Toney Edwards met his daughter around midnight in the hallway at Fort Sam Houston's Brooke Army Medical Center in Texas. Prepare for a shock, she told Toney and his wife as they entered the hospital room that night in 1998. The father edged to the bedside and peered down at the distorted face of his Army son, Kevin. Toney flinched. The boy's face reminded him of something he'd seen in Vietnam: a battered, swollen GI, the victim of friendly fire.
One of America's 26.4 million war veterans, father Toney had joined the Army 30 years earlier, going from the backwoods of Virginia to become an airborne soldier in the Vietnam jungles, where he was exposed to the herbicide Agent Orange. "The Army gave me a life," he liked to say and then add that the life included post-traumatic stress disorder and maybe prostate cancer, linked, he thinks, to the chemical defoliants he was told were harmless to humans. It had been tough to live with his military memories. Now he had to face living with his son's as well.
Hovering over Kevin, Toney was confused. How could the boy suffer such an injury? The father had witnessed members of his own unit in 'Nam after they were hit with napalm fired by U.S. aircraft. Their faces looked seared, inflated, cockeyed.
Did Kevin's Army truck turn over? Was there a fire? An explosion?
Say what? An inoculation?
Moments after being given, under orders, a shot of anthrax vaccine while on duty in Korea, Army Spc. Kevin Edwards lapsed into a partial coma and stopped breathing. While being airlifted by helicopter to a hospital, he was given a tracheotomy. The stab of vaccine was supposed to protect him. Instead, it put him near death and cost him part of his eyesight.
Kevin Edwards survived, though he will never fully recover. The Army sent him to the Boston Foundation for Sight a year after he began complaining about his fading vision where he was fitted with special lubricated lenses.
His father says he's convinced by what he's read in medical journals and heard from doctors and other veterans that his son's condition was caused by an adverse reaction to the anthrax vaccine.
Injections of the vaccine, which was considered experimental and not fully approved for the way the military uses it, were often given without informed consent and other precautions required in civilian medical practice. The drug has never undergone controlled testing in humans for long-term effects. But under the military oath, recruits solemnly swear or affirm they will support and defend the Constitution and obey the orders of their president and commanders, an oath that concludes, appropriately, "So help me God."
Refusing the vaccination is out of the question, unless soldiers are willing to face being drummed out of the corps. Congress approved the law enabling the president to order inoculations. Some soldiers say their commanders have threatened to tie them down and forcibly inject them if they decline to follow orders.
Army cook Sandra Larson of Spokane, Wash., for example, likely wished she had refused. She was 32 when she died for her country. She was shot six times, but there were no medals, no homecoming parades, no Purple Heart. The killer, says her family and investigators, was the anthrax vaccine, known as AVA. It was, in the most profound and painful sense, death by friendly fire.
Like most other soldiers at the time, Sandra Larson was not informed that the AVA being given to combat inhalation anthrax was not fully licensed and that neither its safety nor efficacy could be assured. Almost immediately after her first injection, the young mother had an adverse reaction to the shot. She felt exhausted, developed skin rashes and experienced numbness and pain in her hands. When the symptoms persisted for days, she was granted a two-week leave to recover. She never did. Sandra Larson died suddenly June 13, 2000, at an Army hospital.
A company called BioPort, a private corporation whose investors include former Joint Chiefs of Staff Chairman Adm. William Crowe, was and is today the only authorized manufacturer of AVA in the United States. It hopes that someday all of America, soldiers and citizens, will use its product to combat terrorists.
The Pentagon insists its vaccine is safe and effective, that it has the studies its own to prove it. But this much Toney Edwards knows: One day his son was marched into an Army vaccination tent and wound up a casualty of war. He even had to undergo an operation to remove his tear ducts.
"Imagine," Toney says, "being in a position in which you cannot even cry."
