Medical screening for Afghan conflict

12/24/2001

By EUN-KYUNG KIM
Associated Press Writer

WASHINGTON — Hoping to prevent an Afghan War Syndrome, military health officials are applying a decade's worth of lessons from the Persian Gulf conflict to U.S. troops now in conflicts abroad, whether it's against the Abu Sayyaf rebels in the Philippines or Osama bin Laden in Afghanistan.

Defense officials are being more vigilant about medical record-keeping for their troops, and service men and women are required to get a simple medical screening before and after deployment.

The military is also more selective about who it sends overseas.

During the 1990-91 Gulf War, some reservists and National Guard troops were deployed in a hurry.

``And we found that we actually had shipped to the gulf some people who really weren't healthy enough to go,'' said Dr. Francis O'Donnell, who heads the Pentagon's medical readiness department.

Some critics, however, argue that Pentagon officials aren't doing enough.

Steve Robinson, executive director of the private National Gulf War Resource Center, said medical screenings required since 1997 should include physical exams before, during and after deployment.

``That is what will protect soldiers who are out there fighting in Afghanistan,'' he said.

Robinson said he learned during visits to military installations while working as an investigator with the Pentagon unit that dealt with the Gulf War Syndrome that many troops failed to complete the mandatory questionnaires. He left the position on retiring from the military in October.

Robinson said troop commanders would rather put their emphasis on areas other than health protection.

``For them, it's more important to talk about how we're going to distribute (ammunition), or to talk about where the enemy is,'' he said.

An estimated 90,000 troops who served in the Gulf War say they suffer from a strange assortment of maladies including memory loss, anxiety, nausea, balance problems and chronic muscle and joint pain.

The government reported this month that Gulf War veterans are nearly twice as likely to develop Lou Gehrig's disease as other military personnel. It was the first acknowledgment of a scientific link between service in the gulf and a specific disease.

Pentagon officials have acknowledged that a serious health problem exists but insist that no single illness is behind what has become known as Gulf War Syndrome.

O'Donnell said the medical questionnaires have helped catch problems that might otherwise have slipped through.

``This is something that got its emphasis because of what happened with the illnesses in Gulf War veterans — the notion that maybe we missed something when we sent folks to the Gulf and brought them home,'' he said.

O'Donnell said other post-Gulf War measures implemented to prevent a recurrence of massive mysterious symptoms include environmental monitoring of areas where they plan to send troops.

Military officials learned that Bosnia, for example, was an ``environmental nightmare,'' O'Donnell said, referring to the region's waste from industrial chromium and lead plants.

In 1998, the Pentagon also required the collection of data on non-battle injuries and diseases for troops abroad. While yellow fever or other infectious diseases can wound troops, ``dumb old things like diarrhea from eating the local fare'' can disable more troops than bullets, said Capt. Jeff Yund, the Navy's deputy director of preventive medicine and occupational health.

The data collection is ``meant to give us the ability to monitor rates of illness and injury and when things start to go awry, we can detect it sooner rather than later,'' he said.

``The purpose is to allow the organic medical personnel to follow trends and illness and injuries in its own unit, and to be able to detect early on when those rates go up.''

The armed forces are moving to convert the medical records of each service member into an electronic database.

Despite all recent efforts, no one is saying such actions a decade ago could have eliminated the symptoms linked to Gulf War Syndrome.

``It is very challenging to draw lessons from the Gulf War Syndrome when its still an incompletely defined syndrome,'' said Dr. Donald Krogstad, chairman of tropical medicine at Tulane University. ``That's certainly the biggest barrier to laying out a list of lessons learned.''

On the Net:

Office of the Special Assistant for Gulf War Illnesses, Medical Readiness and Military Deployments: http://www.deploymentlink.osd.mil and http://www.gulflink.osd.mil