Examination of Witnesses (Questions 140
- 159)
WEDNESDAY 15 DECEMBER 1999
MR SHAUN
RUSLING, DR
DOUG ROKKE,
MR TONY
DUFF, PROFESSOR
MALCOLM HOOPER,
MR JOHN
DENNIS AND
DR HARI
SHARMA
140. Is this a permanent severance?
(Mr Rusling) We had an open day in Whitley Bay two
weeks ago and there were 150 members present and we voted unanimously
not to form any contact with the Ministry of Defence until at
least March of this year.
141. What is the significance of March?
(Mr Rusling) We have our Annual General Meeting then
and that would be a case for the whole of the members because
it is such a serious issue but, having said that, all the members
are agreed that there is just no point in going to the MoD Medical
Assessment Programme because it is just deceit and lies that we
get from them.
Chairman: We will come back to the Medical
Assessment Programme shortly after. Mr Blunt?
Mr Blunt
142. Can I just ask about the cause of you breaking
off relations when somebody was tested for total uranium and not
depleted uranium.
(Mr Rusling) That is correct.
143. I understand the position to be, as we
have been advised, that if you test for total uranium and there
is none found to be present in significant quantities that would
include depleted uranium. Is that right or wrong?
(Mr Rusling) Could I refer to Dr Sharma or Dr Rokke?
(Professor Hooper) I could take that just as easily.
I think the point at issue seems to have been completely missed
by everybody. Lord Burlington missed it in the House in response
to the Countess of Mar's question. Harry Lee missed it in presenting
his response to Paul Connolly. The point at issue is if depleted
uranium is found in the urine even at low levels now, nine years
after the event, it has come from exposure to emissions in the
Gulf War. It has been there for nine years.
144. What I was getting to was the point at
issue of the test, that if you test for uranium and then you find
none, then there is no depleted uranium. That is what we have
been told.
(Professor Hooper) You do not find none.
145. If you find none in significant quantities.
(Professor Hooper) If you find low quantities of uranium,
you can say that this person is not suffering from acute uranium
poisoning. If the DU is present—and this is the crunch point
and it is in here and I have labelled it the nub of the problem—it
has been there for nine years, so this person has been sustaining
an accumulative toxic radiological dose from that source for nine
years.
146. If someone is tested for uranium, in order
for them—
(Professor Hooper) That is a red herring.
147. But if they had depleted uranium in their
system as a result of the Gulf War, that would show up in a uranium
test as an abnormally high level of uranium?
(Professor Hooper) Not after nine years
(Dr Rokke) Excuse me, if I could clarify some of this,
since I have got the highest known internalised uranium content
personally. First off, depleted uranium was a misnomer put on
by the US Department of Defense to confuse people. If you have
100 mg of uranium you will have 99.2 mg of uranium 238 and .8
mg of uranium 234 and 235. After the removal of the uranium 234
and 235 you have 99.8 mg for every 100 mg of uranium 238. This
is what is known as depleted uranium. One of the things that has
got into this thing is that medical literature identifies specifically,
as the US protocols are now, that testing should be initiated
within 24 hours of exposure, not nine years after the exposure.
The uranium that we are going to find in the urine today is only
what is currently mobile in the urine. It does not represent the
uranium that has been sequestered in the body. After 30 days it
only represents one-thousandth of what the original exposure was.
My own documents verify that. We did a simple match back and could
not get it. What has happened today with the uranium testing and
exposures, although the Directive for Uranium Testing was initiated
by myself and Dr Thomas Little during the Gulf War immediately
upon all the casualties, it was ordered by the current Chief of
Staff for the United States Army in 1993 and it did not happen
so today nine years after the fact, if you are going to do a urine
analysis, even on those with absolutely known, verified, documented,
astronomical levels, you are got going to find it because the
stuff is being sequestered except what is mobile. What we may
find today is when we have an acute medical crisis, which is what
happened to me in February with this stuff, and you all of a sudden—Dr
Sharma can explain this—will start seeing the uranium coming
out of sequestering into the body. It becomes mobile again and
what you see is an acute physiological crisis, respiratory, kidney,
neurological, the whole thing goes on down, and we do see that
and we have seen that since day one. So when we ask today how
the testing is going to work or what has happened, if I am talking
total or depleted uranium, the problem is if you have got uranium
in the urine or in the semen which has been verified by the VA,
it does not belong there whatsoever. Especially at the levels
we are talking 5,000, 10,000 or 100s of times beyond the normal
acceptable levels. That was measured years after the fact, not
within 24 hours as we directed.