There are other Kevin Edwardses and Sandra Larsons. They're the soldiers and veterans who have increasingly been injected, gassed, medicated, experimented on and exposed to chemicals by their own government in recent decades. Some may have died from chemicals we sold to our enemies. Anthrax, for one, was provided to Saddam Hussein by American firms in the years just before Gulf War I. (After Saddam began using weapons of mass destruction on Iranians and his own people, the United States sent then-envoy and now Defense Secretary Donald Rumsfeld to shake Saddam's hand as the United States renewed its ties and later provided intelligence and steered more arms and chemicals to Iraq to ensure the defeat of Iran.)
They have also faced the threat of faulty weapons and equipment. They face vanishing health services and broken promises of veterans benefits from the country they risked everything to defend. They endure the hazards of foreign battlefields, then return home to face another wave of forces: the Pentagon, the Veterans Affairs Department, Congress and the White House. Talk about incoming.
The government is not out to injure its soldiers, nor is the military a democracy. But the Pentagon has a vested interest in defending its hazardous medicines, vaccines and the depleted uranium munitions it thinks are needed to fight wars, and its bureaucracy of mass destruction will mislead, misinform, and lie to its troops if, in the minds of war makers, that's what it takes to win. The policy is to experiment now and worry later.
This is later.
MOST TOXIC WAR IN HISTORY
The American combat death toll from Desert Storm, the "100-hour" Gulf War of 1991, was 148. Another 145 were killed in nonbattle incidents and, officially anyway, 467 were wounded in combat.
That's how we tend to see wars in terms of battlefield casualties. But the major battle toll today, more than ever, is the one that relatively quickly follows a war.
In the decade since the first Gulf War, more than 320,000 veterans of the 696,000 deployed have sought medical treatment from the VA the country's largest hospital system, run by the Department of Veterans Affairs, the second biggest government agency next to the Pentagon.
About 214,000 of those veterans have filed disability claims for war-related injuries, diseases, and conditions, and so far 161,000 are receiving war-related disability payments.
That's right, 214,000. And counting. The public perception is that we suffered minimal losses in a war that flittered across TV screens for hardly a week. Yet almost a third of America's soldiers came home as casualties.
Here's another figure to think about especially if you're serving or have served in Iraq and Afghanistan: Since the first Gulf War ended in 1991, at least 11,000 veterans, whose average age during the war was 36, have died. Eleven thousand. That's based on both government figures and veterans' estimates.
The VA says not to make too much of these raw numbers. "The use of these data to draw conclusions regarding mortality rates will result in inaccurate conclusions," a VA disclaimer warns. The government doesn't explain how it knows in advance that your conclusions will be inaccurate. But then, it's the government.
One postcombat study found that veterans of Gulf War I had a significantly higher mortality rate than veterans who had been deployed elsewhere during the war. But the study linked most of the increase to routine accidents car crashes, for one rather than war-related diseases. That was a finding consistent with patterns of postwar mortality among veterans of previous wars, the VA claimed.
To date, there's no agreement on what, exactly, are the war-related diseases of the Gulf. Despite more than 150 federally funded studies at an estimated cost of $150 million, there's no meaningful breakdown of those mortality figures.
But anecdotal evidence and the widespread illnesses of Gulf veterans suggest they're a select group of humans facing an early demise. Many of them suspect it has something to do with serving in the most toxic war in military history. So far.
"Gulf War illness" was earlier called "Gulf War syndrome," which addressed the existence of patterns but withheld the admission of illness and drew the line at establishing any clear source. The term carried the implication that such ailments were the imaginary manifestations of whiners and opportunists seeking to get on the government dole. While there are surely deceivers in the VA system, as there are, say, in Congress, too many thousands of Gulf veterans took ill or died for the government to continue insisting there is no distinct correlation to their encounters with the battlefield-related combination of chemical releases, radioactive munitions, oil-fire fumes and unapproved investigative drugs and vaccines, along with antibotulism and antimalarial medicines and pesticides. Gulf veterans refer to this volatile concoction as the cocktail effect. Their ailments can include neurological, skin, cardiac, gastrointestinal and urinary tract ailments, commonly manifested as chronic fatigue, muscle and joint pain, as well as difficulties with concentration and memory. They are, at best, life-limiting complications. At worst, they are fatal.
