National Defense Authorization Act (NDAA), and I request for my fellow veterans that Congress unanimously support this critically important amendment.

However, as I testified before Congress two years ago, being seen is not the same thing as being treated.   Coordinated team care is an important VA advance.  Just like for me, many Gulf War veterans have told me that their treatment has consisted of suppressing individual symptoms, but without any apparent understanding of the underlying mechanism of their chronic multi-symptom illness.   Treatment based on a scientific understanding of the underlying mechanisms of Gulf War Illness and not just focused on symptom-management is of key importance, and I believe is within our reach. 

Flawed Research Efforts.  There are a number of important, negative outcomes that have resulted from VA’s failure to adequately assess, monitor, and treat ill Gulf War veterans like me through its halting, piecemeal, seriously flawed research program.

Clinicians at local VA hospitals still, after 18 years, seem to have had no idea what to make of, or to do for Gulf War veterans.  In my experience, nearly all have been competent and compassionate professionals who have sought to treat every symptom they could.  I stated in my testimony before another House Veterans Affairs Subcommittee in 2007 that being seen is not the same thing as being treated.  What I meant by that was that having countless VA appointments, resulting in no effective treatment for the underlying injury or illness and only limited symptom management, is really just about as good as not being seen at all.  As I said then, I know of many Gulf War veterans who long ago gave up on getting effective or relevant health care from VA years ago, with some seeking alternative or experimental options and others simply struggling with their array of debilitating symptoms as best they can.

Because of VA’s research inadequacies, clinicians have not known to tell us ill Gulf War veterans what to do that might help improve our health and lives. In more recent years, as it became clear throughout much of the medical community that Gulf War illness is real.  In my case, it became clear to my doctors that Gulf War illness was real long before its reality was acknowledged by the federal government or in the media, though sadly, I have heard of Gulf War veterans as recently as this Spring who are still being told that it’s all in their heads.

Through recent, federally funded research, we know that veterans with PTSD who have subsequent traumatic exposures may get even worse.  And we now know that one of the most dangerous things for veterans with even mild traumatic brain injury (TBI) is another brain injury while the brain is still healing. 

But, because of VA’s research inadequacies, clinicians have also not known to tell us ill Gulf War veterans what to avoid or be careful of.  VA and other doctors have not known to tell ill Gulf War veterans to avoid at all cost any additional exposures to pesticides, paint primers, and related chemicals.  Like so many of my Gulf War veteran friends, I’ve had to learn that the hard way, through personal experience of the terrible effects of subsequent exposures.  And, VA and other doctors haven’t been able to warn us of the terrible potential effects of future injuries or illnesses involving inflammation, either.  Like many of my Gulf War veteran friends, I have also had to learn that the hard way – in my case, it was a whiplash that was the straw the broke the camel’s back, with chronic widespread pain.

Finding old friends.  In the last several months, many of my former Army colleagues have found each other again via Facebook.  While it feels like “coming home” to be reuniting like this, it is also deeply disheartening to learn how many are also continuing to suffer without relief or effective treatments.  As I have found and shared some old pictures from back then, finding friends like Joel–a career soldier who now lives in Iowa.  When I had the honor and privilege of serving with him, Joel was the epitome of what a special operations soldier should be– smart, physically and mentally fit, a respected and beloved leader, self-sufficient yet thrived on being part of or leading a team, always ready at an instant to improvise, adapt, and overcome.  And, Joel is a multi-combat tour veteran, having at least three combat tours, if not more.  He’s truly a hero to so many of us, so much so that he, and others like him would never consider themselves so, saying he was just doing his job.  So it was all the more heartbreaking to learn that he’s now totally debilitated, disabled and at home, overcome by the chronic, widespread pain that affects so many of us, and more health issues than he can name. I can only say one thing about how VA’s failures in Washington and beyond have affected a decorated, multi-tour combat veteran hero like Joel – THIS. IS. NOT. RIGHT.

These issues also affect women veterans.  I was deeply saddened to hear from Trish from Ohio—a friend with whom I had lost contact before the war—that she, too, has suffered terribly since the 1991 Gulf War with her Gulf War Illness.  another friend, Michelle in Maine is another of the 175,000 who has such severe neurological issues that she’s now losing her eyesight, in addition to the debilitating array of chronic multi-system symptoms that affect us all. 

And there’s Ed, from Missouri, who can barely walk due his muscle and joint weakness and pain, and I could go on and on and on.  Joel and Trish and Ed and Michelle are not alone – they are just of few of thousands of ill Gulf War veterans that are in every state and every Congressional district.

These are real people, who volunteered to serve their country and to risk their very lives in service to our nation.  Yet, VA’s limited scope of research has failed, and continues to fail, all of us. 

End Results.  Like many Gulf War veterans, I have beliefs on how we got to this point – where more than 18 years later, we have almost nothing to show for it all (with the exception of the most recently funded, promising, ongoing DoD and University of Texas-Southwestern efforts)—no treatments, advisements, or adequate assistance to give our ill Gulf War veterans.  And, because we haven’t fully learned the lessons of the Gulf War toxic soup, our force protection measures remain inadequate.

However, I won’t discuss that here.  And, later in this hearing you’ll hear from others more eloquent than me about how VA’s fundamentally flawed contracts with, and reliance on the subsequently flawed reports issued by the Institute of Medicine has led directly to today’s most stark failure regarding Gulf War veterans’ illnesses.  The greatest failure is one of outcomes—that more than 18 years after the war, VA has essentially nothing to show for its “efforts” and little or nothing to offer the one-fourth to one-third of all Gulf War veterans who, like me, remain ill and with no effective treatments.

