IIR 2 201 0030 95/GULF WAR SYNDROME INVESTIGATIONS IN Filename:22010030.95a ENVELOPE CDSN = LGX017 MCN = 94290/12628 TOR = 942901247 RTTCZYUW RUEKJCS0230 2901236- --RUEALGX. ZNY HEADER R 171236Z OCT 94 FM DIA WASHINGTON DC INFO RUEAHQA/CSAF WASHINGTON DC RUEACMC/CMC WASHINGTON DC RHHJMCY/JICPAC HONOLULU HI RUETIAQ/MPC FT GEORGE G MEADE MD RUCJACC/USCINCCENT MACDILL AFB FL//CARA// RUCQVAB/USCINCSOC INTEL OPS CEN MACDILL AFB FL RUQYSDG/FOSIF ROTA SP RUEOFAA/COMJSOC FT BRAGG NC//J2// RUEHC /SECSTATE WASHINGTON DC RUDMQAN/MARCORINTACT DET QUANTICO VA RUDMGRD/COGARD INTELCOORDCEN WASHINGTON DC RHEPAAB/ACCIS LANGLEY AFB VA RUEALGX/SAFE R 141157Z OCT 94 FM CDR [ (b)(1) sec 1.3(a)(4) ]USAFIA INSCOM FT BELVOIR VA//[ (b)(1) sec 1.3(a)(4) ] TO RUEKJCS/DIA WASHINGTON DC RUEADWD/DA WASHINGTON DC//DAMI-POH/DAMI-FIT// RUEATAC/CDRUSAITAC WASHINGTON DC RUDHAAA/CDRINSCOM FT BELVOIR VA//IAOPS-H-C// [ (b)(2) ] RUFTAKA/UCIRF AUGSBURG GE RUDOHDC/UDITDUSAREUR HEIDELBERG GE RUFGAID/USCINCEUR INTEL VAIHINGEN GE RUFOADA/JAC MOLESWORTH RAF MOLESWORTH UK INFO RUERJFI/CDRUSAFIA FT GEORGE G MEADE MD//IAFIA-CM// RUCDGDA/DIRMSC REDSTONE ARSENAL AL//MSC-2A// RUEOAYA/NGIC INTEL OPS CHARLOTTESVILLE VA//IAFSTC-CR2// RUEARDF/DIRAFMIC FT DETRICK MD//AFMIC-CR// RUCIAEA/NAIC WRIGHT PATTERSON AFB OH//DXLA/TATH// RUDMONI/ONI SUITLAND MD//622/24// [ (b)(2) ] RUERHNA/CDRUSASOC FT BRAGG NC//AOIN-IOT// RUDPSOC/CDRUSASOC INTELCEN FT BRAGG NC//AOIN-IOA// RUDHDTO/CDR [ (b)(1) sec 1.3(a)(4) ]USAFIA INSCOM FT BELVOIR VA//[ (b)(1) sec 1.3(a)(4) ]// BT CONTROLS SECTION 1 OF 5 SERIAL: (U) IIR 2 201 0030 95. X- /*********** THIS IS A COMBINED MESSAGE ************/ BODY PASS: (U) DIA FOR CH-6, DO-6 FOR INFO. X- COUNTRY: (U) KUWAIT (KU). X- SUBJ: IIR 2 201 0030 95/GULF WAR SYNDROME INVESTIGATIONS IN KUWAIT (U). X- WARNING: (U) THIS IS AN INFO REPORT, NOT FINALLY EVALUATED INTELLIGENCE. REPORT CLASSIFIED X - - - - - - - - - - - - - - - DEPARTMENT OF DEFENSE X - - - - - - - - - - - - - - - DOI: (U) 940402-940407. X- REQS: (U) G-OSG-2520-01-92. X- SOURCE: //2 243 1022//[ (b)(1) sec 1.3(a)(4) & (b)(7)(D) ] X- SUMMARY: (U) THIS REPORT CONTAINS INFORMATION ABOUT MEDICAL INVESTIGATIONS CONDUCTED BY THE KUWAITIS AND OTHERS ON THE MEDICAL PROBLEMS KNOWN AS "GULF WAR SYNDROME. X- TEXT: (U) 1. IN MARCH OF 1994, A PROPOSAL WAS PRESENTED TO THE PEROT GROUP OF DALLAS TEXAS, SUGGESTING THAT VALUABLE INFORMATION ON MULTIPLE CHEMICAL SENSITIVITY (MCS) EPIDEMIOLOGY COULD BE GAINED BY LINKAGE OF THE ONGOING STUDIES OF US AND BRITISH VETERANS WITH SIMILAR RESEARCH BEING CONDUCTED ON THE KUWAITI CIVIL