"I don't know why the government, if it cares so much about its troops, isn't saying, 'My God, 200,000 disabled in that war, 11,000 dead! What did we do?'" Joyce Riley of the American Gulf War Veterans Association tells me. "Instead, if you make the mistake as some veterans have of going in and saying you have Gulf War illness, that just gets you a trip to the psych department. You're an instant head case. That way they don't have to treat you medically. They'll give you Prozac or Zoloft and send you on your way." She and others say mental-health and drug-addiction treatment are two of the greater challenges facing the VA. Some doctors report fourfold increases in addiction patients and overwhelming mental-health caseloads.
According to a CIA report, the possible weapons of mass destruction that could have been released on Gulf War I coalition forces, due to accidental exposures through our mishandled destruction of Iraq's chemical-weapons storage sites, included the blister agent sulfur mustard, the mixed nerve agents sarin and cyclosarin and the riot control agent CS. The United Nations Special Commission on Iraq found indications that some warheads had contained VX gas. A General Accounting Office review says that containers of 19.9 metric tons of sarin and cyclosarin and 15 metric tons of the chemical agent mustard were damaged, and some of their contents released, by Allied air strikes on the storage sites.
In one incident, more than 134,000 American troops were exposed to chemical warfare agents at Iraq's Khamisiyah chemical-storage depot in 1991, which was destroyed by U.S. forces. After denials and false starts for more than a decade, the Pentagon has now confirmed Khamisiyah as a friendly fire incident. Not only was it the single largest chemical-weapons exposure of American soldiers ever recorded, the Army had been aware of the depot's hazards all along. The Pentagon covered up the miscommunication, as it was called, until Gulf War veterans and others turned up military documents and forced disclosure.
NOT A REAL WAR
Official government lies about the health of soldiers are surprise not rare. As Agent Orange was to Vietnam veterans, Gulf War illness has become the military's intestinal disorder of the day: You don't have a disease until we say you do. If we're wrong, well, we have those new burial benefits.
The government seems in no great hurry to solve all this. Steve Robinson, executive director of the National Gulf War Resource Center a hell-raiser for veterans rights formerly worked for the Pentagon's Office of the Special Assistant for Gulf War Illnesses. A Gulf vet, he took the desk job with no preconceived notions about the government's role to keep veterans informed about their postwar health complications. What he saw made him the activist he is today.
"From the day I walked in there, I saw a concerted effort to lean against the veteran, to minimize the truth, to summarize events favorable to the government, to come to assumptions and conclusions that could not be proven and to make great leaps of faith," he told me. "There was a callousness to everything they did."
After the war, a Senate Committee on Veterans Affairs survey of 146 Gulf veterans demonstrated how dismissive the military was of soldiers who complained of illness. Vets complained about quality of care and lack of compassion by VA physicians and nurses. One recounted a doctor's comment that the Gulf War "wasn't a real war" and another said a doctor told her she was fine after using a stethoscope he forgot to plug into his ears.
Says veterans leader Robinson: "The first thing the government said when you returned was, Ã?OK, you're sick? Prove it.' One by one. That's tough to do when you have no expertise at this. Which they are counting on."
It's not a new attitude or phenomenon. Mysterious battle illnesses can be traced back to the "irritable heart" of the Civil War subsequently called the "soldier's heart" and eventually found to be a psychological disturbance not unlike shell shock in World War I, battle fatigue in World War II and Korea and post-traumatic stress disorder (PTSD) in Vietnam. With newer ways to fight wars came newer ways to die from them, including from the very drugs intended to protect against such deaths. Then came the new denials.
Strategically and politically dependent on those weapons and medicines to fight wars, the government grew ever more reluctant to curtail their use. It similarly grew more defensive about their friendly fire-like consequences.
In Gulf War I, the military's M8 chemical detection alarms went off an estimated 14,000 times likely all of them false alarms, said the Pentagon. But who really knew? A later Army audit determined the alarms weren't regularly inspected to see if they were operational. There was a similar disregard for the condition of protective masks, and no system existed to report the alarms or the masks as broken or hazardous.
