U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON : 

For sale by the Superintendent of Documents, U.S. Government Printing Office

Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800

Fax: (202) 512–2250 Mail: Stop SSOP, Washington, DC 20402–0001

83–281 PDF 2002

S. HRG. 107–792

MILITARY EXPOSURES: THE CONTINUING

CHALLENGES OF CARE AND COMPENSATION

HEARING

BEFORE THE

COMMITTEE ON VETERANS’ AFFAIRS

UNITED STATES SENATE

ONE HUNDRED SEVENTH CONGRESS

SECOND SESSION

JULY 10, 2002

Printed for the use of the Committee on Veterans’ Affairs

(
COMMITTEE ON VETERANS’ AFFAIRS

JOHN D. ROCKEFELLER IV, West Virginia, Chairman

BOB GRAHAM, Florida

JAMES M. JEFFORDS (I), Vermont

DANIEL K. AKAKA, Hawaii

PAUL WELLSTONE, Minnesota

PATTY MURRAY, Washington

ZELL MILLER, Georgia

E. BENJAMIN NELSON, Nebraska

ARLEN SPECTER, Pennsylvania

STROM THURMOND, South Carolina

FRANK H. MURKOWSKI, Alaska

BEN NIGHTHORSE CAMPBELL, Colorado

LARRY E. CRAIG, Idaho

TIM HUTCHINSON, Arkansas

KAY BAILEY HUTCHISON, Texas

MARY J. SCHOELEN, Deputy Staff Director, Benefits Programs/General Counsel

WILLIAM F. TUERK, Minority Chief Counsel and Staff Director

(II)
CONTENTS

JULY 10, 2002

SENATORS

Page

Nelson, Hon. Bill, U.S. Senator from Florida, prepared statement ..................... 4

Rockefeller Hon. John D., IV, U.S. Senator from West Virginia, prepared

statement .............................................................................................................. 8

Specter, Hon. Arlen, U.S. Senator from Pennsylvania, prepared statement ...... 1

WITNESSES

Cole, Leonard A., Ph.D., Adjunct Professor, Department of Political Science,

Rutgers University, Newark, NJ ........................................................................ 55

Prepared statement .......................................................................................... 57

Cooper, Hon. Daniel L., Under Secretary for Benefits, Department of Veterans Affairs; accompanied by Robert Epley, Associate Deputy Under Secretary for Policy and Program Management, Veterans Benefits Administration, and Susan Mather, M.D., Chief Officer, Public Health and Environmental Hazards .................................................................................................... 9

Prepared statement .......................................................................................... 11

Schwartz, Linda Spoonster, Chair, VVA Healthcare Committee, Vietnam Veterans of America, joint prepared statement ...................................................... 42

Smithson, Steven R., Assistant Director, National Veterans Affairs and Rehabilitation Commission, The American Legion .................................................... 50

Prepared statement .......................................................................................... 52

Weidman, Richard F., Director of Government Relations, Vietnam Veterans

of America; accompanied by Linda Spoonster Schwartz, Ph.D., Chair, Vietnam Veterans of America Healthcare Committee ............................................. 39

Joint prepared statement ................................................................................. 42

Winkenwerder, William, M.D., Assistant Secretary for Health Affairs, U.S.

Department of Defense; accompanied by Ellen Embrey, Deputy Assistant

Secretary for Defense for Force Health Protection and Readiness, and Michael E. Kilpatrick, M.D., Director, Deployment Support, Force Health Protection and Readiness .......................................................................................... 14

Prepared statement .......................................................................................... 16

APPENDIX

Campbell, Hon. Ben Nighthorse, U.S. Senator from Colorado, prepared statement ...................................................................................................................... 61

Hayden, Paul A., Deputy Director, National Legislative Service, Veterans

of Foreign Wars of the United States, prepared statement .............................. 70

Ilem, Joy J., Assistant National Legislative Director, Disabled American Veterans, prepared statement .................................................................................. 61

Love, Kirt P., President, Desert Storm Battle Registry, joint prepared statement ...................................................................................................................... 64

Lyons, Paul, President, Desert Storm Justice Foundation, joint prepared

statement .............................................................................................................. 64

National Gulf War Resource Center, prepared statement ................................... 66

Wolf, Dannie, President, American Veteran Justice Foundation, joint prepared statement ................................................................................................... 64

(III)

(1)

MILITARY EXPOSURES: THE CONTINUING

CHALLENGES OF CARE AND COMPENSATION

WEDNESDAY, JULY 10, 2002

U.S. SENATE,

COMMITTEE ON VETERANS’ AFFAIRS,

Washington, DC.

The committee met, pursuant to notice, at 9:42 a.m., in room SR–

418, Russell Senate Office Building, Hon. Arlen Specter, presiding.

Present: Senators Rockefeller, Wellstone, Nelson, and Specter.

Also present: Senator Nelson of Florida.

Senator SPECTER [presiding]. Good morning, ladies and gentlemen. Senator Rockefeller, who is en route, has asked that I begin

these proceedings.

This morning the Committee on Veterans’ Affairs will hold a

hearing on so-called Project SHAD, an acronym for Shipboard Hazard and Defense, a U.S. Navy project in the 1960’s. This program

was designed to test effectiveness of both delivery and protective

systems relating to chemical weapons, and it was comprised of

many tests, more than a hundred.

A number of issues have arisen as to the propriety of subjecting

U.S. naval personnel to these tests: whether there were deadly biological agents to which they were exposed; whether such exposures

were intended, or merely incidental to collecting data on animal

subjects; whether VX and sarin—very lethal agents—were used;

and whether the U.S. personnel were really, in effect, guinea pigs,

which the Department of Defense has denied.

There is a problem in the present of identifying the people who

were subjected to these exposures, and this committee has decided

to convene this hearing to try to make a determination as to what

the facts are, whether the action taken by the Department of Defense was proper, what exposures there were, and what were the

circumstances of those exposures. There has been an assertion that

consent was given, but no formal written consent forms have been

located.

[The prepared statement of Senator Specter follows:]

PREPARED STATEMENT OF HON. ARLEN SPECTER, U.S. SENATOR FROM PENNSYLVANIA

Thank you, Mr. Chairman, for convening this important hearing. You have done

so, at least in part, at my request. I appreciate that consideration.

With this hearing, the Chairman and I hope to shed some light on an episode in

the history of the Cold War—so-called ‘‘Project SHAD’’—that has, at minimum,

some unfortunate features. Project SHAD—an acronym referring to ‘‘Shipboard Hazard and Defense’’—was part of a larger Department of Defense effort—labeled

Project 112—designed to identify and test defenses against potential chemical and

biological weapons.
2

Of course, the identification and testing of potential defenses against potential

chemical and biological weapons was a salutary goal—one that has relevance to this

day. Unfortunately, the way DOD went about Project SHAD testing appears to have

been, at minimum, less than salutary. Based on material we have seen—and I hasten to add we have seen information related to only 12 of 103 tests, and that information has been ‘‘scrubbed’’ by the Pentagon to include only information that DOD

deems to be ‘‘medically relevant’’—we are not looking at a ‘‘horror story’’ here; it

does not appear that, as a general proposition, DOD used Naval crews as ‘‘guinea

pigs’’ to test the efficacy of highly dangerous weapons or of protective devices.

It is clear, however, that Naval crews were exposed—likely, needlessly exposed— to the deadly chemical warfare agents sarin and VX. It is clear, further, that Naval

personnel were directly and intentionally exposed to biological agents—ones less

deadly, it appears, than sarin or VX, but agents that are hardly harmless. Finally,

Naval crews were exposed to supposedly harmless ‘‘simulants’’—agents designed to

mimic the properties of sarin and VX.

These exposures raise significant questions relating to informed consent. Was consent actually sought and gained? Was it truly ‘‘informed’’ and freely given? Was consent properly documented? And perhaps most importantly, was it proper to conduct

these experiments at all—even with consent? These are questions I look forward to

exploring with our DOD, and other, witnesses.

I am pleased, also, to see that VA is present today. For whatever judgments might

be made on the propriety of DOD actions in the 1960s, the Federal Government

surely must rectify the situation now. And just as it was the case after Vietnam

and after the Gulf War, VA is—once again—the agency left to pick up the pieces.

I am interested to learn of VA’s assessment of the health status of Project SHAD

veterans. I am also interested in learning of VA’s experience in notifying them,

treating them, and in processing their claims for compensation.

It is imperative that the Pentagon do better in getting information to VA relating

to Project SHAD, and other, exposures to dangerous chemical or biological agents

by service members. VA must have this information so that it might provide Project

SHAD veterans with medical treatment and, if appropriate, compensation. In this

regard, I note that of the approximately 2800 service members who were exposed

in 12 of 34 Project SHAD tests—only the tip of the Project 112 iceberg—just 622

have been notified. For DOD to state that it cannot usefully identify more than 622

veterans by Social Security number is wholly inadequate. If DOD has no way of

cross-referencing Service Numbers to Social Security Numbers, it must find a way— and it must do so now.

Mr. Chairman, I look forward to hearing this testimony and questioning the witnesses. So let us proceed.

Senator SPECTER. And now I yield to the distinguished chairman

of this committee, who has arrived.

Chairman ROCKEFELLER. No. You go ahead.

Senator SPECTER. Now I do not yield to the distinguished chairman. [Laughter.]

I call on Senator Nelson for an opening statement.

Senator NELSON of Nebraska. Thank you very much, Mr. Chairman, and I certainly want to thank you, the chairman, Senator

Rockefeller, for holding this hearing today and the witnesses for

appearing to help us understand the hazards which our men and

women have been exposed to during these past several decades.

As you know, the United States is not only a great country but

a compassionate country, so the men and women who serve in the

military do understand that there are certain risks that are assumed. But sometimes there are risks that are assumed unknowingly. And in spite of the risks that are there, the men and women

of the military serve our Nation with distinction and with great

sacrifices. And that is why it is so disheartening when we hear

from veterans today who feel that the country isn’t honoring the

commitment that has been made to them when they pledged to

give their lives and their commitment to our country.

So it is difficult to understand why some veterans aren’t being

told what they have been exposed to in order to ensure that they
3

can get proper treatment. If they don’t know, they can’t followup

on it.

Additionally, it is important that health care providers know

what these hazards are that their patients have been exposed to

so that they can build a knowledge base on how to treat their current patients and similar patients in the future. It is apparent that

the veterans service organizations, the Department of Defense, as

well as the Department of Veterans Affairs need to communicate

better and more openly on this issue of military exposure.

I truly believe that the improved communications will benefit the

veterans who are suffering by allowing them to get the care that

they need and that they deserve. And so I want to again thank the

chairman and ranking member for this hearing today and look forward to as much of the testimony as I might hear today, and we

will follow the written testimony as well. So thank you very much,

and thank you, Mr. Chairman.

Senator SPECTER. Senator Wellstone, would you care to make an

opening statement?

Senator WELLSTONE. Thank you, Mr. Chairman. You know what

I think I will do is I will include my opening statement in the

record and make about 2 minutes of remarks. And I have talked

to Senator Nelson about this, and as I look at this experience with

Project SHAD——

Senator SPECTER. Which Senator Nelson?

Senator WELLSTONE. You are right. Both. How about both? Both

of them, both Nelsons, Senator Nelson from Florida, but I also was

listening to the comments of my colleague from Nebraska, and I

agree.

The only thing I want to say besides the statement that is in the

record—and Jay and I have, I think, talked about this as well— this is—we have this kind of awful record. I mean, I remember the

work with Atomic veterans, and this just reminds me of Atomic

veterans, Gulf veterans, Agent Orange, and it is this awful record

of excessive secrecy and sort of people, you know, veterans and

their families feeling like the Government is not being honest with

them, they are put in harm’s way, and, you know, they keep asking

for some recognition of what has happened. They keep asking for

some compensation. They keep asking for treatment, and over and

over again they come up against this wall of—I don’t know whether

it is the secrecy or whether it is just sometimes incompetence. But

I really hate to see this again, and I really believe that this is an

extremely important hearing. Finally, because of Secretary Gober

and Secretary Principi, we are able to get the compensation for the

Atomic veterans.

The other point is it is just an awful thing when veterans feel

like, you know, they haven’t been dealt with honestly by their Government and they were put in harm’s way and now no one is really

listening to them.

My other point is, assuming that the scientific evidence, Mr.

Chairman, both chairman and ranking minority member, remains

ambiguous, that you don’t know for sure, then it seems to me the

policy question is which side do you err on. And it seems to me that

we have got enough experience here to know that we ought to err

on the side of these veterans and their families. And that is my
4

second point and last point. It is a very important hearing, and I

thank my colleagues and the Chair for this.

Senator SPECTER. Senator Nelson of Florida has introduced legislation on this subject, and while he is not a member of this committee, we welcome him here and invite him to make any comments at this time as he may choose to make.

STATEMENT OF HON. BILL NELSON, U.S. SENATOR FROM THE

STATE OF FLORIDA

Senator NELSON of Florida. Mr. Chairman, the Nelson boys are

here, and I might say, just prior to my remarks, that this Nelson

is a very honorable Nelson because we both had a stake in the national championship in the Rose Bowl. [Laughter.]

And we had a little friendly bet: a crate of Florida oranges versus

a box of Omaha steaks. And I am certainly enjoying those steaks.

Senator SPECTER. Thank you very much for those relevant comments. [Laughter.]

Senator NELSON of Florida. I thought you would enjoy that.

Senator SPECTER. Do you have anything to say on the subject at

hand?

Senator NELSON of Florida. Mr. Chairman, I have quite a bit to

say about this issue. In the 1960’s and 1970’s, sailors were gassed

on ships in the Pacific. It is unclear as to whether or not they were

told. It is unclear as to whether or not they were given the protective gear. Thirty and forty years later, those sailors are now receiving letters saying, ‘‘You may have some ill health effects, and we

want you to go into a veterans’ medical facility.’’ As a matter of fact, there were 113 of these tests that were conducted in those two decades, and only 6 of those 113 tests have

been declassified. And of those 6 tests, there is an approximate

population of 4,300 veterans that are to be notified, but of which

only 622 have been notified by mail by the Veterans Administration. Fifty-one of those 622 happen to be in the State of Florida,

and I would say to each of the Senators here there is a list of how

many veterans have been notified in your State. I know that in

Senator Wellstone’s, of those 622 there are some 14 or 18, and, of

course, those numbers will just increase as the various tests are declassified and as the notification process continues.

So the question is: What happened? In fact, if the issue needs to

be kept classified, then it can certainly be handled within the

bosom of the appropriate committees. In the DoD authorization bill

that we just passed before the break, Mr. Chairman, we added an

amendment that would require the DoD to come forth and explain

what happened in these tests, not only in SHAD but in a host of

other tests.

For example, in the 1950’s, in Boca Raton, FL, there were tests

being conducted on developing a toxin that would destroy the Soviet wheat crop. And when I inquired as to this, because there is

an 85-acre parcel at the old Boca Raton military air field, which,

by the way, is now the site of Florida Atlantic University, one of

our State universities, and the very busy Boca Raton Airport, the

general aviation airport. But that 85-acre site is still untouched.

And so when I wrote after having heard a number of the comments come out of that area, the Department of Defense says it is
5

classified. So we just added an amendment to the DoD authorization bill that said if you have to come forth, you are going to come

forth, Mr. DoD, and report to us, and if it has to be classified, so

be it. But we need to know what happened. We need to know were

people exposed, both civilian and military. And if so, as these first

622 letters have been sent out by the Veterans Administration on

the declassified SHAD experiments, then what is the medical problem that would now two and three decades later having the Government suggest that these veterans come in.

So I just wanted to come, and I thank you for the opportunity

of holding this hearing. It is extremely important to how we honor

the people who wore the uniform of this country and have protected this country when it was in harm’s way, and we need now,

if they are in harm’s way, to respond appropriately.

Thank you, Mr. Chairman.

Senator SPECTER. Well, thank you, Senator Nelson. I think it is

worth noting that it was not until May of this year that the Defense Department acknowledged that these tests used real nerve

and biological agents, and I think it is not just a matter of coincidence—Senator Rockefeller and I were exchanging notes on this—

that yesterday afternoon at 5 o’clock the Department of Defense

announced an expanded investigation on this issue. That is an anticipatory advantage or an anticipatory benefit of congressional

oversight. Or perhaps it is just a coincidence.

Chairman ROCKEFELLER. I don’t think so.

Senator SPECTER. And now the chairman speaks. Senator Rockefeller?

Chairman ROCKEFELLER. Thank you very much, Senator Specter.

I am always a little bit late, as you know, those of you who come

to these meetings. I am not usually this late. But I was held up

by a lot of traffic, and the more I was held up, the less I cared because my Department of Defense friends—not my VA friends who

have been terrific on this—make people wait, and you make them

wait forever. I don’t know where you get the guts.

I think back to an American hero, General Norman Schwarzkopf,

in one of the more ignominious moments of this committee’s history. He kept diaries on the Persian Gulf War, including a little incident called Khamisiyah, where a lot of chemical bombs had been

blown up by the Americans, and he went over to look at them. He

was really mad at the committee because he didn’t like the idea of

the committee demanding that he turn over his diaries because,

you know, generals and people who fight wars don’t truck or give

in to mere politicians. He considers that an insult to his integrity.

He came up here and he said, you know, I looked at those bombs,

and they had these little yellow ribbons around the front of them.

But the problem, he said, was that everything was written in Arabic. And how was I meant to know what was going on?

These were his words, if you want to go back and check the

record. And, of course, he probably didn’t have more than 30 people

surrounding him who could have read those things to him. But was

he willing to admit a single mistake, a single error, a single anything? Nothing.

And that is my view of DoD. I used to get into this subject. Now

I just get mad about it. VA has been terrific. Anybody from VA
6

here has been terrific. Tony Principi has been terrific. They have

shoved this, they have pushed this. This press release that Senator

Specter referred to is a joke. And you are going to answer to it. At

5 o’clock yesterday, DoD expands SHAD investigation. Well, congratulations, 5 o’clock yesterday. I am sure that was a coincidence.

Now, I am just a politician, you understand? People like you

don’t have to worry about people like me. You can disdain people

like me. Because I represent people, I have to go back to the Persian Gulf War just like Senator Wellstone and all the rest of us

have. You saw people who couldn’t move, who had lost their wives,

who had lost their jobs, who couldn’t sleep, who couldn’t pick up

a newspaper, who you couldn’t touch because they would scream in

agony. Did DoD have anything to say about it? No.

And we had an atomic war veteran come in. He had been

through these tests earlier in the 1940’s and 1950’s. He testified.

And you know what he testified about? He testified: I want to tell

you what it is like to die, to be in the process of dying—which he

did shortly thereafter—knowing that the Government never told us

anything, and the Government refuses to because it said you can’t

prove you got cancer because of us. He’s a soldier or a sailor and

he’s dying.

A couple years ago we got something done about that. What did

it take to do something about Agent Orange? You know what it

took to get someone to look into Agent Orange exposures? Not anybody here, nobody from the Defense Department, I will guarantee

you, because you never make mistakes. You never make mistakes.

You know what it took? It took Admiral Zumwalt to come in here

because his son was dying, and that got the Congress finally to

wake up. His son was dying from Agent Orange, and that got Congress to wake up. And then we passed legislation, 20 years too late.

There is a lot of talk about the CIA and the FBI not cooperating,

but there is no talk about either of them not caring. They just have

cultural problems. The FBI investigates crimes that have already

taken place. The CIA is looking forward to try and prevent crimes.

Those are two different cultures, and they don’t mix very well. But

nobody doubts that they care.

I doubt you care unless you can prove to me otherwise this morning.

Now, you, Dr. Winkenwerder, are a young man. But one of these

days, you are going to be a veteran and you may care how you are

treated, or you may not. You may be rich enough by your retirement that you don’t really care because you can handle it on your

own.

But the State that I come from and the States that most of us

come from have veterans who can’t afford to take care of themselves, and they depend upon the VA, which in this case had to depend upon you, the DoD. Because the Department of Defense never

makes a mistake, can’t make a mistake because they are over there

fighting wars. You can’t make mistakes, psychologically you can’t

admit mistakes.

And maybe you will just care. Maybe you will be a little bit nervous. Maybe you will understand what some of these veterans have

to go through.
7

I don’t know if there is a disdain in the Department of Defense

for veterans, the people who fought, who kept your freedom.

I don’t know if you care. Really, one of the things I am going to

probe is how you care. How do you insult us with something like

this press release? How do you insult us? You know, we are elected. You are not. You get appointed. You go, you apply for a job, and

you get a job. You are good enough to get a job, you pull strings

to get a job, you are qualified to get a job, you get a job and you

keep that job. You are accountable to the person above you, but you

are not accountable to the people. You are not accountable like we

are accountable.

We spend our weekends, we spend our time with people. You go

home at 5, you go home at 7, you play golf on weekends. We don’t.

We work. We go back and we spend time with our people.

We are responsible to our people, and we take it seriously. There

is not one person here who doesn’t take what we do seriously. You

don’t have to face them. They are numbers to you. They are papers.

They are things that come across. You don’t even see veterans.

Now, you make policies, or you refuse to make policies, or you

make policies the day before the hearing because you know you are

going to have to testify. You would have done better not to have

put this out, in my judgment. I would have had more respect for

you, to come in and say, you know, we really haven’t done this very

well and we are going to do a better job rather than something like

this.

Now, I am a temperate person, believe it or not. But I am not

temperate when it comes to veterans getting shafted by inattention. And I have about eight questions for you, and I can’t wait to

ask them.

Could I give my statement now, Mr. Chairman?

Senator SPECTER. Yes, we understand that was just an introduction.

Chairman ROCKEFELLER. Yes. I don’t know how much of this I

have to give. It is the same old story, and Bill Nelson pretty much

gave it: waiting, waiting, waiting, refusing to do anything, getting

pressure from the VA, Tony Principi doing a good job, and then, of

course, DoD is too busy to do anything about it.

You know, you are getting lots of money. You are not under a

restrained budget like veterans health care is under. We can’t

stretch our budgets. You can.

So I suppose what we are here is to find out whether veterans

are endangered by all of this. I suspect they are. I don’t know, Doctor, if you were around during the PB investigations. Were you?

Dr. WINKENWERDER. No.

Chairman ROCKEFELLER. OK. Well, that is just too bad. You

know that? Because you might have learned something from that.

Because what the military was doing, they were taking an investigational drug that had not been approved by the FDA, forcing soldiers to take it. The smart ones didn’t. And the ones who did may

have paid a terrific price for it, many of them. And then all kinds

of studies come up showing that, no, there is no particular connection, including reports from the National Academy of Sciences. You

know, who am I to talk about the National Academy of Sciences?

I don’t buy any of it. I think there is a direct connection.
8

And all during this time, we had to fight DoD for everything we

wanted to do, including demanding that the esteemed General

Schwarzkopf make a trip all the way from his comfortable home in

Florida up here to Washington to talk to a terrible group of politicians who he so totally disdains, who dared to question the wisdom

of the way he won his war, which is partly how you handle your

soldiers and what you do about them. Do you stand up for your soldiers, your men and women, or don’t you?

Dr. WINKENWERDER. I do.

Chairman ROCKEFELLER. I am not asking you. I was talking

about him. And I don’t think he did.

Now, he is a big American hero, but when I think of him, I think

of what he did to a lot of veterans by his inaction. He wouldn’t even

release the notes he had kept. That is why we had to threaten to

subpoena him, to try and get at his notes. It wasn’t anything about

him. It was just trying to get at his notes. When he finally turned

them over, he only gave us a few pages.

So this is about the Department of Defense attitude. I mean, do

you guys care? I am not sure. I am not sure. It is just too big a

building, too many cultural problems, and you have got other problems. You are fighting wars. And then there are veterans. Oh, yes,

we have veterans, but you are not veterans and you are out there

fighting the war. Well, VA takes care of veterans. We try to take

care of veterans. We are not a big and famous committee. But we

can get really ticked off sometimes, and I hope this thing is on television somewhere. And I hope there are a lot of people listening because you have got some explaining to do. I will be looking forward

to your statements.

[The prepared statement of Chairman Rockefeller follows:]

PREPARED STATEMENT OF HON. JOHN D. ROCKEFELLER IV, U.S. SENATOR FROM

WEST VIRGINIA

Good morning. I wish that I could say that this is the first time the Committee

has gathered in this room to talk about the struggles of veterans who might have

been exposed to hazardous agents during their military service. I wish that it were

the first time that veterans and officials from the Departments of Defense and Veterans Affairs have met to talk about the legacy of battles and tests long over but

still not resolved. Unfortunately, it is not.

First, I want to acknowledge that my colleague, Ranking Member Arlen Specter,

requested this hearing based on his outrage over the Project SHAD revelations to

date. I was pleased to accommodate his request, especially given my long history

of investigating military exposures and the consequences for veterans.

In 1994, I chaired a hearing in this room on the legacy of military research, on

the double battle that veterans must wage with illnesses that may have resulted

from service and with the shroud of secrecy that bars them from the care and the

benefits they so desperately needed. We talked about the hazards that military research posed to veterans’ health, and the lessons we have learned from World War

II until today. The transcript from that hearing is in front of me, and contains a

lot of good ideas and good intentions and regrets about the way veterans have been

treated in the past. Eight years later, we still haven’t learned those lessons.

DOD recently released information on Project SHAD—Shipboard Hazard and Defense—tests that took place in the 1960’s. That information was released only after

pressure from veterans and Congress spurred VA to look for answers, and after VA

in turn pressed DOD for details that had remained quietly hidden for decades. Two

years after VA asked for information on SHAD, for a simple list of who and what

hazards might have been involved, DOD finally released information on one-third

of those tests.

While a delay of thirty years for this trickle of information is appalling, sadly it

is no longer shocking. Veterans have had to struggle to learn about the consequences of exposures that were no secret at all—the tests that exposed American
9

forces to radiation during and after World War II, Agent Orange in Vietnam, and

the myriad chemical and biological hazards of the Gulf War.

We are here to learn whether Project SHAD endangered veterans’ health, but we

are also here to address the military culture that still fails to keep good medical

records and to share those records with servicemembers and veterans in a clear and

timely way. When confronted with questions from veterans, VA, and Congress, DOD

first obfuscates, and then delays. This is unacceptable.

I don’t want to hear about difficulties in sorting and declassifying records, I want

to hear about how we can streamline that process so that veterans do not have to

wait years for answers. I know that SHAD took place decades ago on somebody

else’s watch, but I want to hear what we are doing to understand whether veterans

are now at risk because of those tests, and what we can do to help them if they

are at risk. Most importantly, I want to hear what all of us can do to guarantee

that we don’t perpetuate this cycle of delay and dismay again.

We are not sitting in this room today because I want answers to these questions,

or because Congress wants answers, but because veterans want—and deserve—answers.

Senator SPECTER. Our first witness is Daniel Cooper, Under Secretary for Benefits of the Department of Veterans Affairs. So let us

proceed. We have a long list of witnesses. We will hear from you,

Mr. Secretary.

STATEMENT OF HON. DANIEL L. COOPER, UNDER SECRETARY

FOR BENEFITS, DEPARTMENT OF VETERANS AFFAIRS; ACCOMPANIED BY ROBERT EPLEY, ASSOCIATE DEPUTY UNDER

SECRETARY FOR POLICY AND PROGRAM MANAGEMENT,

VETERANS BENEFITS ADMINISTRATION, AND SUSAN

MATHER, M.D., CHIEF OFFICER, PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS

Mr. COOPER. Yes, sir. Thank you. I will make a brief statement

if I may.

Mr. Chairman, members of the committee, I am pleased to be

here to talk about SHAD and the services that VA must provide

our veterans to ensure they are given proper notification, necessary

claims filing assistance, and medical attention, when required.

Having just recently studied the situation and attempting to define a path that we can follow, I will state that the process has

been developed in fits and starts and must be improved. The problem is, as you know, greatly exacerbated by classification of the operations. That has severely hampered our getting the names of the

units, the tests, and the individual participants.

