Gulf War Illnesses

Research, Clinical Monitoring, and Medical Surveillance Gao ID: T-NSIAD-98-88 February 5, 1998

This testimony draws on two recent GAO reports (GAO/NSIAD-97-163, June 1997, and GAO/NSIAD-97-136, May 1997) on health care issues involving U.S. troops deployed overseas. GAO discusses (1) the adequacy of efforts by the Defense Department (DOD) and the Department of Veterans Affairs to monitor the quality, appropriateness, and effectiveness of Gulf War veterans' care and to follow up on their clinical progress over time; (2) the government's research strategy for studying Gulf War veterans' illnesses and the methodological problems posed in its studies; (3) the consistency of key official conclusions with available data on the causes of Gulf War veterans' illnesses; and (4) the extent to which DOD's efforts for Operation Joint Endeavor in Bosnia succeeded in overcoming the medical surveillance problems encountered during the Gulf War.

GAO noted that: (1) in it's report on Gulf War veterans' illnesses, GAO noted that while DOD and VA had provided care to eligible Gulf War veterans, they had no system for following up on their health to determine the effectiveness of their care after initial treatment; (2) also, because of methodological problems and incomplete medical records on the veterans, research has not come close to providing conclusive answers on the causes of the illnesses; (3) given the data needed versus what is available, which is primarily anecdotal, it will be very difficult, if not impossible, to determine the causes of the illnesses; (4) the support for some official conclusions regarding stress, leishmaniasis, and exposure to chemical agents were weak or subject to other interpretations; and (5) regarding GAO's report on the medical surveillance of servicemembers deployed in Bosnia, while GAO found that DOD had improved its capability to monitor and assess the effects of deployments on servicemembers' health since the Gulf War, certain problems remained: (a) the database containing deployment information was inaccurate; (b) not all troops received postdeployment medical assessments; and (c) many of the medical records GAO reviewed were incomplete.

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