The New Statesman Special Report - Who cares for the Gulf war veterans?
Alexandra O'Brien Monday 5th February 2001
The results of war service for Britain include suicide, prison and chronic illness.
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By Alexandra O'Brien

Delia McShane's son, James, was 21 years old when he went to the Gulf as a full-time soldier with the 1st Royal Highland Fusiliers. "When he went," she says, "he was young, and in the best of health; he had beautiful teeth, was very helpful, loved acclaim." Now, she says, he has completely changed.

His teeth and gums are rotting and he cakes them in Bonjela to relieve the pain; his skin is a yellow, pallid colour; his eyes and cheeks are sunken; and he has a large lump on his shoulder which is growing unchecked. But when he first returned from the Gulf and felt unwell, local doctors told him that it was all in his head, and Delia was told that she should "go away". One GP said to her: "Your son is quite, quite mad . . . and I can't help him."

Now his mental state is such that he won't have the lump tested; he is so ashamed of his physical and mental state that he seeks medical care only to get painkillers for the unbearable aches in his legs. The tragedy and the waste have left Delia feeling suicidal. "I feel that God gave me big shoulders to carry a lot of weight, but the load is getting too heavy for me." James's sister Angela adds: "He was always very outgoing and he returned very withdrawn. I used to be very close to James, but the Gulf really changed him. He's very aggressive and irritable now. I love him, but I don't like him any more."

Trisha Holt (not her real name) is a 36-year-old ex-nurse who served with the 205 General Hospital in Riyadh. On her return, she says, "I went crazy and hit the drink; I couldn't adjust to being home; it took me a month to collect my daughter from a friend". In 1994, Trisha's son was born with a hernia problem and bags hanging from his ears (known as skin tags), which are common among the children of Gulf war veterans. He is in good health now, but bringing up children is hard work for anyone, let alone a woman whose self-esteem has been obliterated, partly because of her inability to work. Trisha spends most of her days in bed because of chronic fatigue. She has tried to commit suicide several times.

Roseanne Gallagher and her husband, John, also served at the 205 Hospital, as combat medical technicians. Both complain of multi-symptomatic illnesses; Roseanne has cancer and has endured a hysterectomy and double mastectomy. She says: "I bled constantly for the three months while I was out there." She claims that women in her unit were instructed not to conceive for six months after their return from the region. Her doctor recently told her she has a 20 per cent chance of living out the next five years. Visibly in agony, she rarely leaves her home or her immediate family's homes because "I feel like a freak". All the muscles and many of the lymph nodes around her shoulder area have been removed, and she can only slightly lift up her left arm. John also endures great pain and restricted mobility, but has to work on the roads seven days a week to keep the roof over their heads.

John Callaghan suffered anxiety, depression, post-traumatic stress disorder and debilitating physical symptoms on his return from the Gulf. Before being sent there, he found drugs abhorrent and he rarely drank. In early 1996, he was charged on drug offences and, that night in the police station, he tried to hang himself. The police noted he was a suicide risk on their records.

John was found guilty and sentenced to two years in a Manchester prison. He entered the prison with medication and a letter from Chris Jones, a consultant forensic psychiatrist, explaining that his illness required treatment. Despite this, according to his father, the prison called in a doctor who insisted that there was nothing abnormal about him and changed his medication.

John was put in the prison healthcare centre which, according to Sir David Ramsbotham, the chief inspector of prisons, is a place where prisoners, if highly distressed, "would be observed and if they were suicidal they would be put on a suicide watch". Ramsbotham added: "A psychiatrist would be arranged to do a clinical assessment and it would then be decided if the prisoner should be transferred to a prison with appropriate psychiatric care or, indeed, removed altogether and put into the care of the NHS."

Nothing like that happened in the case of John Callaghan. He killed himself in the healthcare centre. His father says that "they provided inadequate care and did not have the appropriate expertise". Now his mother, completely consumed by grief, suffers from anorexia and panic attacks. She has also lost her job.

James McShane, Trisha Holt and her son, the Gallaghers and John Callaghan all suffer or suffered from the multi- symptomatic condition known as Gulf war syndrome or, more commonly now, Gulf war illness. Nobody knows the cause: vaccinations, pesticides and DEET (an insect repellent), chemical and biological weapons, depleted uranium and oil, smoke, fuels and solvents have all been blamed.

