VA's Implementation of the "Persian Gulf War Veterans Act of 1998"
November 15, 2005

Submitted by:

Denise Nichols, Vice-Chairperson Natonal Vietnam and Gulf War Veterans Coalition, Veteran Gulf War,
MSN (303-726-0738)

Good day, Chairman Shays, Committee members, and members of the audience today. I am Denise Nichols,
Vice Chairperson of the National Vietnam and Gulf War Veterans Coalition, President of the Desert Storm
Veterans of the Rocky Mountains, a Gulf War Veteran, Major,USAFR(ret), Retired Nurse, MSN and Flight
Nurse. I came forward when I realized I was sick after returning from Saudi in 1991. I have been actively in
attendance and in testimony at every hearing on the hill and elsewhere since 1994.

Gulf war veterans who are ill have been abandoned and hundreds if not thousands of hours of investigative
hearings since 1993 have been conducted without resolution of the problems. Today the gulf war veterans are
still seeking resolution and we are getting sicker while tens of thousands of our peers are now dead and buried.
We came forward requesting: prompt and effective physiological assessments and subsequently relevant medical
care to cure or alleviate medical problems and to obtain compensation and pension support. Obtaining
compensation has improved somewhat at least by the number of claims approved. The process of applying for a
VA compensation is without a doubt a nightmare and continual war for each veteran. This system should be viewed
as a national disgrace and a dishonor to our ill veterans. The sick and medically incapacitated veteran has to somehow
get through each step in the process while requesting but not obtaining help.

Thousands of gulf war veterans are still coming forward into the claims process having gone as long as they can in
denial and now accepting their illnesses and seeking answers, we ask that all deadlines for the registry, presumption
of service connection, spouse and child registry, and all previous legislated efforts be extended indefinitely or at least
until 2012. A streamlined fast claims process for gulf war veterans is desperately requested as part of this legislative
package.

There is not an effective advocacy program for each veteran. VSO service officers have variable talents and abilities,
some are excellent and severely overworked, while others are less qualified and knowledgeable. The Rating
officials run the whole range of being informed on gulf war illness to incapable and uncaring in attitude. Somehow, the
care and respect and concern for each of our veterans for their best interest falls by the wayside.

The registry exams that were established by DOD and VA officials appears to have been set up to fail! By performing
less than complete physicals and not being sure that each ill gulf war veteran was given the complete physical, the
data would be screwed and the count of veterans suffering would never be accurate. Was this the DOD/VA plan to
discredit the reality of the damage from the very beginning?

The registry exam was structured to be a three phase physical. It appears to me, a person with a great deal of medical experience and organizational abilities, that these registry exams were never meant to be completed for each soldier.
Veterans enrolled in the registry exams hoping to get through the complete physical and diagnostic testing did not get the complete testing in all three phases, a check-off list was not provided nor guidance given by the DOD/VA to the soldier
veteran. Those of us that were health care providers saw that this did not occur.

We trusted our leaders that the evaluation would document our medical problems with subsequent medical care provided
based on a valid diagnosis or even ill defined illnesses, and the trust has been definitely broken. The system of exams was
not universally applied or even structurally complete. With such a wide degree of compliance, the registry exams did not
provide the testing the veteran deserved nor did it meet the need to provide data that could be utilized easily in assessing the overall problem. The problem was in the implementation of the plan. Either the coordinators and OIC headquarters were
ill-informed, compromised, or totally incapable, incompetent, and criminally negligent in the performance of their duties.

We trusted that each ill veteran would get the complete list of tests so that a baseline of good medical data collection would happen that could be utilized in assessing a total group of patients that were exposed to hazardous substances. Then healthy individuals could also have tests that were needed for a healthy comparison group. The health care providers know also, that data collected on ill individuals should also involve a review of prewar tests that might be available in comparison to our post
war data to see shifts that did occur in relation to such items as RBC counts and renal and liver blood results. If environmental NBC poisoning had occurred it would show up in these basis tests as subtle but significant changes. We saw that this type of indepth, thorough, and consistent reviews were not done.

Instead when we look back on the registry exam process, we saw from the initiation that some soldiers were sent through the
full range of diagnostic testing, while others were not and that specific high level neurological and immunological tests were not ordered. We see a glaring deficiency that no attempt was done to identify units and geographical locations that would document exposure levels and vaccination records.

When this surfaced as a problem, the CDC should have been activated to do the through investigative medical work that would be needed. Full units of affected soldiers should have gone thru the process and those that said they were not affected should have had the same baseline workup done and soldiers in those units that had not deployed should have also been tested, therefore you would have started with a complete array of data.

