By: EdwardPerello
On: 06.06.12 23:09
http://truth-out.org/news/item/9601-a-guantanamo-connection-documents-show-cia-stockpiled-antimalaria-drugs-as-incapacitating-agents
A Truthout analysis of historical records concerning government research and nonmedical use of antimalarial medications has revealed that such drugs were the objects of experimental research under the CIA's MKULTRA program. Even more, one of these drugs, cinchonine, was illegally stockpiled by the CIA as an "incapacitating agent."
Antimalarial drugs were studied as part of the CIA's mind control program MKULTRA. Cinchonine, an antimalarial drug derived from chichona bark, was one of the drugs used by the operational components of MKULTRA, code-named MKNAOMI and MKDELTA. The CIA worked with researchers for the Army's Special Operations Division, a secret component of the US Army Chemical Corps based at Fort Detrick, to develop delivery systems for the drugs.
Revelations concerning CIA interest in use of antimalarial drugs would be of historical interest, as it has never been written about before. But such interest gains contemporary significance in the light of actions taken by the Department of Defense (DoD) in the "war on terror," and the fact that a key DoD expert on antimalarial drugs was a psychiatrist involved in training personnel for Guantanamo interrogations.
In January 2002, the DoD deliberately decided that all incoming detainees at Guantanamo would be given a full treatment dose of the controversial antimalarial drug mefloquine, also known as Lariam. The purpose was supposedly to control for a possible malaria outbreak, in deference to concerns from Cuban officials.
But specialists in malaria prevention have said they have never heard of such presumptive treatment for malaria by mefloquine in this type of situation. Furthermore, a summary of antimalarial measures at Guantanamo given to Army and Center for Disease Control (CDC) medical officials at a February 19, 2002, meeting of the Armed Forces Epidemiological Board failed to describe the mefloquine procedure approved a month earlier.
Was mefloquine used at Guantanamo to help produce a state of "learned helplessness" in detainees? Were experiments conducted on adverse side effects of mefloquine on the prisoners held there?
Some years ago, this might have been considered a crazy scenario to even consider. While there is no smoking gun that can prove mefloquine was used for nefarious purposes, a strong case can be made that use of the drug at Guantanamo was not related to malaria control.
Antimalaria Drugs and MKULTRA
The revelation concerning cinchonine came from hearings the Senate's Church Committee held in September 1975 on CIA "Unauthorized Storage of Toxic Agents." The agency's illegal stockpile of chemicals and drugs, which included the antimalarial drug cinchonine, was supposed to have been destroyed by order of President Nixon in December 1969.
At the time of the president's order, the US had also signed an international agreement that such chemical and biological weapons would be destroyed, so the revelation of the CIA's stockpiling of such substances was highly embarrassing to the US government at the time.
At the behest of Congressional investigators, the CIA provided an inventory of all "lethal" and "incapacitating agents" they had kept contrary to presidential order. On this list, the CIA indicated it held two grams of cinchonine, stored as an incapacitating agent, that is, a substance meant to temporarily disable an individual. Temporary incapacitant or not, the CIA inventory listing for cinchonine states, "Overdose leads to severe cardiac convulsions, nausea and vomiting."
In separate testimony from another Senate investigation, a CIA-linked researcher, Dr. Charles F. Geschickter, told Sen. Edward Kennedy in 1977 hearings that the CIA was interested in antimalarial drugs that "had some, shall I say, disturbing effects on the nervous system of the patients." Geschickter's CIA researchers became interested in these antimalarial drugs as part of the work they were doing in the CIA's MKULTRA program. Dr. Geschickter ran the Geschickter Fund for Medical Research, and the Kennedy hearings also revealed how the fund laundered money for MKULTRA projects.
According to MKULTRA documents released as part of a related Senate investigation in 1977, research into quinolines, the class of drugs that include cinchonine, quinine and the modern antimalarial drug mefloquine (Lariam), was part of MKULTRA subprojects 43 and 45.
The CIA prior to the Congressional investigations destroyed most records concerning MKULTRA and chemical, biological and bacteriological research. Moreover, according to Senate testimony by former CIA Director William Colby, many of the organizational directions concerning both research and operationalization of such weapons were never written down.
An Antimalarial "Incapacitant"
Cinchonine is a quinine-derived drug and similar in some ways to the artificial quinine derivative antimalarial drug mefloequine, also known as Lariam. Mefloquine, a product of Army research, has been the subject of numerous controversies over its side-effect profile, and as recently as 2009, the DoD significantly cut back on its use for the military.
The stockpiling of cinchonine as an "incapacitating" agent was directly contrary to Nixon's order that all such toxic and bacteriological stockpiles held by the DoD and the CIA be destroyed. Other incapacitating agents held by the CIA for years after the disposal order included the powerful hallucinogen BZ; the anticholinergic drug Cogentin; digitoxin; and Phencyclidine HCL, commonly known as "Angel Dust"; among other drugs.