POPULATION. TO THIS END IT WAS DECIDED TO SEND A REPRESENTATIVE TO A CONFERENCE HELD IN KUWAIT FROM 2 TO 6 APRIL 1994 FOR THE PURPOSE OF ASSESSING THE LONG TERM DAMAGE RESULTING FROM THE IRAQI OCCUPATION OF THE COUNTRY AND THE WARS OF INVASION AND LIBERATION. THIS CONFERENCE WAS SPONSORED BY KUWAIT UNIVERSITY. FORTUITOUSLY, A US UNIVERSITY IS CONDUCTING A COLLABORATIVE PROJECT WITH THE AL-HARBI RESEARCH GROUP AT KUWAIT UNIVERSITY FACULTY OF MEDICINE INVOLVING VARIABLE EXPRESSION OF TWO CELL SURFACE ANTIGENS (ADENOSINE DEAMINASE AND CD26) WHICH CORRELATE STRONGLY WITH MCS DEVELOPMENT. TRAVEL EXPENSES WERE PROVIDED BY THE PEROT GROUP, HOTEL AND OTHER EXPENSES BY KUWAIT UNIVERSITY. IN THE TIME SINCE THE LIBERATION OF KUWAIT FROM IRAQI FORCES IN MARCH OF 1991, LARGE NUMBERS OF US MILITARY VETERANS OF THE CONFLICT HAVE SUFFERED INCREASINGLY SEVERE DETERIORATION OF GENERAL HEALTH. VICTIMS MANIFEST SYMPTOMS MOST CLOSELY RESEMBLING MCS, A DISORDER SEEN HERETOFORE PRIMARILY IN INDIVIDUALS ACCIDENTALLY EXPOSED TO HIGH CONCENTRATIONS OF ORGANIC TOXINS. THE US VETERANS ADMINISTRATION AND OTHER GOVERNMENT AGENCIES HAVE BEEN RELUCTANT TO ACKNOWLEDGE THE EXISTENCE OF WAR RELATED HEALTH PROBLEMS AMONG THOSE WHO SERVED IN THE GULF, HENCE COLLECTION OF DATA ON THIS PROBLEM HAS BEEN LEFT TO PRIVATE ORGANIZATIONS AND CONCERNED MEMBERS OF THE US SCIENTIFIC COMMUNITY. 2. (U) OBJECTIVES OF THE CONFERENCE WERE - (1) OBTAIN ANY INFORMATION AVAILABLE CONCERNING ADVERSE HEALTH EFFECTS OBSERVED TO DEVELOP IN THE POPULATION OF KUWAIT DURING AND AFTER THE IRAQI OCCUPATION; (2) ATTEND THE INTERNATIONAL CONFERENCE ON THE EFFECTS OF IRAQI AGGRESSION ON THE STATE OF KUWAIT. DURING THIS CONFERENCE, A BRIEF OVERVIEW OF THE HEALTH RELATED PROBLEMS MANI- FESTED BY US MILITARY PERSONNEL WHO SERVED IN OPERATION DESERT SHIELD/DESERT STORM WAS PRESENTED; AND (3) IDENTIFY ANY MEMBERS OF THE KUWAITI SCIENTIFIC/MEDICAL ESTABLISHMENT WHO WOULD BE WILLING TO CONTRIBUTE TO THE ONGOING LONGITUDINAL STUDY OF GULF WAR SYNDROME (GWS) CURRENTLY BEING PURSUED IN THE UNITED STATES. THIS CONTRIBUTION TO INCLUDE EITHER INITIATION OF A PARALLEL STUDY IN KUWAIT AND/OR LINKAGE TO ANY EXISTENT RESEARCH ALREADY UNDERWAY IN KUWAIT. 