What's killing Staff Sergeant Wesley Black?
The VA doesn't want to talk about it

By Brianna Keilar and Catherine Valentine
March 6, 2020

  Washington (CNN)"I'm not bullshitting you when I say the conversation went like this: 'Hi Wesley, I just wanted to call and see how you're doing. Are you alone this weekend?'" retired Staff Sergeant Wesley Black said, describing the call he received three years ago from his doctor.
  "'No, my wife is here,'" he answered.
  "'Great, OK good, because we wanted to let you know you have stage four colon cancer, and we'll be in touch with you Monday, OK? Have a good weekend.'"


  Black was 31 years old and had recently begun a new career as a firefighter. His wife had just given birth to their baby boy. Days before, they had signed the mortgage on their first home.
  The colon cancer had spread to his liver and lungs and Black says doctors gave him three to five years to live. That was three years and one month ago.
  Later, he learned burn pits used by the military to destroy trash in Iraq and Afghanistan, where Black had served in the Vermont National Guard, were to blame.

What is a burn pit?
  Ask any veteran of the Iraq or Afghanistan wars what went into the burn pits, and they'll tell you: everything. Food, human waste, tourniquets, bloody gloves, cans of paint, plastic water bottles, unexploded ordnance, batteries, tires, big screen televisions, mini-fridges, Kindle E-readers and entire humvees, too damaged by IEDs to salvage.
  They would add diesel and jet fuel, both known carcinogens, and light the trash piles on fire. At times, they burned around the clock, churning out acrid, black smoke.
  At one base in Afghanistan, soldiers saw the entire fuselage of a Soviet-built Afghan airplane smoldering as they jogged along a burn pit on their daily run.
  Veterans repeatedly describe choking air wafting through their sometimes makeshift barracks as the wind shifted.
  Eighty-six percent of post-9/11 veterans who served in Iraq or Afghanistan say they were exposed to burn pits, according to the most recent survey by the nonprofit Iraq and Afghanistan Veterans of America.
  Wesley Black estimates the burn pit at his base in Ramadi, Iraq, was five football fields in size, but it was far from the biggest one the US military operated.
  At the height of these wars at least 230 burn pits were in operation, according to the Government Accountability Office.
  In eastern Afghanistan, Black served on a combat outpost with a burn pit located just 150 feet from the front gate.
  "If you were the unfortunate sucker who got tasked to stand gate guard that night to watch the control point, then guess what you breathed all night long," he said.
  "We would get blinding tears, your nose would start running, you'd get that weird sensation in the back of your throat, you'd get a cough going, but you're charged with watching the front gate - you can't go anywhere. You're breathing this shit in for 8-12 hours at a time." 

General Petraeus sounds the alarm
  Retired General David Petraeus is sounding the alarm about burn pit exposure.
  "We did raise concerns about this at the time. It was pretty clear that the fumes from these burn pits were potentially serious in their effects over time," Petraeus told CNN. He served in Iraq for four years, including as commander of the coalition during the Surge. Later, as commander of US Central Command, he oversaw the war in Afghanistan. He subsequently commanded coalition forces in Afghanistan for over a year.
  "The challenge was, of course, that we were at war. While this was a concern, we were more concerned with enemies that were trying to kill us and our partner forces."
  Petraeus was part of a successful effort last year to get Congress to require the Defense Department to collect data on burn pit exposure so that the Veterans Affairs Department can cross reference that data with a registry of service members exposed to toxins.
  The VA must now use that information in periodic health assessments of veterans.
  If a veteran's health problems are tied to burn pit exposure during service, they can file for full disability compensation from the VA, as Black has done, but often the data to support claims is incomplete.
  The VA refused to answer specific questions about how burn pit data is collected and analyzed and how the exposure affects service-related illnesses.
  The VA declined multiple interview requests from CNN, instead providing links to old press releases, explanations of how to file a disability claim or appeal a denial, and a list of mostly non-VA research projects on respiratory disorders, including some on unrelated topics like sleep apnea and the effects of cigarette smoking.
  None of the research appeared to address cancer related to burn pit exposure.
  Officially, the VA denies that burn pit exposure is harmful.
  "At this time, research does not show evidence of long-term health problems from exposure to burn pits," the 
VA website states.