Chairman: I will come back on to depleted
uranium in a few minutes. You mentioned the Medical Assessment
Programme so we have a block of questions led by my colleague
Laura Moffatt on that and then we will go back to depleted uranium.
Then we will look at epidemiological studies, war pensions and
other compensation and a comparison with treatment received by
US Gulf veterans. If there is anything else you want to add after
those topics, please feel free to do so. Laura Moffatt?
Laura Moffatt
148. Gentlemen, I want to divide my questions
into the gut reaction of people, and I think you have probably
started to give us that about having a sense of not having any
trust in the Medical Assessment Programme, and the clinical aspect
of the programme. If you do not mind, I will do that. We have
heard recently that psychological and psychiatric assessment is
now being offered for those who wish to pursue that. I know the
effect it has on my constituents whenever it is mentioned that
they have psychological illness. They are anxious and say, "What
are they saying about me?" I do not believe it is entirely
negative, and I want to hear from you what you believe, because
what we heard in the States, and I hear very much what you are
saying about the shortcomings of both programmes and the way both
nations have approached their veterans, but what we were hearing
was the impact of stress on the ability of people to be able to
respond to infection, to invasion of some sort, poisons and my
own thought is that there may be something in this. The conditions
under which people were operating and the way in which their body
was reacting at the time may have made them more susceptible to
whatever it may be. I make no assumptions about whether it was
inoculations or poisoning, but there may be something in that.
I wonder if we can divide that into two parts, the clinician and
the gut reaction of the veterans.
(Dr Rokke) It was one of the things that started off
immediately when I was in theatre with the preventative medicine
staff in the Gulf War because of complex exposures to water-borne
and food-borne illnesses that we were seeing throughout the theatre
as part of preventative medicine. In the immunisations what we
saw was a reduction in individuals' capability to fight off or
ward off problems. When you combine the stress—I am a Vietnam
veteran and I can guarantee that the stress in the Gulf War was
insignificant, there was not even a single fire fight—stress
does come into play in partially reducing the resistance of an
individual to all the other problems. The testing that they are
doing today with the psyche and everything would be more appropriate
as far as neuro-psychology is concerned because what we are seeing
there is the overall toxic battlefield effects on brain functioning
and brain operation. That is what Dr Bob Haley has recently reported
on in the last few weeks where we had the chemicals, all of the
exposures going across the blood/brain barrier and we were seeing
the immediate responses. Now the stress, the lack of sleep, the
food, the water, all come into play because it is like anything,
if your immune system drops down or you are put under stress,
you are going to become more susceptible so everything hits you.
What you have, like you said, ma'am, is a combination and then
the real toxin hit and all of a sudden we have a nightmare.
Mr Hood
149. Are you saying that stress suppresses the
immune system therefore it is more incapable of responding?
(Professor Hooper) Yes, that is right, but all sorts
of things depress the immune system. Organophosphates depress
the immune system. There is a whole catalogue of exposure from
PBs to organophosphates to lindane through to pyrethroids through
to the DU, through to the oil supplies and smoke. The whole lot
have got immuno-depressants in them. On page 28[2]
of my submission there is a table which shows the impact the different
toxins have on the different systems of the body. I am not speaking
as a clinician; I am speaking as a scientist but my assessment
of the whole issue is that the stress can be biological, can be
evoked by the vaccines or the PBs. It is not just a matter of
anxiety about the battle conditions. We do know for example that
troops would take an extra PB pill when they felt they were going
into an area where they might be exposed to nerve agents because
it was a protective substance. It was not if you took it as an
extra because you have got to take it in the set form. In any
case I do not think that worked. I think that whole strategy was
fatally flawed but that is another issue. The other thing I would
say about the psychiatric diagnosis, which the lads are very angry
about, and on page 30[3]
I have written about this, is there are some psychiatrists who
are wanting to explain all the overlapping syndromes, like for
example chronic fatigue syndrome, fibromyalgia, multiple chemical
syndrome, PMT even, as being psychiatric in origin. Does the psychiatry
drive the symptoms or the symptoms drive the psychiatry and I
think there is evidence from history. There is a quote from Daniel
in 1936, who described diabetes as sexual repression driving into
the metabolism. Making a comment like that would be laughable
now yet here is a peer reviewed paper talking about sexual repression
and neuroticism driving a metabolic disease. It is entirely the
other way round.