3. (U) OBJECTIVE ONE (IDENTIFICATION OF POSTWAR HEALTH PROBLEMS IN KUWAIT) - THE FOLLOWING INFORMATION WAS PRESENTED AT THE CONFERENCE - A. (U) RESIDUAL ATMOSPHERIC POLLUTION EFFECTS - (SOURCE; "IMPACT OF PAST OIL FIRES ON ATMOSPHERIC RESPIRABLE PARTICULATES IN KUWAIT", AL-SUDAIRAWI ET AL, SUMMARY CL.3, PAGE 134). THIS PRESENTATION REPORTS THAT APPROXIMATELY 2.5 MILLION BARRELS OF CRUDE OIL WERE RELEASED INTO THE ATMOSPHERE BY THE FIRES, GENERATING SOME 1500 TONS OF PARTICULATES. NOTE - 727 WELLS WERE OBSERVED TO BE ABLAZE ON 17 FEBRUARY 1991. THE LAST OF THESE FIRES WERE EXTINGUISHED ON 6 NOVEMBER OF THE SAME YEAR. MAJOR HAZARDS ARE POSED BY PARTICLES LESS THAN 10 MICRONS IN DIAMETER CAPABLE OF DEEP PENETRATION INTO THE RESPIRATORY SYSTEM, THUS INCREASING RISK OF DISEASE. MEASUREMENTS TAKEN AT THREE LOCATIONS IN KUWAIT, INDICATE THAT AS LATE AS MARCH 1993, PARTICLES IN THE HAZARDOUS DIAMETER CATEGORY WERE STILL PRESENT AT LEVELS SIGNIFICANTLY HIGHER THAN PREWAR VALUES. B. (U) CORRELATIONS BETWEEN SMOKE AND ILLNESS - (SOURCE; "THE OIL WELL FIRES OF KUWAIT; RELATIONSHIP BETWEEN OIL SMOKE POLLUTANTS AND ACUTE ILLNESS". AL-OWAISH ET AL, SUMMARY C2.1, PAGE 137). DURING 1991, THE MOST COMMONLY DIAGNOSED CONDITIONS AT KUWAITI PRIMARY HEALTH CARE CLINICS WERE ACUTE RESPIRATORY ILLNESS, HEADACHES, SKIN AND EYE IRRITATIONS. ADDITIONALLY, SYMPTOMS OF RESPIRATORY MORBIDITY WERE NOTED AT LEVELS SIGNIFICANTLY HIGHER IN POSTWAR SAMPLE GROUPS THAN IN A CONTROL GROUP OF UNEXPOSED PERSONNEL DATING FROM 1987. THESE SYMPTOMS VARIED WITH SAMPLE LOCATION AND WERE FOUND TO BE CONSIDERABLY HIGHER IN CHILDREN AGED ONE TO 12 YEARS THAN IN OTHER AGE CATEGORIES. C. (U) SPECIFIC EFFECTS SEEN ON CHILDREN - (SOURCE; "THE EFFECT OF AIR POLLUTION DURING KUWAIT OIL WELL FIRES ON CHILDREN'S CHEST". AL-GHAWABY ET AL, SUMMARY C2.2, PAGE 139). 40 PERCENT OF 4398 PEDIATRIC CASES SEEN AT AL-JARA HOSPITAL FROM AUGUST TO OCTOBER 1991 HAD SOME FORM OF RESPIRATORY DISORDER. THESE DISORDERS AND THOSE MEASURED FROM AUGUST TO OCTOBER 1992 SHOWED STRONG CORRELATION WITH OBSERVED LEVELS OF NITROUS OXIDE, NITROGEN DIOXIDE AND CARBON MONOXIDE CONCENTRATIONS. D. (U) AIR POLLUTION IMPACT ON MORTALITY - (SOURCE; "THE INFERNAL SMOKE; THE IMPACT OF AIR POLLUTION UPON MORTALITY IN KUWAIT". ABDALI ET AL, SUMMARY CLL.1, PAGE 183). DAILY MORTALITY AND DAILY ENVIRONMENTAL MEASUREMENT DATA FROM PREWAR (1989) AND POSTWAR (1992) COMPARISONS INDICATED AN INCREASE OF 58 PERCENT FOR RESPIRATORY DISEASES, 54 PERCENT FOR UNSPECIFIED LUNG DISEASES AND 43 PERCENT FOR HEART FAILURE BETWEEN THE TWO GROUPS. EVIDENCE EXISTS THAT PREVAILING WIND PATTERNS HAVE DECREASED MORTALITY RATES SOMEWHAT. 