For America and her allies, the Gulf War was close to casualty-free.

Of the 697,000 American troops in the Gulf theater, fewer than 200 were killed in action.

That was during the war.

But after the last SCUD missile was fired, thousands of soldiers started complaining about the effects of their service. They felt sick.

Savannahian Chris Ondriezek was one of those vets.

Polite and soft-spoken, Ondriezek is proud to have been part of the Army 7th Corps, which helped clear a path for troops coming behind it. Mostly, he spent his four months in the Gulf driving, pulling guard duty and blowing up left-behind Iraqi artillery.

He was 27 then and recently divorced. Now he's 37, remarried and back in civilian life in the city where he grew up.

The tidy mobile home he shares with his wife and 4-year-old daughter off Quacco Road is crammed with photos of Ondriezek dressed in green camouflage against a sandy background, smiling at the camera. A small American flag that went everywhere he did in Iraq and Saudi hangs framed by the front door.

He'd do it over again in a minute, he says, but he's convinced that something over there made him sick. Maybe it was exposure to chemicals when America blew up an Iraqi weapons depot. Maybe vaccines.

Ondriezek's back hurts. He gets migraines. He's developed a Jekyll and Hyde personality that got him fired from his last job, his 12th since he left the Army in October 1991.

"I don't dream anymore," he said. "I don't know what happened. I don't know what I lost, but I lost something."

Sherri Craig's story is a common one, too. The 42-year-old Hinesville special-ed teacher and mother of two spent eight months in the Gulf. As a quartermaster officer, she traveled from the desert to town, buying supplies for the 724th Support Battalion out of Fort Stewart.

Even though she felt the ground shake from SCUD missile hits, she never felt in immediate danger. The worst part was spending her first Christmas ever away from her parents.

But now she's certain her joint pain, memory problems and a peculiar burning in her stomach are related to something she encountered in the Gulf -- the near-constant smoke from burning oil wells or the anti-chemical warfare pill called pyridostigmine bromide she had to take even though word among the troops was that the drug wasn't FDA approved. In fact, the drug was approved, but for a different use -- the treatment of a neuromuscular disease called myasthenia gravis. Troops were given PB in the hope of moderating the effects of nerve agents.

"If you didn't take it, you were in violation of a direct order," she said.

Ondriezek and Craig may never know why they feel sick.

Ten years after the war, the only consensus about Gulf War syndrome is there's no consensus.

The U.S. government has spent $155 million on the question. Scores of researchers have looked at dozens of possible causes. And the research isn't confined to the United States -- British, French, Czech, Saudi, Canadian, Norwegian and Kuwaiti troops are among those that have reported chronic illnesses with symptoms similar to those of American Gulf War veterans.

But you won't find "Gulf War Syndrome" as a diagnosis in most medical texts.

Distinguished review panels including the National Institutes of Health, the Presidential Advisory Committee and the Special Investigative Unit have concluded the illnesses observed in Gulf War veterans don't constitute a unique disease.

An expert committee at the non-governmental Institute of Medicine only put a point under the question mark. The panel culled through 1,000 published studies of occupational, clinical and terrorist exposure to agents considered suspects in Gulf War Syndrome.

Its conclusion, announced in September, was a colossal shoulder shrug.

"When it comes to the long-term health effects of these substances, the bottom line is that we simply don't know enough to say whether there is a connection between exposure to these agents, or combinations of these agents, and specific health outcomes that remain long after the exposure," the chair of the committee, Dr. Harold C. Sox Jr., said at a news conference in Washington.

That conclusion doesn't mean some Gulf War veterans aren't sick.

"The data indicates that although there's real illness (among Gulf War vets) there's no unique disease that affects all Gulf War veterans," said Dr. Emily Foster, a staff physician at the Ralph H. Johnson VA Medical Center in Charleston. "Studies suggest there's no single cause or underlying disease."

But the common symptoms of what's now called Gulf War Illnesses -- including headaches, fatigue, joint pain, memory lapses -- are more common among Gulf War vets.

"There's no question the studies have shown Gulf War veterans suffer symptoms two-three times more frequently than service members not deployed to the Gulf," Foster said.

Veterans see their own experience as clear evidence.

Ondriezek and Craig both explain their illnesses this way: They weren't sick, they went to the Gulf, they got sick.

But where vets see cause and effect, researchers demand more proof.

And that's the source of a lot of frustration.

Researcher Katie Lucas, who's part of a Johns Hopkins University study of Gulf War Illnesses, recognizes that.

"I think a big part of the problem is communication," she said. "No one has told (vets) the process of what scientists have to be shown before they'll believe something."

Hurried doctors and VA bureaucracy don't help either.

