A Battle Plan Against Gulf War Illness

Pentagon Aims to Prevent Repeat of Mystery Syndrome

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U.S. soldier inspects an Iraqi Scud missile.

Exposure to hazardous fumes from Iraq's Scud missiles has been implicated in illnesses exhibited by veterans of the Gulf War. Courtesy U.S. Department of Defense hide caption

itoggle caption Courtesy U.S. Department of Defense
Kuwaiti oil well fire

A Kuwaiti oil well burns during the 1991 Gulf War. Fumes from such fires would pose health risks to soldiers in the event of a new war with Iraq. Courtesy U.S. Department of Defense hide caption

itoggle caption Courtesy U.S. Department of Defense
Steve Robinson

During the Gulf War, Steve Robinson (above, left) served with the Special Forces in northern Iraq. Today, Robinson is an outspoken critic of the Pentagon's efforts to address the health concerns of Gulf War veterans. Courtesy Steve Robinson hide caption

itoggle caption Courtesy Steve Robinson

A Mysterious Syndrome

Almost 700,000 members of the U.S. Armed Forces served in the Gulf War. Returning U.S. troops began reporting a variety of illnesses:

• Fatigue
• Memory loss
• Shortness of breath
• Muscle and joint pain
• Skin rashes
• nausea
• Infertility and sexual dysfunction

Soldiers who deployed to the Persian Gulf were two to three times more likely to report these symptoms than their counterparts who stayed home.

Initially, soldiers attributed their symptoms to the inhalation of fumes and smoke from burning Kuwaiti oil-well fires. Other risk factors eventually implicated include exposure to:

• pesticides and insect repellants
• depleted uranium
• nerve gas
• pyridostigmine bromide (PB) pills used to protect against nerve gas
• immunizations against anthrax and botulism

Research has yet to provide concrete answers as to the causes of Gulf War illnesses.

It's still unclear why large numbers of soldiers in the 1991 Gulf War came home with unexplained illnesses. Now, faced with the possibility of a new war in the Persian Gulf, the Pentagon wants to try to prevent a repeat of those health problems. As NPR's Joseph Shapiro reports, one military doctor is in charge of figuring out how.

An infectious disease specialist, Michael Kilpatrick runs the Pentagon's Force Health Protection program. His chief responsibility is to prevent a recurrence of the health problems that plagued Gulf War veterans. Of high concern are environmental hazards, such as burning oil fields and chemical and biological weapons, that could arise in the event of a new war with Iraq.

Kilpatrick says the first line of defense is data — and lots of it. Medical personnel now headed to the Persian Gulf are carrying laptops and personal digital assistants. The data they collect is downloaded into a classified, centralized system and, within hours, can be accessed by Pentagon health officials in Washington, D.C.

Unmanned drone aircraft will also play a role, sampling for anthrax spores and other airborne agents. And then there are the soldier scientists who, armed with testing gear, will dig up soil samples and use hand-held devices to check the ground and water for toxins. Kilpatrick says these environmental surveillance teams will be among the first to hit the battlefront.

Veterans of the 1991 Gulf War blamed their health problems on exposure to chemicals, drugs and vaccines. At first, the Pentagon was slow to acknowledge their complaints. As a Navy doctor, that bothered Kilpatrick. He tried to change things as a senior medical official in the office the Pentagon then set up to investigate. Kilpatrick and others arrived confident they could figure out what caused the Gulf War illnesses, but a cause was never proven.

One key problem was a lack of data. Records were missing that might have indicated which troops were in places where they may have been exposed to chemicals. Also absent were records of vaccinations against anthrax and the administration of pills against nerve agents.

Kilpatrick knows that many veterans felt betrayed by the Pentagon.

"As an individual who was on active duty as a physician at the time in the Navy, I could see that loss of trust, loss of faith in the system," Kilpatrick said. "We can really only deal with that by treating one patient at a time. You cannot do a propaganda campaign or a news campaign to change people's attitudes. I think our military health-care system today is performing very well to show people we do care."

However, some doubt that Kilpatrick's and the Pentagon's efforts will have much effect. Among those critics is former Army Ranger Steve Robinson. In 1991, Robinson's unit led Kurds through mountain passes back to their homes in northern Iraq. Later, Robinson worked for Kilpatrick as an investigator looking into the causes of Gulf War illnesses. Now he runs a group called the National Gulf War Resource Center, which is pushing the cause of Gulf War veterans.

Robinson says the Pentagon is not doing enough to protect soldiers who may fight a new Gulf War.

Prompted by the complaints of Gulf War veterans, Congress passed a law requiring soldiers to receive medical examinations before being sent to battle. But Robinson says what soldiers get now, a questionnaire that asks them to rate their health and provide information on medical problems, falls far short.

"Soldiers are trained to go to war," Robinson said. "They are trained to fight and kill and do their job. No soldier is going to write down that I have bronchitis, therefore I want to be left behind while my buddies go off to Baghdad."

At the Pentagon, Kilpatrick concedes the questionnaire is not foolproof. But he says the process has caught many health problems since it was first used in Bosnia. The Pentagon, he notes, will have other ways to monitor health, including the computer data collected on the battlefield.

But Robinson — who returned from the Gulf with his own health problems — worries that the careful plans made in Kilpatrick's office will break down in the chaos of battle.

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