Gulf War Syndrome, Physical and Psychological Stress - Essay Example

143730 When Iraq attacked Kuwait on 2nd of August 1990, with 100,000 soldiers, for no convinctingly apparent reason, United s and its allied forces acted quickly and decisively against Iraq and unlike today's Gulf War, it was a war that most of the countries in the world, and in Middle East appreciated, because Iraq's act was seen as pure and naked aggression against the smaller country, an act, which could not be permitted to go further. Not only the oil supply was threatened, but also there was a danger of emboldened Saddam invading the neighbouring countries like Saudi Arabia. Hence, operation 'Desert Shield' was launched with great public support and at that time, George Bush was at the zenith of his popularity. Today there are reports that US administration deceived the rest of the world, because the suppressed photographs of Russian network showed that there was absolutely no danger to oil supply by the Iraqi forces. The truth of this statement is yet to be established beyond doubt, although this war became the inception of the present Gulf War. Iraq had the world's 4th largest army with the elite 'Republican Guard'. It was widely assumed that Iraq used chemical weapons against Kurds and Iran. The contagious bacteria connected with the chemical weapons became a threat to the region. Even though now we are in the throws of another Gulf War, it should not be forgotten that the first Gulf War has left behind a trail in the form of Gulf War Syndrome. Most of the forces returned by the spring of 1991 to their home countries with apparent good health, other than the injuries of a few soldiers. Slowly self-reported, real or assumed health symptoms started emerging out. American, Canadian and British soldiers who served in the first Gulf War seemed to have developed certain common ailments after the war, which are generally termed as Gulf War Syndrome (GWS). The symptoms are varied, but if looked into, there is a common thread running in all of them. "These veterans have been exposed to a variety of damaging or potentially damaging risk factors including environmental adversities, pesticides such as organophosphate chemicals, skin insect repellents, medical agents such as pyridostigmine bromide (NAPS), possible low-levels of chemical warfare agents, and multiple vaccinations in combinations, depleted uranium, and other factors" says a University Neurology Department paper of NHS Glasgow," http://www.ncbi.nlm.nih.gov/entrez/query.fcgicmd=Retrieve&db=PubMed&list_uids=9638279&dopt=Citation Many researches were conducted, findings of the clinical epidemiological studies were codified and now we have a remarkable knowledge of this syndrome that has bothered soldiers, their families and their physicians for a long time. With every new patient, old records were reviewed diligently. There were many studies that have tried to link them together so that one clear picture could emerge out of the entire problem. Soldiers were exposed to toxins, drugs, environmental hazards and many more risk factors and physicians feel that they have left behind strong negative affects on genetic and biological factors. Many of the researches have tried to find out the far reaching implications, including psychological affects left behind by the war. Some of them have questioned the safety level of the drugs used on soldiers as pain killers, or while treating the wounded soldiers. Some of the reviews have highlighted the importance of a combined approach, psychological as well as clinical while treating the problem. Emerging picture still is confusing and of little cohesion. It is also referred as "Chronic Multisystem Illness" according to Keiji Fukuda, in JAMA, Vol. 280, No. 11, September 16, 1998 (981-988). He had conducted well designed cross sectional survey of characters and symptoms with clinical evaluations, and research and he has arrived at the following conclusions: "Among currently active members of 4 Air Force populations, a chronic multisymptom condition was significantly associated with deployment to the GW. The condition was not associated with specific GW exposures and also affected nondeployed personnel" (ibid). Another research took into account the job involved stress and other environmental exposures and compared them with the self-reported characteristics. International Journal of Epidemiology (1998), Volume 27, Number 6, (Pp. 1000 - 1010) concluded: "Veterans deployed to the Persian Gulf have higher self-reported prevalence of health symptoms compared to PGW veterans who were deployed only as far as Germany. Several Gulf-service environmental exposures are associated with increased health symptom reporting involving predicted body-systems, after adjusting for war-zone stressor exposures and PTSD" This research also concluded that the symptoms prevailed more in Persian Gull-deployed cohorts compared to the Germany cohort. They concluded that " Persian Gull-deployed veterans were more likely to report neurological, pulmonary, astrointestinal, cardiac, dermatological, musculoskeletal, psychological and neuropsychological system symptoms than Germany veterans" (ibid). Exposure to Neuro-toxic Chemical combinations was the crux of another study conducted on 249 Gulf War veterans. This study collected the data on impaired cognition, confusion-ataxia, arthro-myo-neuropathy, N,N-diethyl-m-toluamide etc. and concluded that " Some Gulf War veterans may have delayed, chronic neurotoxic syndromes from wartime exposure to combinations