Health and Safety at DOD

Questions of Health, Safety, and Public Relations: What should the Department of Defense do to Protect the Health of our Soldiers

Cara M. Kafchinski

Public Policy 710

May 9, 2003

Contents

Scope

Background…………………………………………………………………….1

Methodology…………………………………………………………………..2

Rresults and Findings………………………………………………………….2

What is Gulf War Illness?……………………………………………..2

Explanations for Gulf War Illness…………………………………..4

The Biological Warfare Theory……………………………………………….5

The Chemical Sensitivity Theory……………………………………………..7

The Nuclear Weapons Theory………………………………………………..8

The Chemical Weapons Theory………………………………………………8

The Stress Theory…………………………………………………………..10

The Phantom Illness Theory…………………………………………………11

The Combinations Theory……………………………………………………12

Treatments for Gulf War Illness……………………………………..12

Interesting International Factors…………………………………..13

Explanations in Summary………………………………………………13

The Department of Defense…………………………………………….16

Discussion……………………………………………………………………..19

Reasons for Improving Current Policy………………………………19

Reasons for Leaving the Policy Alone……………………………….19

Possible Solutions……………………………………………………..20

Conclusion……………………………………………………………………..23

Recommended Solution…………………………………………………23

Final Words………………………………………………………………24

Bibliography………………………………………………………………………………..B-I

Exhibits

Explanations of Gulf War Illness and their Ability to Explain Symptoms……14

Explanations of Gulf War Illness and their Ability to Explain Various Phenomena….15

Policy Solutions and their Effects………22

Purpose

The purpose of this research is to determine what additional policies the Department of Defense could make to underscore the importance of soldiers’ health and what the Department of Defense could do to minimize health risks soldiers face going into a war, and veterans experience after a war. When taken into context with Gulf War Illness, and bearing in mind other war health problems that turned into public relations and soldiers’ health problems, the Department may be able to improve policies to avoid or better handle these kinds of problems in the future.

Scope

This paper covers an intense examination of what Gulf War Illness is, what explanations are currently offered for how the disease was contracted, and how the Department of Defense has responded to this illness. Paper topics include what health hazards soldiers face in a setting abroad, and what needs to be done to minimize risks. In a broader context, the Department of Defense is responsible for the health and safety of its soldiers abroad, and has failed to convince the public of its full endeavor to inform the people and the soldiers whose lives are at stake, to keep soldiers healthy, and of its concern for the health-safety of veterans. This paper covers various solutions to these problems, and how these solutions might affect the Department of Defense, the public, and military personnel.

Background

Upon return from the Persian Gulf War in 1991, many soldiers and their families found themselves with health problems that could not be diagnosed as a particular illness, or they were diagnosed with illnesses later to find that a number of Gulf War Veterans were also being diagnosed with these illnesses and experiencing the same types of symptoms. Symptoms included memory loss, sleep problems, fatigue, physical imbalance, sore joints and muscles, irritability, thick saliva, weight loss or weight gain, hair loss, sore gums, diarrhea, nausea, swelling, labored breathing and frequent headaches [1] [2] . Symptoms became so frequent among Gulf War Veterans that public alarm was raised and the Department of Defense (DoD) had no other choice than to face the possibility that something from the Persian Gulf War may have caused these symptoms in the soldiers. The illness was given the name Gulf War Illness (GWI) (or Gulf War Syndrome – GWS).

The problem faced at the time was the utter lack of an explanation for what caused this syndrome, and to date DoD does not have an explicit cause for GWI. Families of soldiers currently in Iraq during the Second Gulf War, and the soldiers themselves probably wonder if the same thing is going to occur all over again with them. What is DoD doing to ensure this does not happen to them? What should the government be doing? What kind of policies might DoD develop to ensure that everything is being done to eliminate health risks soldiers abroad face, or at least to ensure the risks are as minimal as is possible?

To broaden the scope of this problem, issues of health and health risks did not occur solely within the Persian Gulf War. After the Vietnam War a similar, though possibly not as widely known, problem occurred when soldiers flying crop-duster airplanes claimed a higher risk for cancer throughout the rest of their life due to their exposure to Agent Orange [3]. Just as research about GWI demonstrates, DoD lacked proper knowledge of who was exposed to what and where to be able to thoroughly investigate the claims of the soldier

After taking a penetrating look at GWI, and considering the lack of information necessary for DoD during the Vietnam War, government patterns demonstrated the need for a wider and better policy on keeping up with our soldiers and understanding the risks they are facing before these soldiers face unexpected and untold health problems. By understand health risks, the government can better prepare for treating soldiers after wars and by preparing to minimize health risks before wars. While knowing and understanding the regions where the soldiers are fighting is very important, having a groundwork policy for all international “peace-keeping” or war events would benefit the nation.

Methodology

Through research efforts, Gulf War Illness is first defined, including a specialized definition for the federal government. Various explanations of Gulf War Illness are explored, with final thoughts on how effective they are at explaining the illness. Next, treatments are explored, to help extract whatever information that will afford on the nature of the illness. After wrapping up the study of Gulf War Illness, a look at the government’s current situation and how the illness has affected it is extracted. Finally, information can be compared and a discussion of the government’s policy is analyzed, offering a possible solution to help avoid these situations in the future.

Results and Findings

This section highlights the definition of Gulf War Illness, explores the explanations and treatments for the illness, and gives an overview of the Department of Defense’s view of the situation.

What is Gulf War Illness?

According to the International Council for Health Freedom Newsletter, a reported 30,000 Gulf War Veterans are dead and more than 100,000 suffer from Gulf War Illness symptoms [4] . Gulf War Illness (GWI) is associated with a hodgepodge of symptoms soldiers claim to have began experiencing during and after the Gulf War. Official (Department of Defense) interpretations of GWI do not allow for symptoms experienced by returning solders’s family members. GWI is recognized by both the U.S. and British governments, but not by the Canadian government. Soldiers in Canada do, however, complain of symptoms. Symptoms reported include memory loss and other cognitive problems; difficult sleeping or sleeping too much; fatigue not improved by sleep or rest; weight loss or weight gain; irritability; nausea; diarrhea; swelling; labored breathing; and headaches. In addition, physical brain damage has been associated with some ill soldiers. “Scans performed on 12 veterans with sever cases of the syndrome found cell losses of between 10 percent and 25 percent in three regions deep inside the brain. [5]

Accordingly, these losses affect sense of direction, and cause memory lapses and depression, can make it more difficult to understand instructions, and affect movement and emotion. GWI carries with it several interesting links and associations. The Department of Veterans Affairs reports there are at least 40 cases – and indicates possibly more – of Amyotrophic Lateral Sclerosis (ALS – also known as Lou Gehrig disease) among the nearly 700,000 soldiers who participated in the First Gulf War [6]. Statistics, according to the article, would account for only 6 cases among 700,000 people. Other scientists have pointed out, on numerous occasions, how similar symptoms of GWI (or Gulf War Syndrome) are to Chronic Fatigue Syndrome (CFS) and Fibromyalgia Syndrome (FMS). Symptoms of CFS include sever fatigue; forgetfulness; memory loss; confusion or difficulty concentrating; sore throat; tender lymph nodes; muscle pain; joint pain (no redness or swelling); and headaches [7]. Symptoms of Fibromyalgia include widespread pain and tenderness; muscular stiffness; fatigue; and difficulty sleeping [8].

Furthermore, family members of Gulf War Veterans claim to experience the same symptoms. A research couple, Doctors Garth and Nancy Nicolson, claims that 77 percent of spouses and 65 percent of children of GWI patients had developed the same or similar symptoms, making a case for GWI being a contagious illness [9].

Among all of this descriptive information and varying factors of GWI, one question no one seems to be able to answer, and one question that policy makers and government officials would really like an answer for in order to better help soldiers with symptoms, is: What caused Gulf War Illness?

We have soldiers in Iraq right now. How do we know everything is being done to prevent the same health hazards for them?