Even the existence of the illness is questioned. Are the 53,000 Gulf war veterans (those who served in the region between 1 September 1990 and 30 June 1991) more likely to fall ill or die prematurely than other people of comparable age? The Ministry of Defence, on the advice of the Medical Research Council, commissioned a mortality report, carried out by researchers at the University of Manchester. It found that, between 1 April 1991 and 31 March 1999, 395 veterans died. The number of deaths in a control group was 378. The MoD report stated that the "5 per cent overall excess in Gulf veterans' mortality was considered to be very small by the study team and not statistically significant". But by 20 July 2000, at least another 57 veterans had died.

According to Alun Jones, a psychiatrist who cares for veterans of military campaigns: "Every campaign has its own characteristics. But in the mid-1990s, I began to see something quite different. I was seeing men who weren't just traumatised, but who were ill as well."

He has seen between 400 and 500 Gulf vets since then. By 1999, 3,149 Gulf veterans had voluntarily presented themselves to the medical assessment programme that the MoD belatedly set up in 1993 to assess the psychiatric and physical conditions of veterans. Many were sent away with diagnoses of post-traumatic stress disorder (PTSD) and were told that their physical conditions stemmed from this. The term PTSD was first used during the early 1980s to describe what some Vietnam veterans were suffering. Common characteristics include: hyper-alertness, high anxiety, nightmares, flashbacks and distressing memories.

Some veterans are undoubtedly suffering PTSD as a result of their horrific experiences during the conflict (particularly those in the Warrior tanks who were subjected to, and virtually incinerated by, depleted uranium shells from US helicopter gunships; and those who witnessed the carnage on Basra Road). But Jones disputes any suggestion that this should be the main diagnosis. The catalogue of symptoms that Gulf veterans suffer is shockingly long: immune suppression, chronic fatigue syndrome, irritable bowel syndrome, muscular aches, joint stiffness, memory loss, deteriorating eyesight, deteriorating hearing, rotting gums and teeth, breathlessness/asthma, heart murmurs, skin rashes, diarrhoea, insomnia, cancer, leukaemia, lymph node fibrosis, paranoia, anxiety and uninhibited violence represent an incomplete list. A comprehensive report on these illnesses, presented to the defence select committee of MPs in December 1999 by Malcolm Hooper, emeritus professor of medicinal chemistry at the University of Sunderland, was titled "The Most Toxic War in Western Military History".

Some of these illnesses started soon after Gulf veterans returned from the region. They have increased in ferocity and those left to care for them are under mounting pressure: many of the veterans have been or are drinking heavily, are addicted to various forms of drugs or are on the brink of suicide. At least 200 veterans have been imprisoned since the war ended, often as a result of actions completely at odds with their characters prior to going to the Gulf. When mothers ring Jones seeking help, they often say: "My son's never come back from the Gulf."

As well as childbearing problems and child deformities, a less commonly known effect of the illness is "burning semen". It literally burns women, so sex is avoided. One woman would not have sex with her husband for 18 months on his return; since then, he has threatened to set her on fire, beaten her up on several occasions and held a meat cleaver to her neck. Another veteran kicked his wife out because, he thought, "something was wrong with her". Others accuse their partners of having affairs.

The causes of death for the 452 who have died so far (the Gulf Veterans Association claims the actual figure is 467) include 64 cancers, 13 diseases of the digestive and respiratory system, and 57 diseases of the circulatory system. There are also 83 who died due to "suicide and injury undetermined whether accidental". This does not include those who died under highly suspicious circumstances, including 15 lost to "submersions/suffocations/foreign bodies", seven who died due to accidental falls, nine who perished after accidental poisoning and 31 who died after other accidents. There is no accompanying explanation for the circumstances of these deaths, which may well, according to the Countess of Mar, the patron of the Gulf Veterans Association, have been intentionally fatal mishaps. "There's a traditional attitude," she says, "that suicide is not good. Coroners would prefer to bend over backwards to find a reason other than suicide." She believes that the MoD, engaged in damage limitation, is ignoring the suicide rate.

So, ten years after the Gulf war, veterans are still looking for answers and assistance to help alleviate their suffering. This does not suggest a good prognosis for the treatment of those who served in the Balkans war and who now believe they are suffering from exposure to depleted uranium. At this stage, it seems that the main political parties are more concerned with the plight of hunted foxes than with the veterans and those who care for them.