Pay Any Price (22 page)

In 2008, Steven Coughlin, an epidemiologist at the Centers for Disease Control in Atlanta, was recruited by the Department of Veterans Affairs (VA) to help run the largest health survey of veterans of Iraq and Afghanistan ever conducted. He jumped at the chance to shape what he hoped would be a comprehensive inquiry into the health effects of modern war. In 2009, the VA's National Health Study for a New Generation of U.S. Veterans was launched with an effort to contact sixty thousand recent veterans. Eventually, more than twenty thousand responded to the survey.

In 2012, while he was reviewing the questions and answers in the data, Coughlin discovered a clear correlation between veterans who said they had been exposed to burn pits in Iraq or Afghanistan and those who said they had recently been to a doctor or medical clinic because of asthma or bronchitis.

The evidence seemed to support a growing belief, among both veterans and health professionals who had studied the issue, that the KBR burn pits had damaged the lungs of American soldiers. Several studies had already revealed that veterans returning from Iraq and Afghanistan had higher rates of asthma and bronchitis than other soldiers who had not served in the war zones, and some health experts saw a link between burn-pit exposure and the higher rates of respiratory diseases. Dr. Anthony Szema, a researcher at Stony Brook University's medical school, found in one study that 6.6 percent of veterans from Long Island who served in Iraq between 2004 and 2007 had contracted new cases of asthma, compared with just 4.4 percent among soldiers who had remained in the United States. “Deployment to Iraq and Afghanistan is associated with new-onset asthma,” his study concluded. In addition, he said that his and other studies found that about 14 percent of veterans who had served in Iraq complained of shortness of breath. Separately, Dr. Robert Miller of Vanderbilt University treated soldiers from Fort Campbell, Kentucky, home of the 101st Airborne Division, and discovered a high rate of constrictive bronchiolitis among troops who had deployed to Iraq. Those findings followed a 2006 internal air force memo, later made public, that concluded that the burn pit at Balad represented “an acute health hazard” for personnel stationed there.

There was also mounting anecdotal evidence that, in addition to the inhalation diseases, alarming numbers of previously healthy veterans were coming home from Iraq with unusual yet dangerous medical conditions. For example, Szema discovered titanium and unusual biomasses in the lungs of several veterans of Iraq who had reported trouble breathing. “My patients shouldn't have lots of metal in their lungs,” said Szema. “They didn't have it when they left for Iraq, but they have it now.” Medical experts began to describe a new disease unique to veterans from Iraq and Afghanistan—“war lung injury.”

Among veterans, war lung injury soon began to take its place alongside post-traumatic stress disorder and traumatic brain injury as one of the signature medical problems of the global war on terror. Independent veterans' groups fielded worried calls from returning soldiers, and, beginning in 2008 and 2009, hundreds of veterans around the United States filed lawsuits against KBR seeking damages for their exposure to the burn pits in Iraq.

But the medical establishment at the Department of Defense and the VA were not yet willing to draw a connection between war lung injury and the KBR burn pits. A 2008 Pentagon study found no significant health risks tied to the burn pits in Iraq, and a 2011 study by the independent nonprofit Institute of Medicine conducted for the VA was inconclusive. Outside medical experts following the issue began to suspect that the medical establishments at the Defense Department and the VA were downplaying the possible connection between burn pits and war lung injury.

Meanwhile, KBR was aggressively fighting back in the courts against the veterans' lawsuits. So by 2012, when Steven Coughlin discovered the connection in the survey data between burn-pit exposure and reports of asthma and bronchitis, the battle lines on the issue were already clearly drawn.

Officially, the Department of Veterans Affairs did not acknowledge any conclusive evidence of a connection, but Coughlin saw that the initial tables prepared by statisticians working on the VA's New Generation survey included data showing a strong correlation. According to Coughlin, that initial analysis was later discarded by VA officials in favor of more general—and much more vague—data. “The tabulated findings obscure rather than highlight important associations,” Coughlin later complained to Congress. He said that his supervisor “told me not to look at data regarding hospitalizations and doctors' visits.”

