Protecting Those Who Serve: Strategies to Protect the Health of Deployed U.S. Forces.

摘要

The 670,000 service members deployed in 1990-1991 to Southwest Asia for Operations Desert Shield and Desert Storm (the Gulf War) were different from the troops deployed in previous similar operations: they were more ethnically diverse, there were more women and more parents, and more activated members of the Reserves and National Guard were uprooted from civilian jobs. The overwhelming victory that they achieved in the Gulf War has been shadowed by subsequent concerns about the long-term health status of those who served. Various constituencies, including a significant number of veterans, speculate that unidentified risk factors led to chronic, medically unexplained illnesses, and these constituencies challenge the depth of the military's commitment to protect the health of deployed troops. Recognizing the seriousness of these concerns, the U.S. Department of Defense (DoD) has sought assistance over the past decade from numerous expert panels to examine these issues (DoD, 1994; National Institutes of Health Technology Workshop Panel, 1994; IOM, 1996 a, b, 1997; Presidential Advisory Committee on Gulf War Veterans' Illnesses, 1996). Although DoD has generally concurred in the findings of these committees, few concrete changes have been made at the field level. The most important recommendations remain unimplemented, despite the compelling rationale for urgent action. A Presidential Review Directive for the National Science and Technology Council to develop an interagency plan to address health preparedness for future deployments led to a 1998 report titled A National Obligation (National Science and Technology Council, 1998). Like earlier reports, it outlines a comprehensive program that can be used to meet that obligation, but there has been little progress toward implementation of the program.