NRC (National Research Council). 2000. Strategies to Protect the Health of Deployed U.S. Forces: Analytical Framework for Assessing Risks. Washington, DC: National Academy Press. PL 105-85 Sec. 765. National Defense Authorization Act of 1998. Improved medical tracking system for members deployed overseas in contingency or combat operations. 11 Mr. SHAYS. Thank you, Dr. Feinleib. Mr. Robinson. Mr. ROBINSON. Mr. Chairman, the National Gulf War Resource Center thanks you for this hearing and all the hearings that you've conducted to get to the bottom of what has been very troublesome for people who served in the last Gulf war. Why is this hearing important? It's important because I and others in this room have family members within striking distance of Saddam's chemical and biological weapons right at this moment. It's important because it's been a personal experience for Gulf war veterans. It's important because it matters, and it's important because a lack of that has prevented meaningful research and prevented scientists from interpreting what really happened on the battlefield. You don't walk up to your F-16 in the morning and ask it how is it doing. You put your hands on it. You look at the internal mechanisms that control its flight. You make sure it has enough gas. You do what you have to do to ensure that that system will perform. Public laws that were specifically designed to protect soldiers on the battlefield are currently being ignored, thereby setting a stage for mystery illnesses to again present themselves after a war. Unfortunately, the results of force health protection, as described by the Department of Defense, have been utterly disappointing. These shortfalls demonstrate a lack of willingness to follow the intent of Congress and the public law. Understanding the lessons from medical mistakes made more than 12 years ago, it's important for us to ensure that these mistakes are not made on a new generation of veterans. Recently the Institute of Medicine completed its review of pesticides and solvents used in the first Gulf war, and one of the conclusions the committee made was that lack of data prevented them from linking exposures of the war to the illnesses that veterans suffer from. And as the IOM began its next round investigations into oil well fires and chemical compounds, they are keenly aware that there's also a lack of data on these types of exposures. We can safely predict that they may reach the same conclusion, because the baseline data was never considered and the post-exposure data was never collected. It's important also to note that the reports from the IOM are used by the Department of Veterans Affairs to make conclusions on whether or not illnesses are service-connected to wartime-related exposures. Briefly I'd like to talk about what we are aware of in terms of what has been implemented and what is not being implemented in terms of the public law. The Department has standardized methods for identifying medical threats and appropriate countermeasures prior to deployment. They've also incorporated planning efforts into the early stages that continue throughout the deployment. They also use surveillance teams to monitor the environment and chemical-biological weapons exposures. These things are lessons learned from the first Gulf war. What they're not doing and what is the meat of why we are here today is that they are not conducting medical screening and analy sis, both pre and postdeployment. Congress passed Public Law 105-85 in 1998 as part of the defense authorization bill at a time when veterans were experiencing various illnesses. The reason Congress passed this law was so that physicians could monitor changes over time, particularly during and after the deployment. This law also called for the drawing of blood samples, significant medical recordkeeping, and an examination of the soldiers's mental health before and after the conflict. Instead of following the letter of the law in a meaningful way that will produce scientifically valuable evidence, the Department of Defense and the people responsible for force health protection are interpreting the law so that it creates a deceptive compliance. This half-hearted evidence will produce similar results that have prevented the Institute of Medicine from reaching conclusions from the last Gulf war. The Director of the Deployment Health Support Directorate is charged by this law to implement the lessons learned, and DOD is not following the law. I will now describe what we understand is the current status of affairs for force health protection. In the predeployment phase, the Department is not conducting hands-on physicals to determine the health status of the force before deployment, as required by law. Instead, they give out a questionnaire. A DOD quote from a recent congressional inquiry described its own questionnaire as follows: These forms contain a limited amount of information. They do provide a means to document health status before and after deployment and afford the deployed service member the opportunity to have deployment-related health concerns addressed. More significantly in the predeployment phase, the Department is not drawing blood samples from the entire force prior to the deployment, as required by law. Instead, the Department relies on serum collection for HIV testing. This serum could be anywhere from 1 to 3 years old and will not be a snapshot of the soldier's current predeployment health condition. Every scientist from the IOM agrees that predeployment and postdeployment surveillance is the key to understanding illnesses on the battlefield after wars. More data is preferred over less data. The current activities of DOD and health monitoring in the postdeployment phase are that the Department is not conducting mental and physical evaluations after deployment, as required by law. Instead, the DOD hands the soldiers a questionnaire. The survey, as demonstrated by the testimony of the gentleman to my right, is inadequate and does nothing to satisfy the requirements of the law or provide meaningful information. Additionally, the lack of mental screening has been demonstrated as problematic. Soldiers recently who served in Afghanistan were sent directly home without any medical assessments. Some of these soldiers committed horrible crimes that may have been related to combat stresses. Had the public law been followed, perhaps a terrible tragedy might have been averted. In the postdeployment phase, the Department is not drawing blood samples from the force after the deployment as required by law. Instead, they rely on the serum collection for HIV. This serum collection can be old and will not be a snapshot of what has recently occurred on the battlefield. Because the Department is again failing to collect the baseline data, veterans will not be able to meet the burden of proof required by the Department of Veterans Affairs for treatment. This mistake is precisely what created the controversy surrounding Gulf war illnesses. Service members are being set up to face another round of delays, denials and obstructions. This prospect is unacceptable and must be corrected. The current medical practices of DOD are all half-hearted, and they are a public disaster waiting to happen. Since forces are actively engaged in combat, we have missed the opportunity to conduct baseline predeployment screening. Mr. Chairman, I humbly request that we implore, demand and make the Department collect the postdeployment data so that we will not face another round of unanswered questions. In the military that I served in, there were consequences for failure to obey orders, and anything less than 100 percent effort was unacceptable. We were not allowed to interpret the intent of orders but rather to obey them implicitly. These core values do not seem to work both ways. Veterans will be the ones who will suffer the consequences of the poor implementation of this law, and veterans will be the ones who face another fight because of the lack of data. I hope that those responsible for the implementation of this law will understand that their failures are going to impact the lives and well-being of soldiers returning from this conflict. Mr. Chairman, I would like to know who we may hold accountable, and I humbly request that we find out immediately. Thank you. [The prepared statement of Mr. Robinson follows:] |