This year marks the 25th anniversary of the Persian Gulf War.
It was fought in late 1990 through early 1991 by a U.S.-led coalition of 34 countries against Iraq in response to Saddam Hussein's invasion of Kuwait.
It also was the first U.S. war to be waged after the advent of the 24-hour cable television news cycle.
The conflict was accompanied by memorably intense and round-the-clock coverage on CNN.
But there've been few recognitions of the war's 25-year milestone on the cable news networks, let alone in broadcast or print media.
For David Winnett, a Gulf War combat veteran who climbed the ranks from private to captain during his 20-year career in the U.S. Marines, it's just the latest in a succession of insults to the men and women who served in this largely forgotten war.
"It's no surprise that many people could easily forget 'our war.' It was far too fast by any historical measure," Winnett told Healthline. "Perhaps things would be different had we continued our advance all the way to Baghdad, but the fact is, we didn't. So regardless of whether or not we think our war has been unfairly set aside in the history books, it is what it is."
While ground combat in the Persian Gulf War only lasted days, Winnett said, the toxic legacy of the war has been just as devastating for the postwar health of Gulf War veterans as the defoliant Agent Orange has been for those who served in Vietnam.
Winnett is just one of hundreds of thousands of Gulf War vets who suffer from Gulf War Illness (GWI), also known as Gulf War Syndrome, the panoply of chronic and often debilitating symptoms reported by veterans of that conflict.
The acute symptoms, which for many veterans never go away, include extreme fatigue, neurological issues, insomnia, migraines, joint pain, persistent coughing, gastrointestinal issues such as diarrhea and constipation, skin problems, dizziness, respiratory disorders, and memory problems.
The National Academy of Sciences estimates that as many as 250,000 of the 700,000 U.S. troops who served in the Persian Gulf War have been affected by GWI, which studies have shown is the result of a litany of toxic exposures that troops like Winnett endured while serving.
Troops were exposed to toxic smoke from the fires of thousands of military burn pits in the war zone. The fires involved tires and other things that contain harmful chemicals.
There was also sarin and other toxic chemicals dropped on U.S. troops.
Two peer reviewed scientific research studies released in 2012 concluded that weather patterns carried massive toxic chemical cloud that fell on U.S. troops. The cloud was created by the U.S. bombing of Iraqi chemical weapon storage facilities
The first study concluded that nerve and blister agents, which were supplied to Iraq by the U.S. before the Gulf War when Hussein was an uncomfortable ally, were bombed by U.S. forces. The toxic substances were swept into the atmosphere and subsequently dropped on U.S. troops.
The second study confirmed the number of GWI reports was in fact higher at the places where the sarin fell.
"Our peer reviewed scientific findings bring us full circle by confirming what most soldiers believed when they heard the nerve gas alarms. The alarms were caused by sarin fallout from our bombing of Iraqi weapons sites," James Tuite, who led the first study, said in a statement.
The VA's Position
Despite the scientific evidence and a mandate from Congress that Department of Veterans Affairs (VA) recognize several of the symptoms as connected to service in the Gulf War, the VA maintains that there are no definitive scientific studies that link symptoms and diseases associated with GWI to toxic exposures during the war.
According to a 2015 report, about 80 percent of Gulf War veterans who file disability claims citing presumptive chronic multisymptom illnesses connected to toxic exposures are denied by the VA.
A written statement from the VA's Post-Deployment Health Services team to Healthline stated that in the past few years the VA has "ramped up educational efforts to VA providers on Gulf War Illness." However, the statement read, "there are times when referral to a psychiatrist is indicated due to a co-morbid condition such as severe depression or another severe mental health condition."
In another email to Healthline, VA officials said a claim could be denied for a number of reasons, including the belief an ailment was caused by something other than military service or the ailment could be "less than 10 percent disabling."
Most often, say multiple sources for this story, veterans who say they have these symptoms are sent to the psychiatric departments of VA centers, where they are typically given psychotropic drugs that don't help them, and in many cases make things worse.