The CIA's stockpile of dangerous substances also included numerous "lethal agents," including shellfish toxin; cobra venom; fish toxin; and numerous substances only known by their code names ("E-4640," "F-270" etc.). It is not known if any of the lethal or incapacitating agents were ever used, or if so, by whom or where. (The one exception the CIA admitted to was the use of an arsenic suicide pill provided to Francis Gary Powers, a U-2 pilot shot down over the Soviet Union in 1960. Powers did not use the pill.)
According to Senate testimony, the stockpile was discovered after a review of secret programs ordered by Colby. Originally, the various drugs and weaponized biological substances were kept at the Army's Fort Detrick compound and were apparently moved later to a CIA storage facility.
The neurological side-effects of mefloquine are similar to the side effects of cinchonine. Cinchonism (or quinism) includes such side-effects as blurred vision, tinnitus, skin rashes, vertigo, nausea, headaches and other even life-threatening serious health problems. Mefloquine has been cited for neurological, but also psychological side-effects, including depression, anxiety, panic attacks, confusion, hallucinations, bizarre dreams and suicidal and homicidal behavior. The effects can be long or short-term.
But even the "short-term" effects can be debilitating, as one military doctor, Captain Monica Parise, told a group of other physicians at a government meeting in May 2003. Parise told the meeting of the Armed Forces Epidemiological Board (AFEB) that "there are a host of other more acute less severe neuropsychiatric issues that occur short-term [with mefloquine], such as insomnia, strange dreams, fatigue, lack of energy, inability to concentrate and some people have reported that those effects have lasted a very long time."
Parise noted that it takes "three, four, or five months to really wash the drug out of your system," and that she'd "heard that there might be some data in DoD ... that might shed light" on how the drug had "ruined people's lives." As we shall see, a psychiatrist present at this same meeting was also involved in training other psychiatrists to assist Guantanamo interrogators.
Administering Mefloquine to All the Guantanamo Detainees
In December 2010, Truthout and Seton Hall School of Law's Center for Policy and Research revealed that it was medical standard operating procedure (SOP) to give all arriving detainees full treatment doses of the antimalarial drug mefloquine upon arrival at the US prison camp. The military's own newspaper, Stars and Stripes, followed up with their own story a few weeks later.
A treatment dose of mefloquine is five times the amount taken weekly by those who use the drug for prophylactic purposes. Larger doses are associated with a higher percentage of side effects.
The Truthout investigation showed that at the time the SOP was put in place, internal discussions within the DoD and an Interagency Malaria Working Group were expressing strong doubts about the serious neuropsychiatric side effects of the drug. Despite this, the surgeon general of the JTF-160 Task Force at Guantanamo signed off on the unprecedented mefloquine protocol.
The chief surgeon, who also served as commander of the Navy Hospital at the base, was Capt. Albert Shimkus. Shimkus told Truthout in late 2010 that he had first sought consult regarding the use of malaria drugs from an assortment of agencies, including officials from the CDC, the Navy Environmental Health Center (NEHC) and the Armed Forces Medical Intelligence Center at Fort Detrick, Maryland. All three agencies have told Truthout they were not involved in this decision or had no documents related to such consultation.
Shimkus told Truthout in a phone interview last October that the US State Department "would have been involved" in discussions about malaria concerns at Guantanamo, though he maintained no State Department officials were directly involved in the "clinical decision making."
In June 2004, the CDC announced, "'presumptive treatment' without the benefit of laboratory confirmation should be reserved for extreme circumstances (strong clinical suspicion, severe disease, impossibility of obtaining prompt laboratory confirmation)." Hence, "presumptive treatment" - the mass administration of a drug without knowing whether or not it is actually necessary - is reserved for situations when there is no possibility of laboratory confirmation of malaria, but that was not the case at Guantanamo.
Yet, even a year later, the mefloquine SOP was renewed at Guantanamo.
DoD spokeswoman Maj. Tanya Bradsher told Truthout, "A decision was made to presumptively treat each arriving Guantanamo detainee for malaria to prevent the possibility of having mosquito-borne [sic] spread from an infected individual to uninfected individuals in the Guantanamo population, the guard force, the population at the Naval base, or the broader Cuban population."
According to Bradsher, "The mefloquine dosage was entirely for public health purposes to prevent the introduction of malaria to the Guantanamo area and not for any other purpose." Nevertheless, when hundreds of contract workers from malaria-endemic countries such as India and the Philippines were brought by Halliburton subsidiary Kellogg Brown and Root (KBR) to build the new Guantanamo Delta Block in 2002, there was no DoD scrutiny of any exposure by these workers to malaria.
According to Bradsher, KBR alone was responsible for its own workers, belying a concern over possible reintroduction of malaria to Cuba, which, according to Captain Shimkus, had produced State Department concerns when it came to the arriving detainees.
In his October 2011 interview, Shimkus also said he sent "pretty detailed reports" regarding the mefloquine decision to JTF-160's Commanding Officer, Marine Corps Brig. Gen. Michael R. Lehnert. He had nothing further to say about a statement made to Truthout a year earlier in which he stated that he had been told not to talk about the mefloquine decision.
When Shimkus was asked if he was aware of any detainees who had suffered psychiatric problems because of drugs administered to them, he said, "Maybe. That's confidential," adding a moment later, "No for that."
