Q: Is the government taking the right approach toward Gulf War illness?

0 Comments | Insight on the News, Jan 27, 1997 | by Kenneth W. Kizer, | Garth L. Nicolson

Yes: the VA responded quickly to the first reports of illness and is giving vets the treatment they deserve.

For some veterans, the Persian Gulf War is not over. Shortly after returning from the Persian Gulf War in 1991, veterans began to report a variety of symptoms and illnesses. In preparation for the expected needs of our latest wartime heroes, the Department of Veterans Affairs, or VA, immediately began to develop its Persian Gulf programs even before the war had ended. The first component of the previous administration's comprehensive gulf-war response was the establishment of a health-care program, the VA Persian Gulf Registry Health Examination. The registry was developed in 1991 and implemented in 1992. Persian Gulf health programs in the early days after the war already were being given high priority and attention. No headlines, no fanfare, just thousands of dedicated health-care professionals mobilizing to provide the care and services gulf-war veterans had earned.

When I joined the department as under secretary for health in 1994, VA already had a well-established set of programs to respond to the illnesses some Persian Gulf veterans were reporting. Since that time, VA has worked continuously to improve and expand its Persian Gulf programs to encompass a comprehensive, four-pronged approach, addressing relevant medical care, research, compensation, outreach and educational issues. VA provides health examinations at each of its medical facilities, specialized Persian Gulf Referral Center evaluations at four regional centers, readjustment and sexual-trauma counseling and special health-care eligibility nationwide for gulf-war veterans. To date, more than 62,000 such veterans have completed registry examinations, almost 187,000 have been seen in VA ambulatory-care clinics and more than 18,000 have been hospitalized at VA medical facilities.

Gulf-war veterans participating in the registry examination commonly have reported that they suffer from a diverse group of symptoms including fatigue, skin rash, headache, muscle and joint pain, memory problems, shortness of breath sleep disturbances, gastroin-testinal symptoms and chest pain. Note that 12 percent of the VA registry participants had no current health complaints but wished to participate in the examination because they were concerned about their future health as a consequence of their service in the war. While 26 percent of the group rated their health as "poor," 73 percent reported their health as "all right" to "very good." This examination program was established to assist veterans' entry into the continuum of VA health care and all gulf-war veterans, symptomatic or asymptomatic, are encouraged to get a registry examination. Furthermore, if gulf-war veterans have health problems that they believe may be related to an exposure that occurred during gulf service, they are eligible for outpatient and inpatient care at VA medical facilities at no cost to them.

In spite of the public perception that the illnesses of gulfwar veterans constitute a "syndrome," we have learned that the illnesses span a range of medical diagnoses but do not cluster in one organ system or disease category While some symptoms of gulf-war veterans are difficult to diagnose and remain unexplained, there is growing consensus among government and nongovernment medical experts that current evidence does not support the existence of a single disease process--that is, the variety of symptoms and organ systems affected means that these illnesses do not meet the medical definition of a syndrome. Recently published research also has shown that gulf-war veterans are not suffering from life-threatening medical conditions at higher rates or being hospitalized at higher rates than their nondeployed counterparts.

Does this mean that there is no problem and that gulfwar veterans' concerns have been dismissed or ignored by VA? The answer is a resounding no!

Statements about the lack of a gulf-war syndrome in no way should be misconstrued or taken to mean that we do not believe our gulf-war veterans are ill and are suffering. We do believe that our gulf-war veterans who seek care in our system are suffering from genuine illnesses and VA has set up medical programs for diagnosis and treatment, compensation programs for those disabled and research programs to better understand what has caused these illnesses.

Gulf-war veterans with chronic disability from a diagnosed or an undiagnosed medical condition may be eligible for disability compensation. More information about health care and compensation programs can be obtained by calling VA's national toll-free Persian Gulf Helpline at 1-800-PGW-VETS. I urge all who served to call us if they are concerned or need help.

VA's timely and well-orchestrated response to gulf-war veterans belies the rhetoric of some editorials, attention-grabbing headlines and congressional hearings related to the recent Defense Department announcements concerning troop exposures to chemical warfare nerve agents. The efforts have received the highest-level attention: The president and first lady met personally with gulf-war veterans, their families and veterans' service organizations to hear their concerns.