Explanations for Gulf War Illness

To-date there is no steadfast explanation for what happened to the soldiers of the First Gulf War. While the Department of Defense (DoD) has accepted that there is a Gulf War Illness (GWI), and has made an attempt to placate soldiers with reimbursements, the public will never fully trust its government without a better account of what happened. At this time articles rant and rave about the incompetence of the federal government, or they point out all of the missing files and insinuate that there is more than the government wants us to know going on in the battlefield. When looking at the explanations of what may have happened, one must either take the view that the government is very much incompetent, or the government has something to hide and would be in great international trouble if all information came out. (Disclaimer: For the purposes of this paper, the assumption that the government is incompetent will be the prevailing one unless otherwise stated. Assuming the government is hiding terrible information of an international dimension is beyond proof.)

At this point, many explanations are forthcoming, but they can all be grouped into the following categories, hereby named in this paper:

  • The Biological Warfare Theory (including mycoplasmas or squalene);
  • The Chemical Sensitivity Theory (including inoculations and allergic reactions);
  • The Nuclear Weapons Theory (depleted uranium);
  • The Chemical Weapons Theory (VX, GB, Mustard);
  • The Stress Theory;
  • The Phantom Illness Theory; and
  • The Combinations Theory.

The Biological Warfare Theory

The Biological Warfare Theory seems to be broken into two allotments: the claim that mycoplasmas is the cause for the “infection,” and the claim that squalene is the reason so many of our soldiers have GWI.

Mycoplasmas come from a class of small bacteria that lacks cell walls and is capable of invading human cells. This class of bacteria is associated with some of the diseases that seem so closely linked with GWI, including FMS and

CFS, as well as “pneumonia, asthma, rheumatoid arthritis, immunosuppression diseases such as AIDS, genitorouinary infections.” [10] Research behind this idea is controversial, and while reported in a variety of magazines, seems to have its strongest backing in the International Council for Health Freedom Newsletter, which often tends toward the more radical solutions (as the title may imply). According to the research performed by Drs. Garth and Nancy Nicolson of the Institute for Molecular Medicine in Irvine, California, the mycoplasmas were found in the blood of 40% of tested soldiers experiencing GWI [11]. Because mycoplasmas are related to CFS and FMS, and GWI patients seem to have many of the same complaints, it would be easy to make the transition that the mycoplasmas have the same effects on GWI patients, and that’s why the illnesses are comparable.

The encouraging reasons of the mycoplasmas argument include:

  1. Most symptoms can be explained
  2. Antibiotic treatments (see the Treatments for Gulf War Illness later in this paper) have been effective in eliminating symptoms and returning soldiers to pre-war health status.
  3. Soldiers’ families’ symptoms can be explained as contagious bacteria. [12]
  4. Scientifically, being able to relate diseases with common symptoms together with a common type of cause could be advantageous in creating a robust explanation for many autoimmune type illnesses.

The discouraging points for this explanation include

  1. Scientists who “discovered” mycoplasmas are controversial and make radical claims to support their argument such as: [13]
    • Mycoplasma was manufactured by altering a normally harmless mycoplasma with the ‘envelope’ gene of HIV-1 and both GWI and AIDS are a result of biological warfare. (The Germans are responsible for AIDS and it is not HIV that causes AIDS.)
    • This agent was distributed to Iraq by the U.S. Government in clear violation of World 1972 anti-chemical and biological warfare treaties (intimating that the government will never recognize mycoplasmas as a cause for GWI even if they could treat soldiers with antibiotics and cure their health symptoms.)
    • At this point several courses of antibiotics were able to bring about some recoveries (emphasis mine). Why not all soldiers with the infection?
    • If symptoms cannot be explained by mycoplasmas, they must have been brought about by the “micro-beladen” inoculations soldiers were given. (Clearly the Nicolsons seek to ‘blame’ the government – insist the government did something wrong without taking responsibility – for all symptoms.)
  2. Only a special blood test designed by the Nicolsons can be used to detect the infection.
  3. Thirty-five to 40% of soldiers studied up to the year 2000 had mycoplasma in their blood. [14]

Squalene is another explanation for the symptoms of GWI, and could also be included in the Biological Weaponry Theory. In 1990 squalene, a synthetic chemical, was used in experimental inoculations against the AIDS virus HIV.

Supposedly squalene “stimulates the body’s immune response when mixed with vaccines to make medications more effective.” [15] Logical arguments for the Squalene argument include:

  1. Squalene is a Non-FDA approved substance with unknown side effects on humans
  2. Squalene would be a logical experiment in trying to activate the autoimmune system against mycoplasma-type bacteria, if the government knew of the possibility of this type of biowarfare.
  3. Article sites two prestigious laboratories (through they prefer not to be identified yet) as the testing sources. [16]

Arguments against Squalene being a cause of GWI include:

  1. Squalene antibodies have been found in blood samples of soldiers who have and soldiers who have not become sick. Even if it were administered in an experiment to the soldiers, why would we blame it for symptoms if it were present in soldiers experiencing the illness when it is also found in soldiers who are not?
  2. The Pentagon and US Government medical authorities say only trace amounts of squalene can be found in the Anthrax vaccine. [17] (Prior to the year 2000, they claimed squalene was not at all present in the vaccine.)
  3. Double-blind testing has not been completed.

The Chemical Sensitivity Theory

The Chemical Sensitivity Theory is based on the idea that soldiers were exposed to burning oil fires and other such harsh carcinogenic elements during the war, and furthermore were given an unproven concoction of inoculations for any number of feared diseases in the Middle East . In the end, GWI symptoms could be a series of reactions to any one of these elements or chemical reactions among inoculations. The Chemical Sensitivity Theory even allows room for allergic reactions to explain some of the symptoms. A British study indicated that a particular combination of inoculations “strongly correlated with GWI and that veterans who were given multiple shots during deployment were five times more likely to suffer from a range of physiological and psychological complaints than others in the military.” [18]

Squalene can also be included in this argument, as a portion of a vaccination soldiers allegedly received. The Department of Defense maintains that symptoms of Gulf War Veterans are too broad to target a particular illness, and the chemical sensitivity argument may or may have some basis, but they do not believe vaccinations caused the illness.

Arguments for Chemical Sensitivity include:

  1. It can cover a number of symptoms, including brain damage.
  2. The DoD admits that Gulf War soldiers were given experimental inoculations (they just don’t know who was given what now.)

Arguments against Chemical Sensitivity include:

  1. There is lack of proof of what experiments cause what problems.
  2. There is lack of knowledge on which soldiers were exposed to what elements or vaccines, making it difficult to pinpoint what caused which symptoms.
  3. It brings about many arguments about DoD policy in giving experimental drugs.

The Nuclear Weapons Theory

There are claims, again among the more radical, that the United Stations Government along with a handful of other nations is covering up wrong doing of even greater proportions than the purported biological weapons theory: the use of depleted uranium (nuclear) weapons in the First Gulf War. Accordingly the exposure to weaponry affected more than the intended targets, creating Gulf War Illness among Middle Eastern residents, Canadian, British, and US soldiers as well as any other population with the symptoms. [19] The article sites sources such as the US Attorney General and the Shanti RTV News Agency in London. Claims include that the use of nuclear weaponry has devastating effects including increased cancer rates among Iraqi children.

At first the government completely denied using depleted uranium. A report about it is, however, now available off the DoD website, which explains “DU” is a “weakly radioactive element that occurs naturally in the environment” and that the Agency for Toxic Substances and Disease Registry (ATSDR) for the Department of Human Services “estimates that there are an average of 4 tons of uranium in the top in every square mile of land.” [20]

Pros for the Nuclear Weaponry Theory include:

  1. Soldiers were exposed to DU oxides.
  2. Possible, but unproven, side effects include damage to liver and kidneys, increased chance of lung cancer, and animal studies show some effects on DNA.
  3. Side effects are basically unknown even today.

