The Persian Gulf War ended almost eight years ago and some veterans say they've become sick as a result of their service. But no one agrees as to how or why.
In 1990 and 1991, almost 700,000 American soldiers were sent to the Persian Gulf to defend and free an invaded Kuwait from Iraqi occupation. The Gulf War itself lasted only about six weeks, beginning mid-January 1991 and ending at the end of February. Iraq was eventually forced out of Kuwait and relatively few allied casualties were reported. Veterans came home victorious and proud. It was a good war. They had fought for democracy and won.
However, shortly after coming home, veterans began experiencing a host of symptoms that they couldn't explain. Many of the complaints were of a nonspecific nature: night-sweats, fatigue, skin rashes, muscle and joint pain, headache, shortness of breath, loss of memory, and gastrointestinal problems.
Mysteriously, most of the health problems reported come from American veterans. While allied troops included representations from Canada, Britain, France, Czechoslovakia, and several Arab countries, relatively few cases have been reported amongst these troops in comparison with the Americans.
In 1992, in response to the growing list of American veterans who were claiming to be ill, both the Department of Veterans Affairs and the Department of Defense set up health care registries - respectively called the Persian Gulf Registry and the Conference of Clinical Evaluations Program. Of the almost 700,000 American soldiers who served, approximately 100,000 signed up. And of those that registered, approximately one-quarter had symptoms with no readily available explanation.
Veterans claim that their illnesses are a result of military service. Some say that their spouses, children, and health care workers have become sick too. These claims provoked the scientific community to take action. Yet, despite a plethora of scientific studies, there is still no agreement on the cause of what has been called gulf war syndrome.
In fact, even the term "gulf war syndrome" has engendered debate. Dr. Richard Miller, Director of the Medical Follow-up Agency at the Institute of Medicine, has noted that his agency supports use of the term "unexplained illnesses" (UI) rather than "gulf war syndrome" (GWS). The reason for this can be found in a 1996 Institute of Medicine report, Health Consequences of Service During the Persian Gulf War: Recommendations for Research and Information Systems, which stated that "at this time, although studies of Gulf War veterans suggest that these veterans suffer from a variety of recognized diseases, such studies do not establish the existence of a new disease."
Psychological versus physical factors
There are almost as many theories for the cause of these unexplained illnesses as there are symptoms. Soldiers were exposed to a variety of potentially hazardous conditions from burning oil wells to the very fine particulate sand that is specific to the Gulf region. However, chief among the theories behind the cause(s) of gulf war illness are: physical symptoms brought about by the psychological effects of combat stress; potential exposure to chemical weapons; the use of depleted uranium bullets; a self-administered, pre-treatment drug called pyridostigmine bromide to combat poisoning in the event of chemical warfare; and the administration of various vaccines.
Since the American civil war, military officials have been aware of the psychological after-effects of military service. What is now called post-traumatic stress disorder (PTSD) has earlier been called shell-shock, battle fatigue, and war trauma. PTSD is thought to be brought on by a particularly stressful event beyond ordinary life experiences and is manifest in a variety of physical ailments. Military and government-sponsored research generally leans towards PTSD as the primary cause of Gulf War veterans' illnesses.
Some researchers adamantly disagree. Dr. Robert W. Haley, an epidemiologist at the University of Texas Southwestern Medical Center at Dallas, has published his findings in several well-known medical journals including the Journal of the American Medical Association. He criticizes research that claims Gulf War illnesses are purely psychological in origin. His research suggests that "Gulf War veterans are not generally suffering from PTSD." Of course, for every researcher that agrees with his conclusions, there is another to offer a dispute.
Chemical exposure and Medication
Veterans also believe their physical ailments are the result of more than psychological fall-out. They believe that they were exposed to something besides trauma. Only recently has the government admitted to the possibility that troops may have been exposed to chemical weapons. In March 1991, shortly after the war had ended, allied troops blew up an Iraqi munitions depot at Khamisiyah. At the time, it was not believed to house chemical weapons. However, in October 1991, UN inspectors found the site contaminated with the chemical agent sarin. It is now conceded that 100,000 allied troops were exposed to the toxic plume that resulted from the explosion. While not all those exposed are now sick, that chemical exposure occurred is now a fact.
Another potential source of illness in veterans is the use of depleted uranium (DU) bullets. DU bullets are very dense and are therefore used because they are able to pierce the armor of tanks. Because depleted uranium had never been used in actual combat before the Gulf War, its health effects are relatively unknown. While its radioactive properties are vastly reduced, uranium is itself toxic to the kidneys. University of Western Ontario toxicologist Dr. George Cherian has served as a consultant for the United States National Institutes of Health in reviewing grant proposals for Gulf War research. He says that a lot more "friendly fire" (fire from your own side) took place than the public has been led to believe and that the effects of depleted uranium on allied troops is therefore underestimated.
The use of pyridostigmine bromide (PB) is another factor. PB tablets were given to troops for self-administration in the event of chemical warfare. Although it is considered safe at the doses recommended, it is not clear whether or not troops may have taken more PB than was called for. In addition, troops were not screened for conditions contraindicated to the use of PB, such as asthma, peptic ulcer, and kidney or liver disease.
The army's vaccination program has also been questioned. Because the program was considered secret, there have been concerns that many vaccines were given without consent or without approval by the Food and Drug Administration. To confound the issue is the fact that not all troops received all vaccinations and no complete records exist as to who got what.
The list of potential hazards that Gulf War veterans were exposed to is almost as long as the list of symptoms themselves. Complicating the issue are the unknown consequences of interactions that might have arisen as a result of more than one particular exposure.
Dr. Robert Roswell is executive director of the Persian Gulf Veterans Coordinating Board. At a conference on Federally Sponsored Gulf War Veterans' Illnesses Research he said that "because of the complex interplay between physical and psychological factors coupled with all of the difficulties associated with this, we probably will never have a complete and thorough understanding of the problems associated with the Gulf War efforts." University of Western Ontario professor Tim Blackmore, an expert on war and trauma, believes this kind of statement is an effort in self-preservation. The government's admission to any liability in Gulf War illnesses would be an expensive statement. "What [the government] can see coming is a massive group action suit that would parallel the Dow Corning suit."
Professor Blackmore believes that the truth will come out eventually. The government's recent admission that soldiers were exposed to chemical weapons at Khamisiyah is a case in point. Others are following.
At this year's annual conference of the American College of Chest Physicians (ACCP), researchers presented results of a study supporting evidence of respiratory impairment in veterans who served in the Persian Gulf War.
Dr. Ossama Ikladios of the Brooklyn Veterans Affairs Medical Center presented the results of his study comparing lung function between Gulf War veterans with a control group of Department of Defense recruits. The results of his research indicate that Gulf War veterans had a significantly lower lung function capacity than other recruits. He believes that this is "objective evidence of respiratory impairment" in Gulf War veterans.
Professor Blackmore sees this as a sign. "To have someone come out and say that we have physical proof that [gulf war illness] is not brought on by PTSD is the first chink in the armor about what we've been told about the Gulf War. This is the beginning of it. It's going to come out in a piecemeal fashion, a paper here and a paper there, until the evidence mounts and these guys get really sick and the government will have to admit to something."
Susan Jagminas is currently studying toward her Master's degree in Journalism at the University of Western Ontario.