Once we get those names, we have some difficulty because we get

the names along with the military ID numbers. We have to get

SSN’s, so we have to go through a whole process. Then, when we

try to notify them, we have to go through OSHA in order to have

the IRS release their addresses. So the notification process is a

rather onerous one that we are trying to work through and do

properly.

The participants are being identified by name but, unfortunately,

quite slowly. Once we determine the Social Security numbers, we

submit those numbers, get them to the IRS, get the addresses back,

and then finally get notifications sent out.

Despite the difficult problems, as both a veteran and a VA official, I must state that we could have and should have done better.

The problems cited, and particularly the certification firewall,

caused a very difficult situation which has hampered, in my opin-
10

ion, well-intentioned people within the organization who are trying

to do the job properly.

By mid-May of this year, we had identified by name just over

2,700 participants in 3 of the 12 tests. We have been able to locate

and send letters to 622 of those that we could identify sufficiently.

In this last week, we have submitted 800 more names to the IRS

through the circuitous OSHA path in order to try to get the addresses and notify those people.

Every step taken has been difficult. We received the first set of

names in April to July of last year, but we didn’t receive information on the tests until September. In January through May of this

year, we received the names of other participants. Again, we have

had to cull through the whole list to find out exactly where they

were stationed and when.

Finally, on 22 May, we sent a letter to the people that we could

properly identify. When I signed that letter, I was assured it had

been well coordinated and that the veterans service organizations

had had input. I learned later that they did have a problem with

one of the sentences in our letter, and we will change that with the

next letter that we send out to ensure that everybody is satisfied

that we are doing it properly.

We presently have a hotline to receive calls. We have carefully

trained the people on that hotline. But occasionally we have some

problems with the information they put out. We have given them

strict guidelines as to what to tell the veterans, primarily to go to

a medical center and get an examination, and we give them the

name of an individual there. We are continuing to test that hotline

to ensure that we are being properly responsive.

Since the 622 letters were sent, we have received approximately

100 calls from potential participants in response to those letters. I

might add that in my statement for the record I have an incorrect

number on page 6. I would like to have that corrected, please, for

the record.

Senator SPECTER. Without objection, it will be placed in the

record.

Mr. COOPER. As I stated, we in VA must and will remain focused

and work more closely. Secretary Principi has taken steps to ensure better coordination within VA. Similarly, VA and DoD must

work more closely both on information availability and information

transfer between the two of us.

We must continue to improve the system as effectively as we can

while adhering to the laws of the land. We strongly welcome any

assistance possible from any source, particularly veterans services

organizations.

Finally, I would say I have two personnel with me today who are

much more expert than I: Dr. Susan Mather, who is the Chief of

VHA’s Office of Public Health and Environmental Hazards; and

Mr. Robert Epley, the Associate Deputy Under Secretary for Policy

and Program Management in VBA. I am ready to answer any questions you may have, sir.

[The prepared statement of Mr. Cooper follows:]
11

PREPARED STATEMENT OF DANIEL L. COOPER, UNDER SECRETARY FOR BENEFITS, DEPARTMENT OF VETERANS AFFAIRS

Mr. Chairman and Members of the Committee, thank you for the opportunity to

testify today on the efforts of the Departments of Defense (DoD) and Veterans Affairs (VA) to provide health care information and support to veterans who were exposed to environmental hazards during military service. Accompanying me today is

Dr. Susan Mather, Chief Officer, VA Office of Public Health and Environmental

Hazards, and Mr. Robert Epley, Associate Deputy Under Secretary for Policy and

Program Management.

War and training for war have always exposed America’s men and women in uniform to a wide variety of health hazards. Each war in the last century has produced

unique hazardous exposures. In World War I, chemical warfare agents, including

chlorine and mustard gas, were used. World War II saw the first deployment of nuclear weapons. Korea exposed many American POWs to psychological brainwashing

techniques and to extremely cold weather conditions. The widespread use of herbicides during the Vietnam War is now associated with several adverse health effects.

Military personnel encounter a broad array of environmental hazards, infectious disease, and psychological health risks any time they deploy outside the United States.

During peacetime, America’s Armed Forces prepare for health hazards through research and by developing better preventive measures and conducting appropriate

training. Many of these efforts have been well publicized, while others have been

conducted in secret. For example, the testing of nuclear weapons during the Cold

War exposed many American veterans to increased levels of radiation. Similarly, VA

became aware in 1991 of approximately 4,000 American servicemen who had been

exposed to high concentrations of mustard gas in both study chambers and field

tests as a part of a larger chemical defense research program begun in World War

II. In response, the National Academy of Sciences assessed the medical literature

on health effects from those exposures, leading to new VA compensation regulations.

Following the Gulf War in 1991, Congress identified thirty-three separate hazardous substances to which Gulf War veterans may have been exposed. Public Laws

105–277 (signed Oct. 21, 1998) and 105–368 (signed Nov. 11, 1998) required VA to

establish an agreement with the National Academy of Science to review and evaluate the medical literature on possible health outcomes from these exposures. The

first phase of this study was published in 2000 and additional studies are underway.

In addition, extensive analysis has been conducted to determine the potential health

effects of exposure to sarin and cyclosarin at Khamisiyah following the Gulf War.

Most recently, VA became aware of the exposure of an undetermined number of

U.S. service members to a variety of biological and chemical agents in secret tests

called Project SHAD (Shipboard Hazard and Defense) conducted during the 1960s.

Because of this long history of hazardous exposures of U.S. military populations,

we must carefully examine our methods for identifying exposed veterans, studying

the potential effects of the contaminants, and for providing our veterans with appropriate health care and deserved disability compensation.

In the past, VA has established special programs for specific groups of veterans

potentially exposed to environmental health hazards. For instance, VA responded to

Gulf War health issues through a comprehensive program of health care, research,

outreach, and special compensation for ‘‘undiagnosed illnesses.’’ About 12 percent

(84,000) Gulf War veterans have participated in a clinical registry program. The

principal finding from this clinical evaluation program is that these veterans are

suffering from a wide variety of recognized illnesses that respond to conventional

treatments. Subsequent research studies have supported these findings, as have

similar results from studies conducted in the United Kingdom and Canada among

their Gulf War veteran populations.

Although special programs are useful, VA has learned many lessons since the

Gulf War and is now taking a more pro-active approach in establishing policy and

programs that will address environmental health concerns as early as possible.

LESSONS LEARNED

Clinical Practice Guidelines

Special clinical programs, such as the Gulf War Registry reach only a limited

number of eligible veterans. Therefore, the VA, in cooperation with DoD, has taken

concrete steps to better understand and to routinely manage post-deployment health

problems. A further goal is to improve veterans’ satisfaction with their health care.

VA is using an evidence-based approach to develop clinical practice guidelines for

the evaluation of military veterans following hazardous deployments. Just completed in collaboration with DoD are a ‘‘Post-Deployment Health Evaluation and

Management Guideline’’ and a second clinical practice guideline for unexplained fa-
12

tigue and muscle pain, which was recently released. These guidelines will provide

VA physicians with the best medical practices for dealing with veterans following

deployment. A clinical guideline for PTSD, now in the planning stage, will be the

next step in the development of a sound strategy for the screening, assessment, and

care of all veterans returning from military deployments.

The regular use of standardized clinical practice guidelines that outline the best

medical practices will decrease the need for ad hoc registries. Troops will be specifically screened early in the primary health care setting for illnesses that may be related to a military deployment. The Gulf War registry programs only reached a minority of veterans and the clinical findings from examinations of self-selected populations were difficult to interpret. In contrast, the post-deployment clinical practice

guidelines will ensure that the health problems of all veterans returning from hazardous deployments are addressed whenever they seek care in the DoD or VA

health systems. These new Guidelines will give VA primary care providers the tools

they need to diagnose and treat veterans who had participated in hazardous deployments.

War-Related Illness and Injury Study Centers (WRIISC)

For veterans with severe symptoms that remain unexplained after examination,

the local VA physician can refer them to one of VA’s two War-Related Illness and

Injury Study Centers (WRIISC) (formerly known as Centers for the Study of War

Related Illnesses). Many of these veterans are concerned that their illnesses are related to environmental hazards they encountered during deployment. The two Centers are located at the VA medical centers in Washington, DC, and East Orange,

NJ. They are charged with identifying current effective treatments, developing new

treatments, providing environmental hazard health risk communication to veterans

and their families, and promoting education for VA health care personnel on the

‘‘difficult-to-diagnose’’ illnesses found among veterans from all military deployments.

Veterans Health Initiative/Independent Study Guides

Recognizing the need to educate health care providers about the unique medical

care needs and concerns of veterans—including the effects of environmental hazards—VA began an ongoing training program known as the Veterans Health Initiative (VHI). Two key products are our independent study guides ‘‘A Guide to Gulf

War Veterans’ Health,’’ and ‘‘Vietnam Veterans and Agent Orange Exposure.’’ In addition, VA has developed other new independent study guides on a broad range of

unique veteran health issues, including Cold Injury, Hearing Impairment, Post

Traumatic Stress Disorder (PTSD), Prisoner of War (POW), Radiation, Spinal Cord

Injury, Visual Impairment, and Traumatic Amputation and Prosthetics.

Enhanced Outreach

The Gulf War emphasized to us the value to veterans and their families of timely

access to reliable information about the environmental health risks during military

deployment. Acting on these lessons, VA developed a new brochure that addresses

common health concerns for military service in Afghanistan and South Asia. It answers questions about health care and eligibility for VA benefits that veterans, their

families, and their health care providers will have following this military deployment in the war on terrorism. The brochure also describes relevant medical care

programs that VA has developed in anticipation of the health needs of veterans returning from combat and peacekeeping missions abroad. This outreach material has

been distributed to all VAMCs and Regional Offices.

PROJECT SHAD

The recent revelations concerning a series of Cold War tests known as Project

SHAD reinforces the potential environmental hazards that our military forces face.

This project was part of a DoD chemical and biological warfare test program conducted between 1963 and 1970 to evaluate the vulnerabilities of U.S. warships to

attacks with chemical or biological warfare agents. Project SHAD exposed veterans

to potentially harmful biological and chemical agents.

VA first learned of SHAD when a veteran filed a claim for service connection for

disabilities he felt were related to his participation in Project SHAD. In two meetings held with DoD in late 1997, VA was advised that all material was classified

and access to material was not assured and could only be given on a case-by-case

basis. VA was able to grant that particular veteran’s claim without reliance on classified information.

In May 2000, the Under Secretary for Benefits responded to a Congressional inquiry requesting assistance for veterans involved in Project SHAD. A VA/DoD

workgroup was subsequently established and met the first time in October 2000.
13

Since that time, DoD and VA have worked together collaboratively to develop the

facts surrounding Project SHAD.

DoD began the formal process of declassification, compiling rosters of participants,

and providing VA with names and service numbers of test participants. Initially, information was provided for 1,149 veterans involved in the tests Autumn Gold, Copper Head, and Shady Grove. Over a period of several months, VBA engaged in the

labor intensive task of identifying the participants of those three tests identified initially. The social security numbers of 703 veterans were found. Using social security

numbers, VA worked through the National Institute for Occupational Safety and

Health to obtain from IRS the current addresses for 622 of these individuals. On

May 21, 2002, outreach letters were mailed to the 622 identified participants involved in the three initial tests.

VA has initiated a significant outreach program to contact Project SHAD veterans

once they are located. For SHAD veterans we have so far been unable to identify,

VA has established a SHAD Hotline (at 1–800–749–8387), Internet web-site (at

www.VA.GOV/SHAD), and e-mail address (at SHADHELPLINE@VBA.VA.GOV).

The VA Internet website provides veterans with information currently available and

a link to DoD’s web page. To date, approximately 125 SHAD hotline inquiries and

43 e-mail messages have been received. Approximately 14 SHAD related claims for

service connection are currently pending.

Since the beginning of calendar year 2002, DoD has provided VA with information

on nine additional tests. Information on three tests was provided in January: • Eager Bell I • Eager Bell II • Scarlet Sage

VA received information on six additional tests in May of this year:

• Fearless Johnny • Flower Drum Phase I • Flower Drum Phase II • Purple Sage • DTC Test 68–50 • DTC Test 69–32

DoD has identified one hundred and three potential SHAD tests. However, the

number of tests actually conducted is unknown. Furthermore, the total number of

service members involved in these tests is not known at this time. Unfortunately,

the number of veterans who participated in multiple tests, the names of those tests,

and the potentially harmful agents to which they may have been exposed cannot

be determined until all relevant documentation has been collected, reviewed, and

declassified.

DoD continues to review documentation and declassify additional SHAD tests. As

names and service numbers or social security numbers are provided, VA will conduct the efforts required to identify the individuals who participated in these tests

and then to locate their current address. We will engage in an aggressive outreach

program to provide appropriate information to SHAD veterans.

Project SHAD information has been provided to VA medical staff through annual

publication of Information Letters from VA’s Under Secretary for Health. The Information Letters provide VA health care personnel with background information on

Project SHAD, along with information about the potential short- and long-term

health effects of the specific chemical and biological agents that DoD tells us were

used in these tests. This information has been made available on our SHAD web

site at www.va.gov/SHAD, including the information letter and other relevant information. As more information becomes available, satellite video-conferences are

planned to broadcast relevant information to all VA health care facilities.

In addition, VA will begin to work with the National Personnel Records Center

in St. Louis to review personnel and medical files for individuals listed as participants in tests for whom we have been unsuccessful in finding social security numbers. This represents approximately half of all the known participants provided to

date. We are not particularly optimistic that this search will be fruitful but we believe that it represents a possible source of at least a few numbers otherwise unknown.

Importantly, a contract with the Medical Follow-up Agency of the National Academy of Sciences is being developed to include a formal epidemiological study of mortality and morbidity among SHAD participants. In contrast to a clinical registry,

which cannot provide scientific data, this independent study will give us the clearest

picture of the health status of SHAD veterans and tell us whether their health was

harmed by prior chemical and biological exposures.

In the meantime, it should be stressed that there are no markers or laboratory

tests for the exposures currently known to have occurred in Project SHAD. However,
14

the provision of appropriate medical care for any of the conditions that have developed in the ensuing 40 years since the SHAD tests were begun is not dependent

on specific information about prior exposures. High quality medical care can be provided right now for each SHAD veteran who seeks a clinical evaluation in the VA.

SERVICE-CONNECTED COMPENSATION

In order for VA to make accurate rating decisions on claims for service connection

for disabilities associated with SHAD, complete evidence is necessary when the

issue is first decided. Because of the piecemeal and fragmented approach of declassifying and providing information, VA may be required to readjudicate claims as additional evidence becomes available for those service members involved in multiple

tests. Likewise, as evidence is declassified and made available, VA may find that

the new evidence regarding SHAD tests supports grants of service connection previously denied.

VA will continue to send outreach letters to participants as additional tests are

declassified and participant names and Social Security numbers are made available.

Because it now appears that many of the service members participated in more than

one test, our initial outreach efforts run the risk of being incomplete until DoD’s

declassification efforts are finished. It should be noted that in those cases where inquiries have come from veterans regarding tests not yet declassified, VA has been

able to provide names to DoD and they have responded by providing relevant information on a timely basis.

VA also realizes that we cannot understand all the potentially hazardous exposures experienced by members of the Armed Forces without consultation and cooperation with other government agencies, particularly DoD, but also HHS, EPA,

and DOE. This coordination is being addressed at the highest levels in VHA through

the VA/DoD Executive Council.

In conclusion, the Department of Veterans Affairs shares this Committee’s concern about the adverse effects of hazardous exposures during military service and

will continue to aggressively address them. VA sponsors research to assess the effects of these exposures; is actively contacting veterans of Project SHAD to notify

them of potential exposures; and has developed numerous studies with the Institute

of Medicine to determine the health effects of hazardous exposures.

This concludes my testimony. My colleagues and I will be happy to answer any

questions that the Committee may have.

Senator SPECTER. Thank you very much, Mr. Secretary.

We turn now to Dr. William Winkenwerder, Assistant Secretary

of Defense for Health Affairs. Dr. Winkenwerder, we are very much

concerned about—and focused on—what happened and why nothing was done up to this point. But at this point, we will invite your

opening statement.

STATEMENT OF WILLIAM WINKENWERDER, M.D., ASSISTANT

SECRETARY FOR HEALTH AFFAIRS, U.S. DEPARTMENT OF

DEFENSE; ACCOMPANIED BY ELLEN EMBREY, DEPUTY ASSISTANT SECRETARY FOR DEFENSE FOR FORCE HEALTH

PROTECTION AND READINESS, AND MICHAEL E. KILPATRICK, M.D., DIRECTOR, DEPLOYMENT SUPPORT, FORCE

HEALTH PROTECTION AND READINESS

Dr. WINKENWERDER. Thank you. Senator Specter, Mr. Chairman,

and members of the committee, thank you for the opportunity to

appear today and to provide this testimony. I have a written testimony that I will provide for the record. I just want to start by making a couple of comments.

First, in response to your comment, Senator Rockefeller, the first

is that I do care. I care greatly about these men and women, not

only today but those of the past, the veterans. They are an important and critical part of the whole DoD responsibility. When it

comes to veterans, over half, for example, of all the people we care

for in the defense health program are veterans. We care for vet-
15

erans, and I consider it a high responsibility, an important responsibility. That is why I am here today. I could have ignored this

hearing. I chose not to because it is an important issue.

I came upon this information not too long ago, certainly after I

started, which was just after September 11th. I left my job in the

private sector to come work here—— Senator SPECTER. Dr. Winkenwerder, how could you have avoided this hearing?

Dr. WINKENWERDER. Pardon?

Senator SPECTER. You say you could have avoided this hearing

but chose not to.

Chairman ROCKEFELLER. Nobody has ever said that to us before.

Dr. WINKENWERDER. Well, I am just saying, you know how you

can certainly say someone else go testify. I wanted to testify.

Senator SPECTER. Well, whom would you have sent? Secretary

Rumsfeld?

Dr. WINKENWERDER. No. There are others that could represent

the Department on this issue.

Chairman ROCKEFELLER. So we should be pretty grateful then

that you are here, shouldn’t we?

Dr. WINKENWERDER. No. I am telling you I wanted to be here.

I wanted to be here.

Chairman ROCKEFELLER. You had a duty to be here.

Dr. WINKENWERDER. Absolutely, and I want to be here, period.

Chairman ROCKEFELLER. Well, then, why did you point out to us

that you didn’t have to come? I am going to give you a hard time,

OK?

Dr. WINKENWERDER. OK. Fine.

Chairman ROCKEFELLER. But I will accept your point. You are

here. And I can’t argue that.

Dr. WINKENWERDER. I care about this issue. I came upon this information, and I can assure you that I am fully engaged and that

the other people that are with me are fully engaged.

Senator SPECTER. Dr. Winkenwerder, we will accept that. Proceed with your statement.

Dr. WINKENWERDER. OK. Well, that is in essence—that is the

main message. I want to assure you that the Defense Department

is committed to working with VA and sharing medically relevant

information from Project 112 and SHAD so that veterans who were

involved can be notified and receive appropriate care.

When we started our investigation into Project SHAD, which

was, as I understand it, a couple of years ago, we encountered several challenges, as it has been explained to me. But I think today

it is fair to say the investigation has established a format for sharing that information with the VA, has created a system to declassify this information in a relatively expedited way, and has determined the locations of the necessary documents. These documents,

again, as it is explained to me, are spread out in many places. They

have not been well catalogued. This is a problem. This is an issue.

I fully accept that. And we are working with the respective services

to look at literally boxes of information that are in warehouses and

various places around the country to get the information

catalogued and to get it back and to declassify it rapidly so that

we can provide this information.
16

We provide test information as fact sheets to the VA as soon as

it is declassified. However, in order to expedite the VA’s notification process, we are forwarding to the VA the names of service

members involved in each test we identify before the declassification process ensues.

To date, we have produced fact sheets on 12 SHAD tests, which

involved about 2,700 or 2,800 service members, and so far our investigation indicates that most of these tests were done using

simulants and not live agents or real agents that were thought and

believed at that time to be harmless, not something that would

cause any medical harm.

Those service members involved in using live test agents appear

from the information that we have been provided to have been appropriately protected from those agents. Since the Gulf War, the

services each have made efforts to fulfill today’s requirements,

which are much greater and appropriately need to be, of medical

recordkeeping and to include documenting potentially harmful exposures. And we plan to consolidate all of these efforts into something we are calling—a software and a data collection system we

are calling Theater Medical Information Program. TMIP will provide an electronic record of care in theater that can be entered into

the individual’s permanent medical record and it can be then provided to the VA.

Our commitment is to get this information literally from the

start of a service member’s experience in the service so that we

have it and then subsequently the VA would have it as well.

Senior leaders from DoD and VA are working closely together on

these efforts, and let me just close by saying that I am very interested in getting to the bottom of this as quickly as possible and getting the information out.

Thank you, and I would be glad to answer your questions.

[The prepared statement of Dr. Winkenwerder follows:]

PREPARED STATEMENT OF WILLIAM WINKENWERDER, M.D., ASSISTANT SECRETARY

FOR HEALTH AFFAIRS, U.S. DEPARTMENT OF DEFENSE

Mr. Chairman and members of this distinguished committee, thank you for the

opportunity to be here today and thank you for your continuing support of the men

and women who have served in our Armed Forces.

As Assistant Secretary of Defense for Health Affairs, I want to stress that the Department of Defense is committed to ensuring that we deploy fit and healthy military personnel, that we monitor their health and environmental exposures while

they are deployed, and that we assess their health status and address their health

concerns when they return. My Deployment Health Support Directorate is conducting the investigation into Project SHAD. Today, I would like to explain some

of the challenges we face in the investigation into Project SHAD, and why I think

problems associated with that situation, particularly in regard to medical record

keeping, are not likely to occur for post-Gulf War operations.

As you know, Project SHAD (Shipboard Hazard and Defense) was a chemical and

biological weapons vulnerability testing program conducted in the 1960s by the Deseret Test Center in Utah. In August of 2000, the Secretary of Veterans Affairs requested that the Secretary of Defense provide information concerning three classified Project SHAD tests: Autumn Gold, Copper Head and Shady Grove. In September 2000 DoD assigned responsibility for fulfilling that request to the Deployment Health Support Directorate. Within a month, VA and DoD personnel began

meeting regularly to define what medically relevant information the VA needed to

address veterans’ concerns. This collaborative effort established a communications

process, coordination for the exchange of information between the agencies, and a

format for fact sheets to inform the VA, veterans and the public about the nature

of these exposures and the agents used.
17

SHAD was part of a larger program called Project 112, which was itself one of

many projects run by the Deseret Test Center. Project 112 consisted of 103 chemical

and biological warfare agent tests. SHAD involved thirty-four planned tests, many

of which were never performed. These were not clinical trials, but rather were done

for operational preparedness purposes. Leaders at the time thought they were appropriate tests given the information they then had available. So far, our investigation indicates that most of the tests were done using simulants that were thought

to be harmless. Moreover, service members involved in tests using live agents were

appropriately protected. Nonetheless, the Deployment Health Support Directorate

quickly recognized the necessity to investigate all Project 112 and SHAD tests, and

expanded the scope of the original effort.

The first year of this investigation we discovered the difficulties in obtaining the

needed medically relevant information and put systems in place to overcome them.

First, we had to find the needed documents. In the 1960’s, joint operations were not

so common. The Army planned the SHAD tests, but for the most part the Navy and

Marine Corps conducted the tests, with assistance from the Air Force. The primary

planning was done at the Deseret Test Center, a facility that closed in the early

1970’s. Records that were kept were stored at different facilities in different geographic areas, ranging from Dugway Proving Grounds, Utah, to Aberdeen Proving

Ground, Maryland. Remember, these test plans and reports are not computer files

but paper records stored in boxes or folders in file cabinets, so finding what you

need is a painstaking manual process.

Learning who may have been involved in a particular test involves finding personnel records in the Navy archives. Navy deck logs aren’t found in the military system at all, but are maintained by the National Archives and Records Administration. At this point our investigators believe they have established the locations of

most of the relevant records. Of course, the ongoing search could lead to new locations and we will pursue those leads until we have all relevant data.

When the desired test reports are located, there is still the task of declassification.

Most of the operation plans and results of these tests remain classified. These documents contain operational information about ship vulnerability to and defenses

against chemical and biological weapons. These agents remain a threat to our forces

today so, as you can understand, these records can not be casually declassified.

DHSD developed a solution. Investigators with appropriate clearances comb through

the documents to identify the medically relevant data. Early on, VA staff members

who also held appropriate clearances joined our investigators to verify that the information being sought was what they needed to help settle benefits questions. Following the identification of these specific topic areas, our investigators requested

that specific information be declassified. The Army has greatly expedited this declassification process.

When we first provided data to the VA we learned that DoD and VA computer

systems were not compatible. Both agencies have made the necessary adjustments

to allow the smooth transfer of this information. We now have the data the VA

needs formatted in such a way that they can use it immediately and easily. In fact,

I believe that one positive outcome of this investigation has been a new level of cooperation between the VA and DoD that is focused on providing the information our

veterans need and deserve.

To date we have produced fact sheets on 12 SHAD tests, which involved between

2700 and 2800 servicemembers. The VA has a process in place for notifying the

servicemembers, however, we understand the VA has a significant challenge in

identifying them because at the time they served, they were identified by service

numbers, not their social security numbers. The process to translate service numbers to social security numbers is also labor intensive. So, to give the VA time to

make positive identifications, we are implementing a process to provide the VA with

the list of names and service numbers as soon as we have them, before the investigation of a particular test is completed. And as soon as complete information becomes available, we will continue to share it with the VA and the public.

At the time of the project SHAD tests, there was little awareness of the possible

long-term effects of low level toxic exposures. Our recognition of the importance of

individual assignments, unit locations and documenting medically relevant exposures following the Gulf War have dramatically changed our processes. Today, DoD

monitors the servicemember’s environment closely. The U.S. Army Center for

Health Promotion and Preventive Medicine and the Naval Environmental Health

Center maintain environmental surveillance wherever our military forces go. For example, you may have seen news reports of possible chemical warfare agent exposures at Karshi Khanabad Air Base in Uzbekistan. Routine environmental monitoring discovered what appeared to be traces of possible chemical agents on the

base. The base commander immediately cleared the areas where the contamination
18

was suspected and notified troops of the situation. Closer investigation proved that

the substances that caused the alert were not chemical warfare agents. However,

that example does demonstrate that we have procedures to protect our people from

environmental dangers, and that we keep them aware of possible risks.

We are also dedicated to improvements in medical record keeping. In this area,

DoD has stepped boldly into the 21st century. The services have made individual

efforts to fulfill today’s requirements. We plan to consolidate those efforts into a

joint program under the Theater Medical Information Program, or TMIP. TMIP,

which is being tested right now, is a tri-Service system designed to provide information to deployed medical forces to support all medical functional areas, including

medical logistics, blood management, patient regulation and evacuation, medical intelligence, health care delivery and more. TMIP will integrate several existing and

developmental systems into a single system that can be easily used by theater commanders and medical personnel in combat environments. It will also provide an

electronic record of care provided in theater that can be entered into the individual’s permanent medical record and provided to the VA

DoD is in the process of setting up a system that will monitor the health of all

military members for the duration of their service. It will begin with the Recruit

Assessment Program, which will collect comprehensive baseline health data from all

U.S. military personnel. That program is in pilot testing right now.

After deployments, servicemembers now receive care based on a set of clinical

practice guidelines for post-deployment evaluation and treatment developed jointly

by DoD and VA medical personnel. The guidelines are designed to assist health care

providers in screening and evaluating service members and veterans with health

concerns following deployment.

At the other end of the system is a joint DoD/VA exit physical for service members

who are returning to civilian life.

We already have a number of initiatives working through our VA/DoD Executive

Council, co-chaired by myself and my colleague Dr. Roswell, the VA Under Secretary

for Health. This council provides the forum for senior health care leaders, including

our Surgeons General, to proactively address potential areas for further collaboration, and resolve obstacles to sharing.