Cons for the Nuclear Weaponry Theory include:

  1. Studies have not conclusively linked DU with any long-term side effects.
  2. The government does not believe soldiers were exposed to enough DU to affect them.

The Chemical Weapons Theory

The Chemical Weapons Theory argues that troops were exposed to some kind of chemicals while in Iraq, and this caused the various symptoms manifested in Gulf War Illness. Possible chemical weaponry includes mustard, sarin (GB), VX, and Tabun (GA). The organophosphates (Sarin and VX) appear to be the primary concern of many, possibly because it is “well established that British and US service personnel were significantly and intensely exposed to organophosphate pesticides, which French troops were not.” [21]

The Federal Government also acknowledged troops’ exposure to GB at Khamisiyah, Iraq in March 1991. [22] Organophosphates affect the central and peripheral nervous systems “by inhibition of the enzyme acetylcholinesterase,” which destroy acetylcholine and ends the transmission of a nerve impulse. [23] Immediate side affects would include “bronchial constriction, sweating, increased tracheobroncial secretions, and depending on the level of exposure, tremors, seizures, and death.” Small doses can cause death.

This appears to be an open and shut case – easily, one may decide, the description and reaction along with knowledge that soldiers were indeed exposed to these agents should make it easy to determine that chemical weaponry is the cause. The greatest problem with this determination is that for every argument that organophosphates caused the symptoms [24] [25] , we find scientific research determining there is an utter lack of data to show these symptoms are long-term effects of organophosphates. On the contrary, studies indicate “subjects who received nerve agents, as a group, did not differ from controls who had received no chemical treatments.” [26] Long-term effects have not been proven on humans, according to some sources.

Other sources [27] indicate that effects have been proven, including cell damage in brains of rats.

Encouraging points of the Chemical Weaponry Argument include:

  1. It accounts for the fact that British and US soldiers experience symptoms and French did not. (It is not clear, however, how British and US soldiers were exposed and the French were not.)
  2. There were (now) known exposures, including the pesticides that British and US troops used.
  3. It accounts for symptoms including brain damage.
  4. It is the most robust and all-inclusive explanation for the government’s accepted definitions of GWI.

Discouraging points include:

  1. Sources say long term effects are not proven and to the contrary, studies show no long term effects at all.
  2. DoD published a report that it does not believe it is possible that chemical weaponry caused the broad array of problems. [28] [29] [30]

The Stress Theory

The Stress Theory recognizes the difficulty of war and how stressful being in another culture can be, as well as the reverse culture shock soldiers face upon returning to normal American culture. This theory was initially the most popular partially because the recovery would be, at least in great part, the responsibility of the soldier, and government needed offer any further explanation. The Stress Theory could account for the “contagious” illness in that the soldiers’ stress affects their entire family, also churning about stress in family individuals.

Factors in favor of the Stress Theory include:

  1. It covers many symptoms (irritability, withdrawal, overeating or loss of appetite, headaches, need for excessive sleep, upset stomach, depression, small pains really hurt, and so on).
  2. All indications are that stress is a normal reaction to war and changes in culture.

Factor against the Stress Theory include:

  1. “Soldiers interviewed indicated that the Gulf War was not a particularly stressful war, and they strongly disagreed that stress was the origin of the their illnesses.” [31] If the soldiers are not experiencing stress symptoms, how can we assume otherwise?
  2. Soldiers feel insulted that their severe symptoms are, in their eyes, treated so indifferently and “minimalized” to this level.

The Phantom Illness Theory

The Phantom Illness offers that symptoms are due to a combination of factors, and that there is really no such thing as Gulf War Illness because there is no definable syndrome [32]. The Phantom Illness theory is specifically against “the doctrine of ‘unless you prove otherwise, my ill health is your fault.'” [33] Those who agree with the Phantom Illness Theory point to the incident of Agent Orange, after the Vietnam War, in which the connection between exposure to Agent Orange and cancer (and other health problems) was never proven; Veterans nevertheless insisted the Government owed the monetary reimbursements and medical care for their exposure to the Agent and particularly for its effects on their health. This theory insists that, barring proof that wartime exposures caused health problems, the problems soldiers and their families experience are most likely health problems they would have experienced anyway, or merely reactions to stress. And if they are indeed caused by stress, it is still not a syndrome or illness, but simply stress that should be treated.

Arguments for Phantom Illness Theory include:

  1. Many symptoms could indeed by chalked up to stress.
  2. Symptoms are by-and-by identical to symptoms for CFS and FMS; perhaps they really are from CFS or FMS.
  3. Many veterans later began claiming symptoms. This delayed effect could be from those out for profit.
  4. It explains the Government’s hesitancy to accept GWI and confusion over what is causing the illness.
  5. If GWI cannot be proven contagious, family members claiming to have it is impossible. (The Government does not recognize GWI as contagious)

Arguments against Phantom Illness Theory include:

  1. Brain damage among veterans of the war can be proven in some cases.
  2. A large number of Veterans have symptoms.
  3. Symptoms range among the Middle Eastern population, British and Canadian soldiers, and other members of the coalition.
  4. Denying that GWI exists altogether could discourage open relations between soldiers and government.

The Combinations Theory

The combination theory makes several claims based on important points. Not all soldiers are ill; not all soldiers suffer brain damage. Some soldiers have illnesses they probably would have had anyway. (Not all soldiers would have remained healthy for the rest of their lives and these are common symptoms for various illnesses.) Some soldiers were exposed to oil fires, some possibly to chemical weapons, and so forth. Maybe it is not one congruent illness, but rather various reactions to the varied but tough conditions soldiers faced.

One article, for instance, points out:

GIs in the Persian Gulf were exposed to chemical agents, biological agents, propylactic medications, smoke from oil fires, and many other military and nonmilitary substances. One must wonder if those who have developed this syndrome are manifesting proving {sic} symptoms to one or another of these agents. [34]

This particular article points to a case where a soldier (not a Gulf War Veteran) claimed to have many of the symptoms of GWI. The doctor involved gave the patient a single dose of Nux Vomica, which cured the patient’s illness. The doctor believed the patient had cinchonism, a syndrome resulting from taking quinine or its congeners.

Positive points for the Combination Theory include:

  1. It allows for various interpretations of each soldier’s illness, encouraging flexibility among medical practitioners in treating GWI.
  2. It covers all symptoms.
  3. It is less concerned with placing blame and more concerned with dealing with each individual.

Points that could hurt the Combinations Theory include:

  1. It could be interpreted as denying GWI, which would greatly upset soldiers.
  2. It does not pinpoint what caused which symptoms, making it difficult to develop future preventions.

Treatments for Gulf War Illness

Because the source of Gulf War Illness (GWI) is unknown, various treatments range from alternative medicine (herbs, acupuncture, and so forth), to antibiotics. According to one source, “massage and bodywork is a great place to start with GWI patients.” [35] The same article also points to Chinese Traditional Medicine as a productive alternative. Several 6-week courses of antibiotics have worked for some soldiers, according to Drs. Garth and Nancy Nicolson. Some soldiers were even able to return to active duty. Penicillin, however, made symptoms worse. In the end however, unknown causes and such a variety of symptoms leads to no known single treatment.

Interesting International Factors

British and Canadian soldiers claim to have experience with GWI. The British Government, like the U.S. Government, recognizes GWI as at least a syndrome, though only within the past year or so has it done so. The Canadian Government does not recognize GWI; French soldiers do not report incidents related to GWI. At least 15% of the entire population of Kuwait reports symptoms concurrent with GWI [36] and between 15 and 20% of the whole population of Middle Eastern countries reported signs of GWI. [37] Twenty-seven out of 28 countries in the coalition that took part in the first Persian Gulf War reported symptoms of GWI. The only country not to report incidents was France.

Explanations in Summary

The following two charts demonstrate the complexity of Gulf War Illness. The first chart, Explanations of Gulf War Illness and Their Ability to Explain Symptoms, assesses current explanations and their ability to account for symptoms as determined through research of the bibliography materials. Ability is assessed by yes, possibly (not determined definitely), and no. The second chart, Explanations of Gulf War Illness and Their Ability to Explain Various Phenomena, assesses ability to account for various factors of Gulf War Illness in the same terms based on research noted in the bibliography.

