The myth of the malingerer

Observations on Gulf war syndrome

It is not just sufferers from Gulf war syndrome who may have cause to be grateful to Lord Lloyd, whose independent and privately funded inquiry has concluded that the condition should be recognised as genuine. So may those who suffer myalgic encephalomyelitis (ME), chronic fatigue syndrome (CFS) and organophosphate poisoning (sheep-dip syndrome). All these have clinical similarities to Gulf war syndrome, all have been politically controversial, and all are claimed to be psychosomatic. They have been termed "illness-beliefs" by a psychiatric lobby that has had undue influence over government thinking.

Gulf war syndrome goes back to 1991 when, before setting off for the first war against Saddam Hussein, troops received 14 vaccines within two days, plus NAPS tablets - an antidote to nerve toxins chemically similar to organophosphates - and anti-malarials. Pertussis (whooping cough) and anthrax vaccines should not have been given together, but they were. In the Gulf itself, troops were exposed to sarin, depleted uranium, pesticides (more organophosphates), carcinogenic and metal-rich oil drops, often without protective clothing. Of the troops, 10 per cent became ill; 10 per cent of those have died.

Their symptoms included chronic fatigue, debilitating joint and muscle pains, depression, memory loss, insomnia, sexual dysfunction, kidney damage, cancer and birth defects. But encouraged by precedent from the Boer war - which labelled such complaints "post-combat syndrome", with the inference that it was all in the mind and those affected were in some way morally inferior - successive governments refused to recognise the condition. UK soldiers who fell ill said they were made to feel like the enemy, while in the US, troops similarly affected were called malingerers and liars.

Research into these illnesses has been biased by the government's wish-belief that Gulf war syndrome does not exist. In the US, researchers have had funding withdrawn and work blocked. The reprehensibly poor medical records in the Gulf were a serious obstacle to research.

But as well as Lloyd's report, we have a prestigious US report that rubbishes the "stress" theories and identifies multiple low-level toxins as capable of damaging nervous and immune systems. The US scientist Robert Haley, whose work on toxins has now been confirmed by others, has shown damage to basal ganglia brain cells and to autonomic nerve cells in sufferers with Gulf war syndrome. The poisoning potential of pesticides, nerve gas and "protective" tablets - nerve toxins all - seems to be additive. We now need reliable diagnostic tests. The jury is still out on the part played by depleted uranium in causing cancers and other illnesses. Much work remains to be done. Too much time has been wasted on psychological theories. But no longer can any establishment hide behind ignorance and denial. After 13 years of denigration and humiliation, the psychiatric hold over Gulf war syndrome has been destroyed. Research into that condition will hopefully dispel the mysteries surrounding the related conditions of ME, CFS and chemical poisoning.

This article first appeared in the 29 November 2004 issue of the New Statesman, Would you buy a car that looked like this?