We are building on the success of our health care council through the newly established VA/DoD Benefits Council, which is examining ways to expand and improve

information sharing, refining the process of records retrieval and identifying procedures to improve the benefits claims process. The VA/DoD Joint Executive Council,

co-chaired by the Under Secretary of Defense for Personnel and Readiness and the

Deputy Secretary of the VA, brings the leadership of the Health and Benefits councils together quarterly to demonstrate their commitment to improving inter-departmental cooperation at all levels. As Under Secretary of Defense David Chu said of

the first meeting, ‘‘Our concern for the well-being of servicemembers extends beyond

just their time on active duty.’’ The two panels will work together to improve coordination between the departments in such areas as health care services, benefits delivery, information sharing and capital asset coordination. The future will hold increased cooperation between our departments, because our focus is the health of our

servicemembers throughout their military careers and throughout the rest of their

lives.

Mr. Chairman, this concludes my statement. I thank you and the members of this

committee for your outstanding and continuing support for the men and women of

the Department of Defense. Now, what are your questions?

Senator SPECTER. Doctor, is it a fact that Navy personnel were

exposed to VX and sarin, both lethal agents?

Dr. WINKENWERDER. It appears in one of the tests that that is

the case. They were, in my review of this information. I may turn

to Dr. Kilpatrick, who has been directly involved in this effort—

that people——

Senator SPECTER. Was that exposure——

Dr. WINKENWERDER [continuing]. Were wearing all the protective—appropriate and necessary protective equipment, and it was

in part to test the ability of that equipment to protect. Not something we would do today, obviously, but I think it reflects in my

judgment, looking back on this, certainly not the level of informed

consent that we would expect today, but it is——

Senator SPECTER. Well, let’s just establish a few basic facts.
19

Dr. WINKENWERDER. OK.

Senator SPECTER. They were exposed to VX and sarin, lethal

agents, correct?

Dr. WINKENWERDER. That is correct.

Senator SPECTER. All right. Now, they were wearing—— Dr. WINKENWERDER. Let me turn to Dr. Kilpatrick.

Senator SPECTER. And you say that they were—— Dr. WINKENWERDER. It was on a barge, not populated with people.

Senator SPECTER. And you say that they were wearing protective

clothing?

Dr. WINKENWERDER. Protective gear, yes.

Senator SPECTER. Protective gear.

Dr. WINKENWERDER. Everything that would——

Senator SPECTER. Was it determined that they so-called protective gear was adequate to protect them?

Dr. WINKENWERDER. I don’t know what the people at that time—

my understanding, again, these were 40 years ago. The records are

not great in terms of all the details here. But that would have been

my inference that they believed that the masks, equipment and so

forth were protective. I can’t imagine——

Senator SPECTER. Well, Dr. Winkenwerder, you can’t testify as to

what they believe. We have to make a factual determination what

the protective gear was. Have you made a search to determine if

any of the naval personnel involved in these tests are still alive?

A lot of people are alive from the 1960’s.

Dr. WINKENWERDER. Yes, I believe many of these people are

alive, and we have had contact with some of them.

Senator SPECTER. Well, have you questioned them——

Dr. WINKENWERDER. Yes.

Senator SPECTER [continuing]. As to the exposure and the adequacy of the protective gear?

Dr. WINKENWERDER. Yes. Let me turn to Dr. Kilpatrick, who is

here with me, and who has actually had some of those conversations with those service members.

Senator SPECTER. Let me stick with you, Dr. Winkenwerder, for

just a few minutes to outline the scope of what this committee is

looking for. We want to find out what the facts are. We have already said Navy personnel were exposed to lethal agents. We want

to find out the specifics as to what they were exposed to. And we

want to find out the specifics as to what the protective gear was,

whether the protective gear was adequate.

The issue of consent is a very important one. We understand that

there are no documents around which would verify that there was

written consent. Is that correct?

Dr. WINKENWERDER. I cannot answer that question for you today.

We will try to provide an answer for you.

Senator SPECTER. Well, would you please find out?

Dr. WINKENWERDER. Yes.

Senator SPECTER. There are a great many questions to be answered, and we would not be surprised if you don’t have all the answers today. But let us give you an outline as to what we expect

from you and what we want to have determined. We want to get

into the question of informed consent. Then a central issue is what
20

happened from 1963 to the present as to informing these people

about the risks that they were exposed to.

Senator Rockefeller sees red about the subject, and, frankly, so

do I. We went through great pains. I chaired the committee back

when we had the hearings in 1995 and 1996 and what happened

with Gulf War Syndrome and how the Department of Defense did

not tell the truth.

It seems to be endemic and epidemic, happens all the time. And

our oversight function—you can leave my red light on. Don’t turn

the lights off. It reminds me to conclude.

We want to know what happened in the interim. Every time this

committee turns around, it is Agent Orange or some other substance, and it is always the same thing about the records being inadequate. But there are people who were around. Senator Rockefeller and I were around in 1963. I was conducting, helping conduct, an investigation about what the Government did in 1963. And

we want to know what efforts are being made now—Secretary Cooper will respond to this in part—by the Veterans Administration

but also by the Department of Defense. You have 12 tests, 2,700

to 2,800 people involved. They ought to be notified, they ought to

be found, they ought to be located so they can be apprised as to

what they were exposed to. They may have some lingering symptoms. They may have some lingering illnesses. We all wonder why

we respond in certain ways, but if that is part of a medical history,

they are entitled to know about it.

But, most fundamentally, we want to probe the question of why

the Department of Defense did nothing from 1963 until a couple of

years ago. We want the precise date when the investigation started. And we want to know why the probe was expanded and an announcement made just yesterday. Does it really take congressional

oversight and a congressional jar to get the Department of Defense

to do a little something? We want to know that because we expect

affirmative and positive responses.

Dr. WINKENWERDER. We will provide all of that information. We

would be glad to do so.

Senator SPECTER. We would like to know also if you hadn’t come,

who would have come. We are not too fondly disposed to having

witnesses tell us that they could have avoided the hearing.

Dr. WINKENWERDER. I apologize for suggesting that.

Senator SPECTER. Because we are not only going to want to hear

from you, Dr. Winkenwerder, but we are going to want to hear

from your superiors. And when your superiors come in, Senator

Rockefeller is really going to get tough.

Mr. Chairman?

Chairman ROCKEFELLER. Thank you.

You indicated that you came, and we are very grateful that you

made that choice. Dr. David Chu, however, decided not to, and I

would like a little explanation from you. He is Under Secretary for

Personnel and Readiness, and we had requested that he come testify. Now, this committee has oversight over veterans’ care, and I

am going to ask you what you think oversight means and how you

react to the word ‘‘oversight.’’ What do you think the relationship

between congressional oversight and the Department of Defense, as

well as any other agency, might be?
21

DoD has not been at all enthusiastic about this hearing, and I

understand that. But only late last week we were told that Dr. Chu

could not attend.

Now, that is not to dishonor any of you because I think all of you

are experts on this subject, and we are very pleased that you are

here. But, you know, you said you decided to come. Dr. Chu decided not to come. Could you give me a reason for that? Is he busy?

Dr. WINKENWERDER. Mr. Chairman, I don’t know if it was a

schedule issue——

Chairman ROCKEFELLER. Could you find out for me?

Dr. WINKENWERDER. I can.

Chairman ROCKEFELLER. Because I don’t think he wanted to

come. I don’t think he wanted to face the music. That is my interpretation. I would love to have you prove me wrong. But I would

love to have you ask him why it was that he declined late last

week to show up at this hearing on the second day of Congress

being back in session.

Dr. WINKENWERDER. We will do it.

Chairman ROCKEFELLER. I am going to give you a hard time, because I care about veterans. I am not doing this because of you.

You look like a fine person. But you talked about caring for veterans and that you take care of them. Well, you take care of them

because the Congress told you to by law back in 1982. Yes, you do

take care of them, but don’t make this into a big humanitarian gesture. We told you to. And so you have sharing of some facilities.

So that is straight, right? Did you know that?

Dr. WINKENWERDER. I am sorry, but I did not hear you.

Chairman ROCKEFELLER. That we passed a law saying that you

had to share resources with VA?

Dr. WINKENWERDER. I could only have assumed that the Congress did pass a law.

Chairman ROCKEFELLER. You didn’t know, but you know now.

Dr. WINKENWERDER. I certainly know now, yes.

Chairman ROCKEFELLER. In a sense, like Senator Specter said,

this Project SHAD to me is just a perfect example—that is why it

is so upsetting—of how DoD has historically responded to servicerelated exposures. You have got a war to fight, and you get people

to do things, don’t take records, there is no time, people get fired,

people don’t talk. But it is OK because you are not veterans. You

are the warfighters. The veterans are the people that come home,

if they come home.

Now, as has been said, the Department of Veterans Affairs first

contacted DoD about SHAD in 1997, and I note from your written

testimony that only after Acting Secretary Gober formally requested information in August of 2000 did DoD begin to work on

compiling this information. So that is 2 years, and DoD can only

guess that it has established the locations of most of the relevant

records.

You indicate that DoD has contacted the SHAD planners, but the

retired technical director of those tests told this committee personally that he had never received a phone call from DoD. So, again,

there is something askew here. It is so easy to sort of mislead, so

easy to say you are going to do something, you did do something,
22

but then you start digging in and you find someone who knows the

situation and life isn’t quite so easy.

You know, this task could have been hurried up. DoD could have

chosen to contact retired staff, sort of a creative thing to do—but

you have to think about it—such as the former Technical Director

of Planning and Evaluation for Project 112, who might have helped

sort the wheat from the chaff.

You do have many competing demands, but can you please tell

me why, when DoD first investigated VA’s request for information

on SHAD back in 1997, it did not lead to any broader, more aggressive effort? Why must DoD wait until there is a congressional inquiry before it does, or starts to do, more aggressive investigations?

Dr. WINKENWERDER. Mr. Chairman, I cannot give you an explanation for why in 1997 or between 1997 and 2000 there wasn’t

more prompt, expedient response on the part of the Department.

What I can tell you is that I am very committed to getting this information out, that upon learning about this effort and its importance and what it means, that I have directed, am directing that

every effort be made to get this information out quickly, accurately,

appropriately, and that I believe that, yes, there is information that

needs to be classified, but the public and our veterans need to

know about what went on.

And so I am very committed to that, and that is my assurance

to you. We will keep you regularly informed or provide, you know,

whatever information you think would be useful to know more

about this as this investigation goes along.

Chairman ROCKEFELLER. Obviously, some materials have to be

classified in order to protect national security. That becomes a

huge issue in all kinds of fields. People don’t want to risk national

security. You get that with the FBI and the CIA. The FBI is doing

this; they need some information, an intercept from the CIA. The

CIA doesn’t want to give it to them because it would compromise

sources, et cetera. So there are all kinds of built-in conflicts, and

we understand that.

However, many of the details of deployment of tests, including

unit location, are classified when prepared, but need not remain so

after completion. I am assuming that is true.

The importance of this information to VA in determining eligibility for benefits and appropriate health care and research obviously cannot be overestimated. So what can DoD do to expedite the

declassification process that you talk about?

Dr. WINKENWERDER. I have requested the assistance of each of

the Secretaries of the services—the Army, Navy, Air Force—with

respect to their part in this. They maintain and actually have responsibility for the storage of the records, and so finding the locations of them and then actually getting the people who can go in

and physically get boxes out and have them catalogued, as I described earlier, I have requested their assistance on this. I expect

them to respond and to give us the help that we need to get the

job done.

I have asked Ms. Embrey, my Deputy for Force Health Protection, who has responsibility for this and has oversight responsibility for Dr. Kilpatrick in the deployment health support area that

is responsible for the direct work here, that this is a priority to get
23

this done, and to get it done properly. And I have asked to be informed on a regular basis, and by that I mean, you know, every

couple of weeks, on our progress on this.

I think we have got a job to do, and we need to get it done. We

wanted to give some evidence of our recent efforts that we have not

been standing—or sitting on our hands here the last few months

with this effort. We hope for release of 27 tests within a month or

so. We are very hopeful that we will have that additional information, and then we want to speed along to get the rest of it.

Chairman ROCKEFELLER. I have been handed a note here which

I would like your response to. It says that what you have been saying is not a SHAD-specific problem. Declassification will be an ongoing issue, particularly for special forces. Would you agree with

that?

Dr. WINKENWERDER. Could you restate—I am not sure what the

question is there.

Chairman ROCKEFELLER. I am asking if you agree with the

statement——

Dr. WINKENWERDER. The statement——

Chairman ROCKEFELLER [continuing]. That this is not—what you

have just said is not a SHAD-specific problem, that is, limited only

to.

Dr. WINKENWERDER. Correct.

Chairman ROCKEFELLER. Declassification will be an ongoing

issue, particularly for special forces.

Dr. WINKENWERDER. I am going to turn—yes.

Chairman ROCKEFELLER. Would you agree with this statement:

With regard to SHAD, DoD declassified documents for VA on a limited case-by-case basis upon VA request, but this did not trigger a

larger examination of related issues—in other words, the de minimis: you ask me a question, I will give you an answer, but no kind

of larger approach. Since the military quit keeping morning reports, unit locations are frequently the only data available to determine where a veteran may have been—and this brings back many

memories of the Gulf War Syndrome fiasco. Forget the fiasco part.

Would you agree with the rest of the statement?

Dr. WINKENWERDER. I am not sure I would agree with the statement that we are only responding to what is very specifically and,

in a very exquisite, targeted way is asked for. We have an understanding that there is a whole set of tests, these 103 tests under

Project 112 and SHAD. I understand there are two different

names, two different sets of tests, SHAD being a subset of the

Project 112. Our job is to get all of this information that is available.

Our understanding is that some of these tests, even though there

were 103 that were planned, may have, in fact, never been performed. We don’t know how many there may be of that number— what the final number may be that were never performed. Again,

it is a matter of getting the information out, reviewing and finding

out if the test was ever done. But we have clear information on the

roughly 52, I think, of the 103—I am sorry, 55 that we know that

were either done or we know that they were not done. But we are

trying to get this additional information on the other 48. We believe a fair amount of that information may be at the Dugway
24

Proving Ground record storage site. We have requested to get to

that site, to get to that information. We believe we will be there

next month and into those records, and we will know more at that

time.

But that is the best answer I can give you right now.

Chairman ROCKEFELLER. Part of what is coming through is what

has come through so many times before. You have only been here

a short time, and I understand that. That has nothing to do with

you or who you are, what your makeup is. But you just don’t have

any sense of how many times we have been through this exact

same conversation. I would have given anything if you could have

seen that atomic veteran describe dying while his Government

didn’t care because he couldn’t prove—penniless—that the cancer

50 years later had been caused by what happened 50 years before.

And just on and on and on and on, and it always comes back to

the same questions. You know, sometimes the VA is slow. The VA

are good guys, as far as I am concerned right now, but sometimes

they are slow. But they are underfunded, too. They don’t have the

ear of the President like Donald Rumsfeld does. You know, if you

at DoD need more money, you can go get more money.

Now, I understand you think it doesn’t work that way, but VA

can’t do that. They can’t do that. Tony Principi can’t walk into the

Oval Office—he might not get into the Oval Office—to fight for

more money for health care, for researchers that do things. DoD

has got a whole different posture in the culture of this Nation. And

so when you don’t take efforts to find out what it is that happened

to people who are no longer yours but theirs, please understand the

anger of the people who represent those people, who see those people. You don’t see those people. You don’t go to their homes. You

may see them in hospitals if they ever get there, but most of them

never get there.

You didn’t go through the aftermath of the Persian Gulf War

when VA discovered that returning troops were reporting all kinds

of unexplained symptoms. That was kind of a surprise to people.

Now, VA has to take care of those folks. DoD didn’t seem to know

anything about it, and we couldn’t get any information for them.

So this frustration is not personal. It is professional and it has

built over a long period of time. I have been on this committee for

18 years, and I have never seen a change in DoD attitude. I have

never seen a change in DoD attitude. And I don’t like that, and

there is no reason why I should. Because, you know, we get you

your money, and you can think of us what you want. You probably

don’t like politicians, and you think we just are here for show.

I am not here for show. I am here because I represent one of the

poorest States in the Nation which has the highest participation of

veterans anywhere. So I fight for them like I fight for our steel industry. So I have got to fight for my people. The question is: Are

you fighting for our people, too?

There is no ancient history here. Many of the participants and

planners are still alive and active. They are still out there. One of

the planners informed my staff that he had filmed every test and

knew the names and codes assigned to each, but that no one from

DoD had contacted him to help with finding or sorting any records.

Other veterans and scientists involved in these tests have no prob-
25

lems openly discussing the agents used or what the tests looked

like and express the belief that only the technical aspects and vulnerability assessments are classified. Why is this so difficult? Why

is this so difficult? What do you need to do to more efficiently separate sensitive intelligence information from personal exposure histories?

Dr. WINKENWERDER. Mr. Chairman, if I could ask if you have

that and are willing to share the name of that individual, I will ensure that we make the contact with that person. I would welcome

the chance.

Chairman ROCKEFELLER. The Veterans’ Affairs Committee will

do anything they can to help you.

Dr. WINKENWERDER. And if I might, sir, I would just say I sense

your level of frustration and that of the committee and others, and

I don’t have that experience. But what I can tell you is I am committed to trying to put into place at this point in time—and other

things have been done in the past—the sort of systems of collecting

this information, good records systems so that, you know, 15 years

from now or 10 years from now we are not here asking these same

kinds of questions with the inability to know really what happened.

I am a big believer in records systems. I think we have made improvements. We have some other things that we can do. But I

think this is really important. I think it cuts to the very core of

what can help us avoid the problem in the future. That and a sensitivity to the fact that we do put people in harm’s way and we do

put people at or near exposures—I am talking about in the war

battle situation. We need to do everything we can to protect people

from those kinds of risks and injuries, and when they happen, we

need to be as forthcoming as we can given the constraints of where

it occurs, the security constraints, to get the information out. I

think we are all better served if we do that. That is going to be

my tack during my tenure in my job.

Chairman ROCKEFELLER. Clifton Spendlove is the person you

want to talk to.

Under Secretary Cooper, one of the problems here is that we

have put the cart before the horse to some degree. Because of the

delay in releasing this information, the VA is under time constraints to notify aging veterans long before the potential clinical

effects of the SHAD test can be looked at by scientists.

Now that VA is notifying veterans that they may have been

SHAD participants, what will you do with claims for benefits from

these veterans whose chronic illnesses may or may not be due to

chemical or biological exposures?

Mr. COOPER. The answer to that, Senator, is that we will look

at their claims and find out whether we can adjudicate the claims

even beyond the SHAD. If we don’t have all the information, at

least we can see if there is some compensation we can provide,

based on their medical history, to at least get the process started.

Beyond that, as, we are going through a process with the National

Academy of Sciences, which will take time.

I think the important thing is to try to look at the claim as submitted. There have been a couple of cases of people who came in

who had been, in fact, involved in SHAD. We were able to get their

claim processed based on other events that took place. These vet-
26

erans were able to receive compensation without being dependent

upon SHAD information. So we will do everything we can to adjudicate the claim properly and fairly. Other than that, I think we

really have to wait as far as SHAD-specific things until we get the

necessary information.

Chairman ROCKEFELLER. How long do you expect that will be?

Mr. COOPER. I am sorry, sir. I cannot answer that. I will try to

answer for the record, but it is through this laborious process of

getting the technical information back from the medical community, from the National Academy of Sciences, and whoever else is

doing that type of a test. It is a medical research type of problem

as far as getting a justification. And of course, we have to do it as

the law requires as far as justifying the claim. But we will do everything we can with the ones that are coming in, even though

they are SHAD-related, to get them justified and adjudicated based

on the medical information we have. I think that is the best information I can provide right now, sir.

Chairman ROCKEFELLER. Ellen Embrey, do you know how many

veterans die every day?

Ms. EMBREY. No.

Chairman ROCKEFELLER. A thousand. Just think about it.

Senator Specter has indicated it might be good to go on to the

next panel, and I agree. Thank you all very much.

Senator SPECTER. Before you depart, Dr. Winkenwerder, we outlined the scope of the issues which we have in mind, and what we

would like you to do is to report back to the committee in 30 days

as to what you have found on your record searches as to those

issues. I don’t want to have to repeat them now. And we want to

see what you have found with a view to followup.

And, Mr. Secretary, with respect to your pursuit of the medical

records, we would like to be apprised also within 30 days as to

what you have found on ailments from people who were identified,

and you talk about the laborious process of establishing a causal

connection between what this exposure was, and we would like to

know what you find. We don’t want to see this eventuate into

something like Agent Orange when it took more than a decade before there was legislation on a presumptive service-connection, because we may have to move on that route, too. These people have

been waiting for almost 40 years. And if they are going to be subjected to the kinds of scientific analyses which customarily turn out

to be inconclusive—because of the nature of the investigation, you

just can’t establish a causal connection—leading to the burden of

proof being put on the veteran, nothing is going to happen. That

is why this committee has taken the lead on presumptive serviceconnections, on presumptive causation.

So report back to us, if you would, in 30 days so we can take a

look at what we ought to do further.

Mr. COOPER. Yes, sir.

[The information referred to follows:]
27

VA HEALTH CARE AND COMPENSATION FOR PROJECT SHAD VETERANS

Report to the Senate Veterans’ Affairs Committee (August 5, 2002)

EXECUTIVE SUMMARY

Project SHAD (Shipboard Hazard and Defense) was part of the joint service chemical and biological warfare test program conducted by the Department of Defense

(DoD) during the 1960s. During a hearing before the Senate Veterans’ Affairs Committee on July 10, 2002, the Honorable Arlen Specter asked the Department of Veterans Affairs (VA) to send the committee a report on what we currently know about

the ailments afflicting veterans who participated in Project SHAD.

The benefits portion of this report is based on analysis of data extracted electronically from VA’s Beneficiary Identification and Records Locator Subsystem (BIRLS)

and the Compensation & Pension (C&P) Master Record file for those veterans identified, to date, who have filed claims. For health care, the report reflects preliminary

data from VA’s computerized health databases. DoD continues to search and declassify documents associated with Project SHAD. As additional test information and

participant names are made available to VA, we will continue to analyze data and

update our findings.

Thus far, VA has identified 1,739 Project SHAD veterans having VA claim numbers. Social security numbers were associated with 1,419 of the 1,739 names and

that information was provided to the Veterans Health Administration (VHA).

On May 21, 2002, VA mailed letters to 622 veterans who participated in the initial three Project SHAD tests declassified by DoD (i.e., Autumn Gold, Copper Head,

and Shady Grove) for whom social security numbers and addresses had been obtained. The letter informed the veterans of potentially hazardous exposures during

military service and encouraged them to seek an evaluation at a local VA medical

center, if they had any concerns.

Review of health care data shows that of the 622 SHAD veterans, 226 have received health care from VA for a very wide array of common diagnoses. Preliminary

data shows that the most frequent infectious disease diagnosis was

dermatophytosis, a fungal infection of the skin like athletes foot. The most frequent

neurological diagnoses were disorders of refraction (needing eye glasses) and deafness.

Using BIRLS and C&P Master Record file data, VA identified 299 veterans who

were SHAD participants having at least one service-connected disability. There were

many similarities between the disabilities of the 299 SHAD participant veterans

and the total service-connected veteran beneficiary population. For both SHAD participants and the total service-connected veteran beneficiary population, the majority of the disabilities were associated with the following four body systems: musculoskeletal system, skin, impairments of auditory acuity, and the digestive system. The

most common disabilities were defective hearing, scars, and generalized skeletal

conditions.

In order to determine whether SHAD veterans are experiencing particular health

problems due to prior exposures during military service, a formal epidemiological

study will have to be conducted. To answer this question, the Secretary requested

the Institute of Medicine (IOM), Medical Follow-Up Agency, to develop a formal proposal which is expected by the end of August 2002.

VA treatment data in this report is preliminary and based on the initial 622 veterans identified with social security numbers. VA will submit a more extensive assessment of treatment and diagnoses based upon existing computer records.

BACKGROUND

On July 10, 2002, Senator Specter, Ranking Member, Senate Veterans’ Affairs

Committee, requested a report back to the Committee within 30 days about what

VA has found out regarding the ailments of Project SHAD veterans. The information requested was for the ailments of Project SHAD veterans who have been treated in VA health care facilities and the medical conditions of Project SHAD veterans

who have submitted compensation claims.

Project SHAD was part of the joint service chemical and biological warfare test

program conducted by DoD during the 1960s. Project SHAD encompassed tests designed to identify US warships’ vulnerabilities to attacks with chemical or biological

warfare agents and to develop procedures to respond to such attacks while maintaining a war-fighting capability. Although classified, DoD is in the process of declassifying relevant medical information.

At this time, the exact number of Project SHAD tests actually conducted is unknown. As of July 5, 2002, DoD has provided VA with declassified information relat-
28

ing to twelve tests. In addition, DoD has provided VA with test names and participant information for two tests not yet declassified. Approximately 4,684 participants

were involved in the fourteen tests known as:

• Autumn Gold

• Big Tom

• Copper Head

• DTC Test 68–50

• DTC Test 69–32

• Eager Belle I

• Eager Belle II

• Fearless Johnny

• Flower Drum I

• Flower Drum II

• Half Note

• Purple Sage

• Scarlet Sage

• Shady Grove

Some veterans participated in more than one test. Based on current information,

approximately 2,938 unique service members participated in these fourteen tests.

IDENTIFICATION OF VETERANS WHO RECEIVED HEALTH CARE TREATMENT AND FILED

COMPENSATION CLAIMS

VA used the names and service numbers of SHAD participants provided by DoD

to identify veterans who have been treated in VA health care facilities and/or filed

compensation claims. That data was matched against information available in VA’s

Beneficiary Identification and Records Locator Subsystem (BIRLS). The Veterans

Benefits Administration (VBA) matched 1,739 records identified with VA claim

numbers against the June 2002 Compensation & Pension Master Record and May

2002 BIRLS inactive compensation/pension data and extracted information about

SHAD veterans who have filed compensation claims. Of the 1,739 records, we were

able to associate social security numbers with 1,419 names and provide that information to VHA to match against their databases for health care utilization.

REPORT FINDINGS

The benefits portion of this report is based on analysis of data extracted electronically from BIRLS and the C&P Master Record file for those veterans identified, to

date, who have filed claims. For health care, the report reflects preliminary data.

DoD continues to search and declassify documents associated with Project SHAD.

As additional test information and participant names are made available to VA, we

will continue to analyze both VBA and VHA data and update our findings.

I. Project SHAD Veterans Who Have Been Treated in VA Health Care Facilities

VA HEALTH DATABASES

VA is engaged in a complex process to augment its medical record system and to

connect computerized health databases into a coherent network. Because of progress

in integrating VA’s computerized health databases, VHA can now track health care

utilization by special groups of veterans such as the veterans who participated in

Project SHAD.

In this regard, VA is developing the Health Data Repository (HDR) to provide the

support for a full electronic patient medical record. VHA will use a combination of

the existing VistA system and a commercial clinical repository product to record all

patient data, thereby creating a ‘‘longitudinal’’ record covering all care received from

VA. In addition, the HDR will provide the means to electronically receive data from

other health care entities, such as DoD, private health care, and any reference facility (such as specialty laboratories).

For evaluating the health of Project SHAD veterans who come to VA for health

care, the use of these standard health care databases provide several important advantages over clinical ‘‘registries,’’ which have been used in the past to evaluate particular cohorts of veterans, such as Vietnam and Gulf War veterans. The use of VA’s

health databases allows VA to evaluate the health of veterans every time they obtain care in the VA, not just on the one occasion that they elect to have a registry

examination. This will provide a much broader and longer-term assessment of the

health status of these veterans because many veterans return frequently for VA

health care, and because veterans are often seen in different clinics or even different

parts of the country for specialized health care.