*Explanations of Gulf War Illness and their Ability to Explain Symptoms

PossibleCausesMicroplasmas
(Biowarfare)
Chemical Sensitivity (Inocula-tions)**Organophosphates
(chemical warfare GB
and VX)**
Mustard Gas (chemical warfare (non organophosphates) Exposure to Depleted Uranium (nuclear warfare) SqualeneStressDepression
Symptoms Reported
Memory Problems

Cognitive Difficulties

Fatigue

Swelling

Lack of Balance

SoreJoints

Sore muscles

Irritability

ThickSaliva

WeightLoss

WeightGain

Hair Loss

Sore Gums

Diarrhea

Nausea

Labored Breathing

Headaches

Brain damage

Vitamin Deficiencies

Symptoms Treatable?

Table Key

Yes ■ Possibly ◘ No □

*Disclaimer: I developed this chart using information found in my readings in the articles found under the references and bibliography section. To the best of my knowledge this chart is accurate.

** It is believed that chemical sensitivity to the inoculations could cause some of the same symptoms as allergic reactions. Side effects, however, would naturally be unknown without further testing.

***This table indicates immediate side effects of chemical warfare. According to some sources sited in this paper, long-term side effects have not been established (and on the contrary, effects have not occurred in studies) for organophosphates and mustard.

*Explanations of Gulf War Illness and their Ability to Explain Various Phenomena

Biological Warfare
Theory

 

Chemical Sensitiv-ity Theory

 

Nuclear Warfare
Theory

 

Chemical Warfare Theory

 

Stress/ Depre-ssion
Theory

 

Phant-om Illness
Theory

 

Combi-nation Theory

 

How US

Soldiers

contracted

illness

 

 

 

 

 

 

How Families

of US Soldiers contracted

illness

 

 

 

 

 

 

 

 

How British

Soldiers

contracted

illness

 

 

 

 

 

 

 

 

How Canadian

Soldiers

contracted illness

 

 

 

 

 

 

 

 

Why French

Soldiers did not contract illness

 

 

 

 

 

 

 

 

How 15-20%

of Middle

Eastern

Population

contracted illness

 

 

 

 

 

 

 

 

Readily

explains many symptoms

of GWI

 

 

 

 

 

 

 

 

Yes ■ Possibly ◘ No □

The Department of Defense

There are two basic ways of looking at the government’s reaction to Gulf War Illness: what the government perceives and presents; and what the public and soldiers perceive. The government’s initial response to soldiers’ reported illness was that it must be due to stress, battle fatigue, or whatever else, because there is nothing to have caused an actual illness or syndrome. The public and soldiers often choose to interpret this as in one article. The Persian Gulf War seemed like the perfect war. “The pentagon, not wanting the illusion to end, went into a strongly fortified denial.” [38]

As the number grew, however, the government was forced to take a closer look and it determined then to take a closer look at “Gulf War Syndrome.” As far as the government could see, they were being responsible and sensitive to their veterans’ claims. The public, however, saw flat out denial, then a retreat on that denial, which must mean initially the government was covering something up.

In August 1995 at a DoD News briefing, Dr. Stephen Joseph, ASD, Health Affairs, answering a question, distinctly said “It [Gulf War Syndrome] is absolutely not a myth,” but then qualified the statement and ended with “but there is not ‘a’ Gulf War Illness.” [39] Though this qualification could be seen as saying based on the variety of symptoms and possible variety of causes, there is no one illness, statements of such nature are inflammatory to many Gulf War Veterans as the government continues to refuse to accept any blame for their condition.

Since 1994 the government has spent millions of dollars researching what went wrong, how to help the soldiers, and how to prevent these incidents from occurring in the future. In return the government has suffered many accusations ranging from complaints of incompetence to insistence of government cover-ups. In practically every GWI-based news briefing, part of the job seems to be trying to convince others that there is no cover-up. In fact, the DoD has a response to most of the public explanations offered earlier, usually amounting to the effect of “no, no, our research and science indicates that is not the problem.” Not that their research is not correct, but people want to hear more compassion.

Congress listened to testimony of the Nicolsons in 1997 [40] on their mycoplasma research. DoD appears not to have discounted this research to-date, except to say there was no biowarfare exposure. Naturally, someone will point out how this “raises the question of how the Department of Defense claimed that GWI could not be a result of biological weapons when we had no technology to detect that type of weaponry.” [41] Earlier denials and the recants do not help the government in dealing with these issues.

In November 1998, Lieutenant General Dale Vesser talks about the possibility of oil well fires and chemical exposures causing Gulf War Syndrome. He indicated that chemical exposure due to oil well fires was unlikely due to the temperature of oil wells. (We destroy chemical weapons using fires that are not as hot.) He also indicated the lack of a specific link from soldiers’ illnesses to activities, but “… it’s very clear that if you breathed in these fumes during the oil well fires, people had difficulty breathing and had shortness of breath.”

For years the DoD denied that soldiers were administered any squalene through vaccines, in the face of unusual squalene levels in solders’ blood. According to the Washington Times [42], General Vesser acknowledged “recently there’s been a small use of squalene as an adjuvant in some anti-malarial vaccine that some 50 test volunteers have been exposed to… None of this happened at the Gulf War.” The Washington Times also pointed out how revealing information about the anti-malarial vaccine was likely to inflame Gulf War Veterans. That was in 1997. More recently the FDA has found small amounts of squalene in the anthrax vaccine. Thus DoD has had to recant on its absolute response. Nevertheless, DoD now claims the levels were too small to have actually affected the soldiers.

In February 2000 the Washington Times [43] reported further on the research showing squalene antibodies in soldiers’ blood and criticized the DoD’s lack of recognition about the research. Do they seem interested now? The most frustrating stick point for many of these researchers was the “disappearance of 700,000 service-related immunization records.” [44] At the very least this is embarrassing to the Department of Defense. It does not help the government’s case to the public that it does care and is trying very hard to help our soldiers and prevent illnesses in the future.

Articles also point to an incident where files were put on the Department of Defense’s website, when they first insisted they had nothing to hide, only to be pulled down within 24 hours and called restricted. [45] Even the General Accounting Office gets into the act, basing DoD, DVA, and the Department of Health and Human Services, for purportedly wasting more than $130 M on research about GWI without ever clarifying what caused it, in a time period of well over 9 years. [46]

Finally, even today, the Department of Defense is failing to demonstrate true concern for veterans’ well being health-wise. According to the Washington Post, Veterans Affairs (VA) Secretary Anthony J. Pincipi indicates “our clinics, our medical facilities are full.” [47] Because of an overstressed health system, the VA has been forced to cut back some veterans’ access to health care. Adding to the misery, President Bush’s proposed fiscal 2004 budge aims to cut 6.2 billion dollars in veterans funding over the next 10 years [48]. The last thing the DoD can allow to happen at this point, with veterans feeling so under-appreciated and overlooked, is for an already stressed health care system to be faced with a budget cut of those proportions. It really sends the wrong message.

One more important note, before moving on. The government recognizes Gulf War Syndrome – a syndrome being a group of varying symptoms. The public today tends to write of the symptoms as an illness: GWI, not GWS.

What can we learn from all of this? How can we change DoD’s health policies to prevent repeating these confusing incidents in the future? How can we take information from this, if we never find the cause, and use it to prevent soldiers’ problems in the future?

Discussion

In this section, the DoD’s policy is examined in context with the findings of Gulf War Illness research and the DoD’s current reputation and viewpoints.

Reasons for Improving Policy

It costs the government public relations points, shown in the numerous incidents mentioned. It also costs the government money to try and repair its image; do last-minute research (assuming clean up is more expensive than doing it right in the first place); and to pay reimbursements to soldiers that are unnecessary or scientifically proven to be untrue.