The VA acknowledges the following in a statement on its website: "Rockets filled with sarin and cyclosporine mixes were found at a munitions storage depot in Khamisiyah, Iraq, that had been demolished by U.S. service members following the 1991 Gulf War cease-fire. An undetermined amount of these chemicals was released into the atmosphere. The Department of Defense concluded about 100,000 Gulf War Veterans could have been exposed to low levels of these nerve agents."
The VA also adds that "research doesn't show long-term neurological problems from exposure to low levels of sarin. A low level of sarin is an amount that doesn't cause noticeable symptoms during the exposure."
Regarding the burn pits, a VA statement on its burn pits registry page reads, "At this time, research does not show evidence of long-term health problems from exposure to burn pits."
Did the Gulf War Cause Cancer, Too?
Benjamin Krause is a Gulf War veteran who went to law school after he retired from the military, and dedicates his practice to helping his fellow veterans.
He told Healthline that burn pit exposures are associated with an increasing number of diseases, including cancer.
"There's growing evidence showing a link between burn pits and certain cancers like pancreatic cancer, for example," Krause said. "VA is working to create a registry to help with service connection and health benefits for these veterans, but history has shown us that such initiatives take much longer to perfect while sick veterans die."
Compounding the problem, Krause said, are non-VA healthcare providers who are simply unaware of the health risks of military service.
"They don't ask the right questions and risk deadly misdiagnosis of symptoms because of a lack of awareness of the harms of burn pits, among other things," Krause noted. "Veterans are getting sick and dying now. We need our VA to pick up the pace before more veterans get sick and die from burn pit exposure related illnesses."
Congress Steps In
Anthony Hardie, a staff sergeant in the Army who served in combat deployments in the Gulf War and Somalia, has worked for years to get laws passed that set the framework for Gulf War veterans' healthcare, research, and disability benefits.
The director of Veterans for Common Sense and chair of the programmatic panel of directors for the Gulf War Illness Research Program, Hardie's work with fellow veteran advocates on both sides of the aisle led to the passage of the Persian Gulf War Veterans Act of 1998 and the Veterans Programs Enhancement Act of 1998.
Hardie told Healthline that these laws gave Gulf War veterans hope for new treatments and recognition by the VA that their persistent symptoms were related to their service.
"But when veterans suffering from Gulf War Illness walk through the door at VA centers and clinics in 2016," he said, "there are still no evidence-based treatments for them. And most of them are just shuffled off to psychiatric care."
Winnett added that while Congress deemed three symptoms to be "presumptive" to service in the Gulf War, the VA continues to largely ignore that.
"The most widely reported symptoms of Gulf War Illness are profound fatigue, excruciating bodywide muscle pain, and chronic GI problems," said Winnett. "The VA, despite its own regulations that are supposed to give the benefit of the doubt to veterans with symptoms considered 'presumptive' to service in the Persian Gulf War, instead continue as an organization to view Gulf War Illness as a psychosomatic illness."
Winnett explained that if a veteran can't get their symptoms rated as service-connected, "their chance of receiving medical care relative to their symptoms is slim to none. This is a national tragedy of the highest order."
Reasons for Optimism
Despite the frustrations, every veteran advocate interviewed for this story said there is reason for optimism.
For one thing, Congress recently decided to continue funding GWI treatment research at $20 million for the next year.
"[This] is just what we asked for," said Hardie. "It shows that Congress continues to take Gulf War veterans' health issues far more seriously than the Department of Defense or the VA."
In addition to the two House hearings earlier this year, the Senate has also taken up the GWI issue.
Last month, Sen. Tammy Baldwin, a Democrat from Wisconsin, announced that reforms and investments she fought for to improve veterans' care were passed by the Senate as a part of the fiscal year 2017 Military Construction and Veterans Affairs funding bill.
Among Baldwin's priorities stated in the bill is "better treatment for veterans suffering from Gulf War Illness."
Baldwin's provisions, which have received virtually no media coverage, would "improve the approval rates of veterans' disability claims; enhance ongoing studies and research into the causes of and treatments for Gulf War Illness; and strengthen the membership and work of the Research Advisory Committee, which oversees the government's research agenda."