STATUS OF SHAD VETERANS SEEN BY VA

On May 21, 2002, VA mailed letters to 622 veterans who participated in the initial three tests declassified by DoD (i.e., Autumn Gold, Copper Head, and Shady

Grove) for whom social security numbers and addresses had been obtained. The letter informed the veterans of potentially hazardous exposures during military service

and encouraged them to seek an evaluation at a local VA medical center, if they

had any concerns.
29

VA’s health databases were used to assess SHAD veterans who received VA

health care, including how many had newly enrolled in the VA health care system,

what percentage had previously obtained care within the VA, and the general types

of diagnoses that SHAD veterans received at VA medical centers, with the following

results:

• Between May 1 and July 24, 2002, eleven or 1.8 percent of the 622 veterans

who had been mailed letters, enrolled for VA health care for the first time.

• The letter VA sent to SHAD veterans may have had an impact on the number

of veterans seeking VA health care. On average, 15 of these 622 veterans were seen

at a VA health care facility each month from October 2001 to May 2002. A larger

number (48) of these SHAD veterans were seen at VA health care facilities in June

2002, the month after the notification letters were mailed.

• Of the 622 SHAD veterans, 226 have received health care from VA at some

time in the past and with a very wide array of common diagnoses. This is to be

expected in a cohort of veterans who are 50 years of age and older. The most frequent infectious disease diagnosis was dermatophytosis, which is a fungal infection

of the skin like athletes foot. The most frequent neurological diagnoses were disorders of refraction (needing eye glasses) and deafness, which also are common diagnoses among aging veteran populations.

• It is not possible to determine whether any particular diagnoses is occurring at

higher rates than normal because this is a highly select group of veterans who have

sought health care in the VA system.

• The number of SHAD veterans being evaluated by the VA is too small to assess

individual diseases.

VA HEALTH CARE UTILIZATION AMONG SHAD PARTICIPANT VETERANS

In fiscal year 2002, 102 of the 622 SHAD veterans who had been mailed letters

were obtaining health care in the VA system. This is a 16 percent rate of health

care utilization, which is comparable to the 15 percent rate of VA health care utilization by the entire U.S. military veteran population in FY 2002.

The social security numbers of 797 additional veterans who participated in subsequent declassified tests have been obtained. None of these 797 veterans were included in the original group of 622 SHAD veterans contacted by mail in May 2002.

The addresses of veterans associated with this new group have been obtained and,

in the near future, VA will notify them of potential exposures.

Within the constraints of this report, the only health information that VA has

been able to assess for the more recently identified 797 veterans is their VA health

care utilization. Among these veterans, 124 (16 percent) received health care from

the VA during the current fiscal year. This is similar to other groups of U.S. veterans.

INITIAL CONCLUSIONS REGARDING UTILIZATION OF VA HEALTH CARE

To date, the 622 Project SHAD veterans have not demonstrated higher utilization

of VA health care services compared to other veterans. However, Project SHAD veterans directly notified by mail of potentially hazardous exposures appear to have

been prompted to seek health care from the VA. Eleven new veterans who sought

health care from the VA for the first time may have done so because of the notification letters.

EPIDEMIOLOGICAL STUDY TO EVALUATE SHAD VETERAN HEALTH STATUS

In order to determine whether SHAD veterans are experiencing particular health

problems due to prior exposures during military service, a formal epidemiological

study will have to be conducted. Neither VA health care databases nor a clinical

registry can assess rates of disease or possible causes because veterans receiving

care in the VA do not constitute a representative sample for research purposes. As

an example, evaluation of over 100,000 Gulf War veterans in VA and DoD clinical

registries has not answered scientific questions about the health of this population.

Both veterans receiving care from the VA and veterans receiving health care from

other providers have to be sampled in order to conduct a valid scientific study and

determine the nature and causes of their health problems.

The Institute of Medicine (IOM), Medical Follow-Up Agency, has developed a proposal to conduct this independent, epidemiological study, and this proposal is currently undergoing internal review by the IOM. The VA expects to receive the formal

proposal in August 2002.
30

1 In 55 (90%) of these cases, the veteran is deceased.

2Two veterans receiving pension had service-connected disabilities evaluated at 0% and three

had service-connected disabilities evaluated at 10%.

FURTHER USE OF EXISTING VHA DATABASES

While this will not be a substitute for the well designed epidemiological study described above, further information on medical conditions of SHAD veterans is available with some limitations. Medical conditions are not stable over time. Some improve while others get worse. Some are cured while others become chronic. This

complicates any analysis of health status over time. Databases are maintained by

fiscal year and not all patients are seen every year. The two automated databases

containing diagnostic information are the patient treatment file (PTF), which covers

inpatient hospitalization from FY 1970, and the outpatient file (OPC), which contains diagnostic data beginning in FY 1997. These data files are extremely large but

an analysis of the medical diagnoses of the SHAD veterans identified with social

security numbers as of July 2002 has begun and will be made available as soon as

possible. VA will submit a more extensive assessment of treatment and diagnoses

based upon existing computer records.

II. Project Shad Veterans Who Have Submitted Compensation Claims

VETERANS WITH AT LEAST ONE SERVICE-CONNECTED DISABILITY

As of June 2002, of the 1,739 veterans for whom VA claim numbers were

matched, VA identified 299 veterans who were SHAD participants having at least

one service-connected disability. This group included:

• Those veterans receiving compensation (159),

• Those evaluated at less than 10 percent for service-connected disabilities (74),

• Those who had at least one service-connected disability evaluated at 10 percent

or more, but with inactive records 1 (61), and

• Those with service-connected disabilities, but receiving disability pension (5).2

VETERANS WHO FILED FOR BENEFITS WHO DID NOT HAVE A SERVICE-CONNECTED

DISABILITY

Of the 1,739 veterans for whom VA claim numbers were matched, 78 veterans did

not have a service connected disability.

• Sixty-six veterans had all non service-connected disabilities.

• Twelve veterans were receiving disability pension and had no service-connected

disabilities.

COMBINED SERVICE-CONNECTED EVALUATION

The following chart shows the distribution based on the combined service-connected evaluation for the 299 service-connected veterans. The largest number (76 or

25.4 percent) of the veterans had a combined service-connected evaluation of 0 percent followed closely by 23.4 percent with a 10 percent evaluation.

Number of Veterans With Combined Service-Connected Evaluation

Combined Evaluation Number of

Veterans

Percent of

Total

0% ................................................................................................................................................... 76 25.4%

10% ................................................................................................................................................. 70 23.4%

20% ................................................................................................................................................. 33 11.0%

30% ................................................................................................................................................. 25 8.4%

40% ................................................................................................................................................. 21 7.0%

50% ................................................................................................................................................. 13 4.3%

60% ................................................................................................................................................. 18 6.0%

70% ................................................................................................................................................. 8 2.7%

80% ................................................................................................................................................. 5 1.7%

90% ................................................................................................................................................. 3 1.0%

100% ............................................................................................................................................... 27 9.0%

Total ............................................................................................................................... 299 100.0%
31

SERVICE-CONNECTED DISABILITIES

The 299 veterans had 724 individual service-connected disabilities. The following

chart shows the number of disabilities for each veteran. For example, 84 veterans

had two service-connected disabilities; 11 veterans had five service-connected disabilities. On average, each had 2.4 service-connected disabilities.

Number of Service-Connected Disabilities

[Per Veteran]

Number of Service-Connected Disabilities Number of

Veterans

Number of

Disabilities

1 ....................................................................................................................................................... 108 108

2 ....................................................................................................................................................... 84 168

3 ....................................................................................................................................................... 43 129

4 ....................................................................................................................................................... 27 108

5 ....................................................................................................................................................... 11 55

6 ....................................................................................................................................................... 26 156

Total ............................................................................................................................... 299 724

SERVICE-CONNECTED DISABILITIES BY BODY SYSTEM

The 724 service-connected disabilities were associated with 14 of the 15 rating

schedule body systems. The following chart shows the number of service-connected

disabilities associated with each and the percentage of total. None of the disabilities

were gynecological.

Number of Service-Connected Disabilities Associated With Each Body Systems

Body System Number of

Disabilities

Percent of

Total

Grand Total—All SC Conditions (Codes 5000–9999) .................................................................... 724 100.0%

Musculoskeletal System (Codes 5000–5399) ................................................................................. 225 31.1%

Digestive System (Codes 7200–7399) ............................................................................................ 102 14.1%

Impairment of Auditory Acuity (Codes 6100–6299) ....................................................................... 97 13.4%

Skin (Codes 7800–7899) ................................................................................................................. 76 10.5%

Cardiovascular System (Codes 7000–7199) ................................................................................... 61 8.4%

Respiratory System (Codes 6501–6899) ......................................................................................... 44 6.1%

Neurological Conditions (Codes 8000–8999) .................................................................................. 26 3.6%

Genitourinary System (Codes 7500–7599) ...................................................................................... 25 3.5%

Mental Disorders (Codes 9200–9599) ............................................................................................ 25 3.5%

Endocrine System (Codes 7900–7999) ........................................................................................... 17 2.3%

Eye (Codes 6000–6099) .................................................................................................................. 14 1.9%

Infectious Diseases, Immune Disorders, Nutritional Disorder (Codes 6300–6399) ....................... 5 0.7%

Dental and Oral Conditions (Codes 9900–9999) ........................................................................... 5 0.7%

Hemic & Lymphatic Systems (Codes 7700–7799) ......................................................................... 2 0.3%

Gynecological Conditions (Codes 7601–7699) ................................................................................ 0 0.0%

NON SERVICE-CONNECTED DISABILITIES BY BODY SYSTEM

This group of 299 veterans also had 257 disabilities determined to be non serviceconnected. The non service-connected disabilities were associated with 13 of the 15

rating schedule body systems. The following chart shows the number of non serviceconnected disabilities associated with each body system and the percentage of total.

None of the disabilities were gynecological or dental/oral conditions.

Number of Non Service-Connected Disabilities Associated With Each Body system

Body System Number of

Disabilities

Percent of

Total

Grand Total—All NSC Conditions (Codes 5000–9999) .................................................................. 257 100.0%

Musculoskeletal System (Codes 5000–5399) ................................................................................. 62 24.1%

Impairment of Auditory Acuity (Codes 6100–6299) ....................................................................... 28 10.9%

Cardiovascular System (Codes 7000–7199) ................................................................................... 26 10.1%

Mental Disorders (Codes 9200–9599) ............................................................................................ 25 9.7%
32

Number of Non Service-Connected Disabilities Associated With Each Body system—Continued

Body System Number of

Disabilities

Percent of

Total

Digestive System (Codes 7200–7399) ............................................................................................ 23 8.9%

Skin (Codes 7800–7899) ................................................................................................................. 21 8.2%

Respiratory System (Codes 6501–6899) ......................................................................................... 19 7.4%

Neurological Conditions (Codes 8000–8999) .................................................................................. 15 5.8%

Endocrine System (Codes 7900–7999) ........................................................................................... 14 5.4%

Eye (Codes 6000–6099) .................................................................................................................. 12 4.7%

Genitourinary System (Codes 7500–7599) ...................................................................................... 9 3.5%

Hemic & Lymphatic Systems (Codes 7700–7799) ......................................................................... 2 0.8%

Infectious Diseases, Immune Disorders, Nutritional Disorder (Codes 6300–6399) ....................... 1 0.4%

Gynecological Conditions (Codes 7601–7699) ................................................................................ 0 0.0%

Dental and Oral Conditions (Codes 9900–9999) ........................................................................... 0 0.0%

MOST COMMON SERVICE-CONNECTED DISABILITIES

The following chart shows the 15 most common service-connected disabilities,

their associated diagnostic codes, frequency, and the percent of total. For example,

64 or 8.8 percent of the 724 service-connected disabilities were for defective hearing/

hearing loss.

Most Common Service-Connected Disabilities

Service Connected Disabilities Diagnostic Codes Frequency Percent of Total

Total Disabilities ......................................................................................... 5000–9999 724 100.0%

Defective hearing/Hearing Loss .................................................................. 6100–6101–

6102–6282–

6288–6289–

6292–6293–

6296–6297

64 8.8%

Scars ........................................................................................................... 7800–7801–

7802–7604–

7805

47 6.5%

Generalized, Skeletal condition ................................................................... 5299 41 5.7%

Hemorrhoids, external or internal ............................................................... 7336 28 3.9%

Intervertebral disc syndrome ...................................................................... 5293 26 3.6%

Tinnitus ....................................................................................................... 6260 26 3.6%

Hypertensive vascular disease (essential arterial hypertension) ............... 7101 23 3.2%

Hernia, inguinal .......................................................................................... 7338 20 2.8%

Lumbo-sacral strain ................................................................................... 5295 17 2.3%

Arteriosclerotic Heart Disease ..................................................................... 7005 16 2.2%

Duodenal ulcer ............................................................................................ 7305 16 2.2%

Arthritis, Degenerative, Hypertrophic or Osteoarthritis .............................. 5003 14 1.9%

Diabetes Mellitus ........................................................................................ 7913 14 1.9%

Arthritis, Due to Trauma, substantiated by x-ray findings ....................... 5010 13 1.8%

Other impairment of knee .......................................................................... 5257 11 1.5%

Fifteen disabilities accounted for 51.9% of total disabilities .................. ........................ 376 51.9%

MOST COMMON DISABILITIES (SERVICE-CONNECTED AND NON SERVICE-CONNECTED)

This group of 299 veterans had a total of 981 disabilities (both service-connected

and non service-connected). The following chart shows the 15 most common disabilities, their associated diagnostic codes, frequency, and the percent of total. For example, 83 or 8.5 percent of the 981disabilities were for defective hearing/hearing

loss.

Most Common Disabilities

Most Common Disabilities Diagnostic Codes Frequency Percent of Total

Total Disabilities ......................................................................................... 5000–9999 981 100.0%
33

Most Common Disabilities—Continued

Most Common Disabilities Diagnostic Codes Frequency Percent of Total

Defective hearing/Hearing Loss .................................................................. 6100–6101–

6102–6282–

6288–6289–

6292–6293–

6296–6297

83 8.5%

Scars ........................................................................................................... 7800–7801–

7802–7804–

7805

51 5.2%

Generalized, Skeletal condition ................................................................... 5299 50 5.1%

Hypertensive vascular disease (essential arterial hypertension) ............... 7101 34 3.5%

Tinnitus ....................................................................................................... 6260 33 3.3%

Intervertebral disc syndrome ...................................................................... 5293 32 3.3%

Hemorrhoids, external or internal ............................................................... 7336 30 3.1%

Diabetes Mellitus ........................................................................................ 7913 27 2.8%

Arthritis, Degenerative, Hypertrophic or Osteoarthritis .............................. 5003 26 2.7%

Lumbo-sacral strain ................................................................................... 5295 26 2.7%

Arteriosclerotic Heart Disease ..................................................................... 7005 23 2.3%

Hernia, inguinal .......................................................................................... 7338 23 2.3%

Generalized, The Skin ................................................................................. 7899 21 2.1%

Arthritis, Due to Trauma, substantiated by x-ray findings ....................... 5010 17 1.7%

Duodenal ulcer ............................................................................................ 7305 17 1.7%

Fifteen disabilities accounted for 50.2% of total disabilities .................. ........................ 493 50.3%

Appendix A lists in descending order of frequency the 981 disabilities associated

with the 299 veterans.

DISABILITY EVALUATIONS WITHIN BODY SYSTEM

The following chart shows the distribution of 724 service-connected disabilities

based on assigned evaluation and percentage of total for each of the eleven levels

(i.e., 0 percent–100 percent). For example, 93 musculoskeletal disabilities are evaluated at 0 percent and 17 disabilities associated with skin are evaluated at 10 percent. Forty-eight percent of the total disabilities are evaluated at 0 percent and 25.1

percent of the disabilities are evaluated at 10 percent.
34

Number of Disabilities Based on Individual Evaluation

Body System

Number

of Disabilities 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Musculoskeletal System (Codes 5000–5399) ................................................ 225 93 68 30 9 12 1 9 .............. .............. .............. 3Eye (Codes 6000–6099) ................................................................................. 14 8 2 .............. 2 .............. .............. .............. .............. .............. .............. 2

Impairment of Auditory Acuity (Codes 6100–6299) ...................................... 97 55 35 5 .............. 1 1 .............. .............. .............. .............. ..............

Infectious Diseases, Immune Disorders, Nutritional Disorder (Codes 6300–

6399) .......................................................................................................... 5 3 .............. .............. 1 .............. .............. 1 .............. .............. .............. ..............

Respiratory System (Codes 6501–6899) ........................................................ 44 21 8 .............. 6 .............. 1 4 .............. .............. .............. 4Cardiovascular System (Codes 7000–7199) .................................................. 61 8 17 6 8 1 1 11 .............. 1 .............. 8Digestive System (Codes 7200–7399) ........................................................... 102 80 12 4 5 .............. .............. .............. .............. 1 .............. ..............Genitourinary System (Codes 7500–7599) .................................................... 25 14 3 1 1 .............. .............. 2 .............. 1 .............. 3Gynecological Conditions (Codes 7601–7699) .............................................. 0 .............. .............. .............. .............. .............. .............. .............. .............. .............. .............. ..............

Hemic & Lymphatic Systems (Codes 7700–7799) ........................................ 2 .............. .............. .............. 2 .............. .............. .............. .............. .............. .............. ..............

Skin (Codes 7800–7899) ............................................................................... 76 55 17 .............. 3 .............. 1 .............. .............. .............. .............. ..............

Endocrine System (Codes 7900–7999) .......................................................... 17 3 1 11 .............. 1 .............. 1 .............. .............. .............. ..............

Neurological Conditions (Codes 8000–8999) ................................................ 26 3 11 3 1 2 .............. 1 .............. .............. .............. 5Mental Disorders (Codes 9200–9599) ........................................................... 25 2 7 .............. 5 .............. 4 .............. .............. .............. .............. 7

Dental and Oral Conditions (Codes 9900–9999) .......................................... 5 4 1 .............. .............. .............. .............. .............. .............. .............. .............. ..............

Grand Total (Codes 5000–9999) ................................................................... 724 349 182 60 43 17 9 29 0 3 0 32Percent of Total .............................................................................................. 100.0% 48.2% 25.1% 8.3% 5.9% 2.3% 1.2% 4.0% 0.0% 0.4% 0.0% 4.4%
35

3 VBA Annual Benefits Report, Fiscal Year 2001, dated May 2002, Table 6 Chap. 3.

4 VBA Annual Benefits Report, Fiscal Year 2001, dated May 2002, Table 7 Chap. 3.

5 VBA Annual Benefits Report, Fiscal Year 2001, dated May 2002, Table 8 Chap. 3.

6 VBA Annual Benefits Report, Fiscal Year 2001, dated May 2002, Table 10 Chap. 3.

SHAD COMPENSATION CLAIMS PENDING

As of August 1, 2002, there were compensation claims pending decisions for 28

veterans alleging disabilities due to exposure to agents and substances while participating in Project SHAD. Sixteen of these claims were received subsequent to the

May 21, 2002, letter VA mailed to veterans informing them of potentially hazardous

exposures during military service. Only seven of the 16 claims are from veterans

who actually received the letter. The claims are for service connection for a wide

array of disabilities.

CONCLUSIONS REGARDING COMPENSATION CLAIMS

The data obtained from this review was based on a relatively small sample 299—

cases where veterans had filed compensation claims. Nothing unique came to light

regarding the disabilities of these SHAD participants. There were many similarities

between the awards/disabilities of the 299 veterans identified as participants of

Project SHAD and the total service-connected veteran beneficiary population.

• Average Number of Disabilities On average, the 299 SHAD participants had 2.4

service-connected disabilities compared to 2.57 disabilities 3 for the total service-connected beneficiary population.

• Majority of Service-Connected Disabilities were Associated with Four Body Systems For both SHAD participants and the total service-connected veteran beneficiary population, the majority of the disabilities were associated with the musculoskeletal system, skin, impairments of auditory acuity, and the digestive system.

Sixty-nine percent of the disabilities for SHAD participants were associated with

these four body systems compared to 68.9 percent 4 for the total service-connected

beneficiary population.

Body System

Percent of

Disabilities

SHAD Participants

Percent of

Disabilities

Total ServiceConnected

Beneficiary

Population *

Musculoskeletal ............................................................................................................................... 31.1% 40.4%

Digestive .......................................................................................................................................... 14.1% 7.3%

Impairment of Auditory Acuity ......................................................................................................... 13.4% 8.9%

Skin .................................................................................................................................................. 10.5% 12.3%

* VBA Annual Benefits Report, Fiscal Year 2001, dated May 2002, Table 7 Chap. 3.

• Majority of Individual Service-Connected Disabilities Evaluated at 0 percent and

10 percent For both SHAD participants and the total service-connected veteran beneficiary population, the majority of the disabilities were evaluated at 0 percent and

10 percent. That is, 73.3 percent of the disabilities for SHAD participants compared

to 72.9 percent 5 for the total service-connected beneficiary population.

Evaluation Assigned Individual Disabilities

Percent for

SHAD Participants

Percent for

Total ServiceConnected

Beneficiary

Population

0% Evaluation ................................................................................................................................. 48.2% 35.0%

10% Evaluation ............................................................................................................................... 25.1% 37.9%

• Common Disabilities For both SHAD participants and the total service-connected veteran beneficiary population,6 the following disabilities were among the

most common:

Arthritis due to trauma

Defective hearing/Hearing loss

Degenerative Arthritis

Diabetes Mellitus

Duodenal ulcer

Hemorrhoids

Hypertensive vascular disease
36

Intervertebral disc syndrome

Knee impairments

Lumbo-sacral strain

Scars

Skeletal conditions

Tinnitus

APPENDIX A.—FREQUENCY OF DISABILITIES ASSOCIATED WITH 299 COMPENSATION

CLAIMS

Frequency Diagnostic Codes Description of Disability

83 ....... 6100–6101–6102–6282–6288–

6289–6292–6293–6296–

6297.

Defective hearing/Hearing Loss

51 ....... 7800–7801–7802–7804–7805 .. Scars

50 ....... 5299 ........................................... Generalized, Skeletal condition

34 ....... 7101 ........................................... Hypertensive vascular disease (essential arterial hypertension)

33 ....... 6260 ........................................... Tinnitus

32 ....... 5293 ........................................... Intervertebral disc syndrome

30 ....... 7336 ........................................... Hemorrhoids, external or internal

27 ....... 7913 ........................................... Diabetes Mellitus

26 ....... 5003 ........................................... Arthritis, Degenerative, Hypertrophic or Osteoarthritis

26 ....... 5295 ........................................... Lumbo-sacral strain

23 ....... 7005 ........................................... Arteriosclerotic Heart Disease

23 ....... 7338 ........................................... Hernia, inguinal

21 ....... 7899 ........................................... Generalized, The Skin

17 ....... 5010 ........................................... Arthritis, Due to Trauma, substantiated by x-ray findings

17 ....... 7305 ........................................... Duodenal ulcer

14 ....... 5257 ........................................... Other impairment of knee

11 ....... 9411 ........................................... Post-Traumatic Stress Disorder

10 ....... 6600 ........................................... Bronchitis, chronic

10 ....... 7399 ........................................... Generalized, Digestive System

9 ......... 5002 ........................................... Arthritis, Rheumatoid (Atrophic), as an active process

9 ......... 7527 ........................................... Prostate gland injuries, infections, hypertrophy, post-operative residuals

9 ......... 7819 ........................................... New growths, benign, skin

8 ......... 7346 ........................................... Hernia, hiatal

8 ......... 7599 ........................................... Generalized, Genitourinary System

7 ......... 5099 ........................................... Generalized, Acute, Subacute, or Chronic Diseases of the Musculoskeletal System

7 ......... 5290 ........................................... Limitation of motion of cervical spine

7 ......... 6899 ........................................... Generalized, Nontuberculous Diseases

6 ......... 5203 ........................................... Impairment of clavicle or scapula

6 ......... 5271 ........................................... Limited motion of the ankle

6 ......... 6099 ........................................... Generalized, Disease of the Eye, Impairment of Central Visual Acuity, Impairment of Field of Vision, Impairment of Muscle Function (eyes)

6 ......... 6599 ........................................... Generalized, Disease of the Nose and Throat

6 ......... 7017 ........................................... Coronary Artery Bypass Surgery

6 ......... 9405 ........................................... Dysthymic disorder; Adjustment disorder with depressed mood, Major depression without melancholia

5 ......... 6034 ........................................... Pterygium

5 ......... 6603 ........................................... Emphysema, pulmonary

5 ......... 7099 ........................................... Generalized, Diseases of the Heart

5 ......... 7806 ........................................... Eczema

5 ......... 7813 ........................................... Dermatophytosis

5 ......... 7816 ........................................... Psoriasis

5 ......... 8018 ........................................... Multiple sclerosis

5 ......... 8099 ........................................... Generalized, Organic Diseases of the Central Nervous System

5 ......... 9400 ........................................... Generalized anxiety disorder

4 ......... 5015 ........................................... Bones, New Growths of, Benign

4 ......... 5017 ........................................... Gout

4 ......... 5020 ........................................... Synovitis

4 ......... 5227 ........................................... Ankylosis of any other finger

4 ......... 5285 ........................................... Vertebra, fracture of, residuals

4 ......... 6079 ........................................... Defective visual acuity

4 ......... 6510 ........................................... Sinusitis, parnsinusitis, chronic

4 ......... 6602 ........................................... Asthma, bronchial
37

Frequency Diagnostic Codes Description of Disability

4 ......... 6819 ........................................... New growths, malignant, any specified part of the respiratory system exclusive

of skin growths

4 ......... 7007 ........................................... Hypertensive heart disease

4 ......... 7116 ........................................... Claudication, intermittent

4 ......... 7120 ........................................... Varicose Veins

4 ......... 7318 ........................................... Gall bladder, removal of

4 ......... 7341 ........................................... Stomach wound

4 ......... 7528 ........................................... Malignant neoplasms of the genitourinary system

4 ......... 8008 ........................................... Brain, vessels, thrombosis of

4 ......... 8045 ........................................... Brain disease due to trauma

4 ......... 8515 ........................................... Paralysis of the median nerve

4 ......... 8599 ........................................... Generalized, Diseases of the Peripheral Nerves (Paralysis)

4 ......... 9203 ........................................... Schizophrenia, Paranoid type

4 ......... 9499 ........................................... Generalized, Anxiety Disorders, Dissociative Disorders, Somatoform Disorders,

Mood Disorders

4 ......... 9999 ........................................... Generalized, Dental and Oral Conditions

3 ......... 5165 ........................................... Amputation of Leg at a lower level permitting prosthesis

3 ......... 5201 ........................................... Limitation of motion of arm

3 ......... 5211 ........................................... Impairment of Ulna

3 ......... 5215 ........................................... Limitation of motion of the wrist

3 ......... 5262 ........................................... Tibia and fibula, impairment of

3 ......... 5276 ........................................... Flatfoot, acquired

3 ......... 5292 ........................................... Limitation of motion of lumbar spine

3 ......... 5309 ........................................... Group IX Intrinsic muscles of hand

3 ......... 6018 ........................................... Conjunctivitis, other, chronic

3 ......... 6200 ........................................... Otitis media, suppurative, chronic

3 ......... 6731 ........................................... Tuberculosis, pulmonary, chronic, inactive

3 ......... 6799 ........................................... Generalized, Diseases of the Lungs and Pleura—Tuberculosis

3 ......... 7299 ........................................... Generalized, Digestive System

3 ......... 7307 ........................................... Gastritis, hypertrophic

3 ......... 7308 ........................................... Postgastrectomy syndromes

3 ......... 7339 ........................................... Hernia, ventral, postoperative

3 ......... 7344 ........................................... New growths, benign, any part of digestive system, exclusive of skin growths

3 ......... 9399 ........................................... Generalized, Delirium, Dementia, and Amnestic and Other Cognitive Disorders