It costs our soldiers their health in instances when it could perhaps be avoided, and in trying to find treatment when it could not be avoided.

It costs the health system money. It is embarrassing nationally and internationally. Will soldiers continue to enter the military in current numbers if current veterans are unhappy with the system, feel they have been maltreated, and insist the government uses them as guinea pigs and does not care? Finally, the DoD must worry about peacekeeping events as well as wars, and with terrorism being such a problem anymore, we need policies that cover a range of events and cover them for the long-run, not just one area of war-specific guidelines.

Reasons for Leaving the Policy Alone

It takes effort, time, and could be expensive. The Department may also have to change the way it handles the public, to improve relations. If DoD is not actually incompetent, but is truly hiding information, it would be pointless as the government presumably already has stringent regulations in place. The Department itself needs to determine if whatever it is doing or has done is worth the veterans’ ill will and the public’s mistrust.

Possible Solutions

To begin, let us review 5 points that seem central among all Gulf War Illness madness.

  1. The public does not trust the government, and easily flares with accusations, supported or not, that the government is covering something up.
  2. Gulf War Veterans still feel the government has not put their welfare in priority position, ahead of saving their own butts.
  3. Files were “los” that could help define causes. The act of having lost them inflamed points 1 and 2 above.
  4. People are confused when files are made public and then retracted, as with the Gulf War Illness internet site alleged incident.
  5. People are upset when the government says something is definitely without any truth, only to later be forced to recant.

Answers to these points might include:

  1. Improve record keeping. Gives international validity to records keeping and ensures the highest caliber processes for all procedures. With the procedures set in place, there is no excuse for anyone losing files, and file movement can be documented and tracked very closely. (For instance, the current National Quality Monitoring Contract, KeyPRO, handles appeals for TRICARE, the military health insurance plan. In these appeals cases (for what insurance did not or will not cover), there is a stringent set of regulations on how papers are stored (security) and who sees them, but for who handles what and where, and how it is documented, the process is not as precise and measured as it could be.
  2. Avoid making flat denials. Instead of denying an illness or a cause when symptoms crop up and later retracting the statement, the government should save denials for rare cases.
  3. It may sound obvious, but know going in what inoculations can be mixed together. If soldiers are at risk for multiple diseases in the territory, and the inoculations for those diseases cannot be mixed together, consider staggering them or defining which disease soldiers are most likely to find themselves exposed to.
  4. Consider inoculating all soldiers for certain diseases that are known throughout the world, especially if their inoculations do no mix well with others. It’s an international ring now, and soldiers are likely to find themselves anywhere in the world. If possible, stagger inoculations throughout the term of a soldier’s service. With records of who has received what, a determination of who should go to a particular region can even be determined based on prior inoculations.
  5. If an experimental drug must be given to soldiers and not all soldiers are to receive it, let the soldiers know going in that they are receiving an experimental drug. This probably carries more implications and is much more serious and complicated than the face of it, but it is worth studying.
  6. Document all vaccine recipients, and have the policy ready-made that should soldiers experience any unusual health problems, it should reported to DoD personnel immediately. All health care needed because of unusual health problems will be tended to at the cost of the government.
  7. Create public policy for what the government will and will not do for soldiers and/or their families should they become sick from service-caused inoculations. Do not wait until something occurs and try to cover your own back.
  8. Create an Out-in-the-Open policy. The government will have to monetarily back anything that happens to soldiers because of its policies and procedures, but the health risks will be better known and understood without the secrecy.
  9. Attend to “stress” symptoms for all veterans of war. The Government currently has a group of officers whose priority is to comfort survivors of war victims.[49] Have all soldiers be treated for stress after the war and have it receive the same kind of priority.

In the table Policy Solutions and Their Effects, possible solutions are compared with the beneficial and harmful points to help determine how each might affect the Department of Defense. (This table is not an exact science, just an attempt at reflecting solutions and their possible results.)

Policy Solutions and their Effects

Improve Public Relations

 

Likely Cost Factor

 

Respond to Soldier’s Health Risk
Factors

 

Improve Soldier Health

 

Improve International Opinion/View

 

Protect the Department

 

Better Document Management

 

+

 

$$$

 

+

 

0

 

++

 

++

 

Reserve making denials

 

++

 

0

 

0

 

0

 

+

 

++

 

Prior inoculations research

 

++

 

$$$

 

+++

 

++++

 

+++

 

++++

 

Inoculate all military professionals prior to
wartime or peacekeeping initiatives

 

 

$$$

 

++

 

+

 

0

 

++

 

Tell soldiers when they are receiving an
experimental drug

 

+

 

0

 

++

 

+

 

+

 

+++

 

All side-effects or health problems occurring
after experimental drug are automatically at the expense of the Department

 

++++

 

$$$$

 

++++

 

+++

 

+

 

++++

 

Have known and documented government policies
for what government will and will not do for soldiers and families prior to
health-related occurrences

 

++

 

$$

 

0

 

0

 

+

 

++++

 

Out-in-the Open Policy

 

+++

 

$$

 

+

 

+

 

++

 

++

 

Attend to stress symptoms for all veterans of
war

 

+++

 

$$

 

++

 

++

 

+

 

+++

 

Key

Pluses (+) indicate more helpful; minuses (-) indicate harmful; zeros indicate no change; dollar signs ($) indicate more expense or less.

Disclaimer: All of the pluses and minuses are relative to each other. No exact value is assigned to any symbols. This chart is designed solely to give a general indicator of what areas each active point might help or hurt and how much they might cost.

Conclusion

This section offers a conclusive solution and a conclusion about the overall scope of the research.

Recommended Solution

The easiest determinable solution that would be useful as a health policy, a policy to promote public relations, and a security measure, is to improve document record keeping. The DoD is notorious for security standards among its projects, such as bars on windows just for call centers and health contractors’ offices, and insist upon the highest of security measures in its computer systems. If the Department insisted on stringent standards for all record-keeping within the military bases, on the battlefield, and in its various projects across the country (including call centers and health contracts) these embarrassing cases of lost documentation should be avoided. There is no reason for a DoD record to ever be lost. If information is not public, the Department has ready access to say as much. Stories of records being put on the internet (made public) and within 24 hours taken down and considered classified are absurd. We must intimate that the documentation named was made public, and then a superior decided the documents were not for public viewing. In this case, whoever had the ability to decide the records were public should have been the person to put them on the internet, and no superior should have had the ability to take them off. These kinds of goofs are terribly embarrassing, elicit storms of articles insisting the government is covering something up and citing these types of incidences as proof, and are dangerous to the security of country. (If the papers were not dangerous to public security, why should they be removed from the website?) Back in mid 1971, the Vietnam Era, General Creighton Abrams said to his deputy:

Although there has been some improvement in the past year in records preservation and refinement, a great deal of historically valuable information is still being lost…I request that you take necessary action to reemphasize records preservation, particularly within the headquarters (140). [50]

Strangely enough, this could still be said today. The question, then, is how to improve these record standards. I propose that the Department of Defense use what various federal and state agencies are currently using to better control document management – ISO 9000 certification. ISO 9000 certification meets international standards, is extremely stringent on accounting for every step of every process, including who is in charge of what and when, where papers go, how they get there, who accounts for them, and more. The Department of Defense could enforce it upon all military bases, in each contractor’s project, and within the Department’s red tape itself. The only excuse for missing files in that case would be that someone made them come up missing. No one should be confusing authority for declassifying files and putting them on the internet to later find out they should be classified after all. And ISO carries with it international respect.

The process is quite expensive and takes times, but wouldn’t control of Department of Defense documentation be well worth it?