Getting answers
  During a House Appropriations committee hearing Wednesday, VA chiefs were asked directly about their medical coverage for burn pit exposure.
  "We've got 50,000 veterans that have registered for the Burn Pit Registry," said Dr. Richard Stone, the executive in charge of the Veterans Health Administration. "A very small number have come to us for care. They need to come in so we can fully understand the scope of this problem."
  "We won't turn them away," VA Secretary Robert Wilkie added.
  But Wesley Black's name is on the Burn Pit Registry.
  Before his terminal diagnosis, he complained to VA providers about his severe digestive issues for about four years.
  "I kept getting told, 'oh, it's [Irritable Bowel Syndrome], or it's Crohn's disease, or you need to change your diet,'" Black said.
  He was prescribed a topical itch cream for his rectal bleeding but no tests were performed until it was too late.
  It was an oncologist outside the VA system who finally linked his colon cancer to burn pit exposure.

Learning from the past
  Petraeus says the country needs to learn from its past so it doesn't fail what he calls "The New Greatest Generation," the 2.7 million men and women who have served in America's all-volunteer military since 9/11.
  "This issue could be for Iraq and Afghanistan veterans what Agent Orange exposure was for Vietnam veterans," the retired general observed, likening burn pits to the toxic chemical deployed by the US to kill the trees and vegetation used for food or cover by enemy forces in Southeast Asia.
  Many Vietnam war veterans are still unaware that the medical conditions they suffer from may be related to their exposure to Agent Orange.
  Petraeus watched both his mentor, General Jack Galvin, and his father-in-law, General Bill Knowlton, die from Parkinson's disease believed to be linked to their exposure to Agent Orange during multiple tours in Vietnam.
  "We've been slow coming to the understanding of what a problem this is," Petraeus said. "But this is a very important part of health of the force, and it's taken us too long to recognize even the potential implications of this."
  Soldiers like Wesley Black don't expect to die young from disease.
  "When I signed my name on the contract at 18," he said, "I fully expected to come home in a box wrapped in a flag. I was not expecting to come home alive."
  He lost friends in both wars.
  His best friend died in his arms in Afghanistan.
  "When I came home, the survivor of two intense combat deployments, I was like I'm on easy street. I'm going to live the rest of my life chasing my wife and kid around." Black said.
  He's working a full time job as a firefighter and getting chemotherapy every other week, trying to provide for his family and maximize the days he has left with them.
  "Every day I wake up, my feet hit the floor," he said, "and I do what I have to do."

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Military: Burn pits could cause long-term damage to troops