Recommendations.  In addition to immediately directing VA to correct the serious issues related to its contracts with IOM, here’s what I believe needs to be done this year, at a minimum: 

First, the Administration and Congress should take committing to Gulf War illness research focused on treatments as seriously as recent and ongoing efforts related to PTSD, traumatic brain injury (TBI), and prosthetics development.  In recent years, Congress has forcibly appropriated large sums for these and as might be expected, the results are already promising. Scientists who have made presentation before the RAC have stated that effective treatments for Gulf War illness are within our reach, and I believe they’re right, if only we commit to doing what’s right for our ill Gulf War veterans. 

 At the present time, we have the skeleton of a research program but the government needs to put some flesh and bones on it.  The VA funded program at the University of Texas-Southwestern, is focused on basic research, looking for the mechanisms that underlie the illness.  It should be continued, though modified with the recommendations adopted by the RAC to make it more comprehensive.  VA should also substantially expand its internal research as recommended in the RAC Report.

DoD also has a critical role to play.  Historically it has provided two-thirds of Gulf War research funding, but it has zeroed out those programs since the start of the current wars.  In response, Congress has created a Gulf War research program within the DoD Congressionally Directed Medical Research Program.   This is a very exciting program, open to all researchers, which is focused on small pilot studies of drugs and other treatments already approved for other diseases.  So the payoff could be much quicker than the basic science approach.  However, the program is not budgeted by DoD, so ill veterans and their handful of advocates have to struggle to keep it alive each year in competition with earmarks.  It is extremely underfunded—just $8 million in FY09 for research to find treatments for at least 175,000 ill Gulf War veterans.  It should be fully funded at the $40 million level recommended by the RAC. And DoD should have a high interest in having treatments available so this doesn't happen again.

The research agenda should include the most promising potential treatments.  As an example, why can’t VA sponsor an initiative into stem cell research to regenerate our damaged neurological systems, comparable to VA’s efforts with TBI and PTSD?

It is also unclear, and highly troubling, that VA has never developed and implemented its own internal treatment-oriented strategic research plan focused on improving the health and lives of ill Gulf War veterans.  The two RAC reports provide a clear road map for this research direction.  And, there should be a direct connection and perpetual communication between the VA research arm and treatment providers, with a sustained effort aimed at communicating treatment information and “do’s and don’t’s” advisements to treatment providers. 

Second, VA should be directed to provide presumptive service-connection for all the conditions known to be caused by or strongly associated with each Gulf War exposures, with or without IOM input.  Above all, chronic multi-symptom illness should be a presumptive service-connection for ill Gulf War veterans.  As noted earlier, service-connection is not just a compensation mechanism; most importantly, service-connection is the gateway to VA healthcare for the service-connected conditions and veterans.  VA should be directed to increase the maximum allowable percentages for the three conditions currently listed as presumptive under undiagnosed illness claims, which are fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome.

Third, VA should be directed to provide outreach to Gulf War veterans and their loved ones, their advocates and their health care providers about all of the federal government’s efforts related to Gulf War veterans. 

  • The National Center for PTSD (NCPTSD) is an incredible international resource and an excellent example of what VA can do, and could serve as a model for a clearinghouse of Gulf War illness resources and information for scientists, health care providers, veterans, and their advocates.  VA should be directed to create such a center, including developing a comprehensive, informative, perpetually updated website about Gulf War health issues, modeled after the NCPTSD website. 
  • VA needs to be directed to develop a one-page handout on Gulf War illness listing causes, symptoms, and do’s and don’ts, modeled after VA’s extraordinarily valuable pocket card on traumatic brain injury (TBI).
  • VA should be directed to reestablish its now-defunct direct-mail Gulf War Review newsletter, which was VA’s only direct communication to Gulf War veterans related to their Gulf War service.
  • VA should be directed to develop and widely disseminate information related to all ongoing research studies related to Gulf War health issues, including studies seeking volunteer participants.
  • VA should be directed to develop (or revitalize the now defunct) clinician guide for treating Gulf War veterans with Gulf War Illness, updating it regularly with new research findings, promising treatments, and clinical trials.
  • VA should be directed to widely publicize the existence of the Gulf War veteran brain bank, including to Gulf War veterans, their advocates and health care providers, state DVAs and CVSOs, and the scientific community.  While it is too late to benefit its donors, there is hope that knowledge gained from the scientific study of the donations of their brains and spinal cords at the time of their death will help other veterans.   
  • VA should be directed to reinitiate its now-defunct Gulf War Veterans Information System (GWVIS) data reports, which are a critical resource for veterans’ service providers, including State DVAs.  VA should be directed to break out approved undiagnosed illness claims to show actual numbers of claims approved for general undiagnosed illness and for each presumptive condition (of which there currently are three: fibromyalgia; chronic fatigue syndrome; and, irritable bowel syndrome).

Finally, VA needs to be directed and overseen to ensure that Gulf War Illness is not the only Gulf War health outcome that is addressed.  For too long, it was thought that PTSD was the only negative brain outcome of war; we now know that TBI is another terrible outcome of war.  And as we learn more about blast injuries, we will almost certainly determine that such blasts also affect other body systems and organs and not just the brain.  For Gulf War veterans, VA must be directed to focus its attention on Gulf War Illness, which affects the largest number of ill Gulf War veterans.  But, VA must not be allowed to fail to fully address increased rates of ALS, MS, and cancers, Gulf-related vaccination injuries (including in those who never deployed), oil well fire smoke inhalation, raw petroleum exposures, Depleted Uranium (DU) inhalation and ingestion, and the many more issues noted in the RAC’s November 2008 scientific report. 

Thank you again for allowing me to testify.  I look forward to your questions and comments.

What follows is a statement by my mother written in 1998 support of my VA claim for Gulf War illness symptoms and conditions.  It could quite literally have been written by any mother of any of the 175,000-210,000 ill veterans of the 1991 Gulf War.


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