"When you go to the doctor, either private or VA, doctors don't have enough time to sit down and say, 'You're sick but I don't know what you have. It's a puzzle we're trying to figure out.' "

Instead, some vets get the same treatment as Ondriezek, who said for some of his complaints he's been tossed a bag of Motrin and told to get on his way.

Or Craig. She's had stomach pain for years, but only this week was seen at the VA medical center in Charleston.

"If you go to the clinic here (in Savannah) they'll see you, but I don't think they know what to do. I think they're putting a Band-Aid on it." Craig said.

Foster said she does treat the symptoms, so Gulf War vets can get relief even if they never know why they feel sick.

Veterans' advocates would like to see a lot more of that.

The Department of Veterans Affairs keeps a clinical database called the Gulf War registry for vets who believe they have an illness connected to their service. Vets undergo a physical before they're placed on the registry, Foster said. About 550 of those physicals have been done at VA Medical Center in Charleston, the closest VA hospital to Savannah.

Nationwide, 81,000 vets are in the registry, but only about 3,000 vets have had claims for undiagnosed illness approved.

Ondriezek and Craig are on the registry. But Ondriezek's not really sure what's happening with his disability claim and feels frustrated by the apathy and bureaucracy.

Pat Eddington sympathizes.

Eddington runs the National Gulf War Resource Center, a suburban Washington, D.C.-based nonprofit that educates and lobbies for better healthcare for Gulf War veterans.

"The bottom line is that an awful lot of Gulf War veterans are being hosed by the VA when they file Gulf War Illness claims," Eddington said.

His organization contends that there are flaws in many of the studies that find no evidence of Gulf War Illnesses, that the Pentagon has hindered researchers by refusing to release information about what substances soldiers were exposed to, and that treatment is too low a research priority.

"We're concerned with making sure ill vets are compensated and above that, making sure that people get the right treatments," Eddington said.

So Ondriezek and Craig wait.

Foster treats what she can.

Eddington lobbies.

And the research continues.

One good thing may have come from the Gulf War experience, according to Lucas.

"If there's a lesson that's been learned for the military it's how when they think of their enemies it's not just the Saddam Husseins," she said. "They have to think about the environmental things that can affect the troops."

Health reporter Mary Landers can be reached at 652-0337 or landers@s...

Investigate further

The American Legion site offers a comprehensive, easy-to-read question and answer page about Gulf War Illness at www.legion.org/gulftoc.htm

The National Gulf War Resource Center, a nonprofit that lobbies for better healthcare for Gulf War veterans, operates a site at www.ngwrc.org

The full text of an Institute of Medicine study called "Gulf War and Health: Volume 1. Depleted Uranium, Pyridostigmine Bromide, Sarin, and Vaccines" can be found at http://books.nap.edu/catalog/9953.html

Other post-war syndromes

The Gulf War isn't the first conflict to spawn suspected illness among soldiers.

A 1996 study reported in the well-respected Annals of Internal Medicine took a historical look at post-war syndromes.

After the Civil War, soldiers complained of "irritable heart" -- symptoms included shortness of breath, chest pain, fatigue, headache, diarrhea, dizziness and disturbed sleep.

In World War I similar symptoms were called "soldier's heart" or "effort syndrome" because symptoms were made worse by exertion.

The explanation at the beginning of the war was that soldiers' heavy marching packs compressed their chests.

In World War II the effort syndrome was attributed to psychological causes. But its physical manifestations -- fatigue, diarrhea, headache and forgetfulness -- were acknowledged.

After Vietnam, veterans were diagnosed with post-traumatic stress disorder -- again with similar symptoms. That disorder was initially called post-Vietnam syndrome.

Exposure to Agent Orange was another concern, one over which scientific controversy continues. Chronic physical symptoms have generally not been linked to the effects of exposure to that herbicide in Vietnam, the researchers wrote.

They concluded that although war syndromes have recurred since at least the Civil War, no single underlying cause unrelated to stress links the syndromes.

They also noted that research into these syndromes is hampered by poor record-keeping during wartime, media coverage afterward and the need to rely on soldiers' memory of events.

Resources for Gulf War vets

* Researchers at Johns Hopkins University are looking for study participants who have fatigue and at least two other symptoms that began after their Gulf War service. Service in the Gulf must have been on the ground. Travel expenses will be paid to and from Johns Hopkins Hospital in Baltimore. For participants not well enough to travel alone, expenses for a travel companion are also covered. Participants will receive a $100 stipend. Active duty service members participating will receive $50 per blood draw; one draw per participant is anticipated.

Interested veterans can call (877) 800-9516 or check the Web site at
www.med.jhu.edu/gws for more information.

* Veterans who think they have a Gulf War-related illness can get a full physical exam from the Veteran's Administration. Call (843) 577-5011 ext. 7300 for an appointment in Savannah or Charleston.

* A Gulf War veterans' information help line is operated by the Department of  Veterans Affairs at 800-749-8387.

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