He also rejected the opinions of two medical researchers who wrote in PLoS Medicine in April 2011 that "medical doctors and mental health personnel assigned to the DoD neglected and/or concealed medical evidence of intentional harm" to detainees. "They have an opinion and it should be out there," Shimkus said.
Army Mefloquine "Specialist" Trained Psychiatrists for Interrogations
A top psychiatrist working for the Office of the Assistant Secretary of Defense for Health Affairs (OASD-HA), Col. Elspeth Cameron Ritchie, traveled to Guantanamo in October 2002, purportedly to investigate a spurt of suicide attempts among the detainees. Within weeks, according to the AFEB minutes cited earlier, she attended an "experts" meeting on "Malaria Chemoprophylaxis" at the CDC in January 2003 that considered problems with the "neuropsychiatric adverse drug reactions" of mefloquine. Indeed, according to the AFEB speaker, Captain Parise, they specifically included a psychiatrist - presumably Ritchie - in their discussions.
Did Colonel Ritchie bring knowledge of the effects of mass mefloquine administration at Guantanamo to this meeting? We don't know and Colonel Ritchie, now retired from the military and chief clinical officer for the District of Columbia's Department of Mental Health, would not return a request for comment. A public spokesperson for OASD-HA told Truthout it had no connection with any decision to use mefloquine at Guantanamo.
It would be strange, if not highly unlikely that, given the widespread interest in mefloquine adverse reactions at the DoD and contemporaneous statements that the DoD was conducting research on this, that the effects of the Guantanamo mefloquine SOP were never examined.
Ritchie's involvement in mefloquine issues can also be ascertained by the fact that, in 2004, Ritchie, by then "Psychiatry Consultant" to Army Surgeon General Kevin Kiley, gave a presentation to the DoD's Deployment Health Clinical Center on the "Neuropsychiatric Side-Effects of Mefloquine."
Of convergent interest is the fact that, according to Dr. Ritchie, she taught psychiatrists slotted for assignment to the military's Behavioral Science Consultation Teams (BSCTs) working at Guantanamo and possibly elsewhere. She is, at this point, the only known person potentially linking military activities surrounding both mefloquine and interrogations or torture.
According to an Army surgeon general description of BSCT training during the period Colonel Ritchie was involved, such training included instruction in methods of inducing "learned helplessness."
"Learned helplessness" is a condition of near-total psychological breakdown produced by inability to escape an extreme set of stressors. Its study is associated with the work of psychologist Martin Seligman, who did research on the subject as far back as the 1960s. In the 1990s, all the Survival, Evasion, Resistance and Escape schools except the Navy school discontinued the use of the waterboard in their training program precisely because it tended to produce "learned helplessness" in its students, the opposite of the kind of effect they were seeking.
A Guantanamo Autopsy Tests for Mefloquine
The months-long period of time it takes for mefloquine to leave the system may have been involved with a decision to test a detainee at Guantanamo who had committed suicide for the presence of mefloquine in his bloodstream. But the detainee, whose autopsy report included toxicology results that show he was tested specially for mefloquine, had been at Guantanamo for five years at the time of his death.
Abdul Rahman Al Amri entered Guantanamo in February 2002 and would have been given a treatment dose of mefloquine at that time. We do not know why he would have been tested for its presence over five years later. All but one of the other detainees for whom we have autopsy reports due to purported suicides were not tested for mefloquine, showing such testing was not standard procedure.
Al Amri was also found dead with his hands bound behind his back, and his death as well as that of 2009 suicide Mohamed Salih Al Hanashi are under investigation by the UN Special Rapporteur for Extrajudicial Executions, primarily because of Truthout's coverage of these events.
A Plausible Hypothesis
The discovery that the CIA researched antimalarial drugs as part of its mind control program and, moreover, operationalized at least one of these drugs as an "incapacitating agent" means that the hypothesis that mefloquine was used for similar purposes at Guantanamo is not inconsistent with a known pattern of governmental behavior.
There are many reasons to question the supposed use of mefloquine at Guantanamo for purely public health purposes. Consider the following:
The mass use of treatment levels of mefloquine at Guantanamo was unprecedented.
The drug was limited to only one group of potential malaria carriers.
Use of mefloquine for presumptive treatment continued for years past the point when the DoD was already manifestly aware of the drug's dangers.
The mefloquine SOP was hidden from medical authorities at the Armed Forces Epidemiological Board.
Finally, there is the fact no government agency will admit to advising use of the drug, even when a Guantanamo medical officer states they were involved.
As a result of all the above, it appears highly possible that the motive for the drug's use was to psychologically disorient and physically debilitate all or some portion of incoming prisoners.
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sad to see some of the past may be showing it's ugliness again. I had hoped that MKULTRA and everything related to Edgewood Arsenal and the illegal experiments were a closed door.
Wednesday, June 6, 2012
documents-show-cia-stockpiled-antimalaria-drugs-as-incapacitating-agents
Litttle Rock Veterans Home a mess
LITTLE ROCK - In less than three months three top ranked administrators have left the Arkansas Department of Veterans Affairs, and they each have left scandals behind them.
