The New Gulf War Syndrome

What does a war injury look like? In the case of Iraq, we tend to picture veterans bravely getting on with their lives with the help of steel legs or computerized limbs. Trauma injuries are certainly the most visible of health problems -- the ones that grab our attention. A campaign ad for congressman Tom Udall featured an Iraq war veteran who had survived a shot to his head. Speaking through the computer that now substitutes for his voice, Sergeant Erik Schei extols the top-notch care that saved his life.

As politicians argue about healthcare for veterans, it is generally people like Sgt Schei that they have in mind, men and women torn apart by a bullet or bomb. And of course, these Iraq war veterans must receive the best care available for such complex and catastrophic injuries.

Unfortunately, the dangers of modern war extend far beyond weapons. As Iraqis know only too well, areas of Iraq today are among the most polluted on the planet -- so toxic that merely to live, eat and sleep (never mind to fight) in these zones is to risk death. Thousands of soldiers coming home from the war may have been exposed to chemicals that are known to cause cancers and neurological problems. What's most tragic is that the veterans themselves do not always realize that they are in danger from chemical poisoning. Right now, there is no clear way for Iraq war veterans to find out what they've been exposed to and where to get help.

In October, the Military Times reported on the open-air pits on U.S. bases in Iraq, where troops incinerate tons of waste. Because of such pits, tens of thousands of soldiers may be breathing air contaminated with burning Freon, jet fuel and other carcinogens. According to reports, soldiers are coughing up blood or the black goop that has been nicknamed "plume crud".

In other cases, soldiers may have been exposed to poisons spread during efforts to restore Iraq's infrastructure. In 2003, for instance, members of the Indiana national guard were put in charge of protecting a water-treatment plant. They were told not to worry about the bright orange dust lying in piles around the plant, swirling in the air and gathering in the folds of their uniforms. In fact, Indiana soldiers spent weeks or months in a wasteland contaminated with sodium dichromate. The chemical, made famous after its role as the villain in the movie Erin Brockovich, is used to peel corrosion off of water pipes. It is a carcinogen that attacks the lungs and sinuses.

Today, a decade and a half after the first Gulf war, we know that such exposure may lead to widespread suffering. In 1991, veterans began to exhibit fatigue, fevers, rashes, joint pain, intestinal problems, memory loss, mood swings and even cancers, a cluster of symptoms and conditions referred to now as Gulf war syndrome (or illness). For years, the U.S. department of defense maintained that stress caused the veterans' symptoms. Veterans groups blamed war-related toxins. This year, the National Academy of Sciences published an extensive review of years of scientific study of Gulf war illness that concluded a cause and effect relationship existed between the widespread illnesses among veterans and exposure to powerful neurotoxins. Complementing the U.S. studies is an emerging body of epidemiological data linking increased incidence of Iraqi cancer, birth defects, infant mortality and multi-system diseases to toxic exposure.

Strangely enough, though, there has been almost no discussion of whether today's soldiers -- those fighting in Iraq or Afghanistan -- have also been injured by wartime poisons. We don't have a word yet for the constellation of cancers, psychological ills and systemic diseases that may be caused by toxins in today's wars.

In order to care for our veterans, we must do more than offer state-of-the-art hospitals and high-tech prosthetics. Veterans will need information about what poisons they have breathed or touched or drunk and when.

What would such an effort look like? First the military would need to disclose all known incidents of toxic exposure. Then it would have to reach out to veterans and give them information about how to receive care for conditions that arise from this exposure.

This summer, senator Evan Bayh made a first stab at such a system. Bayh pushed the national guard to track down hundreds of those Indiana soldiers who may have breathed orange dust back in 2003. Most of the soldiers are now civilians scattered across the U.S., unaware that they are at high risk for lung cancer and other respiratory diseases. Some of them may already be struggling with illness. The national guard is making an effort to search for these veterans and provide them with a phone number to call in order to seek medical help.

That's a good first step. But what about all the other veterans who believe that they have returned home from the war healthy? Without knowing it, they may be carrying a small bomb inside them. And they have a right to know.