One has to wonder whether the DOD/VA wanted an organized and through approach to the investigation of gulf war illness from the beginning. How the registry data has been conducted lends one to consider that this was a selective, segmented sampling similar to what was done in the Tuskegee Syphilis Study with no intention to quantify the type and extent of the
medical problems.

The registry program has not done what it should have done. The program needs to be extended legislatively past 2006. The program of the registry should be fine tuned to look at body systems that we now know to have been affected to include neurological high level scans, immune, viral, endocrinology, renal, liver, and hematological blood work. Each and every affected veteran should have access to this complete diagnostic workup at sites in each state or at least regionally,even if fee basis or champVA needs to be utilized. When this is done, we need to have the data collected and organized by unit and geographical war time location. This should be done with HHS and through major clinical university hospitals and the VA and DOD should be forced to relinquish this program. They have failed and lost the trust that would be needed to administer the registry program.

We need the best and brightest medical clinical investigative workers involved now. Veterans need to be listened to and their suggestions for improvement need to be highlighted. Legislatively it would be appropriate to have veterans and veterans with health care expertise working on a commission to direct the revamped Registry Program. This commission could have members from CDC, NIH, and Medical universities expert fields. A 3 month time period would be sufficient to meet and set up the inclusive diagnostic tests that would be included. Then the plan of how to coordinate with civilian institutions could be done within the following month. The institutions would need to be briefed and resources made available. This process would be able to be dovetailed into the Nation's Medical Emergency Response program and would become a foundation that would result in our country being better prepared for chemical, biological, nuclear incidents in the future.

The subsequent medical care that the gulf war veterans have experienced within the VA and DOD system has been the worse possible. Fifteen years after Operation Desert Storm the physicians are not allowed to use all their expertise and medical investigative abilities to order the tests that are truly needed. Medical providers at the VA have told those gulf war veterans that were also medical providers that their hands had been tied by policy. The attitude of the doctors has got to be corrected mmediately. The doctors have dishonored again a group of veterans who were environmentally and medically poisoned.

Each veteran should have been and still must have testing for leischmanasis.

Please include this in any legislative package that comes forward.

Testing should also be legislated and done that includes DNA/RNA testing(Dr Howard Urnovitz and Dr Schott(Germany). These would show the true damage done to each veteran of the gulf war.

Again, I am asking that legislation occur that sets up a commission of veteran medical professionals and veterans that would be the commission that set us an operational plan to correct these problems. The system would have a headquarters and then regional and VA hospitals committees to handle veteran complaints that are related to medical care.

We requested research to help find answers and develop effective assessment and diagnosis and treatment techniques but instead we have been trapped by the Military Industrial Research Triangle. Money---Tax payer money was used to fund research that has never had all the findings published and unpublished for each federally funded research project reported and distributed to each doctor military, VA, and or civilian. Independent research on gulf war illness has also not gained widespread distribution. Medical Associations and veteran and civilian doctors need an annual education on the topic of gulf war illness and they need a website and email network that has weekly updates and discussions.

Annual reports of research were not submitted to Congress as required by law

since 2003. Accountability standards demand legal action to be taken for the lack of follow through on this legal requirement.
Is the system, immune to prosecution? Has oversight failed? Whatever the reason, the lack of annual reports has hampered doctors in the past two years to be updated on the latest findings and this impacts directly on the veterans' care. At this point after the war, one would think that a pathological lab for storing and maintaining gulf war veterans brains donated postmortem would have been established. Pathological postmortem research has been zero and this is criminal because within that area of research a great deal of answers could be found.

One would also think that a lab to store blood samples for both those living and dead identified by unit and location should have been established to improve the resources available for researchers.

It is interesting, to compare last year's testimony with what has happened a year later. It took a full year to get a manager for the research portfolio for gulf war illness. This demonstrated the foot dragging slow response evident from the VA at every level. This is quite simply an example of the unacceptable response rate.

The research was purposely slanted by those personnel in control of the process within DOD and VA to deliberately and willfully avoid the truth at all costs or to direct it to psychosomatic, somatization, and stress. It has been exceedingly impossible to obtain funding and get grants approved that were actually viable with applicable outcomes to enhance medical care. Dr Hailey can attest to that fact. Other research was not performed correctly as Dr Nicholson can attest to that and consequently ycoplasma infections have been taken off the table. DU research has been completed controlled and misdirected on purpose so that our government can continue to use this illegal weapon as specified in the infamous March 1991 Los Alamos memorandum while ignoring known and anticipated adverse health and environmental effects.

Research on the death data has not been done. Again we call on legislative remedy. The deaths of veterans should be matched by Social Security number for the most complete accounting. The information that needs to be released includes name, unit, location in theater, cause of death, and contributing causes or diagnoses. In this way we not only open up the field to research projects but also a means to honor those who have died.

