Statement by Dr. Bernard Rostker, Special Assistant to the
Deputy Secretary of Defense for Gulf War Illness
Before the House Veterans Affairs Committee
11 February 1997
Before the House National Security Committee
11 February 1997

Mr. Chairman. Thank you for the opportunity to appear before this committee. As you know, the Deputy Secretary of Defense, Dr. John White, appointed me Special Assistant for Gulf War Illnesses on November 12, 1996. The action was part of a broader set of initiatives undertaken on September 28, 1996, to assess the Department of Defense's Gulf War Illnesses program in view of recent events, to include the reports that soldiers may have been exposed to chemical agents during the destruction of the storage site at Khamisiyah.

As the Special Assistant, my first priority is the health and welfare of our Gulf War veterans. In this capacity, I serve as the DOD coordinator for all issues relating to Gulf War. I see the Gulf War Illnesses mission has three parts. First, to ensure that all who served in the Gulf War receive appropriate medical care; second, that DOD does its part to ensure that we conduct a complete and thorough investigation to determine why so many of our veterans are ill; and third, to apply our findings to future deployments.

Two vital aspects of this mission are to ensure that we learn everything possible about the potential causes of illnesses, including events during and after the Gulf War, and to promote improved communication with Gulf War veterans on the relevant health care issues. This endeavor is critical because we have a moral duty to our veterans and to those who serve now. Therefore, we must understand what is making our people sick so that we can make the changes necessary to protect our people in the future. Our efforts here must have long-term effect. We must ensure that DOD puts into place all required military doctrine, personnel and medical policies, procedures and equipment to prevent future recurrence of the problem and we must work cooperatively with VA to coordinate all issues critical to their program responsibilities.

The guidance from President Clinton is clear: "I want to assure all of you that we will leave no stone unturned in our efforts to investigate Gulf War Illnesses, and to provide our Gulf War veterans with the medical care they need. There are mysteries still unanswered and we must do more." I will make it my business to leave no stone unturned.

To carry out this important task entrusted to me by the Deputy Secretary of Defense, I have expanded by an order of magnitude the Department of Defense's investigation organization. The original team of 12 has been subsumed by a larger, more focused organization and I have completely revamped the way we do business. We are ensuring we have the investigators and analysts necessary to fully review currently known exposures, and I have the authority to search out and pursue reports of any new incidents.

My expanded efforts build on earlier work by refocusing and substantially increasing the level of commitment. Much of that increase is to examine incidents which occurred during the Gulf War, the hazardous exposure that may have resulted from these incidents, and the broader implications of such incidents. Working with VA, we are doing this by communicating with veterans concerned in these incidents in 1991, including those veterans who are on active duty, who serve in the Reserve or National Guard, and those who have returned to full-time civilian life.

I have expanded into new areas to initiate a pro-active, risk communication strategy with the two-way communications between DOD, the VA and the Gulf War veterans as recommended by the Presidential Advisory Committee on Gulf War Veterans� Illnesses (PAC). Today, when a veteran calls our telephone hotline to offer information, the veteran receives a follow-up call and is interviewed by a trained investigator who ensures that information is incorporated into our case files. We are making significant strides in eliminating our backlog in all types of correspondence and in callbacks to our veterans. These calls not only provide an in-depth debrief, but for the future, establish a dialog between a single point of contact in my office and the reporting Gulf War veteran.

The process involves the veteran in the investigative process in a significant and meaningful way. Their information becomes an essential part of the case management process. It is recorded and forwarded to an investigator for analysis, which becomes part of a larger picture as we examine the many incidents and theories associated with Gulf War illnesses. It also serves as a springboard for veteran outreach. The responses from the veterans have been extremely positive.

We are also placing email capability on our GulfLINK website which will enable us to be even more responsive to the concerns of our veterans and to more easily involve them in the investigative process. All of these actions contribute to increasing our understanding.

We also collaborate very closely with veterans service organizations (VSO) to increase their knowledge about potential exposure during the Gulf War. For example, on December 11, 1996 we hosted the VSOs at a demonstration of the protective gear and chemical equipment used during the Gulf War, particularly the M8 alarm, 256 test kits and the FOX chemical reconnaissance vehicle. They appreciated the opportunity to become more familiar with the equipment that has often been described in the media and was the subject of Congressional Debate. Additionally, on January 30, 1997, we hosted a briefing and tour for VSOs of our new office complex and call back operation, which allowed them the opportunity to see how our organization is functioning.

