The war that never ended

Paul Ash spent weeks on the front line in the Gulf war. He was 22, married, outgoing, popular with his mates. Paul and his comrades in the Fusiliers had gone to Saudi Arabia "full of pride" to bring down Saddam Hussein. They had trained for weeks; they were keen for action. The possibility that their worst nightmare might come true, that they might be attacked by chemical or biological weapons, did not shake their resolve.

More than 50,000 British servicemen were immunised against attacks. The Gulf war was supremely modern, yet looming over it was the spectre of anthrax, mustard gas and bubonic plague.

Five years on, thousands of British and American soldiers who served in the Gulf claim they are living through another nightmare, one they were never prepared for: Gulf war syndrome, the mysterious condition whose symptoms vary from motor neurone disease and cancer to a skin rash. Paul Ash has become listless, moody, aggressive and withdrawn.

The syndrome has apparently blighted the lives of 740 ex-service personnel. Those who believe in the condition say 15 have died from it. Recently, it appears to be affecting the children of servicemen - many have been born with deformities.

After three years of pressure from the victims, the Government announced yesterday that it would support an investigation into the syndrome. For the veterans it was better late than never. But why has it taken the Government so long to take seriously an affliction that has devastated the lives of so many? Is it healthy scepticism about the causes of the condition, or has there been a cynical attempt to silence the campaign and avoid tarnishing the legacy of the war?

After every war there are hundreds of servicemen who suffer from trauma and psychological illnesses. Within any large group of people some premature deaths would be normal. Yet according to Gulf war syndrome campaigners, something more sinister began to appear once the soldiers got back to normal life. At first, a handful reported cases of nausea, diarrhoea, breathing difficulties. Then the list began to grow and the condition worsened.

The Government refused to accept the possibility that the syndrome existed until yesterday. Nicholas Soames, the armed forces minister, was insisting last year that the veterans' claims were "a mixture of unsubstantiated rumour [and] incorrect information", a claim repeated by John Major.

For sufferers, the Government response has been viewed with something more profound than disappointment. Campaigners saw it as squarely within the MoD's tradition of disregarding the plight of hundreds of individuals who had risked their lives for their country. Paul Ash is bitter: "The MoD are too frightened to say that the Gulf war wasn't a success because it poisoned its own troops."

The contrast with the way that the United States has dealt with victims is stark. American experts stress the mysterious nature of the illness as much as their British counterparts, yet in the US pounds 54m has been ploughed into research into the condition that has affected more than 10,000 of the 700,000 US troops who served in the Gulf. The Clinton administration also agreed to compensate victims while further investigations were undertaken into their illnesses.

According to Colonel Terry English, controller of welfare for the Royal British Legion, the US was anxious from the outset to be sensitive to the fate of its returning heroes. "The Ministry of Defence was very reluctant to recognise this condition. They said the original numbers affected fell within the amount you would expect to fall ill from that size of population. Part of the American response is in their culture. They are still very aware of the problems they faced over the treatment of veterans after Vietnam, and they are determined to get this right."

Although the announcement of yesterday's inquiry, which will work in tandem with American research, was welcomed by the veterans, most remain cynical of the Government's role. Many believe that the Government's hand was forced by the recent focus on the 60 affected offspring of the victims. These children, little more than two years old, blighted by deformities, respiratory infections and skin problems, have begun to capture the nation's sympathy.

Sarah Whitehead's husband, Paul, served in the Royal Engineers, one of the first units into Kuwait. Two and a half years ago she gave birth to Ben. His left arm, shoulder and hand is much smaller than the right side, and he has severely deformed fingers and hands.

"Nobody likes to see children suffering. That's what really pulls at people's heartstrings. For soldiers, it's different. They're expected to put themselves at risk, whether it's fair or not. But when the public sees these tiny, smiling faces still in the puppy dog bracket, they respond - and the Government cannot ignore that," Mrs Whitehead says.

It is still only the beginning of the battle facing the veterans. The inquiry's initial focus will be on whether the abnormalities in babies are disproportionately high among the children of veterans. That task alone may take more than a year.