A spokesperson for the VA told Healthline, "The Department of Veterans Affairs is currently working on responding directly to Senator Baldwin, and will include relevant post-deployment health information."
Promising New Science
The science surrounding GWI also continues to progress.
Two major, four-year, $5 million treatment development research projects at Nova Southeastern University and Boston University are about halfway completed and are expected to break new ground for possible GWI treatment recommendations.
And while there are no evidence-based treatments yet for GWI, some natural supplements have been shown in studies to effectively lessen some of the symptoms.
Researchers at the University of California, San Diego, concluded a few years ago that 19 of the most common GWI symptoms improved after taking supplements.
"We found in our research that there was significant benefit to the veterans' physical function," Beatrice Golomb, professor of medicine at the school and principal investigator on the study, told the Bergmann & Moore veterans law firm. "And that is a huge issue with these veterans, whose physical functions often decline. Some of them used to run 20 miles. Now they can't jog a couple of blocks."
About 80 percent of veterans with GWI who took coenzyme Q10 (CoQ10) saw improved physical function, and the improvement correlated to higher levels of CoQ10 found in the blood, according to research published in Neural Computation.
"This is not a cure, but we think maybe if we give the veterans more of a mitochondrial cocktail they will see an even greater benefit," Golomb said.
Forgotten After 9/11
Winnett said he felt a "moral obligation" to help his fellow vets after making a 2008 trip to Washington for a VA hearing on Gulf War veterans' health.
"I was taken aback by the physical condition of the veterans I saw there," Winnett recalled. "I was older than most Gulf War veterans because I had 16 years of service under my belt when the war began. In Washington, I saw veterans in their 40s who couldn't walk without assistance. Some were in wheelchairs."
Winnett said that after 9/11, many people in America, including legislators, just forgot about the fact that many thousands of 1991 veterans were sick.
"We moved on as a country following 9/11 to more pressing matters," he said. "I would guess that Korean War veterans experienced a similar phenomenon as the Vietnam War ramped up in the mid 1960s. There comes a time when you're no longer the flavor of the day."
Thomas Bandzul, an attorney and veterans advocate who's testified numerous times before Congress on Gulf War health issues, said the American public to this day simply does not have a good understanding of the effects the Gulf War had on the troops.
"The VA has downplayed the significance of Gulf War Illness and has successfully delayed the research that help veterans with their physical ailments," Bandzul said. "VA still refuses to treat or allow these veterans a disability claim. The unspecific term of 'general illness' is still applied to most Gulf War veterans, and their claims are usually denied. This callous and capricious manner in dealing with veterans is a shame."
Veterans Have Each Other's Backs
But what stands out most among the Gulf War veterans who agreed to talk to Healthline for this piece is their relentless support of each other.
Last year, Larry Cockrell, a combat veteran who served with the 7th Marines in Task Force Ripper during the first Gulf War, was rated 100 percent disabled by the VA and retired from a successful career as an investigator for several Fortune 500 companies.
Cockrell has several serious health issues as a result of his service, but he's dedicated his life to assisting his fellow combat veterans as well as their families on their ranch in Lake Mathews in Southern California.
"We assist combat veterans with file claims or file disagreements with VA," he told Healthline. "Honestly, the Gulf War was forgotten when the parades ended. We fought the largest tank battles, birched the largest minefields, and injected our troops with experimental vaccines, all while fighting on the most contaminated battlefield in the history of warfare."
Cockrell said "everyone dropped the ball" when Gulf War veterans came home and could not get the healthcare they needed. But he said he has gotten new strength and has never felt a stronger sense of purpose than he does now by helping his fellow veterans on his ranch.
"We love having the spouses and partners here enjoying the ambience and horses and giving their kids rides," he said. "Ironically, I've only had a few veterans jump on a horse and ride. But as Winston Churchill once said, 'the outside of a horse is good for the inside of a man.' Just being around them assists veterans. It's a given that our health issues are not going to get better as we get older. It's time to give these combat veterans a 100 percent disability rating and a chance to manage their disabilities."
By Jamie Reno