2 ......... 5019 ........................................... Bursitis

2 ......... 5209 ........................................... Elbow, other impairment of Flail joint

2 ......... 5212 ........................................... Impairment of radius

2 ......... 5224 ........................................... Ankylosis of thumb

2 ......... 5225 ........................................... Ankylosis of Index Finger

2 ......... 5253 ........................................... Thigh, Impairment of

2 ......... 5279 ........................................... Metatarsalgia, anterior (Morton’s disease)

2 ......... 5294 ........................................... Sacro-iliac injury and weakness

2 ......... 5296 ........................................... Skull, loss of part of, both inner and outer tables

2 ......... 5314 ........................................... Group XIV—Anterior thigh group

2 ......... 5319 ........................................... Group XIX—Muscles of abdominal wall

2 ......... 5399 ........................................... Generalized, Shoulder and Girdle Muscles, the Forearm and Hand, the Foot

and Leg, the Pelvic Girdle and Thigh, the Torso and Neck

2 ......... 6029 ........................................... Aphakia

2 ......... 6210 ........................................... Auditory canal, disease of

2 ......... 6211 ........................................... Tympanic membrane, perforation of

2 ......... 6299 ........................................... Generalized, Diseases of the Ear

2 ......... 6310 ........................................... Syphilis, unspecified

2 ......... 6399 ........................................... Generalized, Infectious Diseases, Immune Disorder and Nutritional Deficiencies

2 ......... 6513 ........................................... Sinusitis, maxillary, chronic

2 ......... 6699 ........................................... Generalized, Diseases of the Trachea and Bronchi

2 ......... 6723 ........................................... Tuberculosis, pulmonary, chronic, minimal, inactive

2 ......... 6833 ........................................... Asbestosis

2 ......... 7199 ........................................... Generalized, Diseases of the Arteries and Veins

2 ......... 7312 ........................................... Liver, cirrhosis

2 ......... 7323 ........................................... Ulcerative colitis

2 ......... 7345 ........................................... Hepatitis, infectious

2 ......... 7504 ........................................... Pyelonephritis, chronic

2 ......... 7508 ........................................... Nephrolithiasis

2 ......... 7512 ........................................... Cystitis, chronic, includes interstitial and all etiologies, infectious and non-infectious
38

Frequency Diagnostic Codes Description of Disability

2 ......... 7706 ........................................... Splenectomy

2 ......... 7799 ........................................... Generalized, Hemic and Lymphatic Systems

2 ......... 7999 ........................................... Generalized, The Endocrine System

2 ......... 8100 ........................................... Migraine

2 ......... 8512 ........................................... Paralysis of lower radicular group

2 ......... 8520 ........................................... Paralysis of sciatic nerve

2 ......... 8621 ........................................... Neuritis of external popliteal nerve (common peroneal)

2 ......... 9304 ........................................... Dementia associated with brain trauma

2 ......... 9410 ........................................... Other and unspecified neurosis

2 ......... 9413 ........................................... Anxiety disorder, not otherwise specified

1 ......... 5012 ........................................... Bones, New Growths of, Malignant

1 ......... 5013 ........................................... Osteoporosis, with Joint Manifestations

1 ......... 5021 ........................................... Myositis

1 ......... 5022 ........................................... Periostitis

1 ......... 5024 ........................................... Tenosynovitis

1 ......... 5055 ........................................... Knee Replacement (Prosthesis)

1 ......... 5110 ........................................... Loss of use of both feet

1 ......... 5111 ........................................... Loss of use of one hand and one foot

1 ......... 5154 ........................................... Amputation of middle finger

1 ......... 5155 ........................................... Amputation of ring finger

1 ......... 5199 ........................................... Generalized, Combinations of Disabilities and Amputations of the Musculoskeletal System

1 ......... 5202 ........................................... Other Impairment of Humerus

1 ......... 5219 ........................................... Two digits of one hand, unfavorable ankylosis of

1 ......... 5222 ........................................... Three digits of one hand, favorable ankylosis of

1 ......... 5223 ........................................... Two digits of one hand, favorable ankylosis of

1 ......... 5255 ........................................... Femur, Impairment of

1 ......... 5270 ........................................... Ankle, ankylosis of

1 ......... 5278 ........................................... Claw foot (pes cavus), acquired

1 ......... 5284 ........................................... Other foot injuries

1 ......... 6007 ........................................... Hemorrhage, intra-ocular, recent

1 ......... 6013 ........................................... Glaucoma, simple, primary, non-congestive

1 ......... 6019 ........................................... Ptosis, unilateral or bilateral

1 ......... 6026 ........................................... Neuritis, optic

1 ......... 6062 ........................................... Blindness both eyes having only light perception

1 ......... 6080 ........................................... Impairment of Field vision

1 ......... 6304 ........................................... Malaria

1 ......... 6311 ........................................... Tuberculosis, military

1 ......... 6501 ........................................... Rhinitis, atrophic, chronic

1 ......... 6502 ........................................... Septum, nasal, deflection of

1 ......... 6519 ........................................... Aphonia, organic

1 ......... 6604 ........................................... Chronic obstructive pulmonary disease

1 ......... 6802 ........................................... Pneumoconiosis, unspecified

1 ......... 6820 ........................................... New growths of, benign, any specified part of respiratory system

1 ......... 6821 ........................................... Coccidioidomycosis

1 ......... 6825 ........................................... Diffuse interstitial fibrosis (interstitial pheumonitis, fibrosing alveolitis)

1 ......... 6847 ........................................... Sleep Apnea Syndromes (Obstructive, Central, Mixed)

1 ......... 7003 ........................................... Adhesions, Pericardial

1 ......... 7006 ........................................... Myocardium, infarction of, due to thrombosis or embolism

1 ......... 7015 ........................................... Auriculoventricular Block

1 ......... 7100 ........................................... Arteriosclerosis, general

1 ......... 7118 ........................................... Angioneurotic edema

1 ......... 7304 ........................................... Gastric ulcer

1 ......... 7315 ........................................... Cholelithiasis, chronic

1 ......... 7325 ........................................... Enteritis, chronic

1 ......... 7326 ........................................... Enterocolitis, chronic

1 ......... 7327 ........................................... Diverticulitis

1 ......... 7332 ........................................... Rectum and anus, impairment of sphincter control

1 ......... 7335 ........................................... Ano, Fistula in

1 ......... 7343 ........................................... New growths, malignant, exclusive of skin growths

1 ......... 7502 ........................................... Nephritis, chronic

1 ......... 7507 ........................................... Nephrosclerosis, arteriolar

1 ......... 7509 ........................................... Hydronephrosis

1 ......... 7518 ........................................... Urethra, stricture of

1 ......... 7522 ........................................... Penis, deformity, with loss of erectile power
39

Frequency Diagnostic Codes Description of Disability

1 ......... 7523 ........................................... Testis, atrophy complete

1 ......... 7524 ........................................... Testis, removal

1 ......... 7815 ........................................... Pemphigus

1 ......... 7903 ........................................... Hypothyroidism

1 ......... 7914 ........................................... New growths, malignant, endocrine system

1 ......... 8004 ........................................... Paralysis Agitans

1 ......... 8108 ........................................... Narcolepsy

1 ......... 8199 ........................................... Generalized, Miscellaneous Diseases of the Central Nervouse System

1 ......... 8207 ........................................... Seventh (Facial) cranial nerve, paralysis of

1 ......... 8516 ........................................... Paralysis of the ulnar nerve

1 ......... 8910 ........................................... Epilepsy, grand mal

1 ......... 8999 ........................................... Generalized, The Epilepsies

1 ......... 9204 ........................................... Schizophrenia, Undifferentiated type

1 ......... 9205 ........................................... Schizophrenia, Residual type; Schizoaffective disorder, other and unspecified

types

1 ......... 9206 ........................................... Bipolar disorder, manic, depressed or mixed

1 ......... 9303 ........................................... Dementia associated with alcoholism

1 ......... 9310 ........................................... Dementia due to unknown cause

1 ......... 9326 ........................................... Dementia due to other neurologic or general medical conditions (endocrine

disorders, metabolic disorders, Pick’s disease, brain tumors, etc.) or that

are substance-induced (drugs, alcohol, poisons)

1 ......... 9403 ........................................... Phobic disorder

1 ......... 9404 ........................................... Obsessive compulsive disorder

1 ......... 9432 ........................................... Bipolar disorder

1 ......... 9434 ........................................... Major depressive disorder

1 ......... 9502 ........................................... Psychological factors affecting gastrointestinal condition

1 ......... 9904 ........................................... Mandible, malunion of

981 ..... 5000–9999 ................................. Total Service-Connected & Non Service-Connected Disabilities

Senator SPECTER. And now we will move to panel two. Thank

you.

Chairman ROCKEFELLER. Let me just introduce them. Our second

panel of witnesses are Steven Smithson of the American Legion;

and then Rick Weidman of the VVA, who is accompanied by Dr.

Linda Schwartz of the VVA Healthcare Committee. The VVA has

worked very diligently to bring attention about Project SHAD to us

in Congress. And, finally, we will hear from Dr. Leonard Cole, an

expert in informed consent and military, biological, and chemical

weapons testing, who testified before the committee on these subjects in 1994. So, Dr. Cole, welcome back.

I guess we will stick with the 5-minute rule. All of your testimony is included, and we are very glad that you are here.

STATEMENT OF RICHARD F. WEIDMAN, DIRECTOR OF GOVERNMENT RELATIONS, VIETNAM VETERANS OF AMERICA;

ACCOMPANIED BY LINDA SPOONSTER SCHWARTZ, PH.D.,

CHAIR, VIETNAM VETERANS OF AMERICA HEALTHCARE

COMMITTEE

Mr. WEIDMAN. Good morning, Mr. Chairman.

Chairman ROCKEFELLER. Good morning.

Mr. WEIDMAN. First, Vietnam Veterans of America, we salute

your leadership and that of Senator Specter in holding this hearing

today to begin to unravel a very complicated story. I ask that our

statement be submitted for the record, as submitted, and I will try

and cover a couple of points that highlight things.

It turns out to be a rather complicated story, and it really was

almost like an investigation on our part. I must tell you that I was
40

sardonically amused last night when I first saw that press release

about DoD expanding the investigation, and I just started to laugh

and said, Is John Dean the head of this investigation? I mean,

what investigation? The only investigating that has really been

done into these exposures was done by you, Senator, and folks on

the Hill and one small veterans service organization—actually, two.

I want to salute Senator Nelson for introducing the veteran’s

right to know law, and that will take us some direction toward a

solution.

A little bit of chronology. Last fall, it came to our attention the

whole deal about SHAD existing and that there being many more

questions, and we thought when we first started looking into it

that we had a small throw rug, and the more we pulled on the

strand, the larger and larger the picture became.

Project 112, we kept saying to ourselves as we toiled on this, in

addition to other duties, often until 9 or 10 in the office, that it had

to be larger than just this one Navy project. And that is how we

found out about Project 112. The most important thing about that

press release that was issued last evening by DoD is for the first

time they are acknowledging that Project 112 took place. Heretofore, they had not acknowledged that Project 112 took place.

A number of things were talked this morning about classification,

and I just want to go into that, if I may, just to correct the record

a little bit.

The muster rolls and the deck logs that contain all of the names

of all of the people on all of the ships involved in all of the SHAD

tests were, in fact, in the public domain, in the Archives. So was

the accident reports of the ships involved also, in a different part

of the National Archives. All of that was true until we started

going over to the National Archives seeking this information, and

suddenly 1 day they had it, and the next day it was sealed. In

other words, this wasn’t classified information. It was public information, had been so for 40 years, and only when we started to unravel that there may have been deliberate damage—or deliberate

exposures, excuse me, done to American military personnel was it

suddenly classified.

We would point out, sir, that all of the ships in the fleet involved

in the SHAD test and, indeed, all of the classes of ships involved

in the test are out of the fleet. They no longer exist. The only ones

that exist, because there were some aircraft carriers involved, have

either been mothballed or completely rebuilt keel up in the 1980’s

and the 1990’s. Therefore, there can be from our point of view no

national security consideration here, and that title has been used

or that label has been used of national security to really engage in

bureaucratic protectionism of the worst order. In other words, don’t

admit we ever made a mistake. We couldn’t possibly have exposed

our troops, inadvertently or in this case, many cases, we believe,

deliberately, to all of these toxins.

I want to commend the cooperation that we have had throughout

and the attitude of Secretary Principi and Admiral Cooper and

Nora Egan, who is chief of staff to the Secretary, for their willingness to get at the bottom. While we would agree with you about

VA, many people in VA being very dedicated to veterans, I will tell

you, sir, that the institutional response at 810 Vermont Avenue
41

and within the higher levels of Veterans Benefits Administration

was not what it should be, by any stretch of the imagination.

Beginning in October, in the fall of 2000, the request went over

verbally, and then finally in January of 2001, a formal letter went

from the Acting Secretary of Veterans Affairs to DoD’s Secretary

at that particular time. A response was made, although no letter

was ever sent back to the Secretary of Veterans Affairs. But folks

out of DoD did, in fact, call Dr. Mather. Dr. Mather said she didn’t

want the names, that that was really Veterans Benefits Administration work and, therefore, referred them over there. They were

delivered, in fact, February 2001, to the Veterans Benefits Administration, the first 1,200 names. They didn’t do anything with them.

They put them in a drawer, and it wasn’t until October when we

started pressing that the Secretary’s office found out that the

names actually had already been furnished, the first batch, by DoD

and nothing had been done with them. It took from October of 2001

until May of 2002 to reach out to these first 622 veterans.

We have since that time worked with Admiral Cooper, and they

understand now how to use common search engines available on

the Internet in order to locate most of these veterans very quickly

and not wait for IRS, where you can shorten those months into just

a couple of days before you can put those letters into the mail.

Once again, we believe that the top political leadership at VA has,

in fact, acted with alacrity and with a determination to say we

don’t know what is wrong but we are going to find out what is

wrong and we are going to try and fix it. But that has not been

true of the corporate cultures of VBA and VHA, the Veterans

Health Administration and Veterans Benefits Administration,

which needs to change in a dramatic way toward being proactive.

Instead of deny, dissemble, and wait for an army to die or, in this

case, wait for the Navy to die, it needs to be on a proactive basis

of we don’t know what is wrong but, by gosh, we are going to find

out everything we can and move to provide Americans who serve

their country in the U.S. military with the health care and with the

benefits that they earned by virtue of that service, if, in fact, they

were harmed by that service.

That is the attitude that we believe that we can expect from people who are GS–14’s, 15’s, and SES’s, Senior Executive Service

folks. But that is not what we got in this case. At every step of the

way, we had to go to the chief of staff of the entire VA and with

the weight of the Secretary’s office to get key individuals in Environmental Hazards and Public Health to respond and move forward and for the senior people in VBA—and I am not including Admiral Cooper in that because he actually during much of this was

not on board yet.

We should expect better from people whom we pay, in some

cases, because of ways of getting around the cap, earn more than

U.S. Senators.

Senator SPECTER. Mr. Weidman, we agree with you about that.

We have your point.

Mr. WEIDMAN. OK. Thank you, sir.

The point is that much of this declassification investigation can

proceed much more quickly, literally in a matter of weeks, if they

made the determination to do it, because the muster rolls and the
42

deck logs, they know where they are. They pulled them out of the

Archives. All they need to know is the names of the ships, and we

believe that the names of the ships are much more readily available than they say. So it is only a matter of putting the manpower

on it in a systematic way and turning the information over to VA.

At the rate they proceeded so far—for the first 622, it took 19

months to do that. At this rate most people will be dead before we

get to them.

In terms of the things that we would propose to do, we would be

glad to work with the committee on those particular questions, and

we have made some proposals directly, seven proposals to Secretary Principi’s office, which they are considering now, including

establishing a real registry. A real registry is one that is directly

connected to the patient treatment records.

So I thank you very much, Mr. Chairman, and I know that I

went over my 5 minutes and I apologize. It just does become a very

complicated story. Many of the things said today were inadvertently, we believe, untrue by Mr. Winkenwerder, but he didn’t know

that.

[The prepared joint statement of Mr. Weidman follows:]

PREPARED JOINT STATEMENT OF RICHARD F. WEIDMAN, DIRECTOR OF GOVERNMENT

RELATIONS AND LINDA SPOONSTER SCHWARTZ, CHAIR, VVA HEALTHCARE COM- MITTEE, VIETNAM VETERANS OF AMERICA

Mr. Chairman, Ranking Member Specter, distinguished members of the committee, Vietnam Veterans of America (VVA) is very pleased to have the opportunity

to share our views with you today on a topic that has been at the very core of VVA’s

mission from day one: investigating toxic exposures among America’s veterans. On

behalf of Tom Corey, VVA National President, and all of us in VVA, we thank and

congratulate you and your colleagues for demonstrating strong leadership on these

vital veterans issues.

First, let us briefly summarize the 60-year history of the Pentagon’s use of American military personnel as human guinea pigs:

• Mustard gas testing on servicemembers during WW II

• Atomic testing on servicemembers during the early Cold War period

• LSD experiments on servicemembers during the 1960’s

• Herbicide use and concomitant exposures among troops in Vietnam, Panama,

and stateside

• Chemical exposures during and immediately after the Gulf War

• The use of investigation chemical/biological warfare drugs and biologics during

the Gulf War

• The ongoing use of the controversial (and likely unsafe) anthrax vaccine

The most recent revelations about Project 112—the Pentagon’s master chemical/

biological warfare agent testing program from the 1960’s—have only added to our

sense of legitimate moral outrage over the permanent bureaucracy in the executive

branch’s cavalier approach to troop health and safety.

Two days after the attacks on the World Trade Center and the Pentagon, Department of Defense (DoD) officials invited representatives of the veterans service organization’s (VSOs) to a briefing on what has since become known as Project Shipboard Hazard and Defense (SHAD). Rather than provide the VSO’s with declassified

documents, officials from what was once known as the Office of the Special Assistant for Gulf War Illnesses (OSAGWI) provided sanitized, derivative documents labeled ‘‘Fact Sheets’’ regarding three test series: AUTUMN GOLD, COPPERHEAD,

and SHADY GROVE.

As VVA began doing our own research into this issue, we uncovered a number

of important facts:

• SHAD was only part of a much larger testing initiative, known as Project 112.

According to the U.S. Army’s unclassified history of its biological warfare program,

Project 112 was initiated by then-Secretary of Defense McNamara in September

1961 at a funding level of $4 billion. When Pentagon officials originally briefed us

on Project SHAD, we were told that as many as 113 tests may have been conducted.

We have recently learned that Pentagon officials are now backing off of that figure,
43

claiming that 113 total Project 112 tests were planned but that SHAD only accounted for 34 of the tests. • Testing activities were coordinated through a headquarters established at the

Desert Test Center at Ft. Douglas Utah in 1962. The overall program was governed

by National Security Action Memoranda 235, signed by President Kennedy on April

17, 1963. Testing allegedly began in 1962 and continued through at least early 1969. • Our research indicates that Project 112 tests took place off the east and west

coasts of the United States, in Alaska, and in Panama. VVA believes that additional

test sites were used but because of the Pentagon’s refusal thus far to declassify the

records neither we nor the affected veterans have a full understanding of the true

number and scope of the tests nor the potential health risks that may have resulted

from their participation in Project 112 testing activities.

Without the original documentation before us, we are being asked to trust the

Pentagon’s good word about the scope, duration, and potential hazards associated

with the tests. Based on the 60+ year history of the Pentagon’s role in other such

tests, we have good reason and ample precedent to believe that the ‘‘Fact Sheets’’ were and are an exercise in risk-minimization and public relations, and the odds

are that said ‘‘Fact’’ sheets may not be a legitimate effort to come clean on the potential consequences of the tests. We have recently obtained a document that fully

validates our concerns as to the lack of a corporate culture that promotes and rewards organizational integrity and veracity of OSAGWI and its activities. ‘‘PRSA Bronze Anvil Entry,’’ a partial copy of which is attached for your review,

was (and probably remains) OSAGWI’s media battle plan for minimizing the damaging impact of Gulf War illness-related exposure issues, and, now, Project 112. Let

me quote a passage from the page of this document that I think showcases DoD’s approach to military toxic exposure-related episodes:

Following the war, many veterans began to complain of health problems

they associated with their service in the Gulf. They clamored for health care

and answers, and the news media and some legislators picked up the battle

cry. The President ordered a thorough review and finally, DoD conceded that

America’s finest might have been exposed to low levels of chemical warfare

agent.

For five years, the DoD had denied the possibility of chemical warfare exposure during the Gulf War. With this new information in the news, the

DoD faced charges of a cover-up and conspiracy. Finally, in late 1996, a special office was created and charged to ‘‘turn over every stone’’ and find out

what was making Gulf War veterans sick.

The Gulf War lasted only 100 hours. The public relations battle is still ongoing.

‘‘Bronze Anvil Entry’’ is rife with such language, Mr. Chairman: talk about ‘‘tactics’’ and ‘‘strategy’’ for dealing with the media, the veterans, the Congress. By their

own admission, the [Bronze Anvil Entry] ‘‘communications plan is the basis, guide,

and baseline for almost everything the organization does, from investigating what

happened in the Gulf War, to media relations and responding to veterans concerns.’’

In other words, everything OSAGWI has done has been guided not by a quest for

the facts and the truth but by a media-driven PR-strategy designed to absolve the

department of any and all responsibility for the illnesses reported by the veterans.

Some might well maintain that this is a self-serving bureaucratic protectionism

strategy that has absolutely nothing to do with either true national security concerns nor with the health and welfare of the many decent Americans serving in the

Armed services at the time who may well have been affected.

What has this exercise apparently driven by public relations concern cost the

American taxpayer? Over $150 million since FY1996. For this amount of money, not

one single peer reviewed scientific article has been produced, making all of the ‘‘materials’’ and so-called ‘‘case studies not worth the paper they are written on. The

American tax payers have decidedly NOT gotten their money’s worth from this exercise in appearing to do something.

What has it cost the veteran? Continued pain and suffering, compounded by a relentless less than forthcoming, forthright, and honest Pentagon spin-machine that

has effectively obstructed genuine scientific inquiry and debate over Gulf War illnesses.

How effective was the OSAGWI ‘‘spin machine’’? The document boasts that

‘‘Media relations have matured with national press calling to ask if controversial

issues are ‘news’ before determining level of coverage.’’

Earlier this year, Secretary Rumsfeld said that the proposed Office of Strategic

Influence had been abolished. In fact, it has been operating since 1996 and continues operating to this day. Once known as the Office of the Special Assistant for
44

Gulf War Illness, it now masquerades under the title of ‘‘Deployment Health Support Directorate.’’ VVA believes that the permanent bureaucrats and seemingly permanent agents

of contractors that staff this ‘‘Deployment Health Support Directorate’’ continue to

deliberately mislead the Secretary and his office as to the truth about this operation, as it is in their immediate pecuniary interest to do so, and they appear to

be unfettered by sense of duty and loyalty to the good American men and women

who honorably served our Nation in military service who may have be harmed by

this course of action/inaction.

In the near term, Congress can best serve ill veterans by striking the Deployment

Health Support Directorate’s funding from the TRICARE Management Activity

(where it is currently funded) and prohibiting the Pentagon from any further expenditures on this office, pending GAO’s examination of this office and its activities

over the past several years. VVA believes that any such GAO investigation should

be spearheaded by GAO’s Strategic Issues or Applied Research Methodologies divisions, which have very good track records in investigating DoD activities.

To restore the trust and confidence of the American people, and particularly

American veterans in the federal government’s response to these kinds of exposurerelated controversies, more sweeping changes will be required.

There are four common themes that run through nearly all of the historical examples I’ve enumerated thus far:

1. In nearly every case, servicemembers who were test subjects rarely if ever were

informed of the potential health consequences of the exposures;

2. The tests were almost invariably deemed ‘‘secret’’ or a ‘‘national security issue’’ by the Pentagon bureaucracy, which routinely classified the tests and prohibited affected personnel from discussing the tests or seeking medical treatment for symptoms associated with exposures;

3. Medical record keeping and follow up of the affected personnel was nonexistent;

4. When evidence of a nexus between potential service-connected toxic exposures

and subsequent illnesses veterans emerges, the Pentagon (and Department of Veterans Affairs) immediately seeks to denigrate or minimize any such connection.

At VVA, we have a phrase to describe this phenomenon: the disposable soldier

syndrome.

In our view, the Pentagon has always viewed us—the soldiers, sailors, airman,

Marines, Coast Guardsmen—as nothing more than disposable cogs in the giant military machine. In reality, we are the most critical component of the machine: the literal flesh-and-blood that gives this machine its ability to defend America, her citizens, and her interests. We will not be treated as one more consumable, disposable,

National Stock Number item. We never did, and would hope the distinguished Senators on this Committee will disavow this latter day version of Robert McNamara’s ‘‘spare parts’’ theory of American military personnel.

Mr. Chairman, you and other distinguished colleagues in the Congress have

begun to recognize the need for fundamental reform in this area. We applaud Representative Thompson and Senator Nelson for offering the ‘‘Veterans Right to Know

Act of 2002,’’ which addresses the Project 112/Project SHAD controversy by charging

GAO to thoroughly investigate and oversee the declassification and dissemination

of the test records. The Congress must do much more, however, if we are to ensure

that no such episodes occur in the future.

Because DoD and VA bureaucrats have politicized the medical research arena and

monopolized control over research funding decisions, it is completely impossible for

most non-federal researchers with unconventional or controversial theories about

the origins of Gulf War illnesses to receive federal funding. Moreover, both DoD and

VA have an inherent conflict of interest when it comes to investigating these kinds

of issues.

Consider the following analogy. When the Bridgestone/Firestone ‘‘exploding tire’’

scandal erupted, the Congress did not tell the manufacturer, ‘‘We trust you: go investigate yourself, make recommendations for change, then implement those

changes—you have our blessing!’’ Congress held hearings and monitored the National Highway Transportation Safety Administration’s investigation of Bridgestone/

Firestone. The same model applies to airline crashes. Congress does not rely on the

aircraft manufacturers crash report; it listens to the National Transportation Safety

Board’s investigators, who are independent of both the manufacturer and the aviation industry as a whole. Congress set up this system to ensure that no conflict of

interest would compromise safety investigations, a wise and sensible approach to

transportation safety policy.

Yet for the last decade, the Congress has allowed the agency that most likely created the Gulf War illness problem (DoD), and the agency charged with paying for

the problem (i.e., the VA, through health care and disability payments to sick vet-
45

erans), to both investigate Gulf War illnesses and their own role in responding to

sick Desert Storm veterans. This is an obvious conflict of interest, one that has prolonged the suffering of the veterans, destroyed their trust in the federal government,

and resulted in the waste of at least $150 million over the past five years through

OSAGWI, as the Defense Department has ‘‘investigated’’ its own response to Gulf

War illnesses. It is also how the Pentagon and the Air Force have managed to spend

over $180 million on Agent Orange-related Ranch Hand research that has produced

less than half-a-dozen peer-reviewed scientific papers over the last 15 years. Even

those few peer reviewed articles were produced just recently under extreme pressure

by the Congress to produce tangible scientifically valid results.

To end this conflict of interest and restore integrity to the process of investigating

and treating veteran’s medical conditions, last year VVA called for the creation of

a National Institute of Veterans Health (NIVH) within NIH. This notional NIVH

would not only eliminate the conflict of interest problem outlined above, it would

provide a vehicle for establishing a medical research corporate culture focused on

veteran health care, in contrast to the current VA medical corporate culture of

‘‘health care that happens to be for veterans.’’ VVA recognizes that the VA has established a reputation for providing advanced

care for blinded veterans or those with severe ambulatory impairments. However,

the VA has never truly developed a corporate culture focused on the diagnosis and

treatment of the full range of environmental and occupational hazards that are

unique to military service. This is especially true of the VA’s Research and Development Office, where the overwhelming majority of VA-funded research programs are

geared towards medical problems found in the general population, not those specific

to the veteran patient population or those with military service. Even though it is

possible at virtually no additional cost to collect veteran specific variable information on all the studies funded though this section, the current leadership of VA Research & Development refuses to do so.