Coughlin was furious. With a doctorate from Johns Hopkins and a long career in epidemiology, he was professionally offended. But more importantly, he believed that his superiors at the VA were purposely trying to hide the evidence of the link to burn pits, just as hundreds, if not thousands, of veterans were coming home and reporting that they were getting sick. “It downplayed any connection,” he said. “It was very obvious.”

To Coughlin, it seemed to be a replay of the way in which an earlier generation of bureaucrats had turned a blind eye to the evidence of the health effects of Agent Orange among veterans returning from the Vietnam War. And it also appeared to be similar to the way the Pentagon's medical establishment had initially expressed skepticism that Gulf War syndrome was a legitimate medical condition, not just some sort of mental-health mirage. In fact, Szema, Coughlin, and other experts were beginning to view war lung injury as the Iraq war's equivalent of Gulf War syndrome—but the VA and the Pentagon didn't want to admit it.

Coughlin came to believe that the Department of Veterans Affairs had an inherent conflict of interest that hobbled its ability to conduct honest research. The VA was charged not only with conducting research on medical conditions afflicting veterans but also with paying the benefits to veterans who suffered from those conditions. Whenever VA researchers discovered a new health problem, the VA had to pay out more money. The VA thus had an incentive not to discover new illnesses among veterans.

For Coughlin, the VA's suppression of the evidence on burn pits came after he had already been engaged in a running battle with his supervisors over survey data related to suicides among veterans. In addition to his role on the survey of Iraq and Afghanistan veterans, Coughlin had also been assigned to a 2012 follow-up health survey of Gulf War veterans. The VA was trying to track the health of a large group of Gulf War veterans over long periods of time, and since the veterans had not been surveyed since 2004, Coughlin decided to check the VA's rolls to see how many from the group had died since they were last contacted.

What he found was disturbing: Many of the veterans who had said in the 2004 survey that they had been thinking of killing themselves were now dead. The VA had not conducted any follow-up with the veterans who had expressed suicidal thoughts in 2004, and had not referred them to mental health professionals. The VA had simply taken their responses and filed them away.

Coughlin told his supervisors at the VA what he had found. He said that he wanted to report his findings from the 2004 survey and include new procedures for follow-up interviews by mental health professionals with any veterans who expressed suicidal thoughts in the New Generation survey and in the 2012 follow-up of the Gulf War survey. He was told to drop the matter, not to report it. His supervisor also initially refused to include mental health follow-up calls in the new surveys. Coughlin contacted the VA's inspector general to complain. That action forced his superiors to agree to the change, but it also meant that his relationship with them became turbulent. And that was before he discovered that the data on burn pits was being suppressed.

A series of e-mails and internal memos provided by Coughlin document Coughlin's deteriorating relationship with his supervisors in the VA's office of postdeployment health, including a formal written reprimand for insubordination. Coughlin was under so much stress that he began to grind his teeth intensely and eventually shattered one. Finally, Coughlin had had enough. He decided to resign from the VA in December 2012.

In January 2013, under pressure from veterans' groups, President Obama signed legislation requiring the VA to create a burn-pit registry to help track military personnel and veterans who were exposed to the pits while they were deployed. It remains unclear how the VA will use the registry, and whether the department will be forced to alter its skeptical position. Coughlin said that his superiors inside the VA were privately opposed to the creation of the registry because they did not believe it was necessary.

Just as the burn-pit data was being suppressed in the New Generation survey, KBR was winning its own counterattack against veterans who claimed that they had gotten sick because of the company's burn pits. In February 2013, a federal judge in Maryland dismissed a consolidated class-action lawsuit brought by veterans against KBR. The judge ruled that since KBR was working on behalf of the government, it could not be held liable for the effects of its war-zone operations. Whether the survey data suppressed by the VA could have helped the veterans in their case against KBR is uncertain. But it seems possible that if the Department of Veterans Affairs had issued a report officially identifying a connection between KBR's burn pits and the mounting illnesses among veterans, it could have had a powerful legal impact.