4. (U) ANECDOTAL INFORMATION - THE FOLLOWING INFORMATION IS NOT BACKED BY HARD EVIDENCE; HOWEVER IT IS SUGGESTIVE OF A HEALTH PROBLEM IN KUWAIT SOMEWHAT BROADER IN SCOPE THAN THAT PRESENTED AT THE CONFERENCE. IN ANY CASE, SOME OF THE HEALTH ISSUES DETAILED IN THIS SECTION MAY EVENTUALLY GAIN ENOUGH SIGNIFICANCE TO FORM THE BASIS FOR EXTENSIONS OF EXISTING CLINICAL RESEARCH PROGRAMS - A. (U) SADAFIYA (SOURCE; THE AL-HARBI RESEARCH GROUP, KUWAIT UNIVERSITY FACULTY OF MEDICINE) - MANY KUWAITI PHYSICIANS HAVE CONTACTED THE AL-HARBI GROUP AND REPORTED AN INCREASE IN PSORIASIS SINCE THE END OF THE WAR. THE RECENT CASES ARE PARTICULARLY SEVERE AND HAVE COME TO BE KNOWN AS "SADAFIYA" (SCALES IN ARABIC). B. (U) BIRTH DEFECTS (SOURCE; DR. MICHEAL ((MCCABE)), DIRECTOR, DEPT. OF MEDICAL LAB TECHNOLOGY, KUWAIT UNIVERSITY FACULTY OF HEALTH SCIENCES). DR. MCCABE RELATES OCCURRENCE OF SEVERAL BIRTH DEFECTS AMONG UNRELATED INDIVIDUALS SINCE THE LIBERATION. IN EACH CASE, THE DEFECT INVOLVES A DEFORMITY RESULTING IN BLOCKAGE OF THE INFANT'S AIR PASSAGE. IN ONE CASE, THE AFFLICTED INDIVIDUAL WAS THE CHILD OF THE FRENCH AMBASSADOR TO KUWAIT. C. (U) MULTIPLE CHEMICAL SENSITIVITY (SOURCE; DR. SABAH ((AL-MUMIN)), PHD., RESEARCH SCIENTIST, BIOTECHNOLOGY DEPT, KUWAIT INSTITUTE FOR SCIENTIFIC RESEARCH (KISR)). DURING THE FIVE DAY PERIOD GIVEN FOR THIS MISSION, ONLY ONE DOCUMENTED CASE OF MCS WAS FOUND. THIS INDIVIDUAL IS THE SISTER OF DR. AL-MUMIN. IT IS PERHAPS SIGNIFICANT THAT SHE SERVED AS AN INTERPRETER AND GUIDE WITH US FORCES DURING THE WAR AND WAS SUBJECTED TO THE SAME TYPES OF ENVIRONMENTAL TOXINS. SHE WAS ADDITIONALLY GIVEN THE VACCINES AND ANTI-NERVE AGENT MEDICATION WHICH ALL US TROOPS WERE REQUIRED TO TAKE. ON 7 APRIL, DURING THE STRATEGY MEETING OF THE AL-HARBI RESEARCH GROUP, DR. AL-MUMIN CLAIMED TO HAVE IDENTIFIED ANOTHER POSSIBLE VICTIM OF MCS, CURRENTLY HOSPITALIZED. IT WAS HER OPINION AT THE TIME THAT THERE MAY BE A LARGE NUMBER OF MCS CASES IN KUWAIT MISDIAGNOSED AS SUFFERING FROM OTHER DISORDERS. D. (U) GENERAL INFORMATION CONCERNING LATENT TOXIC EFFECTS (SOURCE; FATIMA KH. ((ABDALI)), PH.D., KISR) - DR. AHMED ((AS-SHAATI)) OF THE KUWAIT ENVIRONMENTAL PROTECTION DEPARTMENT (EPD) IS CONDUCTING A STUDY ON INDIVIDUALS EXPOSED TO TOXINS DURING THE WAR AND OCCUPATION. 5. (U) OBJECTIVE TWO (CONFERENCE; SUBJECT MATERIAL COVERED AND PRESENTATION GIVEN) - THE INTERNATIONAL CONFERENCE ON THE EFFECTS OF IRAQI AGGRESSION ON THE STATE OF KUWAIT WAS GIVEN FROM 2 TO 6 APRIL 1994 AT THE KUWAIT MERIDIEN HOTEL IN KUWAIT CITY. PARTICIPANTS PRESENTED PAPERS DEALING WITH THREE BROAD CATEGORIES OF DAMAGE SUSTAINED BY THE COUNTRY AS A RESULT OF THE INVASION BY IRAQ IN 1990 AND THE SEVEN MONTH OCCUPATION WHICH FOLLOWED. EACH OF THESE THREE CATEGORIES FORMED THE BASIS FOR A SYMPOSIUM, ALL RUNNING CONCURRENTLY AT THE