By establishing a new NIVH with veteran advocates serving on the peer-review

panels that make research funding decisions, the Congress would be creating a research institute that would be truly focused on the unique medical needs of veterans. Locating the NIVH within NIH would ensure that the full medical resources

of the federal government and private sector could be marshaled in a rational, veteran-friendly environment, free of the politicizing and conflict-ridden influences that

have for more than 20 years precluded effective research into the unique environmental and occupational hazards that have impacted the health of American veterans. One of the first lines of inquiry that should be pursued by this proposed entity

is what we term ‘‘the in-country effect,’’ the idea that the totality of the military

experience in a theater of operation has a cumulative effect on the health of the veteran. We believe that more than enough epidemiological research exists to show

that both Vietnam and Gulf War veterans display higher rates of illness than their

nondeployed counterparts. Researching the mechanisms that produce these higher

morbidity rates among those who serve in theater should be a top research priority

for the notional NIVH.

Additionally, this proposed NIVH must be supplemented by the creation of a Congressionally directed mandatory declassification review panel, whose purpose would

be to screen (on both a historical and an ongoing basis) and declassify any operational or intelligence records for evidence of data that would have an impact on

the health and welfare of American veterans. The need for such an entity—completely independent from the Pentagon and the U.S. intelligence community—is obvious.

Even today, thousands of pages of Gulf War-related records remain classified. In

January 1998, the CIA admitted that its own internal review had identified over

1 million classified documents with potential relevance to Gulf War illnesses. Virtually no documents associated with the 1960’s era SHAD program have been declassified, and DoD has thus far rebuffed VVA’s FOIA requests that the documents

be made public. Through the experience of the Kennedy Assassination Review Commission and the Nazi War Crimes Declassification Review panel, we have learned

that such specialized declassification panels work well. If we are to be certain that

all data that may effect the health of American veterans is to be available for the

veterans and their physicians, the Congress must create such a standing declassification review panel immediately. Such a move would also help to restore trust

and confidence among veterans in the federal government and its response to veteran’s health issues.

VVA believes that the VA should remain in the veteran health care business, but

only if there is a dramatic change in the corporate culture of the Veterans Health

Administration (VHA).
46

During his tenure as Undersecretary for Health, Dr. Thomas Garthwaite put forward a proposal known as the Veterans Health Initiative (VHI). The purpose of the

VHI was to put veteran patient care at the core the VHA’s corporate culture. As

Dr. Garthwaite testified before Congress in April 2001,

The Veterans Health Initiative was established in September 1999 to recognize the connection between certain health effects and military service, prepare health care providers to better serve veteran patients, and to provide

a data base for further study.

The components of the initiative will be a provider education program

leading to certification in veterans’ health; a comprehensive military history

that will be coded in a registry and be available for education, outcomes

analysis, and research; a database for any veteran to register his military

history and to automatically receive updated and relevant information on

issues of concern to him/her (only as requested); and a Web site where any

veteran or health care provider can access the latest scientific evidence on

the health effects of military service.

VVA’s experience is that while some progress has been made in development of

curricula by the Office of Public Health and Environmental Hazards, virtually no

one at the service delivery level, or at the researcher level know that these exist.

After three years, there is still not visible effort to train or enlighten staff at the

hospital level or actually doing research of the importance of taking a complete military history and testing for various natural and man-made risk factors that a veteran may have been exposed to based on when, where. branch of service, and what

the veteran actually did in the military. VVA maintains that this is what Veterans

Health Care (and hence VA) should be all about, not just general health care that

happens to be for veterans.

We note that to date, comprehensive clinical practice guidelines and continuing

medical education courses in dealing with Gulf War illnesses have yet to be distributed throughout the VA medical system. The visualized cash awards for clinicians

passing competency exams in veteran specific health issues has not materialized.

We know from internal VA emails obtained via FOIA that senior officials in Public

Health and Environmental Hazards resisted creating a registry for Vietnam era

SHAD veterans. As many members of this committee may recall, there was tremendous resistance by VHA to the idea of creating a Gulf War registry in the early

1990’s; it took an act of Congress to get that effort off the ground. Given this institutional resistance to identifying environmental hazards and their impact on the

health of veterans from multiple eras, how can we trust these same office with no

apparent change in corporate culture to implement Dr. Garthwaite’s well-conceived

vision for veterans’ health care?

We have communicated these concerns to Secretary Principi, urging him to recognize that changing the existing VHA corporate culture immediately is imperative,

and we look forward to working with him towards that end. VVA believes that this

committee can play a key role in this process by offering comprehensive legislation

to create NIVH and an affiliated declassification body. The VA’s Gulf War Research

Advisory Committee has already sent such a recommendation to Secretary Principi.

VVA hopes the committee will use the Research Advisory Committee’s recommendations as a blueprint for changing the way veterans exposure-related health issues

are addressed.

Mr. Chairman, this concludes my written statement. On behalf of our national

president, Tom Corey, please accept my thanks for allowing VVA the opportunity

to share our views on this very important topic.

APPENDIX I: EXTRACT FROM OSAGWI’S ‘‘BRONZE ANVIL’’ COMMUNICATIONS PLAN

Summary

RESEARCH

At the time, the Gulf War appeared to be an overwhelming public relations success. The American public gave whole-hearted support to their military sons and

daughters, sending them off to fight the world’s largest army. The media provided

minute-by-minute coverage from the good-by kisses through the daily military victories to the tearful reunions. Cheering crowds across the nation lined graffiti-filled

streets to honor the returning victor.

Following the war, many veterans began to complain of health problems they associated with their service in the Gulf. They clamored for health care and answers,

and the news media and some legislators picked up the battle cry. The President
47

ordered a thorough review and finally, DoD conceded that America’s finest might

have been exposed to low levels of chemical warfare agent.

For five years, the DoD had denied the possibility of chemical warfare exposure

during the Gulf War. With this new information in the news, the DoD faced charges

of cover-up and conspiracy. Finally, in late 1996, a special office was created and

charged to ‘‘turn over every stone’’ and find out what was making Gulf War veterans

sick.

The Gulf War lasted only 100 hours. The public relations battle is still on-going.

One of the first actions of the Office of the Special Assistant for Gulf War Illnesses (OSAGWI) was to review the backlog of incoming correspondence and identify the concerns and interests of veterans. Meetings with representatives of 60 national veterans groups (VSOs) were conducted, and congressional interest identified.

Goals, objectives, strategies, tactics and messages were formulated. Letters, emails,

and telephone contact were all targeted to specific audiences including veterans, veterans’ groups, Congress, and other government agencies. Monthly updates for VSOs

allowed them to pass information to their millions of members while town hall

meetings across the nation provided one-on-one interchange with veterans. An interactive Internet site was created (GulfLINK, TAB X) receiving up to 60,000 ‘‘hits’’

a week. Audience analysis indicated that many might not have access to the Internet, so a newsletter (GulfNEWS, TAB X) was developed. By March 1997, most of

the national press and veterans’ groups appeared satisfied that the DoD was on the

right track and many thought the issue was dead. However, the public relations professionals were not so sanguine.

Based on the textbook model of ‘‘lifecycle states of issues.’’ (Tab X), the team projected that there was potential for a second wave of high concern and high interest.

Additionally, there was also a strong possibility that the DoD was actually facing

two lifecycles—one in the Washington D.C. area, and a second, later one, in ‘‘Middle

America.’’ (TAB X) The team also analyzed current goals and objectives; strategies

and tactics; media coverage; veterans’ correspondence; and message delivery and acceptance. Media analysis indicated decreasing interest by national and military

press; however, a few influential media continued their negative coverage, which

was repeated in regional and local press on a regular basis (Tab X). A few vocal

legislators continued to challenge the DoD’s commitment to Gulf War veterans. Incoming emails, letters, and telephone calls from veterans, analyzed for content and

tone, indicated a shift toward an increase in level of trust and a greater desire for

information. Interviews with veterans’ service groups indicated similar shifts in interest, focusing more on applying lessons learned from the Gulf War to future operations. Informal surveys indicated that service members still in uniform have a vested interest in the DoD’s efforts and the eventual outcome. Conversely, activist

groups had formed and were becoming very active.

Research confirmed that the crisis had not been resolved. While some veterans

still accused the DoD of cover-up and conspiracy, many simply didn’t know what to

think—they provided fertile ground for activists.

PLANNING

Following this analysis, the communication plan was updated with two new objectives while strategies and tactics were greatly expanded and energized for a

proactive and synergistic effort (TAB X).

New objectives featured DoD’s commitment to the health and welfare of Gulf War

veterans as well as current and future service members and veterans (TAB X). Target audiences were expanded to include all active duty, Guard, and Reserve and

their family members; health care providers in the DoD; plus veterans and community members living and working near military installations. The overall strategy

was to create ‘‘message redundancy’’ through personal and second party contact.

Military members would become ‘‘ambassadors in uniform,’’ influencing other audiences such as neighbors, peers, and extended family members.

The outreach was expanded to target military installations and more conferences,

conventions, and seminars. Town halls at each installation would still target veterans and their families, while briefings would reach the new audiences. Briefers

were selected and trained for specific venues and audiences. Manned displays were

developed for high traffic locations and local media heavily marketed to provide

radio, TV, and newspaper coverage. Presentations, brochures, displays, and visual

aids were targeted to widely varied audiences, incorporating of risk communication

techniques. The brochure was sized to fit in uniform pockets and a pocket added

to the tri-fold.
48

With no dedicated public affairs budget, all research, graphic design, product production and planning was done with the existing staff. The budget for printing had

to be greatly increased as well as travel since a large team now goes on each trip.

EXECUTION

The communication plan is the basis, guide and baseline for almost everything the

organization does, from investigating what happened in the Gulf War, to media relations and responding to veterans concerns.

INVESTIGATIONS. All investigations of the Gulf War are based on veterans’ expressed concerns. Veterans are personally interviewed and their comments incorporated into comprehensive reports, which are then posted on the interactive Internet site, GulfLINK with a request for comment from any reader (TAB X). Many Veterans are personally notified, provided copies, and asked for feedback (TAB X). Fact

sheets, news stories, press releases (TAB X) and often a press conference accompany

every new report when it is published. Veterans’ service organizations (VSOs) are

hosted each month for a roundtable discussion on releases, updates, or to discuss

other issues and concerns. To date, more than 25 narratives, reports, and information papers have been released (TAB X).

MEDIA. From the beginning, OSAGWI has had a proactive media approach. More

than 150 news releases have gone to hundreds of national and local media via the

DoD and OSAGWI Internet sites, list servers, and multi-fax/email (TAB X). Press

conferences are held regularly. Thousands of media queries receive timely and comprehensive response (TAB X) by public affairs professionals while CBS, MSNBC,

ABC, CNN, 60 Minutes, BBC, NPR, Washington Post, etc. interview experts on controversial issues. Extensive media training precedes al interviews and Q&As are

prepared for every release and emerging issue. Media relations have matured with

national press calling to ask if controversial issues are ‘‘news’’ before determining

level of coverage. Currently, approximately 300 local media around the nation are

individually marketed resulting in extensive coverage of OSAGWI’s outreach efforts.

Trade and specialty media are also heavily marketed (TAB X).

PUBLIC COMMUNICATION. OSAGWI is a unique government organization—providing one-on-one interaction via an 800 number 16 hours a day, and more than

200,000 personal responses via emails and letters (TAB X). Q&As for every issue

and concern ensure all interactions with veterans provide consistent and correct information.

We work closely with the VA, and other government agencies to provide answers

to all veterans’ concerns.

GULFNEWS/GULFLINK. All products are posted on GulfLINK and veterans notified about new postings. Nearly 25,000 veterans subscribe to GulfNEWS, a bimonthly newsletter containing highlights of GulfLINK.

OUTREACH. Most members of the organization participate in the national outreach—whether going to military installations for weeklong visits, or participating

in conferences, conventions, or seminars. All receive training on communicating with

veterans, family members, or the news media. All are prepared to discuss individual

issues while many are trained as briefer for specific audiences. Media are also heavily marketed any time we participate in an event—medical media at medical conventions, local media at base visits, and others whenever possible. Local VA representatives and VSOs actively participate in base visits designed specifically for

each unique audience.

PRODUCTS AND DISTRIBUTION. Brochures (TAB X) provide answers to frequently

asked questions while the tri-fold is more generic, but contains a pocket to hold a

postcard, newsletter, and GulfLINK information (TAB X). Five display panels can

be grouped for maximum effect or stand-alone for greater distribution (TAB X).

Briefings are tailored for individual audiences and briefer selected for credibility

with audience (TAB X). An annual report targets Congress (TAB X). Approximately

5,000 brochures, tri-folds, maps, fact sheets, etc. are individually distributed at each

base visit. Additionally, these same products are regularly distributed around the

nation to base libraries, clinics, and family support centers; VA clinics and hospitals;

veterans’ support groups such as VFW chapters; regional veterans’ service centers;

and even state libraries.

EVALUATION

The Department of Defense and its subordinate units are not funded to conduct

formal research in the form of scientific surveys. However, regular analysis of media

coverage, correspondence, activist groups’ issues, and individual veterans’ feedback,

can provide insightful information to evaluate the success of public affairs programs.
49

Evaluation of programs is almost a weekly process. Analysis of correspondence

tone and content, media coverage, activist issues, VSO concerns, and informal surveys result in minor modifications of tactics on a constant basis. Focus groups held

at four installations helped reshape the products while risk communication professionals also provided their expertise on both products and processes. After each outreach, team members participate in an extensive evaluation of presentations; product and display design and distribution; and audience response. Although the erosion of DoD credibility cannot be rebuilt quickly, analysis indicates that we’re on

the right track.

Chairman ROCKEFELLER. Dr. Cole, one of the problems with

Project SHAD and with the use of many investigational new drugs

during the Gulf War has been the niceties of distinguishing ethically between test subjects who have given consent to participate

in an experiment and between participants for whom notification

is implied rather than secured. Based on your studies of other

tests, would you presume that the participants in Project SHAD received sufficient notifications of the hazards of the tests in which

they participated? Is the military doing a better job with that now,

10 years after the Gulf War?

Mr. COLE. That is a good question, and the answer is difficult to

give. It can’t be black and white based on the information we have

about SHAD.

What I do see, having looked at the SHAD reports, the fact

sheets that were issued by the Department of Defense, is a differentiation they make between what they describe as test subjects

as opposed to test conductors.

There is a certain, I think, lack of fairness and realism when you

try to differentiate what rights a person should have in terms of

informed consent if he or she is designated a tester rather than a

subject. So just by changing the category, you are still not changing

the fact that the tester is a participant. And if he is in the area

of a potentially toxic or lethal material, as part of an experiment,

I would think that he deserves the same kind of respect concerning

informed consent as a human subject.

Senator SPECTER. Mr. Chairman, might I ask one question here?

Because I am going to have to excuse myself in a few minutes.

On this issue the line between a test subject and a test conductor

is so vague, if there is exposure, that ought to be the determinant.

Does the Department of Defense now have ironclad regulations

which require written informed consent if there is exposure?

Mr. COLE. I do not know; when you use the word ‘‘ironclad,’’ I

do not know. I know that it has been official military policy since

1953 by way of a memorandum which I cite in my written testimony that the Department of Defense is obligated, as is the rest

of this country, to respect the Nuremberg code. That code was the

outcome of the 1947 trial of Nazi doctors who did horrible experiments on humans during World War II. The Nuremberg code is a

10-item statement. Its sum and substance is that nobody should be

participating or permitted to be participating as a human subject

in research without being informed of what he or she is getting

into. He should have the opportunity to disqualify himself or excuse himself from being a research subject. This is simply summed

up in the two words ‘‘informed consent.’’

Senator SPECTER. Well, Mr. Chairman, my suggestion is that we

make that inquiry at the staff level, and I don’t think we ought to
50

rely on the Nuremberg code as an enforcement mechanism with the

Department of Defense. That is less satisfactory than the International Criminal Court. So this is something which is just baseline fundamental, and in a civil court, without the immunity and

protection of the Federal Tort Claims Act, if there isn’t informed

consent, it is just a major error and imposition on people who are

subjected to these sorts of tests. So we will pursue that.

Mr. COLE. May I quickly say something about this? I am aware

of tests that did take place in which volunteers were given information and then consented to be experimental subjects under the military experimental program. So this has certainly taken place in

some instances.

Ms. SCHWARTZ. Mr. Chairman, if I might, in my research of looking at the Ranch Hand data that the Air Force had, it was—they

do have actually an informed consent. The difficulty is it is so

broad it would never pass the inspection of any internal review

board that we have today. And so if you do embark on this investigation, I suggest that you look at the criteria that is required for

any tests or experiments of research funded by the U.S. Government and compare it with some of the informed consents that military members are given.

Senator SPECTER. Thank you very much.

Thank you, Mr. Chairman.

Chairman ROCKEFELLER. Thank you, Senator Specter.

We have not called upon Steve Smithson yet, and you are giving

testimony, and I apologize to you.

STATEMENT OF STEVEN R. SMITHSON, ASSISTANT DIRECTOR,

NATIONAL VETERANS AFFAIRS AND REHABILITATION COMMISSION, THE AMERICAN LEGION

Mr. SMITHSON. Good morning, Mr. Chairman and members of

the committee. The American Legion appreciates the opportunity to

provide testimony this morning regarding the strategies being pursued by the Departments of Defense and Veterans Affairs to provide appropriate care and support to veterans who may have been

exposed to environmental hazards during their military service. As

U.S. troops are currently deployed overseas fighting the war on terrorism, this topic becomes even more relevant.

While military service is inherently dangerous and certain risks

are to be expected, the Government is obligated to provide proper

health care and compensation to those who sustain chronic disabilities as a result of such service. While VA is charged with caring

for military members once they leave active duty, its mission is

tied directly to information and support received from Department

of Defense. Herein lies a fundamental problem. DoD’s primary mission is to fight wars and maintain national security. Caring for

troops wounded or otherwise injured in the advancement of this

mission has often been seen as secondary to its ultimate mission.

However, without adequate communication, cooperation, and open

sharing of information between these two entities, VA’s ability to

successfully serve our Nation’s veterans is severely compromised.

Prior to the Gulf War deployment, troops were not systematically

given comprehensive pre-deployment health screenings, nor were

they properly briefed on the potential hazards, such as fallout from
51

depleted uranium munitions, that they might encounter on the battlefield or in the theater. Additionally, the recordkeeping was very

poor. Numerous examples of lost or destroyed medical records of

active duty and reserve personnel have been identified. Vaccines

were not administered in a consistent manner, and vaccination

records were often unclear or incomplete. Moreover, personnel were

not provided information concerning vaccines or prescribed medications. Some medications were distributed with little or no documentation or dosage instructions, to include possible side effects or

instructions to immediately report unexpected side effects to medical personnel. Physical evaluations, both pre- and post-deployment, were not comprehensive, and information regarding troop

movements and locations and possible environmental hazard exposures was severely lacking. This lack of such baseline data and

other information is commonly recognized as a major limitation in

the evaluation and understanding of potential causes of the multisymptom illnesses reported by many Gulf War veterans following

the war. Unless the failures in the system just cited are corrected,

we are doomed to repeat this pattern in the current war on terrorism as well as other future deployments.

To avoid the problems just mentioned, the lessons learned from

the Gulf War have precipitated the passage of laws and policies designed to create a concept of force health protection. For example,

Section 765 of Public Law 105–85 directed DoD to take specific actions to provide medical tracking for personnel deployed overseas

in contingency or combat operations, outlining a policy for pre- and

post-deployment health assessments and blood samples. The conduct of thorough pre- and post-deployment examinations, including

the drawing of blood samples, was specifically identified in the law.

Such action is crucial for the accurate recording of a service member’s health prior to the deployment and in documenting any

changes in their health during deployment. Moreover, this is exactly the information that is needed by VA to adequately care for

and compensate service members for service-related disabilities

once they leave active duty.

On the surface the concept of force health protection and related

policies appear to have addressed the major problems of the past.

However, in reality, as it was learned from recent Institute of Medicine and General Accounting Office reports on the subject as well

as in testimony earlier this year before the House Veterans’ Affairs

Subcommittee on Health, the aforementioned force health protection policies are not being fully implemented, a major breakdown

being at the field level. The organizational mechanisms tasked with

ensuring implementation of these policies from the command level

down to the operational unit are obviously not working. Again, this

lack of urgency and compliance with the law appears to be related

to DoD’s corporate philosophy and culture and directly impacts its

ranking of priorities. Unfortunately, the service member and veteran ultimately pay the price for this inaction.

Title 38 of the United States Code places the burden of proof in

establishing a service-connected disability on the veteran and establishing service connection directly impacts the veteran’s ability

to access VA health care. Without adequate DoD health surveillance and documentation of troop locations, environmental hazards,
52

and other exposures, and timely sharing of this information with

VA, this burden is virtually impossible for the veteran to meet. If

relevant health and environmental exposure information is incomplete or does not even exist due to previously discussed breakdowns

in the system, discussions on how VA and DoD can better share

this information is moot. The American Legion believes a total

commitment from all levels of the Department of Defense, especially the Secretary’s office, as well as strong congressional oversight, are needed to ensure that such policies are actually implemented in a timely and consistent manner.

One other major obstacle that prevents sharing of relevant exposure information has to do with classification issues. In the case of

Project SHAD, the mere existence of a potentially hazardous activity, not to mention possible exposure and personnel participation

information, was not known for many years afterwards because of

national security and classification issues. National security is a legitimate concern, but veterans should not have to suffer undue

hardship when national security is used unnecessarily as a justification to withhold information that is necessary for all veterans

to pursue health care and compensation from VA. An oversight

working group on biological and chemical testing as set forth in the

proposed Veterans Right-to-Know Act of 2002 could prove to be an

invaluable tool in overseeing the identification and declassification

of such tests.

The American Legion also believes that a sincere desire in information sharing and mutual cooperation at the highest level of DoD

and VA is needed. A June 2002 letter from the Secretary of Veterans Affairs to the Secretary of Defense, expressing the importance of VA–DoD cooperation in quickly declassifying and releasing

additional information regarding SHAD is a good example of such

a desire. Such action at this level needs to continue if we are to

satisfactorily resolve the hurdles associated with the dissemination

of SHAD-related information as well as to avoid such problems in

the future.

Mr. Chairman, that completes my testimony. I will be happy to

answer any questions you or members of the committee may have.

[The prepared statement of Mr. Smithson follows:]

PREPARED STATEMENT OF STEVEN R. SMITHSON, ASSISTANT DIRECTOR, NATIONAL

VETERANS AFFAIRS AND REHABILITATION COMMISSION, THE AMERICAN LEGION

Mr. Chairman and Members of the Committee:

The American Legion appreciates the opportunity to provide testimony regarding

the strategies being pursued by the Departments of Defense (DoD) and Veterans Affairs (VA) to provide appropriate care and support to veterans who may have been

exposed to environmental hazards during their military service. As U.S. troops are

currently deployed overseas fighting the war on terrorism, this topic becomes even

more relevant.

While military service is inherently dangerous and certain risks are to be expected, the government is obligated to provide proper health care and compensation

to those who sustain chronic disabilities as a result of such service. While VA is

charged with caring for military members once they leave active duty, its mission

is tied directly to information and support received from DoD. Herein lies a fundamental problem. DoD’s primary mission is to fight wars and maintain national security. Caring for troops wounded or otherwise injured in the advancement of this mission has often been seen as secondary to its ultimate mission. However, without

adequate cooperation, communication and open sharing of information between

these two entities, VA’s ability to successfully serve our nation’s veterans is severely

compromised.
53

History is ripe with examples of DoD’s failure to be forthcoming with timely and

accurate information pertaining to toxic exposures such as Agent Orange in Vietnam, radiation exposure from Cold War nuclear detonation testing as well as biological and chemical warfare defense testing, known as Operation Shipboard Hazard

and Defense (SHAD), in the 1960s. These are just a few examples of where crucial

exposure information was unnecessarily withheld or classified, resulting in additional hardship and suffering for those exposed. Unfortunately, the Gulf War was

no different. It took over five years for the Pentagon to publicly admit that U.S.

troops were exposed to low levels of nerve agent following the destruction of an Iraqi

munitions storage facility—Khamisiyah—in Southern Iraq in March 1991. Recent

disclosures by DoD officials regarding Khamisiyah exposure modeling efforts raises

serious doubts as to the accuracy of such modeling, bringing into question the actual

number of U.S. troops exposed and the level of exposure.

Hints of a possible repeat of this pattern recently surfaced in the war on terrorism

with reports that U.S. troops stationed at a former Soviet air base in Uzbekistan

may have been exposed to chemical agents that had seeped from old weapons caches

stored by the former Soviet Union. Such news, initially reported in early June, was

later rebuffed by military officials as a false alarm.

Exposure information pertaining to Project SHAD, a series of experiments designed to test the vulnerability of American war ships to chemical and biological

warfare attacks, is slowly being declassified. To date twelve out of a possible 113

tests have been declassified and participants’ names provided to VA, resulting in the

initial notification this past May of only 622 veterans. In order to ensure that all

information relevant to the health and well being of those involved in the SHAD

tests is provided to VA in an expeditious manner and all identified participants are

notified of the possible health consequences, H.R. 5060 and S. 2704, the Veterans

Right-To-Know Act of 2002, was recently introduced. The American Legion fully

supports this legislation that specifically addresses the tests associated with Project

SHAD and calls for the identification of all DoD tests involving chemical or biological weapons in which military personnel may have been exposed to actual or simulated agents with or without their knowledge or consent. We also note that S. 2514,

the Defense Appropriations Bill for Fiscal Year 2003 was recently amended to include a provision addressing the SHAD issue.

In other instances procedural breakdowns, such as improper record keeping, has

been the culprit. A perfect example is the poor documentation of possible exposures

during the 1991 Gulf War. Prior to the Gulf War deployment, troops were not systematically given comprehensive pre-deployment health screenings, nor were they

properly briefed on the potential hazards, such as fall out from depleted uranium

munitions, that they might encounter on the battlefield or in the theater. Additionally, as referenced above, record keeping was very poor. Numerous examples of lost

or destroyed medical records of active duty and reserve personnel have been identified. Vaccines were not administered in a consistent manner and vaccination records

were often unclear or incomplete. Moreover, personnel were not provided information concerning vaccines or prescribed medications. Some medications were distributed with little or no documentation or dosage instructions, to include possible side

effects or instructions to immediately report unsuspected side effects to medical personnel. Physical evaluations—pre and post deployment—were not comprehensive

and information regarding troop movements/locations and possible environmental

hazard exposures was severely lacking. The lack of such baseline data and other information is commonly recognized as a major limitation in the evaluation and understanding of potential causes of the multi-symptom illnesses reported by many

Gulf War veterans following the war. Unless the failures in the system cited above

are corrected, we are doomed to repeat this pattern in the current war on terrorism

as well as other future deployments.

As briefly outlined above, there are numerous obstacles that impede DoD’s sharing of relevant information on potentially hazardous exposures with veterans and

VA. One major obstruction is that DoD’s primary mission, as previously discussed,

is inherently at odds with VA’s role of providing health care and compensation to

veterans. It is not so much that DoD intentionally puts up roadblocks to prevent

veterans from being properly served by VA, but rather the fact that this is not a

DoD priority. To avoid the procedural problems encountered both during and after

the Gulf War, as discussed above, ‘‘lessons learned’’ from the Gulf War, have precipitated the passage of laws and policies designed to create a concept of Force Health

Protection. For example, Section 765 of PL 105–85 directed DoD to take specific actions to improve medical tracking for personnel deployed overseas in contingency or

combat operations, outlining a policy for pre and post deployment health assessments and blood samples. The conduct of a thorough examination (pre and post deployment), including the drawing of blood samples was specifically identified in the
54

law. Such action is crucial for the accurate recording of a service member’s health

prior to deployment and in documenting any changes in their health during deployment. Moreover, this is exactly the information that is needed by VA to adequately

care for and compensate service members for service-related disabilities once they

leave active duty.