Final Words

Gulf War Illness has brought to the attention of the public how confused and unfeeling our government can seem in the face of accusations. To better protect the health of our future soldiers in both peacekeeping and war missions, we do need to find out what caused GWI. But we also need to change some of the policies that brought about the anger, confusion, and slow reactions. We need to react to the seeming incompetence of the government, and re-build as much trust as possible with the veterans and soldiers. Research on GWI is never-ending, and just at the end of April the government released another report on the causes. We hope the causes will eventually be pinpointed. In the meantime, what is the government doing for the soldiers who are there now? So much confusion over inoculations, pesticides, chemical exposures, biological warfare, and so forth have taken place, yet no change in the policies that caused the confusion appear to be at the forefront of thinking. Changes such as being better protected in case of chemical exposures are in effect, and hopefully the soldiers did not receive the various concoctions of vaccines. There were fewer oil fires to worry about, and with any luck our soldiers were not recipients of bio-warfare agents. The war was probably more stressful for soldiers than the first Persian Gulf War, as soldiers fought even more on the ground and less in the air.

We can hope the government is addressing all of these issues, but at this point we have to wonder how many records will be lost, or never recorded anyway. We have to wonder how many things the government will first deny then later recant when the soldiers do come home, and how the relationship with veterans will further deteriorate with healthcare cutbacks, and a government that claims to be doing everything it can to help in treating illnesses of its veterans. And how much money will the government spend in research when spending the money upfront on record keeping would have saved it from the necessity of such drastic research.

If the government is not covering up something, it should be ashamed of the incompetence displayed in the entire Gulf War Illness debacle.

Bibliography

“Anthrax Shots Continue; Troops Balking.” No author given. International Council for Health Freedom Newsletter, Summer 2000, V. 4 (3)

“Antibodies to Squalene in Gulf War Syndrome Gulf War Syndrome Association.” Retrieved from website: www.nhgws.org/squalene.htm on April 12, 2003

“Anti-HIV Mix Found in Gulf Veterans.” Rodriguez, Paul, M. The Washington Times, August 11, 1997, sec. A, Ed. 2, p A1

“Ball’s in Your Court Now, DoD.” Rodriguez, Paul M., and Michael Rust. The Washington Times, February 21, 2000, sec. NEWS ALERT, Ed. V. 16 (7), p 6

“Behind an International Scandal: ‘Gulf War Biological Weapons Killing Thousands, Sickening Millions; World Governments Remain Mute.'” Culbert, Michael, L. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

“Britain Finally Recognizes Gulf War Syndrome.” No author given. International Council for Health Freedom Newsletter, Winter 2002/Spring 2003

“Capillary Gas Chromatographic Analysis of Nerve Agents Using Large Volume Injections.” Degenhardt-Langelaan, and Ch.E Kientz. A Journal of Chromatography, 1996, 723, 210-14

“A Case of Chloroquine Toxicity.” Schaffer, Rodney. Journal of the American Institute of Homeopathy, Dec 95, V. 88 (4)

“Chemical Sensitivity.” Downing, Damien, MBBS; Journal of Nutritional & Environmental Medicine (2001), 11, 157-8

“Chronic Fatigue Illnesses Associated with Service in Operation Desert Strom: Were Biological Weapons Used against Our Forces in the Gulf War?” Nicolson, Garth, L., and Nancy L. Nicolson. Townsend Letter for Doctors & Patients, May 96 (154)

“Chronic Organophosphate Induced Neuropsychiatric Disorder (COPIND): Results of Two Postal Questionnaire Surveys.” Davies, D.R., MBBS; Ahmed, G.M., MBBS; and T. Freer MBChB MRCPsych. Journal of Nutritional & Environmental Medicine, (1999), 9, p 123-134

“Combined Analysis of the VA and DoD Gulf War Clinical Evaluation Programs: A Study of the Clinical Findings from Systematic Medical Examinations of 100,339 US Gulf War Veterans.” Department of Veterans Affairs, Veterans Health Administration, and Department of Defense, Office of the Assistant Secretary of Defense, Health Affairs, September 2002. Retrieved from website: www.gulflink.osd.mil/combined_analysis/index.htm on April 24, 2003

“Comforting Survivors: Priority One for Casualty Assistance Officers.” Gilmore, Gerry J., American Forces Press Service. Retrieved from website: www.defenselink.mil/news/Mar2003/n03262003_200303268.html on April 15, 2003

“Culture Differences: International Students Coping with Culture Shock.” Schneider, Katherine. Retrieved from website: www.uwec.edu/counsel/pubs/shock.htm on April 15, 2003

“A ‘Depleted Uranium’ Arms Scandal.” No author given. International Council for Health Freedom Newsletter

“Depleted Uranium Information Page: What is Depleted Uranium?” Retrieved from website: www.deploymentlink.osd.mil/du_library/what.shtml on April 12, 2003

“Diagnosis and Treatment of Chronic Mycoplasmal Infections in Fibromyalgia and Chronic Fatigue Syndromes: Relationships to Gulf War Illness.” Nicolson, Garth L., Nasralla, Marwan, Haier, Joerg, and Nancy L. Nicolson. BioMedical Therapy. Oct 98, V. 16 (4)

“DoD Assesses Marines’ Injuries Unlikely Due to Chemical Warfare Agent Exposure.” Gates, Lisa A. Gulflink, May 31, 2001. Retrieved from website: www.gulflink.osd.mil/news/na_2d_recon_31mar01.html on April 15, 2003

“DoD Assessments for Events at Al Jubayl Remain Unchanged.” No author given. Al Jubayl II Case Narrative- Gulflink, February 22, 2001. Retrieved from website: www.gulflink.osd.mil/news/na_al_jubayl_22feb01.htm on April 15, 2003

“DoD NewsBriefing.” Deputy Secretary of Defense John P. White, Tuesday, November 12, 1996 – 1:20 pm. Retrieved from website: www.dod.mil/news/Nov1996/t111296_tasd1112.html on April 12, 2003

“DoD NewsBriefing.” Dr. Stephen Joseph, ASD, Health Affairs, Tuesday, August 1, 1995. Retrieved from website: www.defenselink.mil/news/Aug1995/t080195_t801jos.html on April 12, 2003

“DoD NewsBriefing.” Dr. Steven Joseph, Assistant Secretary for Health Affairs, and Dr. Robert Roswell, Chief of Staff, and Mr. Dennis Boxx, DATSD PA, Tuesday, December 13, 1994 – 1:30 pm. Retrieved from website: www.defenselink.mil/news/Dec1994/t1213asd.html on April 12, 2003

“DoD NewsBriefing.” Lt. Gen. Dale Vesser (Ret.), Thursday, November 5, 1998. Retrieved from website: www.defenselink.mil/news/Nov1998/t11091998_t1105gwi.html on April 26, 2003

“DoD NewsBriefing.” Mr. Kenneth H. Bacon, ASD PA, October 3, 2000 – 1:30 pm EDT. Retrieved from website: www.defenselink.mil/news/Oct2000/t10032000_t1003asd.html

“DOD/DVA Start Study of Nicolson’s Approach.” No author given. International Council for Health Freedom Newsletter, June 99, V. 3 (2)

“Environmental Exposure Report: Pesticides, Final Report.” Winkenwerder Jr., William, MD. US Department of Defense, April 17, 2003. Retrieved from website: www.gulflink.osd.mil/pest-final/index.html on April 30, 2003.