By Adam Levine,
CNN Pentagon Producer
December 18, 2009 

  Washington (CNN) -- The military is backing off its previous position and acknowledging that some troops exposed to the burning of refuse on military bases could be susceptible to long-term health effects.
  Since the issue first arose two years ago, Pentagon health officials have insisted that, based on its analysis, troops who were near burn pits at Joint Base Balad in Iraq -- the largest base in that country -- faced no long-term health hazards. That covered most of the troops who passed through the base.
  The Department of Defense found that the burn pits, which are used instead of incinerators on some bases and outposts in Iraq and Afghanistan, could cause effects in the short term -- including irritated eyes and upper respiratory system problems -- that can lead to persistent coughing. But the department said "it is less clear what other longer-term health effects [there] may be."
  But one of the top military health officials, Dr. Craig Postlewaite, signaled in a recent interview with the Salt Lake Tribune that certain troops, who have other medical conditions, may be at risk for long-term effects.
  "Over time, we have come to recognize that certain individuals may be more susceptible to the effects of burn-pit smoke than others because of genetics and pre-existing health conditions and that some of these personnel may be at risk of more serious health effects following prolonged smoke exposure, and possibility to other inhalational exposures, such as tobacco smoke and possibly high levels of air borne particulate matter," Postlewaite said this week in a statement provided to CNN.
  The military now suspects that exposure to burn-pit smoke combined with other factors -- such as smoking, proximity to the pit, certain genetic factors or pre-existing conditions -- could lead to longer-term effects.
  After an outcry from veterans concerned that burn-pit exposure was not being acknowledged by the 
Department of Defense and Veterans Affairs, both agencies have begun a larger study of troops to determine what other health effects there could be.
  Service members have complained of symptoms ranging from chronic bronchitis, asthma, sleep apnea, chronic coughs and allergy-like symptoms to more severe issues including heart problems, lymphoma and leukemia.
  A senior master sergeant with the Air Force, who did not want his name used because he is still in service, said that he now has a growth on his lungs and that his doctors think the burn pits were a contributing cause.
  He deployed to Iraq in October 2004 and worked there for six months as a contract supervisor for the Army. His daily routine included driving past the burn pits at Balad as he ferried Iraqi contractors around the massive base.
  As he drove by, the master sergeant could see the refuse being burned, from trash to concrete to sides of tin buildings and sheet metal.
  "You just held your breath, because if you breathed, it would burn," he told CNN in a phone interview.
  He slept about a mile from the pit, but, depending on the winds, the burning could create a "fog" over his compound.
  "You could tell when the trash was burning," he said. "You could smell if it was really heavy and feel it burning in your nostrils and lungs."
  The master sergeant was in good health before he left for Iraq. Earlier in his military career, he had worked with hazardous materials, but a predeployment scan in 2004 showed his lungs were in fine shape.
  In 2006, after finding he would get easily winded and feel discomfort in his chest, the sergeant underwent testing, and a military doctor discovered a nodule on his lungs. A biopsy showed it was benign, but he needs to be tested every year. His doctors are concerned that his family history of cancer makes him more susceptible to further problems.
  But his case illustrates just how difficult it is to link symptoms to cause.
  As he said, he had worked with hazardous materials before he deployed. After Iraq, he was stationed in Naples, Italy, where the base also had trash disposal problems. Still, he knows that his lungs were clear before he was in Balad and that within a year of returning, he had the growth.
  The Disabled American Veterans organization has been keeping a database of troops who report problems related to the pit. In one year, nearly 500 service members or their families have come forward, said the DAV's John Wilson.
  That registry is "very narrow," Wilson said, because it relies on self-reporting. Rep. Tim Bishop, D-New York, has proposed legislation to have the Defense Department and Veterans Affairs create a registry of all service members exposed in Iraq and Afghanistan. Congress already passed legislation, which the president signed, to prohibit the use of burn pits for hazardous waste unless there is no alternative.
  A study that compared Iraq veterans with those who served stateside found that those who were in Iraq were diagnosed with new-onset adult asthma at twice the rate of stateside troops.
  The head of the allergy section of the Veterans Affairs Medical Center in North Port, New York, told Congress that since 2004, he has clearly seen an effect on previously healthy and athletic service members.
  "Now these individuals suffer from a variety of respiratory illness, including asthma and difficulty breathing during exertion," Dr. Anthony Szema told a policy hearing in November.
  That's what happened to Reservist Michelle Franco, who was a nurse at Balad from September 2006 through January 2007.
  "What I saw was the smoke. What I felt was the smoke. What I smelled was the smoke," Franco said of her time at Balad. After she left, she started having breathing problems.
  "When I came back, I couldn't climb stairs without problems breathing," she said. Tests by pulmonologists found asthma-like conditions, but her condition wasn't asthma. A private doctor and a military one told her it probably was caused by exposure to contaminants in Iraq.
  Getting that diagnosis was a struggle for her. When she returned, burn pit exposure was not a recognized issue. She was told to lose weight, which she did, and it didn't help. She also exercised regularly and said she took all types of medicine, but medications didn't help, either.
  As a nurse, Franco knew that she didn't just have asthma. But she said others may not realize they have greater problems.
  "Because nobody knows, it seems to me the military member needs to be given the benefit of the doubt. I feel badly for the young men who don't understand this isn't asthma," Franco said.
  Franco has had to prove to the military that her service caused her illness.
  The military is trying to help that by better recording where people served, according to a Pentagon spokeswoman. Before 2006, at best, the records showed what country people served in. Now they can be tracked to the "ZIP code," the spokeswoman said.