On the surface the concept of Force Health Protection and related policies appear

to have addressed the major problems of the past. However, in reality, as was

learned from recent Institute of Medicine (IOM) and General Accounting Office

(GAO) Reports on the subject as well as in testimony earlier this year before the

House Veterans Affairs Subcommittee on Health, the aforementioned Force Health

Protection policies are not being consistently implemented. The organizational

mechanisms tasked with ensuring implementation of these policies from the command level down to the operational unit are obviously not working. Again, this lack

of urgency and compliance with the law appears to be related to DoD’s corporate

philosophy/culture and directly impacts its ranking of priorities. Unfortunately, the

service member and veteran ultimately pay the price for this inaction.

Title 38 United States Code places the burden of proof in establishing a serviceconnected disability on the veteran and establishing service connection directly impacts the veteran’s ability to access VA health care. Without adequate DoD health

surveillance and documentation of environmental hazards and other exposures, and

timely sharing of this information with VA, this burden is virtually impossible for

the veteran to meet. If relevant health and environmental exposure information is

incomplete or does not even exist due to previously discussed breakdowns in the system, discussions on how VA and DoD can better share this information is moot. The

American Legion believes a total commitment from all levels of DoD, as well as

strong congressional oversight, are needed to ensure that such policies are actually

implemented in a timely and consistent manner.

One other major obstacle is the delay in relevant exposure information due to

classification issues. In the case of Project SHAD, the mere existence of a potentially

hazardous activity, not to mention possible exposure and personnel participation information, was not known for many years afterward because of national security

and classification issues. National security is a legitimate concern, but veterans

should not have to suffer undue hardship when national security is used unnecessarily as a justification to withhold information that is necessary for a veteran to

pursue health care and compensation from VA. An oversight working group on biological and chemical testing as set forth in the proposed ‘‘Veterans Right-To-Know

Act of 2002’’ could prove to be an invaluable tool in overseeing the identification and

declassification of such tests.

The American Legion also believes that a sincere desire in information sharing

and mutual cooperation at the highest level of DoD and VA is needed. A June 2002

letter from the Secretary of Veterans Affairs to the Secretary of Defense, expressing

the importance of ‘‘VA–DoD cooperation’’ in quickly declassifying and releasing additional information regarding SHAD, is a good example of such a desire. Such action

at this level needs to continue if we are to satisfactorily resolve the hurdles associated with dissemination of SHAD-related information as well as avoid such problems in the future.

Mr. Chairman, that completes my testimony. I will be happy to answer any questions you or members of the committee may have at this time.

Chairman ROCKEFELLER. Thank you, and your testimony was already previously included in the record.

Mr. SMITHSON. Yes, sir.

Chairman ROCKEFELLER. Dr. Cole, you have testimony, and I

don’t want to keep you from your testimony. And I am really grateful that you are here. We have looked at the Persian Gulf War legacy together, and the business of informed consent for unapproved

drugs, and the discipline within the military to make sure that it

is written at best, verbal if less than best. What are the rules? Two

questions. One is: The law actually, I think, says you have got to

sign your name, the soldier has to sign his name. I don’t think

verbal is enough. I think the soldier has to sign his name. But I

am not sure of that because I am not a lawyer.

Second, if you had to—and I am projecting this forward to the

Gulf War from SHAD—if you had to estimate the number of mili-
55

tary who were subject to taking PB, who were told about it, who

had to give their informed consent on a daily basis, so to speak,

what would that number be? Would it be above 20 percent?

STATEMENT OF LEONARD COLE, PH.D., DEPARTMENT OF

POLITICAL SCIENCE, RUTGERS UNIVERSITY, NEWARK, NJ

Mr. COLE. Well, something like 250,000, as far as we know, but

that is just an approximation, because as far as I am concerned

personally, a lot of what happened can be excused because of, I

think, the fear, the worry, the legitimate anxiety that our troops

might have been exposed to sarin or, in the case of the anthrax

vaccine which was administered, because we were worried about

anthrax during the 1991 Gulf War. What I think is unforgivable

is that we don’t have the records to indicate who got the doses,

when, how many of them received it, so now we can’t go back and

follow their medical history.

Chairman ROCKEFELLER. Isn’t that because they didn’t actually

go collect them? That is what I am trying to get at.

Mr. COLE. Well, I don’t know what the reasons were. There was

disorganization. There was an unwillingness to do the kind of follow-through that would have—— Chairman ROCKEFELLER. But the military has different sections.

They have people who supply the warfighting weapons. They have

people who would deploy. They have people who look at radar.

They have people who worry about health care. So that the confusion argument has always been sort of a dodge to me. I mean, you

have people in the military and DoD, whose only responsibility is

health care. They don’t make decisions about whether you launch

an aircraft to go do something. The only decisions they make are

on the health care aspects of what the DoD is doing, are they being

carried out properly?

And so unless they are vastly understaffed or if they are ignored

when they try to do the right thing, which is always possible, I

don’t understand it. Am I right, though, that the verbal consent

isn’t enough, it has got to be written?

Mr. COLE. OK. We have to——

Chairman ROCKEFELLER. Or is that a bureaucratic distinction

even if it is legally correct?

Mr. COLE. Well, I think beyond bureaucracy, beyond—it enters

into the realm of legality and ethics. Any human subject research

where a person is going to be experimented on is the issue. If an

experimental drug is not necessarily for his own benefit, as would

not be the case with piridostigmine bromide or the anthrax vaccines, but, rather, just simply to see what the effects of a potential

agent would be, a person not only must give consent, but must do

it in writing after being appropriately informed. Such experimentation on human subjects goes on now in the military.

On the other hand, when you are in a battlefield situation and

the troops are imminently threatened, I don’t know that there is

a requirement for anybody to sign his name and say, ‘‘I will take

this kind of medication or drug.’’ I just don’t know the answer to

that.

Chairman ROCKEFELLER. Well, then, what are the implications

for the future? I mean, it is one thing to look back at SHAD and
56

to decry the walking away from all of that. But now we are talking

about a whole different kind of warfighting where people are not

in large clusters, where they are, you know, in the jungles of the

Philippines or Indonesia or they are either tree-covered or they are

not tree-covered, or they are 14,000 feet in the air and there are

5 or 6 of them or 8 or 10 of them or 2 or 3 of them, and there certainly isn’t going to be a medical officer going around getting informed consent should such a kind of thing be required.

So, I mean, if you take the new type of war into account—you

know, al Qaeda is in 70 countries plus all the other terrorist

groups, including the ones we have in our own country—what do

you see all of this leading to? Because biological and chemical

weapons are now on the table. You don’t have a discussion about

anything without talking about them. It was kind of the surprise

back—well, it wasn’t a surprise, but it was new back in the Gulf

War. Now it is expected.

Mr. COLE. Well, the kind of conversation that you want to have

now and that you started having in the 1990’s is already a national

conversation when you talk about vaccines—smallpox vaccine, anthrax vaccine. Never mind just the military. We are talking about

whether every citizen in the United States should receive a smallpox vaccination. That is still under debate. Now there has been a

decision that something like 500,000 people ought to get it, those

people who would most likely be the first responders in case there

is an attack.

We are dealing with really a tough issue. I don’t mean to move

the locus of discussion from just the Veterans’ Affairs Committee

concerns to the Nation at large, but the reality is the questions

that you are raising have national implications for all citizens, not

just for veterans or not just people facing military situations next

week or next month. I don’t know that there is a good answer, but

I do believe that there are good people working on, let’s say, the

least of the bad answers.

In summary, I think you can take the smallpox vaccination as a

model, or piridostigmine bromide, or anthrax, for a whole range of

questions. How many people are we likely to save as a consequence

of this policy as opposed to how many we are likely to injure or

even kill as a consequence of the policy? We don’t have the numbers clearly down yet, but it is risk versus benefit.

Chairman ROCKEFELLER. In a sense, what you are saying—and

I think I will close with this, with the exception if any of you have

anything more that you want to say, which I would welcome. It is

a little bit like all of the American people are potentially veterans,

so to speak. And we are not just talking about Iraq, we are not

talking about other parts of the world. We are talking about this

country. So then the whole question of what are we doing to beef

up our public health system, the number of vaccines, informed consent for Americans who, you know, aren’t at war, who are bringing

up children, working, or whatever it is. They have their agendas,

and they are also facing a form of danger which is very much up

on them. So it suddenly is a different kind of question, isn’t it? It

is not the warfighters overseas but the American people at home,

and all of the ethical and legal questions begin to sort of overlap,

don’t they?
57

Mr. COLE. Yes, I have a personal answer, if I may, for what I

would say would be appropriate. I don’t know that it is necessarily

the correct national policy, but I believe that everybody should

have the opportunity to take or refuse a smallpox vaccination or an

anthrax vaccination, after being given the full panoply of the potential risks and benefits, unless the person is, obviously, not mentally

competent or a juvenile. That is what we are about. We are a democracy. Informed consent is more than just about experiments. It

is about how we should be living in a democracy.

[The prepared statement of Mr. Cole follows:]

PREPARED STATEMENT OF LEONARD A. COLE, PH.D., ADJUNCT PROFESSOR, DEPARTMENT OF POLITICAL SCIENCE, RUTGERS UNIVERSITY, NEWARK, NJ

Thank you for inviting me to comment on the ethics of conducting open air testing

with biological and chemical warfare agents. Ever since 1976, when the public first

learned that the U.S. Army had conducted germ warfare tests over populated areas,

new information about such testing has continued to surface. Most recently, in May

2002, the Department of Defense released information about a series of tests undertaken in the 1960s under ‘‘Project Shipboard Hazard and Defense,’’ or SHAD. These

tests were part of a joint service program to assess the vulnerability of U.S. warships to a chemical or biological warfare attack. Unlike other outdoor biological and

chemical warfare tests, these experiments may have deliberately exposed people to

actual biological and chemical weapons without their informed consent.

For a 20-year period, from 1949 to 1969, the Army conducted hundreds of mock

germ warfare attacks by releasing bacteria and chemicals over populated areas— from San Francisco to New York, from Minneapolis to Corpus Christie, Texas. The

test agents, which the army calls simulants, were intended to mimic more lethal

bacteria and chemicals that would be used as weapons. The purpose was to see how

the bacteria and chemicals spread while people went about their normal activities.

The Army contends that none of the exposed population was at risk because the

agents were harmless. Furthermore, it did not consider those people to be human

subjects with the right of informed consent, but rather people who just happened

to be in the area. Belatedly, the Army recognized that some of the bacteria and

chemicals, including Serratia marcescens and zinc cadmium sulfide, posed health

risks. In consequence, by the late 1960s, those agents were no longer being used

as simulants. [Leonard A. Cole, Clouds of Secrecy: The Army’s Germ Warfare Tests

Over Populated Areas (Lanham, MD: Rowman and Littlefield, 1990).]

In other tests, the Army targeted individuals with actual warfare agents, such as

the microorganism Coxiella burnetti, the cause of Q fever. In these instances, the

targeted people were volunteers who were treated as human subjects. They were

given information in advance about the tests, and were assured of quick medical

treatment if they became ill. [Leonard A. Cole, The Eleventh Plague: The Politics

of Biological and Chemical Warfare (New York: W.H. Freeman, 1998).]

Recent reports about SHAD suggest that, unlike in these other tests, people were

deliberately exposed not only to simulants, but to bio/chem weapons, and that the

exposed people were not treated as human subjects. This is evident, for example,

in material released by the DoD about a SHAD test called ‘‘Shady Grove.’’ The report indicates that Coxiella burnetti, as well as simulants, were sprayed at

ships in open Pacific waters. The report also says:

The crews who participated in Shady Grove were not test subjects, but test

conductors. Participants should have been fully informed of the details of each

test. . . . Under actual test conditions, test conductors should have worn appropriate nuclear, biological, and chemical (NBC) protective equipment and should

have taken extensive safety precautions to prevent any adverse health effects

from the testing. [Fact Sheet, Office of the Special Assistant to the Undersecretary of Defense (Personnel and Readiness) for Gulf War illnesses, Medical Readiness and Military Deployments. Provided at the request of the Department of

Veterans’ Affairs. N.d., circa May 2002.]

No reference is made to the participants’ right of informed consent, apparently because the crews were not considered to be ‘‘test subjects,’’ but ‘‘test conductors.’’

Moreover, the statement is not clear that crew members received appropriate information about risks and protection, only that they ‘‘should’’ have received such information.

In SHAD tests titled ‘‘Flower Drum, Phase II’’ and ‘‘Fearless Johnny,’’ VX nerve

agent was sprayed at ships to assess the resulting contamination and the effective-
58

ness of decontamination efforts. The DoD’s fact sheet indicates that VX is ‘‘one of

the most toxic substances ever synthesized,’’ and that it is able to kill ‘‘within 10–

15 minutes after absorption of a fatal dose.’’ But the fact sheet does not say whether

crews were properly protected from the agent. Nor is it clear that anyone involved

with the decontamination was informed about the nature of VX. [Fact Sheets, Office

of the Special Assistant to the Undersecretary of Defense (Personnel and Readiness)

for Gulf War illnesses, Medical Readiness and Military Deployments. Provided at

the request of the Department of Veterans’ Affairs. N.d., circa May 2002.]

How much danger the crews faced during these tests remains uncertain. In fairness, it is important to recognize that today’s standards and values are not necessarily the same as those of earlier periods. In the 1950s and 1960s, the culture

appeared less sensitive than it is today to the rights of patients and of humans research subjects. Still, even with that understanding, and with due recognition of the

Soviet threat that prompted the tests, ethical questions remain.

During World War II, the Germans used thousands of Jews and other concentration camp inmates as involuntary experimental subjects. The experiments commonly

caused pain, disfigurement, and death. In 1947, doctors who performed the experiments were tried in Nuremberg, and the verdict included a code of conduct for research with human subjects. The Nuremberg code enshrines the requirement that

people be fully informed and give consent before becoming test subjects. The code

became a standard in all civilized societies. In 1953, a DoD memorandum to the

Army, Navy, and Air Force affirmed the code as policy and began with the admonition that ‘‘the voluntary consent of the human subject is absolutely essential.’’ [U.S.

Secretary of Defense, Memorandum for the Secretary of the Army, Secretary of the

Navy, Secretary of the Air Force, subject: Use of Human Volunteers in Experimental

Research, Washington, DC, February 26, 1953.]

Thus, any supposition that rules for human research subjects were different in

the 1950s or 1960s than today would be untrue. Researchers may have been less

sensitive to the requirement of informed consent. Patients and subjects may have

been less informed generally about their rights. But the requirement of informed

consent was official military policy.

In the context of the SHAD tests, several conclusions seem appropriate.

• Deliberately exposing people to biological or chemical weapons without some

level of informed consent, would have been contrary to official policy. Ignoring the

right of informed consent would also have been inconsistent with the military’s

treatment of human subjects in other tests in which actual weapons (as opposed to

simulants) were used.

• The requirement of informed consent should apply to everyone put at risk in

such tests, whether the participants are designated as testers or subjects.

• The United States government has a particular responsibility to people who

were placed at risk by its experiments. The responsibility should include providing

medical care and financial compensation to any participant made ill by the tests.

Chairman ROCKEFELLER. Any other comments? Yes, please?

Ms. SCHWARTZ. Just to let you know, I am retired from the U.S.

Air Force, and I am on the faculty of the Yale School of Nursing,

and I am in epidemiology. And basically one of the things about—

you asked the question about did they go around and get informed

consent before they give medications. Not necessarily, if it is something that has been, you know, a protocol that has already been established by the DoD, by the Air Force or so forth, but you do keep

records of who gets what. Nurses do have to chart, and people who

are giving those injections do have to chart.

And Dr. Cole brought out a very important part. You wish that

you could give the military member the option to have this injection or not, but that is not what happens because there is a certain

commitment to mission readiness, and along with that the person

has the right to know, the military person has the right to know

what it is they are going to be doing.

But the reality of what has happened here, both with SHAD and

what you have been talking about this morning, is one thing. When

everything is all said and done, whatever happened to those people

on those ships, whatever happened to the people in the desert, this
59

country owes them. We owe them. The Veterans Administration is

the workmen’s comp for people who go to war, for the men and

women that have been exposed. And it is—and I know you have

been a leader, and I thank you so much for it, Senator Rockefeller.

But the truth of the matter is that every day veterans around this

country have to beg for help. They have to beg for the care and consideration that they deserve for putting their life on the line every

single day.

We owe them the honor and respect of not making them beg for

this help. We also have to look at the world today. This country has

been jolted every day by something new—the Catholic Church, Arthur Andersen, Wall Street. It is unbelievable to me that we trust

these men and women to defend our country and we will not—we

will question their honesty, we will question what they say happened to them. And it is left to them, left to them and their families and their children, to make sense out of the sacrifice.

We recently did—we looked at the deaths of over 5,000 Vietnam

veterans who served in Vietnam. The average age at the time of

death was 51 years old. And as poignant and as striking as that

might be, the saddest part of all is many of them died without

knowing that they died for their country.

Chairman ROCKEFELLER. The hearing stands in recess. Thank

you.

[Whereupon, at 11:24 a.m., the committee was adjourned.]

(61)

A P P E N D I X

PREPARED STATEMENT OF HON. BEN NIGHTHORSE CAMPBELL, U.S. SENATOR FROM

COLORADO

Thank you, Mr. Chairman. I appreciate your convening this hearing and welcome

everyone here today as we continue our efforts to investigate toxic exposures among

our nation’s veterans.

Recently, we have received new information concerning the use of and exposure

to chemical and biological agents as part of a warfare testing program in the 1960’s. We continue to hear of Gulf War veterans who are suffering from a host of

unexplainable symptoms. And now, we have American soldiers involved in another

war—the war against terrorism.

As our knowledge of scientific methods and research improves, we learn of the

glaring errors we made in the past. There should be no question that our government should provide the necessary care and restitution for injuries caused by these

errors. One might think that after the debacles of the Vietnam and Gulf Wars, accountability for illnesses incurred from exposure to chemical agents during war time

would be a pretty clear issue. Unfortunately, however, the Department of Defense

has not made the task of obtaining all of the data an easy one.

Treating those who protect our nation’s security as human guinea pigs for research purposes is inexcusable. Not only must we discontinue such practices, we

must also make every effort to see that such exposures do not take place accidentally.

Our primary concern should be to take the steps necessary for caring for the

health of our veterans. I am hopeful that through careful analysis of the available

data, we can understand precisely the causes of and the treatments for illnesses due

to exposures. Then, we must implement policies to make sure that such exposures

do not take place either intentionally or unintentionally.

I believe it is imperative that we restore the trust and confidence of America’s veterans in the federal government’s response to these kinds of exposures.

Again, I thank the chair, and look forward to today’s testimony.

PREPARED STATEMENT OF JOY J. ILEM, ASSISTANT NATIONAL LEGISLATIVE DIRECTOR, DISABLED AMERICAN VETERANS

Mr. Chairman and Members of the Committee:

I am pleased to present the views of the Disabled American Veterans (DAV) concerning strategies of the Departments of Defense (DoD) and Veterans Affairs (VA)

to provide the most appropriate care and support to veterans who might have been

exposed to environmental hazards during their military service.

The health and well-being of the men and women who put themselves in harm’s way in defense of our Nation continues to be one of our foremost concerns and is

of great importance to the DAV’s more than 1.2 million members and their families.

We appreciate the Committee’s efforts to identify obstacles that prevent DoD from

sharing relevant information on potentially hazardous exposures with veterans and

VA. We strongly agree with the Committee that veterans deserve assurance that

DoD can work productively with VA to identify, treat and, when possible, prevent

potential long-term health consequences of their military service.

The hazards of military service are well documented and include possible exposure to radiation, chemical and biological agents, herbicides, a variety of environmental hazards, infectious diseases, and a host of other toxins. Each new battlefield

presents a unique set of health hazards. Many soldiers suffer life-long disabilities

as a result of their military experience, due to blindness, spinal cord injury, cold

injury, traumatic amputation, hearing impairment, and post traumatic stress disorder.
62

Following the terrorist attacks on the World Trade Center and the Pentagon, the

United States began to deploy troops to Afghanistan, Pakistan, and neighboring

former Soviet Republics. To date over 30,000 active duty personnel have been deployed and over 50,000 Reserve personnel have been called to active duty in support

of operations in South Asia. According to DoD, these troops may experience highaltitude health hazards, and exposure to a variety of infectious diseases and environmental hazards to include agricultural and industrial contamination of food and

water supplies, air pollution, and severe sand and dust storms.

During Operations Desert Shield and Desert Storm, the United States deployed

697,000 military personnel to the Persian Gulf. Serious health concerns related to

service in the Persian Gulf were reported as Gulf War veterans began to return

home in 1991 with complaints of vexing symptomatology and the development of unexplained illnesses. More than 100,000 troops who served in the Gulf War report

they continue to suffer from a range of maladies including chronic muscle and joint

pain, fatigue, headaches, memory loss, balance problems, and sleep disturbances.

The complexity and controversy surrounding Gulf War illnesses immediately became apparent as the VA attempted to medically treat and compensate veterans

who had become ill following their military service in the Gulf War. Controversy

over this issue still exists today, more than ten years later, as scientists and medical

researchers continue to search for answers and contemplate the various health risk

factors associated with service in the Gulf War and reported illnesses affecting

many veterans who served there.

Following the Gulf War, 33 separate hazardous substances were identified to

which Gulf War veterans may have been exposed. DoD was heavily criticized for

failing to provide explanations about Gulf War veterans’ health concerns or respond

in a prudent manner. Faith in the government’s commitment to ensuring the safety

of servicemembers’ and veterans’ health and providing appropriate care was seriously eroded. After intense pressure, DoD admitted its shortcomings and failure to

properly communicate with troops during the Gulf War about health concerns relating to smoke from oil well fires, required vaccinations and medications, exposure to

depleted uranium, and other chemical hazards.

Most recently, veterans service organizations (VSO) were notified that veterans

who participated in a series of Cold War tests known as Project SHAD (Shipboard

Hazard and Defense), a program encompassing several tests initiated in the 1960s

to determine the vulnerabilities of United States warships to an attack with chemical or biological warfare agents, may have been exposed to potentially harmful biological and chemical agents. Only after intense pressure from veterans and Congress

did DoD finally begin to release information about the tests conducted. VA and DoD,

in a joint meeting, informed VSOs that both agencies would work collaboratively to

develop the facts surrounding Project SHAD and accomplish declassification of materials, compile rosters of participants and inform them of potential exposures and

possible short and long-term health effects. To date DoD has identified 103 potential

SHAD tests. However, the total number of servicemembers involved in the tests is

still unknown. In May 2002, VA initially notified 622 of about 4,300 veterans already identified as participants in project SHAD about potential exposures. The Veterans Right To Know Act of 2002 (H.R. 5060 and S.2704), was recently introduced

in part to expedite the process of gathering all essential information related to

SHAD and test participants. DAV fully supports this legislation, which calls for full

disclosure of each DoD test involving chemical or biological weapons in which members of the Armed Forces or civilians were or may have been exposed to actual or

simulated hazardous agents, whether with or without their knowledge or consent.

In November 1998, President Clinton directed the establishment of the Military

and Veterans Health Coordinating Board (MVHCB), an interagency body including

the Secretaries of Defense, Health and Human Services, and Veterans Affairs, to ensure coordination among the respective agencies with respect to clinical, research,

and health risk communication issues related to the health of military members,

veterans, and their families during and after future deployments. The MVHCB is

responsible for making recommendations to minimize adverse health consequences

of deployment and to coordinate an interagency information management (IM), and

information technology (IT) task force, to ensure that all IM/IT requirements including record keeping are addressed by the agencies. A Deployment Health Working

Group (DHWG) was also designed to determine interagency priorities for the assessment and prevention of deployment and post-deployment health issues. The work

group is focusing on pre- and post-deployment health assessments, medical surveillance during deployments, combat stress control, and individual environmental exposure assessments. The group is responsible for providing recommendations to the

various agencies concerning research, clinical findings, prevention, diagnosis, and

clinical care. Another component of the group is to help ensure lessons learned from
63

previous military combat operations are translated into effective preparation for future missions.

Last year, a new Office of the Special Assistant to the Secretary of Defense for

Gulf War Illnesses, Medical Readiness and Military Deployments (OSAGWI-MRMD)

was formed to continue the support for appropriate health care for sick Gulf War

veterans while promoting changes in existing military doctrine, policy and procedures that will minimize any future hazardous exposures during deployments. DoD

recognized it must properly train military personnel in the use of chemical detection

equipment, effectively communicate safety precautions for depleted uranium, the

use of pesticides, and other chemical hazards future troops may encounter on the

modern battlefield.

Military officials claim they have a new mind set concerning the long-term health

of their troops and have indicated that they are taking measures to improve medical

monitoring of personnel sent overseas to fight the war on terrorism, in an attempt

to avoid lingering health problems like those experienced by Gulf War veterans. Officials claim they are keeping careful records for troops and requiring

servicemembers to complete a simple medical screening before and after they are

deployed. One report indicated that the Armed Forces are beginning to convert medical records for each servicemember to an electronic database. The report also noted

that the Pentagon has started environmental monitoring for areas where its sends

its troops. Certainly, we hope these measures are being carried out. However, only

time will tell if the appropriate agencies have fully addressed the lessons learned

in the Gulf War and if efforts have been effectively coordinated to protect the health

of our troops.

The DAV believes military personnel should have complete medical examinations

prior to deployment and after completion of an assignment to include collection of

blood samples. This would allow clinicians and researchers to ascertain changes in

health status in individuals and groups of servicemembers if health concerns become apparent following a particular deployment. It is also important that accurate

record keeping during deployment is accomplished and accessible, especially if a

servicemember becomes ill during the deployment. Many sick Gulf War veterans

were unable to access field health treatment records once they returned home. DoD

reported that many veterans could not obtain records because they were filed by the

name of the hospital that retired the records and veterans could not furnish the

name of the field hospital to which they were admitted. This documentation can be

crucial to a veteran’s medical treatment and application for VA disability compensation benefits.

It is essential that all appropriate agencies work together to integrate deployment

health-related lessons learned with regard to future doctrine and policy. This will

help to assure that servicemembers and their families understand the possible

health risks they face and how they can best protect themselves and their families’

health and get the assistance and care they need as they transition into veteran status. The appropriate federal agencies must share responsibility for force health protection before, during, and after deployments. Without coordination, future veterans

will likely experience problems similar to those that Gulf War veterans faced. DoD

is obligated to provide accurate information about the health risks servicemembers

face. The Department needs to be proactive rather than reactive concerning risks

servicemembers may encounter during future deployments from the modern battlefield and environmental conditions. Likewise, the Veterans Health Administration

must focus its scientific research, medical treatment, and outreach on veterans who

become ill as a result of their military service. Disabled veterans must have access

to appropriate treatment regimes so they can try to regain their health and wellbeing following military service.