“‘Establishment’: GWI Real, Similar to CFS.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

“Evaluation of Risk Assessment Guideline Levels for the Chemical Warfare Agents Mustard, BG, and VX.” Hartmann, Heidi M. Regulator Toxicology and Pharmacology 2002, 35, 347-56

“Fibromyalgia & CFIDS.” Retrieved from MSN Health – Fibromyalgia Newly Diagnosed: content.health.msn.com/content/article/38/1673_50511.htm on April 30, 2003

“Gulf War Syndrome – a case of friendly fire.” No author given. Spectrum: The Wholistic News Magazine, Jul/Aug 96, (49)

“Gulf War Syndrome and Brain Damage.” No author given. Alive: Canadian Journal of Health & Nutrition, Feb 2001 (220)

“Gulf War Syndrome: a Phantom Illness.” Whelan, Elizabeth M. Priorities for Health, Sep 95, V. 7 (3)

“Gulf War, Chronic Fatigue, and the Miotic Syndromes.” Solomon, Herbert A., OD. Townsend Letter for Doctors and Patients, October 2002, p 70-2

“Gulf War: Army to Probe ‘Biowarfare’ Claim.” No author given. International Council for Health Freedom Newsletter, Spring 97, V. 1 (1)

“GWI Dirty Work at the (Internet) Crossroads.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

“GWI Riddles: Squalene Appears, ‘Shot Charts’ Vanish.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

“GWI: US Government Still in the Dark; Vets Irate.” No author given. International Council for Health Freedom Newsletter, Spring 00, V. 3 (1)

“GWS Challenge: New Hampshire Gulf War Syndrome Association.” Retrieved from website: www.nhgws.org/anthrax.htm on April 12, 2003

“A Healer’s Perspective.” Seltzer, Ondre. Townsend Letter for Doctors & Patients, December 2001, p 81-3

“Health Guide A-Z: Depression.” Retrieved from WebMDHealth: my.webmd.com/content/healthwise/129/32229 on April 30, 2003

“Health Guide A-Z: Allergic Reaction.” Retrieved from WebMDHealth: my.webmd.com/content/healthwise/40/10051.htm on April 24, 2003

“Higher ALS Rate Seen in Gulf War Veterans.” No author given. International Council for Health Freedom Newsletter, June 99, V. 3 (2)

“A Holistic Treatment Approach: Gulf War Syndrome; One Soldier’s Story.” Sullivan, James, Massage & Bodywork, Dec 98/Jan 99, V. 13 (4)

“How to Recognize That You Are Under Stress.” Retrieved from website: www.mindtools.com/smsymstr.html

“Immune Augmentation Therapy for Gulf War Syndrome.” Null, Gary. Townsend Letter for Doctors & Patients, April 98 (177)

“Independent UK Scientists Studying 1,500 GWI Cases.” No author given. International Council for Health Freedom Newsletter, Spring 98, V. 2 (1)

“Long Term Health Effects of Low Dose Exposure to Nerve Agent.” Moore, David H. J. Physiology (Paris), 1998, 92, 325-328

“MCS: USA May Soon Be Taking it Seriously.” No author given. International Council for Health Freedom Newsletter, Spring 99, V. 3 (1)

“Medical Encyclopedia: Chronic Fatigue Syndrome.” Retrieved from MSN Health: content.health.msn.com/content/healthwise/78/19405 on April 30, 2003

“Military ‘Relents’ on Anthrax, Cuts Shot Levels.” No author given. International Council for Health Freedom Newsletter, Fall 2000, V. 4 (2)

“Nazi Scientists Said Linked to West’s Biowarfare.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 98, V. 2 (3/4)

“New Clue in Blood.” No author given. International Council for Health Freedom Newsletter, June 99, V. 3 (2)

“New Data Link Bio-Warfare to Killer Diseases, ‘Weaponized’ Microbes Pose Major World Threat.” Armstrong, Nelson B., Scott, Donald W., Scott, William L.C. International Council for Health Freedom Newsletter, Fall 2000, V. 4 (3)

“Operation Illness? ‘Gulf War Syndrome'”. Fumento, Michael. Priorities for Health, Spring 94, V. 6 (1)

“Pentagon Denies Use of Compounds.” Rodriguez, Paul M. The Washington Times, August 15, 1997, sec. A, Ed. 2, p A3

“Pentagon Ups its ‘Poison Gas’ Count by Fivefold.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

“Poor Record-Keeping?” No author given. International Council for Health Freedom Newsletter, June 99, V. 3 (2)

“Registry: ‘MFI’ Microbe is Easily Contagious, and Is Increasingly Showing up in GWI and CFS Patients.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

“Report Assesses Health Risk of Pesticide Exposure to US Troops.” Retrieved from website: www.gulflink.osd.mil/news/na_pesticides_9jan01.htm on April 15, 2003

“Reverse Culture Shock: What Is It? And Stages of Reverse Culture Shock.” Retrieved from website: www.wings.buffalo.edu/studyabroad/rculture.html on April 15, 2003

“Sickness and Secrecy.” Rodriguez, Paul, M. The Washington Times, August 25, 1997, sec. Investigative Cover Story, Ed. V. 13 (31), p 8

“Signs and Symptoms of Stress.” Retrieved from website: www.gov.mb.ca/agriculture/homeec/cha27s01.html

“Symptoms of Stress.” Retrieved from website: www.d.umn.edu/hlthserv/counseling/stress_symptoms.html on April 15, 2003

“The Gulf War’s Troubling Legacy – Part 2.” Null, Gary. Townsend Letter for Doctors & Patients, Oct 98, (183)

“The Nicolsons’ Testimony Before the US Congress.” Nicolson, Garth L., Nicolson, Nancy L. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

“The Nicolsons Update Gulf War Illness Plague, Say Antibiotic/Metabolic Regimes Work.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 98, V. 2 (3/4)

“The Soldier’s Exposure to Toxic Substances.” Review by Katherine Duff of book: Gulf War Syndrome: Legacy of a Perfect War by Allison Johnson. Townsend Letter for DOCTORS & PATIENTS, August/September 2002

“The Vietnam Conflict: ‘America’s Best Documented War’?” Shaughnessy, C. A. The History Teacher, Feb 1991, V. 24 (2), p 135-47

“Toxic Aftermath of Biological Warfare.” Richard, Louise; Alive: Canadian Journal of Health & Nutrition, May 99, (199)

“Tulane Confirms Squalene Antibodies in GWI Vets.” No author given. International Council for Health Freedom Newsletter, Summer 2000 V. 4 (2)

“Twin Epidemics (GWI/CFS) Bringing ‘Orthodoxy’, ‘Alternatives’ into Models of Integrative Medicine.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

“UK: New Gov’t Earmarks $10.5 M More for GWI.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

“US Gulf Troops Got an Experimental Vaccine.” No author given. International Council for Health Freedom Newsletter, Spring 98, V. 2 (1)

“VA Cuts Some Veterans’ Access to Health Care.” Walsh, Edward. Washington Post, January 17, 2003, p. A21

“VA Notes ALS Connection to Military Gulf War Service.” No author given. International Council for Health Freedom Newsletter, Summer 2002

“Veterans up in arms over Proposed Cuts.” McCabe, Kathy. Globe North, April 24, 2003

“What Awaits Us in Iraq: Warrior Kings and the Test of True Vision.” La Chapelle, David. Sentient Times, October/November 2002, p 10-1.

“What is TRICARE?” Retrieved from website: www.tricare.osd.mil/frequentlyaskedquestions.cfm#info1 on April 15, 2003


[1] “‘Establishment’: GWI Real, Similar to CFS.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

[2] “Operation Illness? ‘Gulf War Syndrome'”. Fumento, Michael. Priorities for Health, Spring 94, V. 6 (1)

[3] “The Vietnam Conflict: ‘America’s Best Documented War’?” Shaughnessy, C. A. The History Teacher, Feb 1991, V. 24 (2), p 135-47

[4] “Behind an International Scandal: ‘Gulf War Biological Weapons Killing Thousands, Sickening Millions; World Governments Remain Mute’.” Culbert, Michael, L. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

[5] “Gulf War Syndrome and Brain Damage.” No author given. Alive: Canadian Journal of Health & Nutrition, Feb 2001 (220)

[6] “Behind an International Scandal: ‘Gulf War Biological Weapons Killing Thousands, Sickening Millions; World Governments Remain Mute’.” Culbert, Michael, L. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

[7] “Medical Encyclopedia: Chronic Fatigue Syndrome.” Retrieved from MSN Health: content.health.msn.com/content/healthwise/78/19405 on April 30, 2003

[8] “Fibromyalgia & CFIDS.” Retrieved from MSN Health – Fibromyalgia Newly Diagnosed: content.health.msn.com/content/article/38/1673_50511.htm on April 30, 2003