On March 13, 2013, Coughlin went public and testified to Congress. He told the House Veterans' Affairs Subcommittee on Oversight and Investigations that the VA's Office of Public Health had repeatedly engaged in unethical research practices. “On the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible,” he testified. Coughlin's congressional testimony finally forced the issue out into the open, prompting the VA to launch its own internal investigation into his allegations of data suppression. The VA, Coughlin says, is reluctant “to release information that veterans, outside researchers, and policymakers need to know.”

On March 16, three days after Coughlin's testimony, Timothy Lowery, fifty-one, who had been healthy before spending three years in Iraq working as a plumber for KBR, died of amyotrophic lateral sclerosis, also known as Lou Gehrig's disease. His son, Dylan Lowery, said that before he died, his father told him he believed that he had been poisoned by working in Iraq.

(In 2014, House staffers said that they had been told by VA officials that their internal review had confirmed some of Coughlin's allegations, including the fact that VA personnel failed to follow up on some veterans who had admitted to suicidal thoughts during a study of Gulf War veterans, and that there was retaliation against Coughlin for attempting to address problems with several VA studies.)

 

Burn pits were just one of many problems that plagued KBR as a result of its work in Iraq and Afghanistan.

On the night of January 2, 2008, Cheryl Harris answered the door of her home in suburban Pittsburgh and saw an army chaplain accompanied by two noncommissioned officers. She trembled. Her twin sons were both serving in Iraq, and she knew this visit meant grim news. It turned out that one of her sons, Army Staff Sgt. Ryan Maseth, a Green Beret, had died in Iraq that day.

But Harris could not get straight answers about what exactly had happened to her son. Many grieving parents in her situation would defer to the military, but Harris wasn't satisfied. She kept asking questions and kept digging, refusing to be ignored by the Pentagon bureaucracy. Her persistence eventually helped to uncover one of the biggest safety hazards American troops faced in the Iraq war.

Ryan Maseth was electrocuted while taking a shower in his quarters in Baghdad. The army wanted to treat it as a random and unavoidable accident in the midst of a combat zone, and at first, army officials gave Cheryl Harris a version of events that suggested that her son was to blame for his own death. They told her that Maseth had taken an electric appliance into the shower with him and had been electrocuted as a result. Later, they changed the story and said that loose electrical wiring hanging down around the shower killed him.

In fact, neither story was true. Cheryl Harris kept digging. Eventually, the trail led to KBR, the defense contractor responsible for maintenance and repair at the building where Maseth had been housed. There was evidence that KBR had failed to adequately update and ground the electrical wiring in the facility, work that it had been contracted to perform. Thanks to Cheryl Harris's digging, the army finally launched a probe into her son's death, and an army criminal special agent handling the investigation in Iraq later told her that Maseth's official cause of death was being listed as negligent homicide, rather than accidental. The army special agent told Harris that investigators had received credible information that the negligence of KBR and two of its supervisors had led to Maseth's death. An army criminal investigator also told Harris that on the night after Maseth's death, officials from both KBR and the Defense Contract Management Agency, the Pentagon unit responsible for supervising contractors in Iraq, were in Maseth's bathroom arguing and blaming each other for Maseth's death.

 

In a December 16, 2008, e-mail to Harris, Amber Wojnar, the army special agent, told Harris that she had just sent in a report “titling two KBR supervisors and KBR itself for the offense of negligent homicide. . . . I believe there is credible information that their negligence led to Ryan's death. I believe they failed to ensure that work was being done by qualified electricians and plumbers, and to inspect the work that was being conducted.”

But the army never pressed criminal charges against KBR or any of its supervisors. The idea of charging the Iraq war's largest contractor with negligent homicide evidently did not get very far once the army investigative report made its way to Washington. In 2009, more than a year after Maseth's death, officials from the army's Criminal Investigations Command met with Harris in Pittsburgh and told her that Maseth's cause of death was being changed back from negligent homicide to accidental death. As she was leaving the meeting, one of the army officials told Harris that, “if she wanted justice, she would have to go to court” herself, Harris recalled.