On Friday, Deputy Director Lawrence Pickard was fired because the VA says he collected almost $600,000 in illegal maintenance fees from veterans at the Little Rock Veterans Home.
Newly-appointed Director Cissy Rucker fired Pickard after he admitted to knowing he was collecting excess fees since December 2010.
"Because he did not take immediate action he was terminated," said VA spokesperson Kendall Thornton.
Former Director David Fletcher resigned last month after an audit revealed $200,000 in funds that were improperly logged. Janet Levine, a former VA Home administrator, was fired in April for misappropriating nearly $600,000 at the Little Rock Veterans Home, according to the Arkansas VA.
"We're going through transitions and we have a new state director that's been in place to correct these issues and to make sure that it does not happen again," said Thornton.
At the center of it all is the Little Rock Veterans Home, where the VA claims Levine and Pickard have collected a combined $1.1 million in illegal fees to veterans living there.
"The Little Rock Veterans Home was collecting fees from residents who had a disability rating of 70 percent or above after a federal rule change ended that practice in 2009," said Thornton.
She says the affected veterans will receive their money back over a period of time that has not yet been determined.
Still, one advocacy group isn't satisfied and they're letting the department know.
They recently created a YouTube video entitled "Swindling Arkansas Veterans" that blasts the troubled the state Department of Veterans Affairs for its recent money mismanagement.
"Our goal was to create a higher level of accountability and transparency," said Teresa Oelke, State Director of Americans for Prosperity - Arkansas Chapter. "Hard-working Arkansas taxpayers and especially our v eterans deserve better," said Teresa Oelke
The VA believes its new director will restore credibility to the department.
"We are working every single day hard to make sure that this does not happen again and that we are going to rebuild the trust of the veterans of Arkansas," said Thornton.
Criminal charges against Pickard are unlikely, according to the VA.
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Why are charges unlikely? Where is the Attorney General or the States Attorney General, if veterans were stealing the money they would be prosecuted, so why are not officials who used their position to steal money not being prosecuted? Send them to jail and demand restitution, the same that would happen to a veteran or their spouse or child who stole from the government, in this case these were government employees stealing from disabled veterans, by the power of their position, there is nothing lower in my opinion. Then to tell us the veterans community that they won't even be charged is a double whammy, hold them accountable.
Friday, June 1, 2012
VA Outreach for Veterans Retraining Assistance Program Garners Over 12,000 Applicants since May 15
New Education Benefit for Unemployed Veterans Has Strong Response
VA Outreach for Veterans Retraining Assistance Program Garners Over 12,000 Applicants since May 15
WASHINGTON (May 31, 2012) – Within two weeks of being announced, a program to give skills training to some unemployed Veterans has garnered over 12,000 online applications, according to the Department of Veterans Affairs.
“VA is committed to supporting Veterans as they seek employment. This initiative will help provide education and training so that Veterans have an opportunity to find meaningful employment in a high-demand field,” said Secretary of Veterans Affairs Eric K. Shinseki. “We will continue to build on the success of our initial outreach efforts to Veterans.”
Called the Veteran Retraining Assistance Program (VRAP), the program allows qualifying Veterans between the ages of 35 and 60 to receive up to 12 months of education assistance. Maximum payments are equal to the full-time rate for the Montgomery GI Bill – Active Duty, currently $1,473 monthly.
Under VRAP, Veterans apply on a first-come, first-served basis for programs that begin on or after July 1. VA began accepting applications on May 15. Forty-five thousand Veterans can participate during the current fiscal year, and up to 54,000 may participate during the fiscal year beginning Oct. 1, 2012.
The goal of the program is to train 99,000 Veterans for high-demand jobs over the next two years.
To qualify Veterans must:
Be 35 to 60 years old, unemployed on the day of application, and have been issued discharges under conditions other than dishonorable;
Be enrolled in education or training after July 1, 2012, in a VA-approved program of education offered by a community college or technical school leading to an associate degree, non-college degree or a certificate for a high-demand occupation as defined by the Department of Labor;
Not be eligible for any other VA education benefit, such as the Post-9/11 GI Bill, the Montgomery GI Bill, or Vocational Rehabilitation and Employment;
Not have participated in a federal or state job training program within the last 180 days; and
Not receive VA compensation at the 100 percent rate due to individual unemployability.
While the initial response has been encouraging, VA officials stress the need for a sustained effort to reach potential VRAP applicants.
“Besides the Veterans themselves, we are asking anyone who knows of an unemployed Veteran to help us get the word out so everyone can take advantage of this new benefit,” said Curtis Coy, VA’s deputy undersecretary for economic opportunity. “With the help of our Veterans community and our partners in the Department of Labor, we hope to reach as many eligible Veterans as possible.”
In addition to its national outreach campaign, VA will seek out potential VRAP-qualified Veterans through online applications and at the National Veterans Small Business Conference being held in Detroit June 26-28. During 2012, VA representatives will also provide VRAP information and assistance at hiring fairs sponsored by the U.S. Chamber of Commerce through the Hiring Our Heroes campaign.
