Pentagon evaluating overseas troops' medical needs: with memories of the Persian Gulf War all too fresh, the Pentagon has taken measures to ensure that this time there will be no mystery ailments

VFW Magazine, Sept, 2003 by Janie Blankenship

As service members return home from the Iraq War, images of the Persian Gulf War 12 years ago come to mind. Chronic unexplained ailments affecting a significant number of vets from the Persian Gulf are likely to be on the minds of this new generation of returning troops.

To avoid what some have coined "Gulf War Syndrome II," the Pentagon has ordered health screenings for every U.S. service member deployed for the Iraq War.

Within 30 days of coming home, everyone will fill out a detailed health questionnaire, review it with a health provider and give a blood sample that will be kept in a repository in case the person later develops mysterious symptoms.

This move was brought on by criticism from Congress and veterans organizations that say health screenings were inadequate during the Gulf War.

Congress pointed out in March that Pentagon officials were not complying with Public Law 105-85. Enacted in 1998, it requires the military to collect health data on troops before and after deployment to war.

A concept known as "Force Health Protection" was put into place in 1999 during the Kosovo intervention. A computerized system to track treatment overseas has been under way in Afghanistan since October 2001. To date, the electronic medical records of 11,600 GIs have been collected.

Additionally, Sen. John Kerry (D-Mass.) requested that the General Accounting Office (GAO) investigate the allegations against the Defense Department.

The VA Subcommittee on Oversight Hearings and Investigations held a hearing in July to review pre- and post-deployment medical protection measures during the Iraq War.

According to GAO's Marjorie Kanof, the Army has not complied with regulations to monitor the medical and dental status of early-deploying reservists, specifically.

"Consequently, the Army does not know how many of them can perform their assigned duties and are ready for deployment," she said at the hearing.

Dr. William Winkenwerder, Jr., assistant secretary of defense for health affairs, provided a few options for National Guard and Reserve personnel. He said they can be retained on active duty and referred to DoD facilities for further evaluation. Or, he said, they could be released from active duty upon their return to the states with arrangements made for a follow-up medical evaluation.

While some evaluations have already reached Winkenwerder's office, he says it's "much too early to establish definitive findings."

Ultimately, most parties feel this is a step in the right direction.

"This is a lesson learned from the Persian Gulf War on undiagnosed illnesses," said Bill Bradshaw, director of VFW's National Veterans Service. "Now there will be strong medical evidence to compare the health status of an active-duty member in order to better evaluate the consequences of future deploying forces."

Additionally, VFW's Res. 613 calls for Congress to adequately fund appropriate medical research to find the root of Gulf War ailments.

"People will come back with symptoms, of course, and they will believe they are related to the Gulf," VA Secretary Anthony Principi told the New York Times. "But I believe we will be able to find answers. Was it the vaccine? Was it low levels of exposure to chemical or biological agents?"

The idea of the pre- and post-blood samples is to compare them if an illness later develops. Until April, the only pre-deployment requirement was that each service member must have had HIV testing in the last 12 months. That sample is kept on file and can be compared to the post-deployment one. Now, blood is drawn specifically for potential comparison testing.

"Without reliable baseline data, a sick veteran of this war may face the same doubts and resistance as his or her Desert Storm compatriots that post-war illnesses were in fact caused by wartime exposures," said Rep. Christopher Shays (R-Conn.), chairman of the House Government Reform, National Security, Veterans Affairs and International Relations Subcommittee. "This post 30-day serum sample will provide solid clinical and epidemiological information about the health of deployed forces."

Getting To the Root of the Problems

In order to get accurate screenings, returning service members need to provide the most detailed information possible. The former post-deployment questionnaire contained only six general questions and left much to interpretation.

The new five-page post-deployment health questionnaire--implemented May 22--asks 18 detailed questions. They touch on whether service members' health changed during deployment; which vaccines they received; whether they took anti-malaria pills or pills to stay awake or used specific nerve-gas antidotes; and environmental exposures they may have encountered, such as insecticides, smoke, fuels, solvents, excessive vibration, sand or depleted uranium.

The questionnaire also delves into mental health, asking whether troops saw anyone wounded, killed or dead and if so, whether they were American/British troops, enemy forces or civilians.

"For someone who saw a friend killed--or killed someone--it's hard to imagine what that must be like," said Col. Paula K. Underwood, chief of the medical staff at Ft. Stewart's hospital in Georgia, home of the 3rd Infantry Division. "It is a life-altering experience."