“It Isn’t Always Fun.” – The Guns of Viéques
Une Cause Célèbre
For 60 years the U.S. Navy has used the eastern tip of the Puerto Rican island of Viéques as a scene for war games, land, sea, and air exercises involving heavy bombings and simulations. For whatever reason, this military practice has become a cause célèbre for activists in Puerto Rico and worldwide. Congressman Robert Kennedy Jr. just missed the birth of his xth child this week while serving a jail term for trespass on the property of his own navy in Viéques. He is in the company of Mrs. Jesse Jackson and the Rev. Al Sharpton, among others.
President Bush, concerned over plaints of these celebrated activists and presumably his Hispanic constituency as well, has called on the Centers for Disease Control and Prevention to respond by analyses of potential health effects of the games. While continuing longer-term measurements of noise, air, and water pollution on the island, CDC recently has addressed a specific health claim about “vibroacoustic disease.” This purported syndrome of heart valve damage and pericardial thickening, with cognitive changes, etc. is thought linked to noise exposure, as described in the aircraft industry by a Portuguese industrial physician, Dr. Nuno Castelo Branco, and recently taken up as a health cause by his Puerto Rican colleagues. CDC entered this fray in the context of the political activism around the health, death rates, and cardiac damage claims for Viéques island compared to mainland Puerto Rico.
Last week I was among a group of U.S. and Hispanic medical experts (politically correctly chosen and paid zero honoraria by the U.S. Government) called by the White House and CDC to examine indirect evidence that the Navy’s war games and bombing of the little island of Viéques are associated with this “vibroacoustic disease.” First off, some of us reviewed a previously unpublished report by Castelo Blanco that kicked off the current issue by its claims of cardiac damage or thickened pericardial lining of the heart. He found the latter in 96 percent of a sample of 50 Viéques citizens (those volunteers, it turned out, who more loudly insisted on being sampled for the study) versus none among unmatched mainland controls. We found that report seriously and incorrigibly flawed. [Without further consideration here of the study’s unacceptable methods, analysis, or conclusions, one is reminded that The Creator rarely reveals His secrets in such an overwhelming and near-perfect (95 percent) demonstration.]
Competent investigators on Puerto Rico’s southern coast, however, responded to the challenge of the activists by designing a more appropriate comparison: of licensed fishermen of Viéques versus Ponce (on the mainland), The Viéques Heart Study. This new study assumed different exposures of the fishermen groups to the Navy’s sonic booms, and we met together in San Juan on July 12-13, 2001, to review it. The research was carried out independently under the dean of Ponce Medical School, Prof. Manuel Martinez-Maldonado and his colleagues, who posed a less ambitious specific hypothesis: that differences exist in pericardial thickness measured by echocardiography among a sample of Viéques fishermen (close by the bombings) compared to Ponce mainland-based (distant) fishermen.
No noise exposure measurements were made available to the investigators but it is common knowledge in the area that fishing is better the closer one gets to the sonic booms. Apparently fish flee the vibrations, so that during actual war games Viéques fishermen tend to crowd the limits of the hazardous zone set by the U.S. Navy. There may be as many as 800 sonic booms in a 3-day marine maneuver. Large-pressure-amplitude (> 90 db), low-frequency (<500 Hz) vibrations are the range purported to cause tissue damage in animals and people. Measurements by the Navy itself of the noise composition, frequency, duration, and amplitude, and of human exposures to the bombings, are not made public, other than the Navy’s acknowledgment that its noisy games exceed EPA legal limits.
Mr. Bush, and Mr. Clinton before him, ordered extensive tests of the air, water, and soil of Viéques purportedly to understand and protect the local citizens (and presumably to anticipate their possible health claims in legal suits). A CDC engineer told us that, so far, “no toxic concentrations” were found. Photographs of the bombed area I saw suggest almost total ecological devastation, however, with generations of rusting war toys lying about.
Bush has declared that the Navy’s war games must be closed down by the year 2003. This, in turn, has incited the fury of Puerto Ricans for not stopping the bombings at once and, on the other hand, of our own Pentagon leaders who grumble that the war games are essential to preparedness. The activists, of course, go on activating. Viéques has in consequence become a lose — lose political issue, but a glamorous one. According to a column in the New York Times of Sunday, July 15, 2001, Viéques is a ready-made cause célèbre; it poses the question: “. . why Viéques and why now?”
The Times raises the probable element of “radical chic,” the social phenomenon that Tom Wolfe “sneeringly identified more than a quarter century ago: there’s a privileged class taking up the cause of a more downtrodden one.” But more than that,
the Times article states: “Viéques is simply an activist’s dream, offering something for everyone. It has the destruction of an ecological system, along with claims that the people are being exposed to toxic chemicals, which environmentalists are seizing upon. It has the specter of American colonialism that human rights advocates and Puerto Rican nationalists are pointing to. It has the suggestion of racism that civil rights activists and Hispanic leaders are up in arms over. To top it all off, the issue has an ideal bogeyman in the United States military, which has been relatively quiet about making its case for the bombing exercises.”
Protests continue and some have resulted in sentences of celebrities for trespassing. The activists vow to step up action until the Navy goes away. We saw banners all about Puerto Rico last week reading, “Paz Para Viéques!” “Peace for Viéques.” Supporters of the war games claim a pull-out will interfere with U.S. military readiness and that there’s no convenient alternative site for such combined sea-air-land action. The Times speculates that “as long as that standoff persists, people are likely to be engaged.”
The CDC Mission
Our review team found the Puerto Rican colleagues we met to be clear-headed, competent, and concerned, led by the dean of the Ponce Medical School and the Secretary of Health for PR. We carefully reviewed their new Viéques Heart Study, in which an independent echo lab at the Mayo Clinic validated the Puerto Rican measurements. Our findings will soon be forwarded to the White House. [We found no significant differences among the fishermen, nor any echocardiographic evidence of cardiac damage or “vibroacoustic disease” among them.]
Independently of our study review, the local medical leaders summarized for us the many health problems on Viéques. First, since the deregulation of health care in PR under President Reagan, medical care has deteriorated dramatically, both public and private. Hospitals and most personnel have emigrated to the mainland. Only one lay-staffed obstetric clinic remains. Moreover, the island has a larger proportion of elderly than mainland PR, and 60 percent of its citizens are rural while 73 percent live under the poverty level (versus PR 59 percent). Mean annual income is $3000 compared to more that $4000 on mainland PR; 62 percent of mothers are single, 27 percent are adolescents, and crude death rates are substantially higher overall (9.3 vs. 7.8 per 100,000). Significantly higher crude death rates are recorded in Viéques for CVD, hypertension, cirrhosis of the liver, cancer, and AIDS, for which PR is on the WHO alert list. [It should be noted that the crude mortality rates are generally lower than those in most of mainland USA.] They also informed us that the citizens of Viéques are divided among themselves about the war games; some may want the Navy to stay around.
We did not learn how many of the 9,000 Viéques population (remember, all Puerto Ricans are U.S. citizens), are on welfare. Whatever — if the activists and lawyers have their way — the Viéquans stand to get richer before very long. In any case, it seems they should have a future say in whether their little island is to continue to be bombed. And there is surely a strong obligation on the part of our government to correct whatever ecological devastation has been done and to consider both individual and population-wide liability for the health and economic impact of our generations-long war exercises in the area.