EDITOR'S NOTE: Amie Muller died on Feb. 18, 2017, after battling pancreatic cancer. Hundreds turned out for her funeral.
ROCHESTER – They are known as the Agent Orange of the Iraq and Afghanistan wars: Massive open-air burn pits at U.S. military bases that billowed the toxic smoke and ash of everything from Styrofoam, metals and plastics to electrical equipment and even human body parts.
The flames were stoked with jet fuel.
One of the most notorious was in Balad, site of the largest and busiest air base operated by the military in Iraq. More than 10 acres in size, the pit burned at all hours and consumed an estimated 100 to 200 tons of waste a day. It was hastily constructed upwind from the base, and its plumes consistently drifted toward the 25,000 troops stationed there.
During two deployments to Balad with the Minnesota Air National Guard, Amie Muller worked and lived next to the pits. And now, she believes, she is paying the price.
Diagnosed last month with Stage III pancreatic cancer, the 36-year-old mother of three from Woodbury has just completed her third round of chemotherapy at the Mayo Clinic here. As she undergoes treatment, she struggles with anger and awaits a VA determination on whether a host of ailments from migraines to fibromyalgia is connected to her military service at Balad.
"It makes me really mad," said Muller, who monitored and edited video feeds from Air Force fighter jet missions while in Iraq. "I inhaled that stuff. It was all day, all night. Everything that they burned there, is illegal to burn in America. That tells you something."
While it took nearly three decades for the U.S. government to eventually link Agent Orange, the defoliant used in Vietnam, to cancer, President Obama has pledged quick action to make determinations about the effect of the burn pits on perhaps as many as 60,000 U.S. troops.
To date, the VA's official position is that research has not established evidence of long-term health problems from exposure to burn pits. The magnitude of the issue, however, may not be clear for decades as delayed war casualties slowly emerge.
In Minnesota alone, it is estimated that more than 14,000 Minnesota Army and Air Guard troops qualify to be part of a national registry for potential exposure to burn pits, based on where they were stationed during deployments.
Muller worries the answers might come too late.
"Maybe way down the road it will tie what's happened to me to the burn pits," she said. "Maybe in 30 or 40 years, they'll actually start taking responsibility for the damage."
Iraqi talcum powder
Open-air burning has always been a mainstay of waste disposal during times of war. But the technology of modern warfare means that such new items as plastic bottles and electronics are being burned, presenting new health risks.
Burn pits were constructed at more than 230 military bases across Iraq and Afghanistan before their use was restricted in 2009. Although the military gave assurances that the air quality was within safe levels, troops returning home began complaining of problems as early as 2004.
In 2006, an Air Force lieutenant colonel who assessed hazards in Balad documented the risks from burn pit exposure and warned of potential chronic problems.
Three years later, the Senate Democratic Policy Committee held hearings to discuss the burn pits and whether KBR, the Houston-based contractor that constructed and maintained many of them, exposed troops, contractors, and civilians to toxic emissions.
A former KBR medic, who came home with his own health problems, testified that 30 to 40 percent of the traffic in the Balad KBR medical clinic was caused by ailments related to poor air quality. The soot even had a nickname: Iraqi talcum powder.
Several veterans have since sued KBR, saying they developed respiratory illnesses, neurological disorders, cancer and skin diseases from living and working near open-air burn pits in Iraq and Afghanistan. KBR, which says it was not responsible for the pit in Balad, said it operated its burn pits safely and effectively under the direction of the U.S. military, and that military personnel were exposed to many hazardous conditions.
"The government's best scientific and expert opinions have repeatedly concluded there is no link between any long-term health issues and burn pit emissions," the company said in a statement.
Joseph Hickman, a veteran and author, says the U.S. military has been reluctant to admit its mistakes. Hickman's book, "The Burn Pits: The Poisoning of America's Soldiers," documents what he says is evidence of negligence by the U.S. military and KBR. He said Afghan and Iraq vets suffering from burn pit exposure should not be forced to wait decades for help like the Vietnam vets who were exposed to Agent Orange.
More than 75,000 service members already have signed up with the burn pit registry. Hickman said the number would be higher except the VA will not recognize registration for troops who have already died. He said he has interviewed more than 1,000 veterans who say the burn pits affected their health, but only a handful have had their disability claims approved by the VA.
"Without any reasonable doubt, it was a hazard to breathe this stuff in," Hickman said. "It would bankrupt the VA, if they had to take care of all these soldiers."
Burn pit registry
Despite the mounting public outcry from vets, their families and members of Congress, the VA says research does not show evidence of long-term health problems, and that most irritation is likely temporary.
Citing a National Academy of Sciences study of air monitoring samples at Balad, the VA also says that high levels of fine dust and pollution in Iraq and Afghanistan may pose a greater danger for respiratory problems. The study does note, though, that many details on what was burned at Balad were not available.
"The challenges we have is that the exposures to burn pits are really variable," said Dr. Nicholas Lezama, the VA's deputy chief consultant for Post Deployment Health Services. "A lot of different things were burned in the burn pits. Sometimes the burn pits weren't used. Sometimes the winds were different. Some veterans had short deployments, some had multiple deployments."
Nevertheless, the VA is encouraging vets to participate in the registry to establish a baseline for research. It is designed to take reports from veterans and service members who served in Iraq and Afghanistan after the 9/11 terrorist attacks, as well as Djibouti. Veterans of the Persian Gulf War may also register, as well as any veteran who served in the Southwest Asia theater after Aug. 2, 1990.
Also, legislation co-sponsored by Sen. Amy Klobuchar, D-Minn., calls for creating a VA center to address the health needs of veterans who may have fallen ill after exposure. The center would establish research and share best practices with doctors trained to treat the illnesses.
"The Agent Orange experience taught people a lot," Klobuchar said. "For years, they [the federal government] were in denial. We don't want to make the same mistake with this issue."
Thought they were lucky
Once healthy and vibrant, Amie Muller was constantly fatigued after returning from Iraq in 2007. She had migraine headaches daily. As doctors struggled to find the cause, she was tested for everything from multiple sclerosis and fibromyalgia to rheumatoid arthritis and irritable bowel syndrome. Her paperwork shows that she told everyone about her fears about the burn pits.
After suffering from abdominal pain and gastrointestinal problems this spring, she was hospitalized for several days. A scan revealed the bad news — a tumor on her pancreas and a diagnosis of Stage III cancer.
The cancer has left the Muller family to struggle with the reality of regular trips to Rochester for treatment, handfuls of medications and a young life put on hold.
It has also left Amie angry. After more than a year, she was recently informed a ruling on her disability claim may not come until February, leaving the family struggling financially.
"I am frustrated because I tried to tell people what it was, and they still didn't take it serious enough," said Muller, who works full time in public affairs with the Duluth fighter wing.
Julie Tomaska deployed with Muller in 2005 and 2007 and the two lived side by side. Shortly after coming home, Tomaska, too, suffered from chronic fatigue, headaches and digestive problems. Her disability claim with the VA was approved with a diagnosis of "environmental exposures."
Tomaska said she and others returned feeling fortunate that they had survived the war without being killed or wounded. She now realizes that some wounds take time to be revealed.
"We always said we were so lucky to come home OK," she said. "Now we don't feel that way."
Mark Brunswick • 612-673-4434