For more information on the Veterans Opportunity to Work (VOW) program, the Hire Heroes Act of 2011, VRAP, high demand occupations, and application procedures, visit the website at www.benefits.va.gov/VOW, or call VA National Call Center toll free at 1-800-827-1000.
Veterans may also access the VRAP application online at https://www.ebenefits.va.gov through eBenefits, a joint project between VA and the Department of Defense.
Veterans are also encouraged to visit the nearly 3,000 One-Stop Career Centers across the nation for assistance from staff, Local Veterans’ Employment Representatives (LVERS), and Disabled Veterans’ Outreach Program (DVOP) specialists. Center locations are listed at www.servicelocator.org.
Thursday, January 5, 2012
First meeting of IOM SHAD II Committee January 19 in Washington, DC
First meeting of IOM SHAD II Committee January 19 in Washington, DC
***We invite you to share this announcement with other interested individuals or organizations***
In response to the Caregivers and Veterans Omnibus Health Services Act of 2010 and an ensuing request from the Department of Veterans Affairs, the IOM has assembled a committee of experts to conduct an epidemiological study comparing the health status of the SHAD veterans with a comparison population. This study will build on knowledge gained from a prior study conducted by IOM between 2003 and 2007.
As part of the data collection process, the committee will plan and conduct meetings to receive suggestions and input from SHAD veterans about their experiences so that the study can be informed by the insights of these veterans.
The first meeting of the Committee on Shipboard Hazard and Defense will take place on January 19-20, 2012, at the Keck Center of the National Academies, 500 Fifth St. NW , Washington , DC. An agenda for the open session of the meeting on January 19th is available at http://www8.nationalacademies.org/cp/projectview.aspx?key=IOM-BSP-10-08 and at an IOM study site: http://www.iom.edu/Activities/Veterans/SHADII.aspx A second committee meeting will be held February 23-24, 2012, in Sacramento, California.
If you would be interested in providing brief comments at the meeting on January 19 in Washington , DC or on February 23 at the meeting in Sacramento , CA , please contact Jon Sanders at jsanders@nas.edu. On January 19, public comments will be heard during the late afternoon. Time constraints may limit the number of speakers who can be accommodated, but all written submissions will be welcome.
Written materials can be submitted to the committee through the IOM staff at the e-mail or postal addresses shown below. Please note that any comments or materials submitted to the committee in paper or electronic form will normally become part of the study’s public record.
Committee on Shipboard Hazard and Defense II
Institute of Medicine, Keck 775
500 Fifth Street, NW
Washington, DC 20001
SHADStudyII@nas.edu
Background
From 1962 to 1973, more than 5,800 military personnel, mostly Navy personnel and Marines, participated in Project SHAD (Shipboard Hazard and Defense) -- a series of tests of U.S. warship vulnerability to biological and chemical warfare agents. Only some of the involved military personnel were aware of these tests at the time. Many of these tests used simulants, which are substances with the physical properties of chemical or biological warfare agents, that were thought at the time to be harmless. The existence of these tests came to light many decades later.
In 2007, the Institute of Medicine ’s Medical Follow-up Agency (MFUA) published a report on the long term health effects of participation in Project SHAD, based on the results of a health survey (the report is available at http://www.nap.edu/catalog.php?record_id=11900). In the new study, an expert committee will work in conjunction with IOM's MFUA and build on knowledge gained from the previous IOM study. The SHAD II study will use the established list of SHAD participants and the comparison population determined from the prior study.
The results of the study will be provided in a brief IOM report by the study committee and an analytic paper for publication.
Questions about the study or providing materials for the committee’s consideration should be directed to study director Lois Joellenbeck (ljoellen@nas.edu) or program associate Jon Sanders (jsanders@nas.edu).
Lois Joellenbeck, Dr.P.H.
Study Director
Institute of Medicine
The National Academies
500 Fifth St. N.W.
Washington, DC 20001
202-334-1715
ljoellen@nas.edu
Lois Joellenbeck, Dr.P.H.
Study Director
Institute of Medicine
The National Academies
500 Fifth St. N.W.
Washington, DC 20001
202-334-1715
ljoellen@nas.edu
Friday, December 16, 2011
Drawing Down Troops from Iraq Infographic
Brought to you by USC: MSW Programs
Thursday, November 3, 2011
Gulf War Syndrome: A lot of questions, few answers
Gulf War Syndrome: A lot of questions, few answers
By Maggie Koerth-Baker at 1:36 pm Thursday, Nov 3
Twenty years ago, the United States sent almost 700,000 soldiers to Kuwait and Iraq as part of Operation Desert Shield and Operation Desert Storm. The war was quick. Bombing began on January 17th and the whole thing was officially over by February 28th. If you started a semester of school just before the first Gulf War began, the conflict would have ended before you even took your midterm exams.
But this short war left a long tail of consequences.