of chemicals that inhibit butyrylcholinesterase and neuropathy target esterase" http://jama.highwire.org/cgi/content/abstract/277/3/231 American Journal of Epidiomology (Knoke et al, Factor Analysis of Self-reported Symptoms: Does It Identify a Gulf War Syndrome), (Vol. 152, No. 4 : 379-388, 2000), reported that according to another set of researchers, Gulf War Syndrome was not fully established. They were doubtful of many of the symptoms and concluded: "Gulf War veterans and nondeployed era veterans reported similar clusters of symptoms and illnesses. However, Gulf War veterans reported these same clusters with greater frequencies than did nondeployed veterans. The authors conclude that, in contrast to a previous report, factor analysis did not identify a unique Gulf War syndrome" In the study conducted only on UK service men, a few more facts emerged. In Pub Med NCBI 1999 Jan 16; 353(9148):169-78, another cross-sectional postal survey was conducted mainly on the symptoms of post-traumatic stress and the results were interpreted as: "Service in the Gulf War was associated with various health problems over and above those associated with deployment to an unfamiliar hostile environment. Since associations of ill health with adverse events and exposures were found in all cohorts, however, they may not be unique and causally implicated in Gulf-War-related illness. A specific mechanism may link vaccination against biological warfare agents and later ill health, but the risks of illness must be considered against the protection of servicemen" http://www.ncbi.nlm.nih.gov/entrez/query.fcgicmd=Retrieve&db=PubMed&list_uids=9923871&dopt=Abstract Talking about the ills of depleted Uranium (DU) poisoning it is impossible not to get alarmed by the high tech battles of today and its silent effects. The environmental degradation that DU could bring along with the human long term health effects, it is imperative that these syndromes are given more attention so that such weapons should be controlled or banned. "Not only those people interested in protecting the environment, or those wanted to protect U.S. enlisted people, or those who believe the world's population is threatened by this radioactive waste have an interest in banning DU. Those who want to arouse the population to stop new U.S. military adventures must make everyone aware how DU poisoning is part of the costs of war," Catalinotto et al (1999, p.59). Soldiers belonging to the main contributing countries like America, Canada and England mainly suffered the syndrome and not much had been reported from Saudi Arabia, UAE, Egypt, Oman, France, Syria, Kuwait, Pakistan, Bangladesh, Bahrain, Morocco, and Qatar other than very stray incidents, which cannot be called as syndrome makers. Even from lesser contributors like Argentina, Afghanistan, Australia, Germany, Denmark, Hungary, Poland etc. there was hardly any such report. Many Evaluation Programmes were conducted, even though they could not be considered as research vehicles. Department of Veteran Affairs, Department of Defense, Presidential Advisory Committee on Gulf War Veterans' Illnesses in USA, Ministry of Defence, Medical Research Council, House of Commons Defence Committee, in UK have their own evaluation programmes that provide significant insights into the problem. Symptoms could be anything between headaches, memory loss, sleeplessness, and skin problems, difficulty in focussing, stomach complaints, dizziness, and abdominal pain, to breathlessness, hair loss, weight loss, confusion, depression and mood swings. The families of the veterans also are affected due to the unpredictability of the problem and there are marital difficulties reported quite regularly. Mortality had not been of very high rate; but mental and psychological conditions had been reported very frequently. Other serious illnesses like cancer, heart problems, and infectious diseases had been reported more with this group. Psychological disorders had been the major problem even in those people, who had not reported the said Syndrome. War, even though a very short one compared to today's Gulf War, had left a long trail of disaster in the minds of participants. No comparable study had been conducted till now, other than a small research by Environmental Epidemiology Service of USA and that report remains inconclusive. Many times doubts and hesitations were raised, to ask if there was a Gulf War Syndrome after all with vehement arguments from both the sides. Some of the symptoms could happen to any individual of any background. There were sceptical remarks asking how they could be linked to service in the Gulf, or was there any underlying mechanism or cause that could result in such a syndrome. These questions had never been answered very satisfactorily either by medical fraternity, or by researchers. So the question remains, is it a mere, popular clich There is another argument that unexplained health problems are not restricted only to Gulf War, but were reported even after US Civil War, World Wars I and II, and later in Vietnam War. The symptoms were almost comparable and similar. Palpitations, Precordial pain, fatigue, exhaustion, fainting, disturbed sleep, concentration difficulties and were reported after all these wars by the war veterans, and to some extent, they were simply brushed off. It is understood that the strongest evidence comes from a cross-sectional telephonic survey conducted in Iowa, USA on 3,700 service men, who unhesitatingly reported chronic fatigue and cognitive dysfunction, bronchitis