MERIDIEN. SYMPOSIUM A - POLITICAL AND ECONOMIC CONSEQUENCES. SYMPOSIUM B - PSYCHOLOGICAL AND SOCIAL IMPLICATIONS. SYMPOSIUM C - ENVIRONMENTAL AND HEALTH EFFECTS. THE FOLLOWING OFFICIAL RECORDS OF EACH SYMPOSIUM INCLUDED IN THE CONFERENCE ARE AVAILABLE AS FOLLOWS - A. (U) RECORD OF RESEARCH SUMMARIES - THIS 191 PAGE BOOKLET CONTAINS ABSTRACTS FOR EACH PRESENTATION GIVEN. THE PRESENTATION ON MCS IS NOT INCLUDED IN THIS DOCUMENT DUE TO ITS INCLUSION ONLY FIVE DAYS SHORT OF THE FIRST DAY OF THE CONFERENCE. B. (U) VIDEOTAPE RECORD - EACH SYMPOSIUM WAS FILMED. COPIES MAY BE OBTAINED BY SUBMITTING A WRITTEN REQUEST TO THE FOLLOWING INDIVIDUAL - MR. FAISEL ((AL-HAJI)), UNDERSECRETARY, KUWAIT INFORMATION MINISTRY, BOX 193 SAFAT, CODE 13002, STATE OF KUWAIT. TEL: 011 965 241-5301/242-7141/243-4512. FAX; 011 965 243-4511. C. (U) THE CHAIRMAN OF THE CONFERENCE, DR. IMAD ((AL-ATIQI)), ARRANGED FOR PRESENTATION OF THE MCS ISSUE AS PART OF SYMPOSIUM C ON MONDAY, 4 APRIL. IT SHOULD BE NOTED THAT THE REQUEST THAT THIS BE DONE WAS SUBMITTED TO DR. AL-ATIQI WELL PAST THE DEADLINE FOR APPLICATIONS. IN FACT, THE ENTIRE SCIENTIFIC PROGRAM HAD BEEN ESTABLISHED BY THE TIME THE REQUEST WAS MADE. 6. (U) STRUCTURE OF PRESENTATION - 15 MINUTES WERE ALLOTTED TO EACH SPEAKER AND THE FULL 15 WERE USED FOR THIS PRESENTATION. A SIGNIFICANT PORTION OF THE MCS INFORMATION TO BE PRESENTED WAS BASED ON ANECDOTAL SOURCES AND AS SUCH DID NOT CONSTITUTE SCIENTIFIC DATA PER SE, BUT DUE TO THE POTENTIAL IMPORTANCE OF THE SUBJECT MATERIAL TO THE LONG TERM HEALTH OF THE POPULATION OF KUWAIT, WAS NONETHELESS A VALID SUBJECT FOR PRESENTATION. A GENERAL DESCRIPTION OF HEALTH PROBLEMS EXPERIENCED IN INCREASING FREQUENCY BY A SIGNIFICANT FRACTION OF GULF WAR VETERANS AND DISPLAYED THE 14 MAJOR SYMPTOM CATEGORIES WHICH THEY FELL INTO WAS DISCUSSED. FOLLOWING THIS, THE CORRELATION OF THESE OBSERVATIONS SHOWED WITH CLINICALLY DEFINED MCS PROVIDED A LISTING OF MCS SYMPTOMS FOR COMPARISON. NEXT, DRAWING ON A REPORT TO CONGRESS OF 5 MAY 1993, COVERED A SUMMARY OF TOXIC EXPOSURE (WELL FIRES EXCLUDED) UNIQUE TO MILITARY PERSONNEL, FOLLOWED BY A DESCRIPTION OF SOME OF THE MEDICAL TESTING PERFORMED ON AFFLICTED TROOPS. THE FINAL PORTION OF THE LECTURE WAS A DESCRIPTION OF RESEARCH, INDICATING A POSSIBLE MECHANISM FOR DEVELOPMENT OF MCS INVOLVING IMPAIRMENT OF PRIVATE KINASE ACTIVITY AT LOW SUBSTRATE CONCENTRATIONS. 