If money is allocated and appropriated to either DOD or NIH oversight and public availability of any research grants funded
and results obtained should be spelled out with legislation. I would think it would also be appropriate to have a separate commission that includes at least 5-6 veteran advocates should be also legislated similar to the VA-RAC. This would facilitate the guidance and feed in to the focus of the research and applicability to diagnosis, care, and treatment.

I definitely feel that money for research into the gulf war illness should also be allocated and appropriated for NIH.

Researchers and physicians need legislated protection. The efforts of many researchers and physicians have been sabotaged
and their careers threatened.

Examples include Dr Hymen, Dr Baumzweiger, Dr Moss, Dr Andras Koryeni-Both, Dr Lu Fang, Dr Durakovic, and Dr Nicholson. Any threatening of doctors and researchers must be stopped now.

The need for Centers of Excellence for Gulf War Illness Research and Care still continues. WE have been promised hospital centers before and this has not been fully implemented. We need these hospitals to be at the regional levels at least and not centered entirely on the East Coast or West Coast. The replication of Dr Hailey's study could have been conducted with MRI-RS availability at multiple sites throughout the country.

The missing link that is glaringly apparent is the lack of application of research (both federal and independent) in a timely rapid manner to diagnosis, care, treatment, and claims applicability. An example is the Hypercoagulation Study done by Hemex Labs(DR David Berg) in Phoenix, AZ. This study was an independent study that showed that Veterans of the gulf war had
hypercoagulation that could impact circulation to all body organs including brain, cardiac, liver and renal. The study was published in November 2000 in the Journal of Blood Coagulation and Fibrinolysis. When I took this study in to my VA primary care physician with the name and phone numbers of Researchers and Doctors she scoffed it off. This study had included my blood sample and my results were abnormal. I wanted treatment and I wanted the findings to be disseminated so
other gulf war veterans could benefit from this study and possibly a larger study of this finding could be performed. Instead no attention was paid and my primary physician offered me a consult to psychiatric. I find this particularly offensive, when I am aware that the editor of the journal that published that peer reviewed research was the current chief of Laboratory Services at the VA Denver Hospital.

This action by this primary doctor was totally inappropriate. This occurrence definitely showed me I should have no trust or confidence in the VA paying attention to physiological findings and providing me the best care possible. I personally feel that
we should not have to go to the VA hospital but that we should have fee basis cards issued to us or that Champ VA that is available for spouses should be the standard for the gulf war veterans.

Each Gulf War Veteran should be getting SPECT Scans, PET Scans, MRI-RS, viral testing, immunological testing, hypercoagulation testing, heavy metal testing, Blood testing on regular basis for renal, thyroid, parathyroid, hormonal and endocrinology, cardiac, and liver function, testing for MS, parkinsons disease, visual testing, audiological testing, dental health exams, and an active cancer detection program ( to include brain).

If this was done and treatment initiated we would have not only better diagnosis and medical care, we would have the research coming directly from each gulf war veteran's own body. As I have said since 1992, the proof is in our bodies if they would just do the right testing.

Why do they continue to refuse us gulf war veterans. Is it simply a cost factor and that we are disposable items of use, or is this willful misconduct and omission of care, by the DOD and VA? There should be no excuse for letting this malpractice and illegal hiding of the truth to continue. WE seek now effective legislation to mandate these diagnostic tests.

Why has the Association of Environmental Care Medicine's offer in 1991 to train and educate the VA physicians been turned down? Their testing and treatment modalities should be instituted now without further delay. Use their testing and treatment outcomes and conduct a research project if necessary. So far their principles and treatments are about the only thing out in the field ready to be implemented to help alleviate the gulf war veterans suffering. If we could do this, there is a great probability
that many thousands of gulf war veterans could be helped to stabilize, neurocognitive function improved, livelihoods saved, and quality of life improved. Unemployment for this group of veterans would potentially be decreased.

For the gulf war illnesses to be truthfully handled the personnel that have been directors for the government in the DOD and the VA need to be removed from their jobs and never allowed any involvement whatsoever. We tried over and over again to rehabilitate them for the good of the system and to give them an opportunity to rebuild the system they broke and the trust that they have lost. They had the opportunity and they forfeited it by their mismanagement and obstructionist patterns of operation.

The facts speak for themselves that the three monkey syndrome is fully operational. Treatment and care ends up being end
stage treatment when the causative factors and effects of delay in care is the end result. Sick veterans then get cardiac surgery, dialysis, etc when we can prove that our organs are dying in the final onslaught that started with our exposures in wartime environment. We only get the medical care we earned in the VA if we have won the whole war consisting of many battles to
win a prompt and effective diagnosis, medical care, and compensation.

Today this congressional hearing is focused on the RAC. Will sir, I see a system that is broken entirely from start to finish. I see a few survivors in the room today and yet thousands are still there from the start line to the finish line all scattered out and barely functioning.