It is the government’s obligation to provide veterans who suffer from service-related disabilities with health care and compensation. However, for VA to make accurate rating decisions on claims for service connection for disabilities associated with

toxic exposures, it must have access to all relevant documentation. The current system in place makes it nearly impossible in some cases for veterans to obtain relevant exposure information in support of their claim for service connection, i.e., barriers reported by DoD in getting relevant Project SHAD information declassified expeditiously. It is essential that DoD practice good record keeping, especially for

high-risk military exercises, and shares that information with the VA,

servicemembers and veterans in a timely manner. Excessive delays for information

are unacceptable. A veteran’s health and well-being should not be put at further

risk due to institutional barriers in information sharing between VA and DoD. This

process must be streamlined and veterans must be immediately made aware of exposure to hazardous toxins and possible health effects.
64

DoD’s past failures in providing servicemembers and veterans with important information about potential toxic exposures and possible health effects is well documented. Project SHAD is just one more example. In the mean time, these veterans

may have been denied treatment form the VA for health problems or compensation

for disabilities that may only now be linked to their military service. DoD says it

is concerned about the health and well-being of its troops; however, veterans believe

actions speak louder than words. DoD reports it is now trying to streamline its medical record keeping process through the collection of pre- and post-deployment

physicals, medical intelligence, health care delivery and other important documentation. This action is long overdue. Veterans who have sacrificed their good health in

defense of our Nation deserve more than just promises. It is essential that DoD

overcome institutional barriers and aggressively pursue initiatives that will ensure

veterans who have suffered severe health consequences as a result of their military

service have access to critical information related to hazardous exposures so they

can be properly compensated for service-related disabilities and afforded timely and

appropriate medical treatments. Without a true collaboration between the involved

agencies we are doomed to repeat the past. Unfortunately, it is veterans who will

needlessly suffer and continue to pay the price for inaction.

We urge the Committee to closely monitor the federal agencies responsible for coordinating force health protection. We sincerely appreciate the opportunity to

present our views on this important issue and its relationship to the health status

of the veteran population.

JOINT PREPARED STATEMENT OF THE DESERT STORM JUSTICE FOUNDATION, PAUL

LYONS, PRESIDENT; DESERT STORM BATTLE REGISTRY, KIRT P. LOVE, PRESIDENT;

AND AMERICAN VETERAN JUSTICE FOUNDATION, DANNIE WOLF, PRESIDENT

Dear Committee Members

At the time in late 2000, OSAGWI had the opportunity to respond to a question

posed to them concerning Project SHAD. Kirt Love and Venus Hammack were

present at this Pentagon NSO meeting to hear CPT. Mike Kilpatrick and

UNSECDEF Dr. Bernard Rostker say they would reply to the question of project

SHAD. It would be nearly 2 years before anything else was said by this agency.

This stall tactic is on going with other investigations, as it does with Gulf War

issues. It started with Warren Rudmans’ statements on behalf of PSOB (investigating OSAGWI) that OSAGWI should change from investigation to medical deployment. Then it produced heavily biased data that was unsupportive of veteran

‘‘benefit of the doubt’’ asto incidents and medical issues.

The moment that Dr. Bernard Rostker left office in 2001 they changed that policy,

they summarily cut all ties with any Gulf War grass roots groups and dealt strictly

with the National Service Organizations. They stopped returning phone calls and

emails, and dodged veterans at public events throughout 2001. The issue fell silent

until the Anthrax incident of October 2001.

OSAGWI has 6,000,000 records related to the Gulf War of which 1,200,000 are

of medical relevance. From that they post 57,000 they claim have relevance, and

never produce evidence that the other 6,000,000 are even real. 12 years later these

materials (mainly CIA and CENTCOM) are 99% classified SECRET or higher—and

not releasable.

It is our firm belief that having viewed some records outside DOD intelligence

main frame that many of the records are of HIGH relevance—like DIA’s unwillingness to discuss its highly classified records on the 9 Nuclear Reactors in the 1991

Gulf War supplied by the Russians. That the Russians recommended we NOT

bombed them, and we did.

If Deployment Health Support Directorate is given the opportunity to run the

SHAD investigation like it did the Gulf War investigation, it will deliberately stall

and with hold vital data to keep damage to a minimum. Without Non-Military oversight, DOD is NOT capable of regulating or investigating itself internally.

Our organization has had interaction with OSAGWI since 1997, and we are very

familiar with their team having interacted with them on every level to include Public Town Hall Meetings. Every where they went around the United States, the veteran groups treated them same—‘‘You have NO credibility with us’’. From observation we also supported that conclusion, they do NOT provide answers to FOIA’s of

medical relevance or even basic request.

Acknowledging medical conditions is one thing, but VA’s ‘‘Burden of proof’’ policy

is punitive in nature, and if DHSD is allowed to continue as is—it will make sure

that SHAD veterans have as much trouble proving their claims as Gulf War veterans have theirs. Exposure dictates treatment, and so far the Deployment Health
65

Clinical Center supported by DHSD is largely psychiatric research. They run on the

basis that Somatization is the answer, which does not support lab baseline data.

As a veteran of the Gulf War, we have first hand knowledge of OSAGWI interaction. On that basis we recommend Oversight investigation into their operation at

this time for the protection of other soldiers currently deploying that are NOT protected from lessons learned by this agency.

MILITARY EXPOSURES

Many Veterans have been failed by the DESP: deployment environmental surveillance program

[1] Info related to service members health and deployments status—was incomplete or inaccurate, according to GAO Report 02–478T.

[2] DoDs’ numerous databases, including those that capture health info, currently

are not linked. • This transfer of data to a common electronic system, that will document, archive and • Access medical surveillance data is poor at best

[3] The Secretary of the Army is responsible for medical surveillance for all of the

DoD’s deployments; this should be consistent with DoDs’ medical surveillance policy.

[4] Without this info, troops may not recognize potential side effects of exposures

or take prompt precautionary actions, including seeking medical care. • Current Policies and Lessons Learned Programs have NOT been full Implemented today.

• The (CHCS II) Composite HEALTHCARE system needs to be audited, according

to GAO Report –02–173T

THE CONTINUING CHALLENGES OF CARE

[1] We have also reported that not all medic encounters in theater were being recorded on individual records.

• So why are veteran’s today, still having to prove to adjudicators their exposures?

• Benefit of the doubt is almost never granted, impart because of DOD’s stalling

of actual exposures and events that surface nearly 30 years later.

[2] VBA considers the VCAA’s implementation a significant factor in the recent

growth of its inventory of Compensation and Pension claims awaiting decisions—

from the law’s enactments.

• Please read PL 106–475, Nov 9 2000.

[3] Despite VBA’s efforts, recent results from its quality assurance reviews indicate a significant decrease in rating accuracy, due in large part, to improper regional office implementation of VCAA requirements.

[4] This law obligated the VA to assist a claimant in obtaining evidence that is

necessary to establish eligibility for service connected benefit’s being sought.

Question—what is being done when claimants are informed relevant records

are unable to be obtained?

[5] This lack of data by design, negatively impacts the STAR system, Systematic

Technical Accuracy Review for the Regional Office.

Today many claimants have not received notification request for evidence from

V.A. federal service officers, and were not obtained by the VBA for evidence. Yet

many vets have been failed by lax Industrial hygiene and sanitation in the Gulf War

Theater; and very sadly, few have been evaluated in this manner.

We, the above mentioned Gulf War Veteran’s groups, insist the proper review of

statistics and the number of claimant information, as seen by doctor’s licensed by

The American Board of Industrial Hygiene or Industrial Health Foundation. Those

who are specialized in Environmental Medicine and/or Environmental Health could

also treat us.

Environmental Medicine is the medical discipline which studies and assesses the

effect of environmental factors upon individuals with particular emphasis on the effect of foods, chemicals, water, indoor and outdoor air quality at home, work or

school. It considers each patient as a unique individual exposed to a unique set of

circumstances and needing an individualized therapy.

Veterans seek this type of this evaluation for their claim.

Once the cause of the health problem is uncovered, treatment is as direct as possible with minimal use of pharmaceutical drugs, which can often have adverse side

effects and also often only mask other symptoms.

Treatment consists of environmental controls, diet, nutritional supplements, correction of hormonal or metabolic deficiencies or imbalances, education and

immunotherapy; (injectable and/or sublingual) where indicated. The amount of phy-
66

sicians in this area working at VAMC’s is insufficient to support the number of post

Vietnam deployed patient population.

COMPENSATION

DVA will find it difficult to assist in conducing research should troops be exposed

to environmental or occupational hazards, and identify legitimate service connected

disabilities to adjudicate veterans disability claims.

Service Connected disabilities adjudication have been hampered by a lock of 1.1

completed baseline health data of GWV

2.2 assessments of their potential exposure to environmental health hazards and

3.3 specific health data on care provided before, during and after deployments.

VSO officials we spoke with at the regional offices we visited expressed concern

about the clarity and necessity of VCAA pre-decision notification letters.

• Some VSO’s are having trouble understanding these letters. There is not a way

for a claimant to be sure the training and skill of the VSO who represents them.

PAUL LYONS, President, Desert Storm Justice Foundation

KIRT P. LOVE, President, Desert Storm Battle Registry

DANNIE WOLF, President, American Veteran Justice Foundation

PREPARED STATEMENT OF THE NATIONAL GULF WAR RESOURCE CENTER

Mr. Chairman and other distinguished members of the committee; the National

Gulf War Resource Center (NGWRC) is pleased to discuss this issue from the Gulf

War veteran perspective. Understanding how members of the U.S. military have

been exposed to chemical, biological, radiological or hazardous material, no matter

how the exposer happened, is critical to developing a strategy for treatment. We

thank you in advance for holding this important hearing.

In your invitation for testimony you wrote ‘‘Veterans deserve assurances that DoD

can work productively with the VA to identify, treat and if possible-prevent potential long-term health consequences from their military service’’

We agree with this statement. It is a simple request. However, with regard to

Gulf War veterans, assurances and productivity have been lacking. We characterize

DoD’s efforts as unacceptable, bordering on deception.

In keeping with the goals of this committee we have divided our testimony into

three sections. Each section covers what we believe is the historical barrier that prevents the flow of information. The barriers we have identified are DoD Culture, Information Dominance, and Burden of Proof.

DOD CULTURE

DoD has a demonstrated 50-year history of mitigating its failures with delay, denial and obstruction. Especially when it comes to exposures and what I call ‘‘bad

policy, resulting in self-inflicted wounds.’’ It is this bad policy, and culture that produced a thirty, forty and fifty year waiting period for admissions of guilt and corrective action from DoD.

The DoD culture is a mindset demonstrated over time and developed into a pattern of expected results based on whatever the external pressure is. Corporate cultures can be a good thing when they are developed to be mutually beneficial to the

organization, the worker and consumer. Examples of organizational cultures that

are bad are in the news today, in these organizations; losses and mistakes are hidden with strategic spin to delay the inevitable outcome. The company that is built

on perception rather than truth will always find it-self in a credibility argument.

Veterans have always understood what they were up against when taking on

DoD.

How can this committee change the DoD Culture? How can we help DoD develop

its credibility with veterans?

We start by holding the spin experts accountable. There should be hearings that

investigate and prosecute those who would lie to delay the inevitable truth. Why

is it acceptable, why do these spin experts continuing to receive taxpayer dollars?

Veterans are the consumers; we demand that the practice of deception be stopped.

We deserve truth and an honest broker. Our health is at risk because of Public Relations tactics. Truth would go a long way toward fixing this problem. Not truth in

30 years but truth now. Veterans have a right to know when they have been exposed to anything harmful.

If DoD knows then why shouldn’t the veteran. SHAD is a classic example of DoD

Culture gone amuck. DoD knew of the exposures in the SHAD test for many years,
67

certainly during the time that veterans like Jack Alderson were making inquiries

into his health status.

What was the response he was given when he asked for information? He was told

that no such test ever occurred. He was blatantly lied to. Even as this lie began

to fall apart DoD’s Office of the Secretary of Defense for Gulf War Illnesses

(OSAGWI) continued to lie to media and veteran service advocates. When asked if

a list of names containing those potentially exposed were available, Mrs. Barbara

Goodno and her public relations experts at the OSAGWI denied the existence of any

such list on more than one occasion.

I do not speculate on this subject. I worked in this organization and saw the list

of names before I retired. The question is: What is it about the DoD Culture that

allowed this person to continually lie to the media and to veterans when she knew

full well that a list was available and it contained the names of veterans who had

been exposed?

I believe that she did it because of the DoD culture of striving for Information

Dominance. It is the nature of DoD to mitigate and control the damage of a story

even if being less than honest harms the public.

I often tell my young nephew that lying is wrong, and dumb. Telling the truth

is always better. Lying becomes even worse when you do it and you know you’re

wrong, because eventually, in 30 or 40 years the institution will be caught. I tell

my nephew that a person who lies when they are obviously caught is twice the fool.

Risk communication, the buzzword of DoD public relations should not mean, let

me deceive you, let me delay the outcome for the benefit of protecting my organization. It should mean that you understand your audience, you understand your message and you deliver it with truth and honesty demonstrating your commitment to

solving the issue and addressing the public concerns.

Our suggestion to this committee is to change the DoD Culture. If DoD won’t

change on its own then we need to establish oversight with teeth. Terminate, prosecute and ban from governmental contact anyone who would purposely deceive

America. We expect high standards from our soldiers, why not the same from the

civilian leadership of DoD. Veterans can’t be held hostage to public relations anymore. A bill recently introduced, S. 2704 and HR. 5060 is an attempt to establish

an oversight mechanism that will protect veterans and allow information to flow

both ways.

INFORMATION DOMINANCE

It should be of no surprise to anyone on this committee that when dealing with

DoD you are subjecting yourself to a multitude of tactics and techniques that are

battle tested and designed for one purpose, domination of the battlefield. It does not

matter if the enemy is a country or a ‘‘perception,’’ the strategy is the same. DoD

Information Dominance is an obstacle that prevents veterans from gaining the truth

about their battlefield exposures.

Information dominance may be defined as superiority in the generation, manipulation, and use of information sufficient to afford its possessors dominance over the

full spectrum of an issue or conflict.

For DoD, information dominance has three sources. DoD Public Affairs representatives use these sources to ‘‘Control the Message.’’ This control becomes the barrier

that veterans face when trying to obtain information. The three sources of Information dominance are:

• Command and Control that permits everyone to know where they are in the

battlespace, and enables them to execute operations when and where they choose.

They understand that no matter what you may want they can wait you out. They

are the sole source provider.

• Intelligence that ranges from knowing the enemy’s dispositions to knowing the

location of enemy assets in real-time. It also means knowing the expected outcome

of a course of action. DoD weighs the cost of admitting the truth now or later based

on the desired outcome. If DoD has done something wonderful you cant make them

stop talking about it. If they have done something wrong they will ‘‘get back to you

later,’’ even if they know the answer already.

• Information Warfare that confounds enemy information systems at various

points (sensors, communications, processing, and command), while protecting one’s

own. Here is the meat of the problem. When you confront DoD in any form you are

the enemy. Confounding the issues with disinformation or one-sided information is

a primary tactic of DoD. Using SHAD as an example we have seen the DoD message

develop over time. First they said the test never happened. Then they said it happened but no list were available. Then they said the list is available but only

simulants were used. Now they admit live agent was used in some test but they
68

say people wore protective clothing. This is a pattern of information dominance that

allows DoD to eek out information and mitigates the story. They have known all

along what the exposures are.

Interestingly, the organization conducting the SHAD investigation is also responsible for producing the Gulf War Investigation. The reports produced from OSAGWI

for the Gulf War are about mitigating the exposure.

Recently a full 11 years after the Gulf War Dr. Michael Kilpatrick of OSAGWI

admitted during a public hearing, that its chemical warfare agent reports from the

Gulf War on Khamisiyah were—in his exact words—‘‘A wild ass guess.’’

The VA used this report and others to deny treatment, benefits and compensation

to veterans. Why did it take 11 years to admit what veterans knew immediately

after the war? Why has it taken SHAD veteran’s 40 years to hear the truth?

DoD proudly sees itself as second to none in the use of information. Controlling

the message is information dominance. This power is the barrier, which prevents

soldiers and veterans from learning the true nature of exposures. The idea of acceptable losses, and no remorse, coupled with strategic spin has become the norm from

DoD. Veterans demand a ‘‘no excuses’’ policy from DoD when they hold the information key to understanding exposures and health consequences. I implore this committee to establish some method to ensure information cannot be used as a weapon

against our own veterans, so this type of ‘‘bad policy’’ never happens again.

BURDEN OF PROOF

More than decade ago, U.S. Forces were deployed to fight in a war that would

be won in a matter of hours rather than years. The speed of battle and the technology that was employed ensured our success as we achieved our objectives. Today

we are beginning to hear the familiar rhetoric in preparation for a new war with

Iraq. We are seeing stories of how important our soldiers are and how well trained

and magnificent they are in the conduct of their duty to protect America.

This sentiment is true and deserved but for some the feeling that ‘‘soldiers matter’’ only comes out in time of war much like people who turn to prayer only when

they find themselves in dire straights. Serving veterans of the Gulf War has taught

me how much soldiers fade from the conciseness of America when the war is over.

300,000 out of 700,000 in theater Gulf War veterans have sought treatment from

the VA for what they believe to be service-connected disabilities. Now in this time

of great need and demand on our military I would like this committee to consider

the burden of proof and how the DoD’s culture and spin control of information has

denied veterans health care.

Under the current policies of the Veterans Administration (VA) soldiers who are

called to war and then return home are required to present evidence of exposure

or injury to the VA—- before they become eligible for care and compensation from

the VA. This policy places the burden of proof on the service member to insure that

DoD does its job. Some examples of the DoD failures in obtaining this burden of

proof during the Gulf War include: Poor record keeping both in and out of theater,

poor unit location management, lack of environmental monitoring, lack of useful

chemical and biological agent monitoring, lack of predictive analysis and consideration of downwind hazards resulting from pre ground-war bombing, lack of knowledge on the effect and use of investigational new drugs and vaccines, poor enforcement of and adherence to pesticides use, lack of standards and methods when using

or working around depleted uranium, the list goes on and on.

The soldier would have needed to be a journalist, lawyer, environmentalist, scientist, chemical and biological weapons expert, meteorologist and doctor to obtain

the proof required by the VA for service-connected disability.

Interestingly enough, the military has all these occupational specialties in its

ranks but the DoD and the VA still requires the individual to be responsible for obtaining and maintaining the required information. This is the crux of the problem:

In obtaining access to the entitlement of medical treatment and services from the

VA the burden of proof is improperly placed on the veteran when it should be placed

on DoD.

Lessons learned from the Gulf War were supposed to address this problem and

as a result of ‘‘Lessons Learned’’ from studying the events of the Gulf War. The DoD

and the JCS developed a plan that would prevent an event like ‘‘Gulf War Syndrome’’ from ever occurring again. This proactive policy was called Force Health

Protection or (FHP). FHP is a protocol and the congress wisely established it in a

public law designed to conduct a series of physical test on soldiers, before, during

and after deployment. It also requires DoD to maintain medical data, exposure and

event reports, and movement and location data. During my last assignment in the

military I briefed this policy to numerous active duty soldiers around the United
69

States. The Office of the Special Assistant for Gulf War Illnesses (OSAGWI) now

called the Special Assistant for Gulf War Illnesses, Medical Readiness and Military

Deployments (SAGWI/MR/MD) was then and is still today the lead agency on the

investigation into Gulf War exposures and has also transitioned into Deployment

Health Policy. The DoD is still ignoring this law, with no implemented policy. I

would welcome your questions for the record to enable me to justify this statement.

The problem of how to improve sharing of information between DoD the VA and

the veterans is two fold:

1. DoD is not enforcing the policy enacted into law as a result of lessons

learned from the Gulf War (PL.105–85, Section 762–765).

2. The burden of proof for service-connected disabilities is obviously misplaced

and should fall on DoD and not the individual.

There have been many initiatives that have been suggested in order to speed the

effectiveness and delivery of health care to veterans, however none have taken the

shape of actual implementation. Despite pressure from two presidents, both the VA

and DoD have made little headway in combining their health-care programs or

sharing critical information. If they took those two simple actions, it would relieve

the burden of proof from the individual. ‘‘Most of the sharing initiatives are more

illusory than real,’’ said Stephen Joseph, assistant secretary of Defense for Health

Affairs during the Clinton administration.

‘‘VA and DoD created several joint facilities in recent years, but most of the management and operational functions at the facilities continue to be run separately,’’

Joseph said.

Joseph further stated, ‘‘The biggest hindrance to greater cooperation and coordination between the two departments is their diverging missions. Delivering quality

health care to veterans is the VA’s primary mission. DoD’s health programs are focused on keeping the military healthy and ready for the next engagement.’’

However there is a flaw in the belief that these missions are different or competing. They should be complimentary. DoD gets the soldier at the reception station,

builds the medical record and in some cases sends the soldier to war. The VA is

the recipient of the veteran when they return from war or leave the service. In order

to take care of the soldier DoD must take responsibility for the burden of proof from

day-1 through the soldiers end of service. The reason that VA health care has been

limited for Gulf War veterans is the lack of commitment from the DoD to do its job

while the soldier is engaged in the conduct of his or her duty.

Let me give an example of how this flaw has impacted Gulf War Veterans. Upon

their return from the Gulf War, veterans began complaining of various illnesses and

diseases that they believed were attributed to their service in the Gulf region. Veterans themselves began to organize and ask for assistance from DoD, the VA and

others. No matter which direction veterans pointed to try and understand their illness the DoD and its selected scientists refuted veterans claims by making bold unfounded statements that were not backed up by scientific research.

Even today DoD requires veterans and the public to simply believe them because

they say so. Poor policies, weak protective measures, lack of records and other failures forced DoD to go back into time and write reports about the events of the Gulf

War to try and explain the multitude of exposures. These reports are ‘‘no more than

guesses’’ at what actually happened. Their conclusions can be easily refuted. The

final reports were then used by the VA as evidence to substantiate lack of service

connection to the exposures Gulf War veterans faced. Instead of actually fact finding

for the purpose of helping veterans the reports have been used as weapons to prevent access to care and compensation. Today, science has caught up with the DoD,

and we are discovering that these illnesses are absolutely service connected exposures and injuries. Allowing DoD to go back in time and guess about exposures and

then give this information to the VA to deny benefits places the veteran in a double

jeopardy. It makes as much sense as letting Enron investigate itself or asking the

fox to guard the hen house.

What are the obstacles and how do we improve benefits and services for Department of Veterans Affairs beneficiaries?

We must first eliminate the DoD culture of delay, denial, and obstruction. Then

Congress must demand that the DoD obey the Force Health Protection law’s already

on the books. This law also extends to the reserve component of the military. The

DoD can accomplish this today, with its existing force structure. The civilian leadership simply needs to issue the order, and follow-up to insure that it’s accomplished.

The Secretary of Defense, on a monthly basis, should brief the Congress until there

is compliance. The VA should be involved in the process proactively not retroactively.
70

It’s often said, ‘‘the first casualty of war is truth.’’ Our veterans are not demanding a big bag of money; they are demanding that which could be granted today.

Truth. The whole truth, and nothing but the truth

PREPARED STATEMENT OF PAUL A. HAYDEN, DEPUTY DIRECTOR, NATIONAL

LEGISLATIVE SERVICE, VETERANS OF FOREIGN WARS OF THE UNITED STATES

Mr. Chairman and members of the committee:

On behalf of the 2.7 million members of the Veterans of Foreign Wars of the

United States (VFW) and our Ladies Auxiliary, I would like to thank you for the

opportunity to comment on the strategies being pursued by the Departments of Defense (DOD) and Veterans Affairs (VA) to provide the most appropriate care and

support to veterans who might have been exposed to environmental hazards during

their military service.

Throughout the past century, in peace and war, our military men and women

have been exposed to a wide variety of environmental and manmade hazards. Aside

from normal deployment exposures such as diseases endemic to certain geographical

locations, troops in WWI were exposed to mustard gas among others agents; in

WWII they exposed to radiation from atomic explosions; in Vietnam they exposed

to herbicides designed to defoliate the jungle, and; in the Gulf War, they were exposed to low levels of toxic nerve gas.

In fact, this Committee found in its 1998 Report of the Special Investigation Unit

on Gulf War Illness, that the ‘‘Gulf War experience can be seen as a microcosm for

continued concerns regarding our nation’s military preparedness and ability to respond effectively to health problems that may arise . . . as ‘‘both [DOD] and [VA]

gave insufficient priority to matters of health protection, prevention, and monitoring

of troops when they [were] on the battlefield and thereafter when they [became] veterans.’’

Now, as a result of DODs recent disclosure regarding a group of Cold War chemical and biological tests commonly referred to as Project Shipboard Hazard And Defense (SHAD) that exposed veterans to dangerous and harmful agents, our Nation’s

attention is once again focused on how DOD and VA can ‘‘collect information adequately about, keep good health records on, and produce reliable and valid data to

monitor the health care and compensation status of veterans.’’

Seeking to apply lessons learned from the past, DODs current efforts in this arena

revolve around the concept of Force Health Protection. One of the ways they accomplish this is by having the servicemember, not a physician, assess their state of

health before and after deployments, by filling out forms DD Form 2795, Pre-Deployment Health Assessment, and DD Form 2796, Post-Deployment Health Assessment. In addition, DD Form 2796 asks the troops for their deployment location,

country, and name of operation.

In the Spring 2002, Vol. 1, Issue 4, Deployment Quarterly magazine, a DOD

health official in response to a question regarding whether a soldier ‘‘should get a

complete physical examination after [they] return from a deployment’’ replied, ‘‘complete physical examinations are not necessary for most people who are returning

from a deployment.’’ This answer clearly contradicts and undermines the intent of

Congress, not to mention the safety of the servicemember, when they authored Section 765 of PL 105–85. Under this law, DOD is required to perform pre-deployment

medical examinations and post-deployment medical examinations to include the

drawing of blood. All of these exams are to be retained in a centralized location to

improve future access.

Aside from DOD’s failure to implement current law, the Institute of Medicine

(IOM) in its report, Protecting Those Who Serve, (the recommendations of which the

VFW concurs) stated that DOD has made ‘‘few concrete changes at the field level’’

the most important recommendations remain unimplemented, despite the compelling rationale for urgent action.’’ Additionally, a January 8, 2002, New York Times

article seems to further illustrate this point. A Pentagon official in deployment

health described the new mind-set in military health care as ‘‘trying to train people

to ask questions, which is a change in military culture . . . Senior leaders need to

understand that there is a major shift.’’

We believe the chair of the IOM Committee on Strategies to Protect the Health

of Deployed U.S. Forces articulated the position that senior leaders are failing to

grasp when he stated, ‘‘while the accomplishment of the mission always will be the

paramount objective, soldiers must know that their health and well-being are taken

seriously. Failure to move briskly to incorporate these procedures (improved medical

surveillance, accurate troop location, exposure monitoring, etc. . . .) will erode the

traditional trust between the servicemember and the military leadership, and could
71

jeopardize the mission.’’ While DOD has received input from numerous expert panels, and has sought to implement changes based on lessons learned, it is our opinion

that they have failed to carry out DOD-wide changes in an effective and efficient

manner. They are not entirely to blame though, as institutional barriers are oftentimes hard to overcome.

Up to this point, our testimony has focused primarily on DOD, and rightly so, because in order for VA to properly care for and compensate a veteran, it depends on

accurate and timely information from the veteran’s military health record. We believe that every veteran is entitled to a comprehensive life-long medical record of

illnesses and injuries they suffer, the care and inoculations they receive, and their

exposure to different hazards. Further, the transfer of this record from DOD to VA

should be seamless. Communication between the two agencies needs to be streamlined so that data can be given to front-line health care and benefit providers. Because that is not always the case, the problem experienced by veterans in the past

has been their inability to convince VA that their disability is service connected. According to Title 38, USC, the burden of proof is placed upon the veteran. This is

an inherit inequity of the system that demands correction.

In cases such as these, Congress has a long history of creating presumptions for

specific cases such as Vietnam veterans and exposure to the herbicide Agent Orange

and presumption for service connection due to undiagnosed illnesses for Persian

Gulf veterans. If DOD provided proper data to VA then there would be no need for

corrective Congressional action and veterans who have a right to know if their illnesses were caused by exposure while in service would not have to wait decades to

properly address their valid concerns.

The VFW believes that only a total commitment to Force Health Protection from

the highest levels of DOD can ensure accurate health data collection and dissemination. Further, the VA must remain vigilant in its role as the chief advocate for our

nation’s veterans; and once again, Congress must use its powers of oversight and

legislation to ensure that future generations of veterans receive the care they were

promised by a grateful nation.

This concludes my testimony.

Æ