7. (U) REACTION TO PRESENTATION - CRITICISM WAS EXTREMELY HARSH AND BECAME SOMEWHAT EMOTIONAL. THE FIRST INDIVIDUAL TO COMMENT ON THE LECTURE CONTENT WAS DR. IBRAHIM ((AL-SAYAD)), MD, AN EGYPTIAN NATIONAL EMPLOYED AS A DERMATOLOGIST BY KUWAIT UNIVERSITY FACULTY OF MEDICINE. HE BEGAN BY LISTING ALL HIS DEGREES, HONORARIUMS, POSITIONS AND ASSOCIATIONS THEN REFUTED EVERY CLAIM MADE AND CHASTISED THE MCS PRESENTATION AS UNSCIENTIFIC. TWO OTHER INDIVIDUALS (BOTH SENIOR RESEARCHERS AT KISR) DID APPROXIMATELY THE SAME THING. THE SUBSTANCE OF EACH ARGUMENT SEEMED TO BE THAT (DESPITE EVIDENCE PRESENTED UNCONTESTED IN PREVIOUS PAPERS), NO RESIDUAL HEALTH PROBLEMS DIRECTLY TIED TO TOXIC EXPOSURE EXISTED IN KUWAIT. FINALLY, DR. JASSIM ((AL-HASSAN)) (CURRENTLY AT KUWAIT UNIVERSITY) DELIVERED A FINAL BARRAGE, BASICALLY REPEATING WHAT WAS SAID BY THE OTHER FOUR INDIVIDUALS; HOWEVER, PRIOR TO HIS DIATRIBE, HE STATED THAT HE WAS VERY SYMPATHETIC TO THE PLIGHT FACED BY US VETERANS; HOWEVER, HE WENT ON TO SAY THAT HE DID NOT BELIEVE THAT THE EFFECTS SEEN IN THE US HAD ANYTHING AT ALL TO DO WITH ANYTHING THAT HAPPENED IN KUWAIT AND SUGGESTED THAT A PROJECT INVESTIGATING THIS POSSIBILITY WOULD BE A WASTE OF TIME. FOLLOWING THIS PHILLIPIC, DR. ((AL-HARBI)) ROSE AND DEFENDED THE BASIC CLAIMS OF THE MCS PRESENTATION, CITING EVIDENCE OF HIS OWN THAT MAJOR PROBLEMS TIED TO THE WAR (SUCH AS SADAFIYA) WERE EVIDENT IN KUWAIT AND AT VERY LEAST BORE FURTHER CONSIDERATION AS SUBJECTS FOR RESEARCH. HE WAS JOINED IN THIS DEFENSE BY DR. FATIMA ((AL-ABDALI)), WHO RELATED PERSONAL KNOWLEDGE OF A KUWAITI WITH MCS AND SUGGESTED THAT EVEN IF THE INCIDENCE OF MCS IN KUWAIT WERE NEGLIGIBLE AT PRESENT, THE PROBLEM SEEN IN US VETERANS WAS AMPLE REASON TO SUPPORT A STUDY IN KUWAIT IN ANTICIPATION OF DEVELOPMENT OF LONG TERM RESIDUAL EFFECTS. 7. [ (b)(1) sec 1.3(a)(4) ] ((SOURCE COMMENT) - REPRESENTATIVE OF THIS GROUP IS DR. SALEH AL-HARBI, MD, PHD. EDUCATED AT BOSTON UNIVERSITY, HE HAS SUCCESSFULLY PIONEERED APPLICATIONS OF IMMUNOTHERAPY IN TREATMENT OF AUTOIMMUNE PROBLEMS SUCH AS PSORIASIS. HE IS NONETHELESS DEEPLY RELIGIOUS AND COMMANDS THE RESPECT OF BOTH THE RELIGIOUS AND SECULAR COMMUNITIES IN KUWAIT. HE HAS SUCCESSFULLY ELIMINATED A GREAT DEAL OF CORRUPTION EXISTENT AT KUWAIT UNIVERSITY FACULTY OF MEDICINE AND AS SUCH GAINED ACCOLADES IN THE PRESS AND IS HELD IN HIGH FAVOR BY THE GOVERNMENT. HE HAS BEEN A LEADING PROPONENT OF DEVELOPMENT OF A NATIVE BIOTECHNOLOGY INDUSTRY FOR KUWAIT. FOR EACH INDIVIDUAL CONTACTED, AN INVITATION WAS ISSUED TO THE NIH (NATIONAL INSTITUTES OF HEALTH) MEETING FOR THE PURPOSE OF DEVELOPING A CASE DEFINITION OF GULF WAR SYNDROME). 