Shortly after the War ended, people who’d served in the Gulf began to turn up in Veterans Hospitals, complaining of a range of symptoms: Fatigue, unexplained pain in their joints and muscles, memory problems and cognitive impairment, malfunctioning digestive systems, and more. There wasn’t a clear pattern—different soldiers reported different clusters of symptoms, some of the people who had symptoms had arrived in the Gulf after the fighting ended, other soldiers had boots on the ground from the beginning but no symptoms. As the years went by, epidemiological studies showed no increase in cancers or other deaths in Gulf War veterans, aside from suicides and accidents. Yet, the symptoms were quite clearly linked to service in the Gulf. The same symptoms occur among other groups of military veterans, but are significantly less common. Today, more than 250,000 U.S. veterans report suffering from one or more unexplained symptoms that have, together, come to be known as Gulf War Syndrome. Scientists are still debating the cause, or even if there is one cause.
In the October 2011 issue of the journal Radiology, Dr. Robert Haley and his colleagues at the University of Texas Southwestern Medical Center published research that identified a nervous system abnormality that exists in some Gulf War Syndrome patients, but not in the healthy veterans who served with them. Haley says it’s evidence that the Syndrome is actually the result of exposure to a miasma of toxins, particularly low doses of sarin nerve gas, extremely high doses of various pesticides, and a drug meant to protect users from the effects of nerve gas.
But, while everybody agrees veterans are suffering, not everyone agrees with Haley’s conclusions, or his evidence. In fact, some big reviews have discounted it completely. There’s a lot we don’t know, but the stakes aren’t just academic. Research on the cause of Gulf War Syndrome affects the funding, benefits, and well-being of the veterans. Ultimately, this Syndrome represents a big, fat example of what happens when the timetables of good science don’t match up with the timetables of individual health needs.
New Pieces
It all began at Khamisiyah. This town in Iraq was the site of a storage center, filled with munitions, including warheads loaded with two different nerve agents, sarin and cyclosarin. In March of 1991, American soldiers blew up the Khamisiyah storage depot, not realizing that there were chemical weapons inside. The diluted chemicals fell on thousands of soldiers who were downwind of the explosion. Nobody was monitoring the air for chemical weapons at the time, and no one reported or was treated for symptoms consistent with nerve gas exposure. But in very low levels, the chemicals were there.
It doesn’t take much sarin or cyclosarin to cause noticeable symptoms. And we know what those symptoms are. As the chemicals attack the central nervous system, victims first get runny noses, watery eyes, and feel a tightness in their chests. As the poisoning progresses, they lose control of bodily functions, twitch and jerk uncontrollably, and finally lose consciousness. That’s all well documented.
But we don’t really know what happens to people exposed to minute amounts of sarin. If the chemical is there, but the dose is so low there’s no symptoms, can it still have an effect on your body years later? That’s where sarin and Gulf War Syndrome cross paths.
Robert Haley thinks he’s found a way to prove that the poison and the illness are more than just passing strangers. His study focused on a neurotransmitter called acetylcholine. Sarin (and certain pesticides that work through a similar mechanism) attack the enzymes that break down acetylcholine. The rhythym of a burst of acetylcholine, followed by breakdown of acetylcholine, followed by a new burst is what allows information to be sent from one neuron to another. If the breakdown doesn’t happen reliably, the message disappears, like an image on a black and white TV suddenly going all white. Haley hypothesized that soldiers who suffered from symptoms associated with Gulf War Syndrome would also have suffered long-term damage to this system.
To test that, Haley measured blood flow in soldiers’ brains. Anything that inhibits the enzymes that break acetylcholine down should also slow blood flow to certain parts of the brain, including the hippocampus. If previous exposure to sarin had damaged those systems, Haley thought, then the brain might not respond in a normal way when the acetylcholine system was put to the test. He took 57 soldiers from a single battalion, some who had symptoms associated with Gulf War Syndrome and some who didn’t. The soldiers were assigned, at random, to get either an injection of a saline placebo, or an injection of a drug that would inhibit acetylcholine breakdown. Then Haley looked at how the different brains responded.
He saw a clear difference. Both healthy soldiers and those with symptoms of Gulf War Syndrome showed normal blood flow to the hippocampus under normal conditions, and with the saline injection. With the injection of the inhibiting drug, however, the picture changed. The healthy soldiers’ brains responded exactly as expected: Blood flow to the hippocampus slowed, and the people got tired. Some of the sick soldiers, however, had a very different experience. When exposed to the drug, their brains didn’t seem to know how to respond. In some, blood flow to the hippocampus actually increased, in others it decreased far more than was normal, and for some blood flow stayed exactly the same. Haley says this is evidence of damage. Those soldiers’ acetylcholine systems no longer functioned as they should.
Old Puzzle
That seems pretty damning, but Haley’s new study has its faults. While it does mark a replication of results from one of his own earlier studies, Haley’s research has focused exclusively on small sample sizes within a single unit—the 24th Reserve Naval Construction Battalion. When the Khamisiyah storage depot was demolished, that unit wasn’t in a location where they would have been likely to receive even a small dose of the sarin. Haley believes they may still have been exposed to sarin gas from another source, or that the damage is due to exposure to the high levels of pesticides that Gulf War veterans remember applying directly to their clothing and skin.
