An offshoot of ongoing research into Gulf War illnesses was the institution of a program that allows anyone in the military who may have been exposed to disease-causing agents while in a combat theater to have access to health care for up to two years after the suspected exposure or after leaving the military.

“This is a special program that will probably be more relevant to Iraqi Freedom veterans than veterans of the first Gulf War,” notes Mather.

The DoD admits it was somewhat slow to react when reports of Gulf War-related illnesses first started popping up. However, lessons have been learned, and several programs have been instituted to better prepare and protect service personnel.

Indeed, the risk of disease in a war zone became abundantly clear when reports started trickling in of debilitating pneumonia among American troops in Iraq and the sudden onset of malaria among vaccinated troops in Liberia.

“Our programs are very focused on letting service personnel know about threats from diseases we anticipate they may experience, threats from chemical and industrial agents in the environments they may go to, and threats the enemy may bring,” notes Kilpatrick. “We have combat stress teams deployed with troops in theaters [because] we now know that immediate intervention is extremely important.”

The maintenance of medical records in theater also has improved dramatically since Operation Desert Storm.

“We learned that record keeping in a war zone needs to be as good as it can be because people’s memories sometimes get jumbled, and we need specific information on any symptoms or problems that may have occurred while they were in the theater,” Mather explains. “The DoD is now taking that much more seriously. A lot of medical records during the first Gulf War were just paper records or were put on laptop computers and shipped home, where they never made it to the patients’ files. Now, many records are being directly transmitted to patients’ stateside medical files.” 

With exposure-related illness a constant threat to American troops in Iraq, Afghanistan, and elsewhere, the DoD and the VA actively are preparing for the possibility of a new round of Gulf War illnesses.

“We are anticipating that there will be post-deployment health problems,” confirms Mather. “Our soldiers are living in rather austere, if not dangerous circumstances, in regard to heat [and other factors]. So I think, yes, we are expecting problems. Do we know the nature of these problems? No, we don’t yet.”

According to Kilpatrick, servicemembers who come to the DoD or VA for health care now routinely are asked if they have a symptom or health concern they believe may be related to deployment. 

“If the answer is yes, there is a protocol to provide information to the patient, as well as follow-up based on information from the theater,” says Kilpatrick. “We want to address patient concerns up front. That clearly is a major lesson learned from the Gulf War, when patients walked away saying nobody believed there was something wrong with them.”

At the VA, says Mather, there has been a noticeable change in attitude among administration and health care providers.

“The short-term remains very, very important —we want soldiers who have been injured in a war to seamlessly receive the care they deserve, whether they are in DoD or have been discharged and are eligible for VA care,” Mather notes. “We have more planning in place for that right now than ever before, but we now also anticipate that there will be long-term problems following this or any other war. We do not automatically think that people will come back fine.

“I wish that we could predict what the problems will be, whether they will be heat-related or some sort of infectious disease or exposures to chemicals,” Mather adds. “But we’re committed to being responsive because the secret of caring for veterans is caring for veterans. We are prepared to tackle whatever problems they bring us as quickly as we can and not downplay their perceptions of their health because they really are the best judge.”