We have also formalized the structure for our incident investigations. We are now preparing a series of narratives that summarize what we know about such incidents as Khamisiyah, the Marine breaching operation, operational logs, Fox alarms, pyridostigmine bromide (PB) tablets, and every other issue under investigation. These narratives will be a status report to the American people of what we know, when we knew it, and what actions we plan to take. As we prepare these narratives, they not only show us what we know, but they also, and perhaps more importantly, reveal what we don�t know, allowing us to focus our investigative efforts. The first case narrative will cover the events at Khamisiyah and it will be available in the near future. I expect this process will facilitate addressal of the concerns of Gulf War veterans and their families.

The expansion of my office has also allowed us to broaden our focus on possible causes of Gulf War illnesses. For example, we are beginning to devote more resources to the investigation of possible environmental causes, such as pesticides and insecticides. As we reconstruct the events that occurred during the Gulf War, we will look closely at our doctrine, policies and procedures. Was our doctrine adequate? Were our policies and procedures correct? If our doctrine, policies and procedures were correct, then did we follow them? If incorrect, what changes need to be made? We must be completely open-minded in our analysis and make the requisite changes based on these lessons learned.

We are building on the major health program initiated by the Department of Defense to care for those still on active duty or otherwise eligible for DOD care. A Comprehensive Clinical Evaluation Program (CCEP) was established to provide in-depth evaluations of health concerns of Gulf War veterans who are on active duty or serve in the Reserve or National Guard. We have asked all personnel who want to be evaluated to contact the program to schedule an appointment for a medical evaluation. To date, more than 38,000 Gulf War veterans are registered and of those, 30,000 veterans have requested a medical examination. Also, as reported by Dr. Kizer, the Department of Veterans Affairs has completed exams for 63,000-plus veterans. We will coordinate our efforts with VA as appropriate.

As you may know, last month, I withdrew the DOD staff paper published on the GulfLINK home page which discounts low-level exposure as the cause for Gulf War illnesses. In doing this, I noted that the PAC concluded, and current scientific evidence does not support, a causal link between low-level chemical exposures and undiagnosed Gulf War illnesses. However, the PAC also recommended that additional research is warranted. We concur in this assessment and plan to fund the appropriate research. I approach this subject with a completely open mind. Our research agenda is clear evidence of this. Again, we will coordinate this research program with HHS and VA through the established Persian Gulf Veterans Advisory Board.

In addition to forming my organization, the Deputy Secretary of Defense generated a number of other important initiatives. In the area of research, the DOD has committed to spend $12M to study a wide range of medical issues related to the Gulf War. Further, the DOD is prepared to spend another $15M to study the long-term effects of chemical and other hazardous exposures, including low-level chemical exposure.

Dr. White also initiated a review by the Institute of Medicine of the DOD clinical health examination protocols in light of the possibility of chemical exposure; a review by the Army Inspector General of military operations at Khamisiyah; and a review by the Assistant to the Secretary of Defense for Intelligence Oversight of the circumstances surrounding the handling of intelligence data concerning Khamisiyah and similar facilities.

Further, Dr. White requested that the National Academy of Sciences provide a mechanism for oversight to meet the President's call for an independent, open, and comprehensive examination of health-related issues and assessment of the multiple issues related to the protection of our forces. The National Academy has deferred now that the PAC has been extended and the PAC is providing oversight of the investigation into low-level chemical exposure events and monitoring of government-wide implementation of its recommendations.

As our investigations and analyses expand and continue, we expect to find new and more complete information. As new information becomes available, it will be provided to you in Congress, to the Presidential Advisory Committee and the American public. You have my assurance that we will continue to disclose fully everything we find, everything we are doing, everything we learn. Our findings will be published on our Internet web site, GulfLINK, for public scrutiny. We welcome this oversight.

In conclusion, we are whole-heartedly committed to finding out everything we can about any factor impacting Gulf War illnesses. This is absolutely necessary, not only because it is right for our veterans, but also because it is imperative for the future safety of our troops. The results of our collective effort will be a better understanding of the illnesses facing our Gulf War veterans, a better way of caring for our troops and their families, and new strategies for protecting our troops in the future. Thank you.

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