DEPARTMENT OF DEFENSE - CONGRESSIONALLY DIRECTED MEDICAL RESEARCH PROGRAMS

Posted March 31, 2023

Dr. Girija Kaimal, Drexel University

Dr. Kaimal Dr. Girija Kaimal (Photo Provided)

After Iraq invaded Kuwait on August 2, 1990, a military intervention by a United Nations-authorized coalition of forces led by the United States commenced, resulting in the first Gulf War. Many of the nearly 700,000 American Service Members who served in the 1990-1991 Gulf War developed chronic health symptoms that could not be explained by established medical diagnoses or standard laboratory tests.1 These symptoms included widespread pain, muscle aches, headaches, persistent problems with memory and thinking, fatigue, breathing problems, and digestive issues. Accompanying these physical challenges were changes in behavior and mood, as well as challenges in interpersonal relationships. This cluster of symptoms is referred to as Gulf War illness (GWI) and is estimated to have affected up to 250,000 Veterans of the Gulf War. According to a National Academies of Sciences report from 2016, when these Veterans sought health care for various undiagnosed medical concerns, they were often dismissed or told “it was all in their heads.”2

To further understand the perspectives of individuals living with GWI with respect to the impact of their illness, differences in their experiences related to health care, gender, barriers faced, and the related impact on interpersonal relationships and quality of life, the Gulf War Illness Research Program (GWIRP) released a Qualitative Research Award (QRA) in fiscal year 2017 (FY17). As defined in the FY17 QRA funding opportunity announcement, “qualitative research is a form of social inquiry that seeks to understand the human experience by exploring how people interpret and make sense of their experiences and the world in which they live.” The intent of the QRA was to support qualitative research that seeks to understand the experiences, perceptions, barriers, and beliefs of Veterans suffering from GWI and those responsible for their care.

One of the FY17 QRA awards, made to Drexel University and led by Dr. Girija Kaimal, aims to understand the human experience of Gulf War Veterans suffering from GWI and seeks to specifically address their perceptions and experiences with respect to symptoms of physical health, cognitive functioning, quality of life, and the quality of care they received. To gather this information, Dr. Kaimal and her team interviewed 40 Gulf War Veterans to obtain their perspectives about life with GWI and their health care experiences. In addition, Dr. Kaimal’s team interviewed 10 health care providers across the U.S. regarding their experiences with Veterans with GWI and asked what resources would be helpful for treating those with GWI. This study is one of the first systematic investigations to highlight Veterans’ voices and perspectives on living with the symptoms of GWI. Through the course of the study, half of the Veterans interviewed emphasized that they feel as though their health care needs have not been adequately addressed.

The primary outcome of the project is the development of an online educational resource for health care providers to convey the perspectives and lived experiences of Veterans living with GWI to their providers. The educational materials are available on Dr. Kaimal’s webpage and are linked on the GWIRP website under “GWIRP Supported Initiatives.” Veterans can send their providers the web address or bring the website link with them to their appointments, where they can review key points with their providers and provide an educational resource for those unfamiliar with the challenges faced by patients with GWI. The course features units on the Gulf War, the physiological and psychosocial impact of GWI on Veterans, perspectives from health care providers, and intervention research on GWI. The educational materials also contain art collage responses based on what participating Veterans discussed and their experience with GWI.

“We hope this resource will improve awareness and education, let the Veterans’ perspectives be heard and understood, and, importantly, aid in the personalized health care received by patients suffering with GWI,” Dr. Kaimal said.

In addition to finding the course on Dr. Kaimal’s website, the web link can also be found on the CDMRP GWIRP website.


References:

1Institute of Medicine (U.S.) Committee to Review the Health Consequences of Service During the Persian Gulf War. 1995. Health Consequences of Service During the Persian Gulf War: Initial Findings and Recommendations for Immediate Action. Washington, DC. National Academies Press. (https://www.ncbi.nlm.nih.gov/books/NBK232147).

2National Academies of Sciences, Engineering, and Medicine. 2016. Gulf War and Health: Volume 10: Update of Health Effects of Serving in the Gulf War, 2016. Washington, DC: The National Academies Press. Page 11 (https://doi.org/10.17226/21840).

Links:

Dr. Kaimal’s website (https://drexel.edu/cnhp/research/faculty/KaimalGirija/gulf-war-illness/)

CDMRP GWIRP website, "GWIRP-Supported Initiatives" (https://cdmrp.health.mil/gwirp/default#SuppInit)

Public and Technical Abstracts: Veterans with Gulf War Illness: Understanding the Spectrum of Experiences Related to Aging and Demographics on CDMRP website

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Last updated Friday, March 31, 2023