8. (U) KUWAIT MINISTRY OF HEALTH CONTACTS - A. (U) HEALTH MINISTER, DR. ((AL-FOZAN)) - DR. AL-FOZAN INFORMED SOURCE THAT HE KNEW OF NO HEALTH PROBLEMS AMONG KUWAITIS RESEMBLING THE SYMPTOMS NOTED AMONG US VETS, HOWEVER HE WOULD DO HIS BEST TO SUPPORT THE EFFORT. HE ALSO STATED THAT HE WOULD TRY TO MAKE IT TO THE PRESENTATION AND IF UNABLE TO DO SO WOULD SEND AN UNDERSECRETARY. NO MINISTRY OF HEALTH OFFICIALS WERE IN ATTENDANCE THE NEXT DAY. B. (U) UNDERSECRETARY, DR. EISSA ((AL-KHALISA)) - HE TOO WAS UNAWARE OF ANY TOXIN-RELATED HEALTH PROBLEMS AMONG THE KUWAITI CIVIL POPULATION. NEVERTHELESS, HE SEEMED EXTREMELY RECEPTIVE WHEN IT WAS SUGGESTED THAT THE SYMPTOMS IN US TROOPS MIGHT BE THE EFFECT OF MORE THAN ONE TOXIN, WHICH IF TRUE, WOULD NOT RULE OUT THE POSSIBILITY THAT KUWAITIS MIGHT AT SOME POINT BEGIN SHOWING LATENT EFFECTS THEMSELVES. DR. AL-KHALISA AGREED TO ATTEND THE NIH CONFERENCE AND PLEDGED HIS FULL SUPPORT IN RECRUITMENT OF ASSISTANCE FROM WITHIN THE HEALTH MINISTRY. C. [ (b)(1) sec 1.3(a)(4) ] D. (U) FORMER UNDERSECRETARY, DR. TARIK JUMMA ((AL-YASSIM)) - DR. AL-YASSIM WAS EXTREMELY SYMPATHETIC AND AGREED TO TRY AND ATTEND THE CONFERENCE AT NIH. ALTHOUGH HE WAS NO LONGER EMPLOYED BY THE MINISTRY, AS SUCH, HIS ABILITY TO DIRECTLY INFLUENCE THE EVENTS DISCUSSED WAS LIMITED. NEVERTHELESS HE AGREED THAT THIS WAS IN SOME WAYS AN ADVANTAGES SINCE HE WAS NO LONGER BOUND BY MINISTRY POLICY AND COULD THUS ACT INDEPENDENTLY. E. (U) THE FOLLOWING MINISTRY OFFICIALS WERE UNABLE TO BE CONTACTED - A. [ (b)(1) sec 1.3(a)(4) ] B. [ (b)(1) sec 1.3(a)(4) ] C. [ (b)(1) sec 1.3(a)(4) ] 9. [ (b)(1) sec 1.3(a)(4) ] 10. ((SOURCE COMMENT) - [ (b)(1) sec 1.3(a)(4) ] 11. (U) OTHER SOURCES OF INFORMATION/FUTURE COOPERATION CONTACTED INCLUDED - A. [ (b)(1) sec 1.3(a)(4) ] B. [ (b)(1) sec 1.3(a)(4) ] C. [ (b)(1) sec 1.3(a)(4) ] 12. [ (b)(1) sec 1.3(a)(4) ] 12. ANALYSIS OF RESULTS - DESPITE THE REFLEXIVE LACK OF OPENNESS WITH WHICH THE GOVERNMENT OF KUWAIT CONDUCTS ITS AFFAIRS, THE OFFICIAL CLAIM OF MINISTRY OF HEALTH REGARDING MCS IS BELIEVED TO BE BASICALLY ACCURATE. ((SOURCE COMMENT) - MY EXPERIENCE DURING THE TIME I LIVED IN THE COUNTRY HAS BEEN THAT IF AN ISSUE BECOMES SUFFICIENTLY IMPORTANT TO ENOUGH PEOPLE, THE GOVERNMENT WILL BE UNABLE TO CONTROL POPULAR REACTION TO IT, ALTHOUGH THEY WILL OFTEN TRY). NO MEMBERS OF THE MEDICAL/SCIENTIFIC ESTABLISHMENT WHO WERE SPOKEN TO DURING THE CONFERENCE OFFERED ANY EVIDENCE THAT MCS WAS PRESENT AS ANYTHING MORE THAN A FEW ISOLATED CASES. THE FACT THAT ONE OF THESE CASES WAS EFFECTIVELY A MEMBER OF THE US FORCES IN THE REGION SUGGESTS (ALONG WITH OTHER EVIDENCE) THAT OUR