[9] “Behind an International Scandal…”

[10] “Diagnosis and Treatment of Chronic Mycoplasmal Infections in Fibromyalgia and Chronic Fatigue Syndromes: Relationships to Gulf War Illness.” Nicolson, Garth L., Nasralla, Marwan, Haier, Joerg, Nicolson, Nancy L. BioMedical Therapy. Oct 98, V. 16 (4)

[11] “The Nicolsons Update Gulf War Illness Plague, Say Antibiotic/Metabolic Regimes Work.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 98, V. 2 (3/4)

[12] “Registry: ‘MFI’ Microbe is Easily Contagious, and Is Increasingly Showing up in GWI and CFS Patients.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

[13] “The Nicolsons Update Gulf War Illness Plague…”

[14] “Anthrax Shots Continue; Troops Balking.” No author given. International Council for Health Freedom Newsletter, Summer 2000, V. 4 (3)

[15] “Anti-HIV Mix Found in Gulf Veterans.” Rodriguez, Paul, M. The Washington Times, August 11, 1997, sec. A, Ed. 2, p A1

[16] “GWI Riddles: Squalene Appears, ‘Shot Charts’ Vanish.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

[17] “DoD NewsBriefing.” Mr. Kenneth H. Bacon, ASD PA, October 3, 2000 – 1:30 pm EDT. Retrieved from website: www.defenselink.mil/news/Oct2000/t10032000_t1003asd.html

[18] “Military ‘Relents’ on Anthrax, Cuts Shot Levels.” No author given. International Council for Health Freedom Newsletter, Fall 2000, V. 4 (2)

[19] “A ‘Depleted Uranium’ Arms Scandal.” No author given. International Council for Health Freedom Newsletter, Spring 98, V. 2 (1)

[20] “Depleted Uranium Information Page: What is Depleted Uranium?” Retrieved from website: www.deploymentlink.osd.mil/du_library/what.shtml on April 12, 2003

[21] “Chronic Organophosphate Induced Neuropsychiatric Disorder (COPIND): Results of Two Postal Questionnaire Surveys.” Davies, D.R., MBBS; Ahmed, G.M., MBBS; and T. Freer MBChB MRCPsych. Journal of Nutritional & Environmental Medicine, (1999), 9, p123-134

[22] “Long Term Health Effects of Low Dose Exposure to Nerve Agent.” Moore, David H. J. Physiology (Paris), 1998, 92, 325-328

[23] “Evaluation of Risk Assessment Guideline Levels for the Chemical Warfare Agents Mustard, BG, and VX.” Hartmann, Heidi M. Regulator Toxicology and Pharmacology 2002, 35, 347-56

[24] “The Soldier’s Exposure to Toxic Substances.” Review by Katherine Duff of book: Gulf War Syndrome: Legacy of a Perfect War by Allison Johnson. Townsend Letter for Doctors & Patients, August/September 2002

[25] “Chronic Organophosphate Induced Neuropsychiatric Disorder (COPIND): Results of Two Postal Questionnaire Surveys.” Davies, D.R., MBBS; Ahmed, G.M., MBBS; and T. Freer MBChB MRCPsych. Journal of Nutritional & Environmental Medicine, (1999), 9, p123-134

[26] “Long Term Health Effects of Low Dose Exposure to Nerve Agent.” Moore, David H. J. Physiology (Paris), 1998, 92, 325-328

[27] “The Soldier’s Exposure to Toxic Substances.” Review by Katherine Duff of book: Gulf War Syndrome: Legacy of a Perfect War by Allison Johnson. Townsend Letter for Doctors & Patients, August/September 2002

[28] “DoD NewsBriefing.” Lt. Gen. Dale Vesser (Ret.), Thursday, November 5, 1998. Retrieved from website: www.defenselink.mil/news/Nov1998/t11091998_t1105gwi.html on April 26, 2003

[29] “DoD Assesses Marines’ Injuries Unlikely Due to Chemical Warfare Agent Exposure.” Gates, Lisa A. Gulflink, May 31, 2001. Retrieved from website: www.gulflink.osd.mil/news/na_2d_recon_31mar01.html on April 15, 2003

[30] “Environmental Exposure Report: Pesticides, Final Report.” Winkenwerder Jr., William, MD. US Department of Defense, April 17, 2003. Retrieved from website: www.gulflink.osd.mil/pest-final/index.html on April 30, 2003.

[31] “Diagnosis and Treatment of Chronic Mycoplasmal Infections in Fibromyalgia and Chronic Fatigue Syndromes: Relationships to Gulf War Illness.” Nicolson, Garth L., Nasralla, Marwan, Haier, Joerg, Nicolson, Nancy L. BioMedical Therapy. Oct 98, V. 16 (4)

[32] “Gulf War Syndrome: a Phantom Illness.” Whelan, Elizabeth M. Priorities for Health, sep 95, V. 7 (3)

[33] “Gulf War Syndrome: a Phantom Illness.” Whelan, Elizabeth M. Priorities for Health, sep 95, V. 7 (3)

[34] “A Case of Chloroquine Toxicity.” Schaffer, Rodney. Journal of the American Institute of Homeopathy, Dec 95, V. 88 (4)

[35] “A Holistic Treatment Approach: Gulf War Syndrome; One Soldier’s Story.” Sullivan, James, Massage & Bodywork, Dec 98/Jan 99, V. 13 (4)

[36] “The Nicolsons Update Gulf War Illness Plague, Say Antibiotic/Metabolic Regimes Work.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 98, V. 2 (3/4)

[37] “Behind an International Scandal: ‘Gulf War Biological Weapons Killing Thousands, Sickening Millions; World Governments Remain Mute’.” Culbert, Michael, L. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

[38] “A Holistic Treatment Approach: Gulf War Syndrome; One Soldier’s Story.” Sullivan, James, Massage & Bodywork, Dec 98/Jan 99, V. 13 (4)

[39] “DoD NewsBriefing.” Dr. Stephen Joseph, ASD, Health Affairs, Tuesday, August 1, 1995. Retrieved from website: www.defenselink.mil/news/Aug1995/t080195_t801jos.html on April 12, 2003

[40] “The Nicolsons’ Testimony Before the US Congress.” Nicolson, Garth L., Nicolson, Nancy L. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

[41] Behind an International Scandal: ‘Gulf War Biological Weapons Killing Thousands, Sickening Millions; World Governments Remain Mute’.” Culbert, Michael, L. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

[42] “Pentagon Denies Use of Compounds.” Rodriguez, Paul M. The Washington Times, August 15, 1997, sec. A, Ed. 2, p A3

[43] “Ball’s in Your Court Now, DoD.” Rodriguez, Paul M., and Michael Rust. The Washington Times, February 21, 2000, sec. NEWS ALERT, Ed. V. 16 (7), p 6

[44] “Sickness and Secrecy.” Rodriguez, Paul, M. The Washington Times, August 25, 1997, sec. Investigative cover Story, Ed. V. 13 (31), p 8

[45] “GWI Dirty Work at the (Internet) Crossroads.” No author given. International Council for Health Freedom Newsletter, Fall/Winter 97, V. 1 (3/4)

[46] “Anthrax Shots Continue; Troops Balking.” No author given. International Council for Health Freedom Newsletter, Summer 2000, V. 4 (3)

[47] “VA Cuts Some Veterans’ Access to Health Care.” Walsh, Edward. Washington Post, January 17, 2003, p. A21

[48] “Veterans up in arms over Proposed Cuts.” McCabe, Kathy. Globe North, April 24, 2003

[49] “Comforting Survivors: Priority One for Casualty Assistance Officers.” Gilmore, Gerry J., American Forces Press Service. Retrieved from website: www.defenselink.mil/news/Mar2003/n03262003_200303268.html on April 15, 2003

[50] “The Vietnam Conflict: ‘America’s Best Documented War’?” Shaughnessy, C. A. The History Teacher, Feb 1991, V. 24 (2), p 135-47