If the inquiry establishes that there is an unusually high number of birth defects, there will be an examination of its likely causes. Yet even if the syndrome's existence were proven, that does not mean the veterans will win compensation. That would be the end of a long tradition for the MoD. The department has always fiercely resisted paying compensation: most famously, it refused to compensate victims of nuclear tests who were exposed to radiation.

So even the inquiry set up yesterday is just another stage in a long legal battle for the victims. For the families, the most troubling issue is not the compensation. "What we really want to know is what the future holds for us. Until something is done, we will never know where this syndrome might be leading for Ben," Mrs Whitehead says.

"Already in the United States research has shown children developing cancer. We want to know what to expect, where Ben might be when he reaches six or seven. We want an explanation, and just some idea of what tomorrow might hold for us."

Gulf war: the background

THE EVIDENCE

740 Britons who served in the Gulf reported "mystery illnesses"; 15 are dead. In the general population, 1 per cent of babies suffer birth defects. In the UK, of 740 soldiers pursuing claims, 60 (7 per cent) reported defects in their children. More than 10,000 US veterans are affected, with 300 cases of birth defects.

THE SUSPECTS

Naps tablets (Nerve Agent Pre-treatment Sets) to protect against nerve gas are the most likely cause of the syndrome. The Commons defence committee found the testing of these tablets inadequate. French troops not given tablets and there are no reported cases in France. The US, UK, Norway and Canada prescribed Naps to their troops - in all these countries there have been reported cases of Gulf war syndrome.

Bats tablets (Biological Agent Treatment Sets). Anti-biological warfare tablets. Troops had to take one every six hours.

Injections: 11 administered for diseases such as bubonic plague, anthrax, yellow fever, meningitis, whooping cough, polio, typhoid, tetanus. Administered together rather than staggered over several weeks. The defence committee concluded this was dangerous.

Pesticides: exposure to powerful pesticides to control sand flies and scorpions.

Toxic smoke: from exposure to burning oil wells.

Fall-out: from the bombing of Iraqi nuclear, chemical and germ warfare plants.

Shells: exposure to blasts from uranium-tipped shells.

Poison gas: Iraq may have used gas in attacks. Gulf troops may have been exposed to as many as 21 powerful toxins.

THE SYMPTOMS

Psychological: heightened aggression and depression, post-traumatic stress disorder, chronic fatigue syndrome.

Minor organic disorders: bleeding gums, hair loss, blackouts/memory loss, mouth ulcers, minor skin complaints, poor eyesight/photophobia, nausea, blisters, irritable bowel syndrome.

Major organic disorders: kidney disorders, arthritis, motor-neurone disease, leukaemia.

In babies of veterans: vital organs missing, skulls too small for brains, limb deformities, heart defects, still-births.

TREATMENT THEORIES

Antibiotics: simultaneous inoculation of soldiers with different vaccines may have permanently damaged their immune systems. Dr Howard Urnovitz, Californian microbiologist, urges use of antibiotic dioxycycline, developed to treat immune deficiency in HIV cases.

Detoxification: exposure to toxic gases and Naps treatment. Robert Lake, British veteran, was sent by the Army Benevolent Fund to a detoxification clinic in Texas, and is now recovering.

THE AMERICAN RESPONSE

Congress has funded a pounds 54m programme of medical assessments. The study involves two sets of 15,000 soldiers. All were immunised and took Naps tablets, but one set were never deployed in the Gulf. This will be followed by an intensive study of 1,000 members of each group.

COMPENSATION

UK: Of the 417 British veterans who underwent an independent medical when they applied for a war pension, 216 were awarded pensions as they had identifiable diseases, not Gulf war syndrome. But if GWS is a weakening of the immune system, these diseases may be the result of that. The solicitors handling British claims, Donn & Co, have some 800 cases pending.

US Legislation was passed in 1994 to allow compensation to be paid to veterans of the Gulf war, despite the absence of firm proof that a syndrome exists. In the US, sufferers are so convinced that chemical weapons might have contributed to their illness that they are mounting a $1bn lawsuit against a consortium of chemical companies.

Tiffanie Darke