TROOPS WERE EXPOSED TO SOME TOXIN AS PART OF THEIR MILITARY DUTIES. IF MCS WERE PRESENT IN THE SAME PROPORTIONS AMONG KUWAITIS THAT IT HAS APPEARED AMONG US VETERANS, IT WOULD BE IMPOSSIBLE TO CONCEAL. THIS IS NOT TO SAY THAT THE POPULATION OF KUWAIT IS NOT SUFFERING FROM LATENT EFFECTS OF TOXIN EXPOSURE DURING THE WAR. THERE IS CLEARLY AN EFFECT ON RESPIRATORY HEALTH RESULTING FROM THE OIL FIRES AS DESCRIBED EARLIER IN THIS DOCUMENT. BEYOND THIS, THERE ARE A NUMBER OF UNRESEARCHED PHENOMENA SUCH AS "SADAFIYA" AND OTHER ANECDOTAL INFORMATION CONCERNING AILMENTS WHICH MAY OR MAY NOT BE TIED TO THE WAR. 13. [ (b)(1) sec 1.3(a)(4) ] OFFERED A POSSIBLE LINK BETWEEN SYMPTOMS SEEN IN US VETERANS AND THE MARGINALLY REPORTED WAR RELATED HEALTH PROBLEMS OF THE KUWAITIS. IT IS POSSIBLE THAT US TROOPS WERE EXPOSED TO SOME TOXIN DURING ROUTINE OPERATIONS WHICH NORMALLY WOULD HAVE NO EFFECT ON LONG TERM HEALTH. NEVERTHELESS, IN THE PRESENCE OF SOME OTHER ENVIRONMENTAL TOXIN - PERHAPS PRODUCED BY THE BURNING WELLS, A SYNERGISTIC EFFECT TOOK PLACE RESULTING IN GENERAL DETERIORATION OF HEALTH FOR AFFECTED INDIVIDUALS. JUST SUCH AN EFFECT HAS BEEN NOTED IN AUSTRALIAN SUGAR CANE FARMERS EXPOSED CONCURRENTLY TO SEVERAL ORGANIC TOXINS (BUL. ENVIRON. CONTAM. TOXICOL., 1986, 37 - PGS 187-191). IF THIS PROVES TO BE THE CASE, THEN INFORMATION FROM KUWAIT BECOMES EXTREMELY IMPORTANT FOR THE US STUDY SINCE THE SECONDARY TOXIN EXPOSURE ALMOST CERTAINLY WAS FROM A WAR RELATED SOURCE. MOREOVER, SUCH A MECHANISM IMPLIES THE POTENTIAL FOR LONG TERM HEALTH RISKS TO THE POPULATION OF KUWAIT, FOR THERE IS NO WAY OF PREDICTING AT THE PRESENT TIME WHAT LATENT EFFECTS EXPOSURE OF A LARGE NUMBER OF PEOPLE TO THE SECONDARY TOXIN OR TOXINS MAY HAVE; HOWEVER, IF THE KUWAITIS DECIDE TO INITIATE A SERIOUS EFFORT TO IDENTIFY THE CULPRIT COMPOUNDS, THEIR MEDICAL ESTABLISHMENT WOULD BE CONSIDERABLY BETTER PREPARED TO DEAL WITH THE LATENT EFFECTS OF THE TOXINS AS THEY BEGIN TO APPEAR IN THE POPULATION. 13. [ (b)(1) sec 1.3(a)(4) ] A. [ (b)(1) sec 1.3(a)(4) ] B. [ (b)(1) sec 1.3(a)(4) ] C. [ (b)(1) sec 1.3(a)(4) ] D. [ (b)(1) sec 1.3(a)(4) ] E. [ (b)(1) sec 1.3(a)(4) ] F. [ (b)(1) sec 1.3(a)(4) ] G. [ (b)(1) sec 1.3(a)(4) ] H. [ (b)(1) sec 1.3(a)(4) ] I. [ (b)(1) sec 1.3(a)(4) ] J. [ (b)(1) sec 1.3(a)(4) ] X- COMMENTS: ((SOURCE COMMENT) - [ (b)(1) sec 1.3(a)(4) ] X- //IPSP: (U) PG 2520//. //COMSOBJ: (U) 172//. ADMIN PROJ: (U) 202029. INSTR: (U) US NO. PREP: (U) 2-10482. ACQ: (U) FT BELVOIR, VA (941001). DISSEM: (U) FIELD: NONE, SENT TO: NONE. X- WARNING: (U) REPORT CLASSIFIED