Haley has also chosen to define Gulf War Syndrome differently than most other researchers. The Centers for Disease Control defines it as, “as the presence, for 6 months or longer, of one or more symptoms from at least two of the following clusters: general fatigue, mood and cognitive abnormalities, and musculoskeletal pain.”
Instead, Haley has used surveys of the 24th Reserve Naval Construction Battalion to split the Syndrome into Syndromes, based on clusters of symptoms. In a 1997 paper, he identified six different syndromes. This new paper focused on three of those: Veterans who reported problems with attention, memory, and reasoning; those who reported far more serious cognitive problems with disorientation, confusion, and balance; and veterans whose symptoms clustered around joint and muscle pain and fatigue.
That makes it difficult to directly compare Haley’s results to those of other scientists. It also muddies the results of his own work. The veterans with confusion and muscular-skeletal symptoms showed damage to their acetylcholine systems, just as I told you before. But the veterans with memory and attention problems didn’t. Their brains seemed to be functioning normally, and it’s hard to say what, if anything, that means.
Haley’s work hasn’t been replicated by others, says Simon Wessely, head of the department of psychological medicine at King’s College, London. Using larger samples, drawn from multiple British military units, Wessely found no neurological differences between people experiencing symptoms of Gulf War Illness, and those who were not. A 2004 American study turned up similar results. All of this suggests to Wessely, and other researchers, that Gulf War Syndrome is psychological in nature—not that soldiers are making up their symptoms, or that they really aren’t impaired, but that the symptoms stem from legitimate psychological causes, like post-traumatic stress disorder.
There could be more to it than that, however. Other researchers have found neurological differences between Gulf War veterans who were likely to be downwind of Khamisiyah and those who weren’t.
Roberta White, professor of environmental health at Boston University, found that the volume of white matter in veterans’ brains varied with their exposure to Khamisiyah—those who likely had high exposures had lower volumes of white matter. In a separate study, White’s team found that likely higher exposure to sarin from Khamisiyah also correlated with poor performance on cognitive tests.
The confusing part is that results like these doesn’t necessarily tell you much about Gulf War Syndrome. Linda Chao, with the Center for Imaging of Neurodegenerative Disease and and the department of radiology at the University of California San Francisco, has run a couple of studies looking for neurological differences in a group of more than 400 Gulf War Veterans. She found that neurological damage didn't correlate with people who experienced Haley’s definition of Gulf War Syndrome, nor with people who experienced the Syndrome the way the CDC defines it. But she did find that neurological damage correlated with likely exposure to sarin from Khamisiyah.
In other words, the people with neurological damage were exposed to sarin, and some of them show observable evidence of that damage, but those people aren’t necessarily ones reporting symptoms of Gulf War Syndrome.
Right now, Gulf War Syndrome is like a puzzle with pieces missing. The theory linking it to toxin exposure makes sense in a lot of ways, but doesn’t line up with all the evidence. Studies are often contradictory, seldom replicated by independent researchers, and frequently use small sample sizes. Meanwhile, hundreds of thousands of people are receiving treatment and benefits (or not, as the case may be) based on an incomplete picture. Haley’s new, small study presents some important questions, but doesn’t do much to help clarify the situation.
Instead, if we really want to understand Gulf War Syndrome we need two things: More studies using large sample sizes drawn from a wide swath of Gulf War veterans (something Haley says he’s turning his research towards next), and more attempts to replicate the findings of other researchers. Without that, all we have is a lot of important questions, and no answers.
Find Out More:
• The Gulf War and Health — National Academies summary of research, published in 2010.
• Acetylcholinesterase Inhibitors and Gulf War Illness — a 2008 research paper by Beatrice Golomb of the University of California San Diego. It looks at epidemiological evidence of whether sarin and pesticides can damage the acetylcholine system in the way Haley has proposed, and what the symptoms of that damage would likely be.
• GulfLink — The primary Department of Defense website for Gulf War Illness information.
Tuesday, September 6, 2011
Panel Hears Grim Details of Venereal Disease Tests
Panel Hears Grim Details of Venereal Disease Tests
August 30, 2011
By DONALD G. McNEIL Jr.
Gruesome details of American-run venereal disease experiments on Guatemalan prisoners, soldiers and mental patients in the years after World War II were revealed this week during hearings before a White House bioethics panel investigating the study’s sordid history.
From 1946 to 1948, American taxpayers, through the Public Health Service, paid for syphilis-infected Guatemalan prostitutes to have sex with prisoners. When some of the men failed to become infected through sex, the bacteria were poured into scrapes made on the penises or faces, or even injected by spinal puncture.
About 5,500 Guatemalans were enrolled, about 1,300 of whom were deliberately infected with syphilis, gonorrhea or chancroid. At least 83 died, but it was not clear if the experiments killed them. About 700 were treated with antibiotics, records showed; it was not clear if some were never treated.
The stated aim of the study was to see if penicillin could prevent infection after exposure. But the study’s leaders changed explanations several times.
“This was a very dark chapter in the history of medical research sponsored by the U.S. government,” Amy Gutmann, the chairwoman of the bioethics panel and the president of the University of Pennsylvania, said in an interview.
President Obama apologized to President Álvaro Colom of Guatemala for the experiments last year, after they were discovered.