The problem starts and ends with accountability and responsibility!

When will our DOD leaders who took us into battle step forward to speak the truth and fix this mess? Who will coordinate and ensure each sick or injured veteran receives the help they were promised for serving our nation. Who will facilitate the complex paperwork or eliminate this unattainable battle required to obtain compensation and medical care? Who will help the veterans of the first Gulf War who are crawling to the door of the VA for help?

Who will get them a complete and through physical with all the high level testing re MRI-RS, Spect Scans, Pet Scans, blood work to include viral, coagulation workup, heavy metal testing, hormonal, endocrine, immunological work ups in order that we can get some definitive treatment. When will they stand up to treat each of these disorders? You see when you hit the Neurological and Immune systems of the body it is a cascade effect to each organ in the body. The powers that be here on the hill removed the very wording we needed re Neurological and immunological disorders from our last bill and law.
(original sponsor Representative Manzullo) This was done deliberately and purposefully to continue to hide the true damage and mplications of our multiple exposures.

Who among you will stand up to correct the past laws and lead us out of this wilderness?

Who among you will make order of the chaos that has stemmed from the DOD actions and decisions and that VA was
complicit in by derogation of duty?

We need an operational plan that eliminates the delay, confusion, and denial. Gulf war veterans should have help and effective advocacy within the system not from without the system. Please I beg you do not continue to dishonor your veterans of Operation Desert Storm and other wars and conflicts. You dishonor us by the collusion and the closed under table secretive plans that have and continue to be laid by each segment of the government. WE believed in our government, we went forth to war and came home damaged. WE have approached each committee, each congressman, each senator, each administrative, DOD, VA, IOM, CDC committee with honesty and a willingness to help and to resolve the problems and optimize medical care. WE are not your enemies as USMC Major Randy Hebert testified to you years ago.

WE need a final resolution and this will only come when an admission of what actually happened to us is acknowledged and revealed from sea to shining sea. When will elected men and women all unite to tell the truth!

Make those that were part of the denial and delay accountable by bringing forward all documents and telling us all what they destroyed and hid. Provide immunity and protection for DOD and VA officials that come forward to expose the truth.

DOD officials must admit liability for all the exposures because until they tell the truth and accept responsibility our very health care is limited to terminal care.

WE need the honest brokers in the VA to do the Right thing and tell the Doctors this is not secret any more. Pull out all the
stops and roadblocks and let the doctors do all they can to get us legitimate answers and effective medical care.

WE need each veteran of the gulf war assisted to the utmost degree with their claim. We need assistance in filing those claims because we have been neurologically damaged. This is like an alzheimers patient trying gallantly to explain, document, do paperwork to get the financial and health care assistance that he needs. Do you understand the desperate dilemma that you
have placed on each of the veterans and their families? Do you realize truly how each of these veterans and their families were abandoned?

Questions I leave the committee with include:

Why have researchers been discredited and their careers threatened?

Why has Dr Durakovic, a highly qualified physician and researcher who was at Army Medical Command Headquarters at CENTCOM in theater been discredited? Why was every urine sample he sent in lost?

Why is the Army and DOD who has been obstructing the truth now being given research funding? Is this not like the fox guarding the henhouse?

Why did the VA contract with the IOM in a way that limited them to strictly a literature review of published peer review
articles? Why wasn't the IOM given full access to all unpublished research by the Army, other services, and agencies on
sarin, depleted uranium, and anthrax vaccines? These unpublished and probable classified research results would provide
the full scope of scientific knowledge on the multiple agents of exposures. Was this all guided by administrative policy to not
Deal with the whole truth and all the facts that science could provide?

Why are we not investigating how the after battle assessment of casualties was distort from the beginning? Why was this assessment guided by the OMB report after the war?

Why did the PAC bring in Risk Management as a full topic of discussion at one of their earliest meetings held in DC?
Has the full battle assessment of ill casualties been distorted since shortly after the cease fire? Are DOD and VA
officials that have led the effort on gulf war illness been protected since the initiation by the Administration by White House Policy Directives? Is it time for the White House to change policy on Gulf War Illness?

Gulf War Veterans call on the President and the White House to change the policy and plan on Gulf War Illness in order
to be able to truly address the needs of the Gulf War Veterans who are ill with truth and an operational plan that
acknowledges the truth and provides actions that will resolve this 14 year history of disgraceful treatment of gulf war veterans.

Please recognize that the time for delay, denial, confusion, and distortion must end now. This nation is currently at war and
the history of the results of earlier policy on gulf war illness wounds our nation's efforts in regards to ability to recruit and to provide for Security, Preparedness and Response in Medical Care from terrorist NBC attacks at home and abroad.