Of course, delayed reaction to treatments and environmental hazards is one of the many lessons of earlier wars. It took years before the nation realized many Korean War vets were suffering from skin cancer they developed from the frostbite of Korea's bitter cold. (Gen. Douglas MacArthur told Americans their boys would be home by summer, and to go along with that charade, the military didn't issue its troops winter gear.) In World War II, thousands of service members came down with hepatitis, puzzling doctors. A lengthy review finally determined the troops had been injected with an infected yellow fever vaccine. But before the source was found, 50,000 hepatitis C cases were recorded. For Vietnam veterans, it took much longer, nearly 30 years of complaining about toxic defoliants ruining personal and family health and shortening life spans, before the VA accepted many of the disorders as a treatable group of Agent Orange diseases. One more time: Nobody died in the field from those ailments. What's the hurry?
In fact, the hazards of Vietnam's dioxin sprays are still being discovered, most recently in links to diabetes (2000) and a form of leukemia (2002). Hundreds of thousands of Vietnam veterans still suffer the effects of Agent Orange and post-traumatic stress disorder. Many of those PTSD victims are among the quarter-million to half-million veterans who make up one-third of all homeless adults in the United States.
A 1999 Australian study showed that suicide rates in the children of Vietnam veterans in Australia were three times that of the general population. It was something researchers still can't explain.
Returning home, Vietnam veterans had to blaze new trails through the bureaucracy to pry loose the secrets of their sicknesses. It's an endless quest. The Vietnam Veterans of America organization is still fighting to determine all the facts of how veterans were exposed to biological and chemical experiments in the 1960s, and why they are three times more likely to die of respiratory and neurological diseases than the general population.
Now it's the 1990-91 veterans of Desert Shield, the defensive Gulf War buildup in Saudi Arabia, and Desert Storm, the offensive war in Kuwait and Iraq, who are being asked to retroactively prove and explain their illnesses. As with Vietnam, it remains the burden of the Gulf vet to demonstrate a cause and effect, while it seems the government's only burden is to try to deny it.
The VA has conceded that Gulf I veterans are twice to three times as likely to develop ALS (aka Lou Gehrig's disease). But officials are not persuaded that anthrax vaccine, depleted uranium used in munitions, oil-well fires and sarin gas are necessarily the Gulf killers. The Defense Department only recently, in 2002, agreed to sponsor a landmark study on brainstem injury in Gulf War veterans and will examine 400 veterans over a five-year period at the San Francisco Veterans Medical Center to gauge the cocktail effect.
Spouses and other family members can also be affected, if not infected. Some studies contend the illnesses of the Gulf, like those of Vietnam, can be passed through sexual and other contact; other studies claim the illness is contagious.
Tomorrow, it will be the 2003-04 veterans of Iraq and their families seeking redress. In addition to exposure to hazards similar to those of 1991, more soldiers were injured in the close-up combat that marked the initial Gulf War II battles, followed by house-to-house fighting and by ambush and guerrilla warfare. By 2004, the number of U.S. casualties in Iraq dead, wounded, and injured physically and mentally had risen inexorably past 10,000.
Not to be forgotten are the veterans of Operation Enduring Freedom in Afghanistan, where more than 100 U.S. troops died from 2001 into 2004, and where thousands more were wounded. Just 16 were killed in the lightning-fast war that drove the Taliban from power in 2001, and the public perception was that the war was over. However, more than six times that number have died in Afghanistan since, and it, too, seems a war without an exit.
For that matter, lest we forget the survivors of Beirut, Grenada, Panama, Somalia, Bosnia and random acts of terrorism, many of those veterans have war illnesses that include PTSD and vaccine reactions.