Since then, the panel, the Presidential Commission for the Study of Bioethical Issues, has studied 125,000 pages of documents and has sent investigators to Guatemala. While the panel will not make its final report until next month, details emerged in hearings on Monday and Tuesday.
The most offensive case, said John Arras, a bioethicist at the University of Virginia and a panelist, was that of a mental patient named Berta.
She was first deliberately infected with syphilis and, months later, given penicillin. After that, Dr. John C. Cutler of the Public Health Service, who led the experiments, described her as so unwell that she “appeared she was going to die.” Nonetheless, he inserted pus from a male gonorrhea victim into her eyes, urethra and rectum. Four days later, infected in both eyes and bleeding from the urethra, she died.
“I really do believe that a very rigorous judgment of moral blame can be lodged against some of these people,” Dr. Arras said.
Also, several epileptic women at a Guatemalan home for the insane were injected with syphilis below the base of their skull. One was left paralyzed for two months by meningitis.
Dr. Cutler said he was testing a theory that the injections could cure epilepsy.
Poor, handicapped or imprisoned Guatemalans were chosen because they were “available and powerless,” said Anita L. Allen, a bioethicist at the University of Pennsylvania’s law school and a panelist.
The panel’s hearings also brought to light that a local doctor had invited the American researchers, and that Guatemalan military and health officials had initially approved the work. In 1947, an international conference on venereal diseases — based on the experiments — was held in Guatemala City, according to Dr. Rafael Espada, the vice president of Guatemala, in remarks quoted by the Guatemalan news media.
Dr. Espada, a physician, is leading his country’s inquiry into the matter and is expected to deliver his report in October. On Monday, he told Guatemalan reporters that five survivors, all in their 80s, had been found and would receive medical tests.
Dr. Cutler’s team took pains to keep its activities hidden from what one of the researchers described as “goody organizations that might raise a lot of smoke.”
Members of the bioethics commission recalled Nazi experiments on Jews and said that Dr. Cutler, who died in 2003, must have known from the Nuremberg doctors’ trials under way by 1946 that his work was unethical.
Also, according to Dr. Gutmann, Dr. Cutler had read a brief article in The New York Times on April 27, 1947, about other syphilis researchers — one of them from his own agency — doing tests like his on rabbits. The article stated that it was “ethically impossible” for scientists to “shoot living syphilis germs into human bodies.” His response, Dr. Gutmann said, was to order stricter secrecy about his work.
Also, one commission member added, “Regardless what you think of the ethical issues, it was just bad science.”
The results were never published in medical journals, note-keeping was “haphazard at best” and routine protocols were not done.
The Guatemala experiments came to light only last year when a medical historian found descriptive notes in the archives of the University of Pittsburgh. The historian, Susan M. Reverby of Wellesley College, was researching the infamous Tuskegee study, in which Alabama sharecroppers infected with syphilis were left untreated from 1932 to 1972. Dr. Cutler oversaw the Tuskegee study after his Guatemala work finished; he was also an acting dean at the University of Pittsburgh in the 1960s.
Dr. Cutler sent his Guatemala reports to only one supervisor, but Dr. Gutmann said they went up the chain to Surgeon General Thomas Parran Jr., a favorite of President Franklin D. Roosevelt. According to a government biography, Dr. Parran was famous for his long campaign against syphilis, which was then a major public health problem but could not even be mentioned on the radio.
In 1943, Dr. Cutler’s team had tried to infect 241 inmates of a federal prison in Terre Haute, Ind., with gonorrhea. But that time they adhered to ethical protocols, using only volunteers, explaining the risks and offering cash or help getting reduced sentences in return for participating.
Dr. Nelson L. Michael, an AIDS researcher at the Walter Reed Army Institute of Research and a panelist, speculated that the research was rushed and badly done because it had started under intense pressure to help the war effort. Curing troops’ venereal diseases was a major goal of military medicine.
The panelists generally agreed that the ethical review boards now mandated by the American government, universities, foundations and medical journals would prevent similar abuses today by anyone spending taxpayer or foundation money.
Pharmaceutical and medical device companies also do research in poor countries and still need watching, panel members said. But large companies say publicly that they adhere to ethical principles.
“The problem in 1946,” Dr. Gutmann said, “was that ethical rules were treated as obstacles to overcome, not as fundamental bedrock of human dignity. That can still apply today. That’s why our panel is doing our report.”
Panel members endorsed the idea of creating compensation funds for subjects who are harmed in the future, or requiring researchers to buy insurance for that purpose. Some countries require these steps; the United States does not.
Elisabeth Malkin contributed reporting.
NY Times page
I follow these type of reports due to my own use in human experiments that were done by the military, and were done with consent which is a far cry from "informed consent" then to be told 40 years later in a letter from the Veteran Affairs that we are not allowed to talk to anyone other than the doctors at the VA about our experiiments issues, excuse me, I don't know any of the data about lethal doses, delivery systems or any other information that would be needed to make these substances into weapons let alone know how to re-create them.
http://edgewoodtestvets.org/ this is about the current active lawsuit over this