etc. and this survey, almost confirmed that there exists a syndrome, whatever the sceptical might say. This was not agreed by all, who argued that there could be common causes for these reports. "In January 1997, a Presidential Advisory Committee (PAC) ON GULF War Veterans' Illnesses set up by President Clinton in May 1995 concluded that the "Current scientific evidence does not suppot a causal link between the symptoms and illnesses reported today by Gulf War veterans and exposure while in the Gulf region", Gulf War Illnesses (p.13). So, the cause cannot be one or simple, but could be various and diverse and attention in recent years had been focused on neurological symptoms and problems. It has been pointed out that exposure to biological, chemical, pesticides, smokes from oil fires, petroleum fuels, depleted uranium combined with the stress and uncertainty of war, physical strain and psychological stress must have caused most of the symptoms. There were undoubtedly long exposures to different risk factors, especially, burning oil wells, combined with chemicals and other harmful warfare agents. Chemical warfare agents could be nerve agents, blister agents or blood agents, that could be volatile depending on the gas inhaled, or vapours which could bring anything between nervous disorders to paralysis. Cyanide is a blood agent, found in hydrogen cyanide or cyanogen chloride. But then, there was no great evidence that chemical weapons were used in this war. There is evidence though, that mustard gas was inhaled liberally. Another argument says that 10 different vaccines that were given to the troops to protect them against infections like tetanus, cholera, plague, hepatitis B, polio, typhoid and anthrax etc. and these too could be the causes as it was too liberal a dose of vaccine to be given to any human at one time. Records of self-administered drugs are unavailable, but it is known that many NAPS tablets were generally taken whenever the troops found themselves at the risk of any contagious or chemical contact during conflict and the doses were contradictory. This is no healthy sign either. There could be many agents affecting the nervous system like pesticides, pyridostigmine bromide etc. and the long term exposure even to a mild agent could affect in the long run. Also some new researches have come up linking chemicals to GW syndrome and this depends on questionnaires sent to these veterans and they have found enough evidence to link the chemicals with the syndrome and these results were derived from statistical analysis. (ibid, p. 25). Physical and psychological stress had been given more attention with the environmental factors and work-related hazards like fear attack, dead bodies, casualties, sufferings and wounded colleagues. Fear of infectious diseases too could have triggered off a certain amount of phobia. Still certainties and uncertainties persist and a definite, comprehensive picture has not yet emerged, even after many rounds of basic, applied and clinical research combined with Medical Assessment Programmes. In UK itself, many studies like a complete epidemiological study, research on the health of veterans' children, research on the effects of vaccines and drugs and other connected research were conducted and most of them came to the conclusion that definitely a syndrome exists. But the smaller voice of negating it could not be stilled. We arrive at the sad conclusion that the modern warfare is not only fought in the battlefield at the time of war, but also fought later for the rest of the lives of the participants, soldiers and civilians alike. It is a sad testimony of our modern discoveries that has brought u the world to the brink of disaster. Every war becomes a terrible threat to the mankind wherever it is fought and the soldiers, naturally, bear the brunt of it. Whether war syndromes exist or not, whether this war weapons and environment was negative enough to cause such a syndrome or not, fact remains that many such syndromes are about the arrive with disastrous results after every such war. Gulf War Syndrome is a mild way of informing the connected people what war can do other than bringing destruction and death. It also can inflict and long and silent death of phobia, fear, anxiety and unhappiness. An enormous amount of money has been poured into the research on Gulf War Syndrome and many more empirical, qualitative and quantitative researches are being conducted today, along with the reviews and medical evaluations. Undoubtedly world will know more and more about GWS in the near future. , 1998 BIBLIOGRAPHY: 1. American Journal of Epidiomology (Knoke et al, Factor Analysis of Self-reported Symptoms: Does It Identify a Gulf War Syndrome), (Vol. 152, No. 4 : 379-388, 2000). 2. Catalinott, John, Sara Flounders (1999), ed., Metal of Dishonor, Depleted Uranium, International Action Center, New York City. 3. Gulf War Illnesses, Dealing with the Uncertainties, (1997), Parliamentary office of Science and Technology, London. 4. Fukuda, Keiji, Chronic Multisystem Illness affecting Air Force Veterans of the Gulf War, JAMA, Vol. 280, No. 11, September 16, 1998 (981-988). 5. International Journal of Epidemiology (1998), Volume 27, Number 6, (Pp. 1000 - 1010) ONLINE SOURCES: 1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgicmd=Retrieve&db=PubMed&list_uids=9638279&dopt=Citation 2. http://jama.highwire.org/cgi/content/abstract/277/3/231 3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgicmd=Retrieve&db=PubMed&list_uids=9923871&dopt=Abstract 4. Read More