Laura Moffatt
150. It would be difficult to pursue that because
they thought that bleeding people helped their good health at
the time. We know we have moved on and I need to get you to buckle
down to this issue of whether this was a good thing, no matter
what people's perceptions are. Unless we get a proper assessment
of the effect of stress, however it is manufactured, whether it
is chemically or through the stress of being there, how can we
genuinely get involved and make sure that we understand what is
happening to people?
(Mr Duff) We did have the ability to do that at the
time. The Combat Psychiatric Team were there to look at these
issues and part of the medical assessment was supposed to happen
on the way back from the Gulf either in theatre or shortly after
we got back. They did no work at all in that area. I certainly
never saw anybody from the Combat Psychiatric Team. We are now
nine years on and suddenly we are saying, "We will look at
the psychological problems." Two years ago we were pushing
this, five years ago we were pushing it, and at the end of the
day we did not push it because we wanted to be known as fruit
loops; we were seriously worried about the fact that people's
ability to cope year on year after the initial insult had gone
or was diminishing and the worst thing about this whole thing
is that individuals cannot represent themselves, they have to
have others to do it for them. That is the biggest insult we have
had.
151. It is difficult. I am with you. I think
it should have been done and that is the reason we are sitting
here today with you because we agree with you but how can we move
forward?
(Mr Duff) We have talked to the MoD on numerous occasions.
Yesterday we talked to them about this. We are always making thrusts
into this argument and going through the steps with them and looking
at the problem from their perspective as well as ours. We want
this to work. There is no doubt about that. What was happening
here was the fact we have got a programme launched across the
road which has been highly dubious and was begun several years
ago and it is not getting better and the people running it are
making statements not just to individuals and other veterans but
making statements in open court, in the media and so on and so
forth, which cast a doubt on the veracity of the whole thing.
If you want it to work then we have to bring people in from all
areas and sit down and discuss this logically.
152. Pursue for me the particular complaints.
You can have a sense that it is not doing the job but we need
to know exactly where it is failing.
(Professor Hooper) Could I come back on one of the
comments you made, quite rightly, about being out of date. This
is from 1998: "inhibitors of ... acetylcholinesterases may
induce psychopathologies that are reminiscent of PTSD". So
why are we not looking at it? Why are we not looking at paraoxonase
like Haley did? Why are we not doing SPECT scans to look for brain-blood
flow? Why are we not building on the relationships that are emerging
with other diseases like ME and CFS?
153. I am with you, this is not a rehearsed
question, this is coming from me because this is a particular
concern of mine. I think you have very well shared that with me.
(Mr Dennis) I have only been involved in this matter
for six months, Chairman, but the impression I get as somebody
who has wide experience of medical research is that there is no
systematic programme. I feel astonished that we are now eight
or nine years down the road and still we have not got the answers
to very fundamental questions. The literature about the psycho-social
effects of stresses in one's life is all there, going back to
the 1950s Hollins and Raleigh social readjustment studies.
Chairman
154. But compared to three or four years ago
the research being done in this country may be piddling compared
with that in the US, but it is positively encyclopaedic compared
to the total indifference the MoD had a couple of years ago when
there were these epidemiological studies.
(Mr Dennis) It still feels like indifference to me
now.
Laura Moffatt
155. What you are actually saying is that MAP
in its present form will never satisfy the veterans.
(Professor Hooper) Yes.
156. You started to expand on what you thought
would be better. Paint a picture for us in a few words.
(Mr Duff) First of all, there needs to be some kind
of regional set up. You cannot ask people, particularly from where
I am from in the north of Scotland, to spend the best part of
two days travelling to come to a hospital for a medical that may
take 25 minutes. I am sure the clinicians themselves are overworked
and stressed like the rest of us but this is a very serious issue
when people's wives come down and say, "Give me some answers
to some questions. Why is my husband like that?"
157. How do you guarantee consistency by nominating
somebody? Is there not a risk in that? Would you not feel "my
assessment was not as good as somebody else's somewhere else"?
I would be worried about that. As a nurse myself I would be really
worried.
(Mr Duff) At the end of the day we have always advocated
that we need continuity. We need to be monitored, first of all.
The MoD says there is not a problem or there is not as big a problem
as we put it. I would say to them what have you done to follow
us over the years? You are not sitting on this side of the fence?
So long as you have got your policy up and running and as long
as you satisfy this Committee and Parliament in general every
six months or every year or whatever, everything else is a ball
of chalk.
158. Has anybody read the management audit of
MAP?
(Mr Duff) Yes.
159. What was your opinion?
(Professor Hooper) If it had been a management audit
of me I would be extremely worried, but we have not had a clinical
audit.
2 See Table 4, p 49. Back
3
See p 50. Back
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