Our newest Gulf veterans, one in six of whom are suffering from PTSD, according to a New England Journal of Medicine report released this month, could face altogether new health complications, beginning with brain injuries. A Walter Reed Army Hospital review in December 2003 showed more U.S. troops in Iraq are suffering brain damage than their predecessors in earlier wars the cause being the high explosives being used by the Fedayeen resistance fighters, with many of the bombs set at roadsides to pick off passing U.S. soldiers. (As of early 2004, more than 100 of the 370-plus U.S. troops in Iraq killed by hostile fire died from such improvised explosive devices; in February 2004, 10 soldiers were killed by the bombs, which can be triggered by such simple devices as remote garage-door openers or egg timers.) The Reed review showed that 67 percent of 105 wounded soldiers they studied had suffered effects ranging from mild concussion to coma to death. "Even Kevlar helmets are not designed to absorb concussive blast wave impact," says Dr. Louis French. Then there's the soldiers' comparatively longer exposure to environmental hazards like sand. A field report by the Marines says Iraq's desert dust not only makes operations difficult but "living conditions for Marines become intolerable. A bigger concern is that commanders in the field are faced with a Catch-22 situation of spraying oil on the ground." They have to choose between the hazardous environment produced by oily chemicals and the one produced by sandy grit.
Last September, the true dimension of Gulf War II's casualties began to filter out publicly. On average, almost 10 American troops a day were being declared wounded in action. The spin on the high count was pure Pentagonese. Officials said the reason for so many wounded was due to advances in medicine: In another war, many of those wounded might have been listed as killed in action, but modern medicine was turning them into merely wounded. But then, that also meant more casualties for the government to treat back home. More than 6,000 service members had already been flown to the United States for treatment of medical wounds and injuries, as well as for psychological and psychiatric treatment, including stress. Within two months, the casualty toll passed 9,000, then climbed to 11,000 in 2004. Estimates were that just over half were physically wounded while many others suffered from mental or environmentally related ailments.
Vet groups asked the Centers for Disease Control and Prevention to step in and do an independent study. It's not only GIs in the field at risk, they say, having learned the lessons of Vietnam and Gulf War I, but those who might come down with related mystery ailments in the future. Data gathered on the battlefield can go a long way toward proving cause and effect. The military has begun doing some of that. Since 1998, it has been developing its Defense Occupational and Environmental Health Readiness System, or DOEHRS, a software program to record chemical and biological exposures; the data can help commanders determine the risks in battle and help medical professionals determine future health risks. But full use of the system is years away.
Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, wonders if Gulf War II illness is not inevitable. "We have improved the way we monitor our soldiers before and after deployment," he says. "But we still don't test treatments against biological or chemical agents in human subjects, relying instead on interpreting results from animals for humans." There are ethical conflicts in testing dangerous agents on human subjects, but that, in effect, is what the military is doing with its soldiers. Yet if we're not doing it in a controlled setting with volunteers, using great new medical technology, Caplan asks, how can we justify battlefield experiments? "In a world threatened by weapons of mass destruction, using hundreds of thousands of troops and civilians as guinea pigs makes little sense," he says.
It's not that soldiers aren't aware of some of the medical, biological and environmental threats of war, which the military downplays. Gulf War veterans who served overseas were three times as likely to get sick as troops who stayed home.
Trouble is, what was it over there that caused it? Between their patriotic service and their personal futures there lingers a nagging fear of the unknown or, in the Pentagon's view, the unproved. The doubts dog them as they stand in line for their shots or march though a microscopic particle cloud across the desert. What did they just step in? Breathe? Touch? Why did they develop that rash? That fear is one of the reasons some servicemen rushed off to freeze their sperm before heading to Iraq in 2003. They feared the weapons of Saddam Hussein and George W. Bush.
Two weeks ago, after briefly halting its anthrax vaccine program due to a legal challenge and then reconsidering how it should be deployed, the Pentagon opted to expand anthrax and smallpox vaccine use, requiring shots for all U.S. troops under the Central Command (from North Africa to Pakistan). Vaccinations also will be mandatory for civilian employees and defense-contract workers. The Pentagon called anthrax and smallpox two of the top biological warfare threats, although more soldiers have died from the vaccines than from these weapons of mass destruction. The order also renews mandatory shots for military personnel headed to South Korea. That's where Army cook Sandra Larson of Spokane was going when she was given the vaccine that led to her death.
This article is an excerpt from Home Front: The Government's War on Soldiers (Clarity Press, 2004).