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A copy of this amendment, Public Law 83–744, title II, is attached to my testimony as exhibit 2.

The amendment was signed into law on August 31, 1954. Three weeks later, on September 21, 1954, the National Research Council and the Department of Medicine and Surgery of the Veterans' Administration published a medical monograph entitled "A Follow-Up Study of World War II Prisoners of War." This valuable study into the problems of ex-prisoners of war almost a decade after their repatriation was used as the basis of the study conducted pursuant to Public Law 83–744. The 1954 Act required a report of the study it had authorized not later than 1 year from the date of enactment. Quite obviously such a report would have to be based on prior research and earlier medical studies.

The 1954 Act followed hearings held by the Senate Committee on Interstate and Foreign Commerce. The purposes of the study, in the words of the committee, were as follows:

The hearings brought out the fact that serious problems have arisen in connection with the adjudication of claims for disability and death benefits arising out of enemy detention. The problem is whether such disabilities and deaths are attributable, in whole or in part, to the hardships suffered by such persons while so detained. The committee feels that the results of the study will be of value in the future adjudication of these claims.

The Veterans' Administration has engaged in continuing studies of the effects of malnutrition and other hardships to which veterans have been exposed. These studies, however, are focused primarily upon the problems of the Veterans' Administration. The committee feels that these studies are worthwhile and should be continued. However, an overall study of the effects of malnutrition and other hardships suffered by prisoners of war and civilian internees will also be of great value, supplementing and bringing together the results of all research. (Report No. 2444, 83d Cong., 2d sess., p. 8).

President Eisenhower transmitted to Congress the report authorized by the 1954 Act on January 12, 1956 (House Document No. 296, 8ith Congress, 2d session). The report is entitled "Effects of Malnutrition and Other Hardships on the Mortality and Morbidity of Former United States Prisoners of War and Civilian Internees of World War II: An Appraisal of Current Information.” This effects of malnutrition report and the follow-up study of the National Research Council and VA are striking for 2 reasons: First, for the shocking and disturbing facts which were brought to light. Second, for the admitted inconclusiveness of both reports and the recommendations that further studies be made.

Both studies found that an excess of mortality in Pacific prisoners of war during the first 6 years following liberation appeared to have been the results of hardships suffered during imprisonment. The principal causes of death responsible for the excess mortality was tuberculosis and accidents. Both studies found that a part of the then present disabilities of Pacific and European prisoners was attributable to prison experiences. The most noticeable and frequent condition as of January 1, 1953, were tuberculosis, residuals of malnutrition, psy, choneurosis, ophthalmological changes, gastrointestinal disorders, and cardiovascular conditions. But both studies were limited, a fact which was well-recognized at the time they were made, and each suggested that further research and stu lies be conducted, in the words of the Na

tional Research Council-VA study, “To detect late effects or confirm early findings.” The Effects of Malnutrition study found that,

The best procedures and standards available today are not adequate to assess completely the effect of the malnutrition and other hardships suffered on the present and future health of military prisoners of war ***.

Now, there are a good number of veterans who were prisoners of war during World War II and the Korean conflict who appeared to recover from their imprisonments and who appeared not to be disabled soon after their liberation. Many of these men who spent 3 hard and cruel years, and more, as prisoners of war began to come down with various symptoms months and even years after their repatriation. Their symptoms involve the central nervous system and they complain of nervousness, insomnia, and excessive worry. Many of these men have been unable to adapt to civilian life, after 3 years of the most barbarous and inhumane treatment. They are unable to hold jobs, they suffer nervous breakdowns, poor memory or impaired mental efficiency. They complain of weakness, undue fatigue, gastrointestinal disorders, and low resistance to a variety of infections. Some of these veterans after 5, 10, or even 15 years from their imprisonment have developed cancer, cardiovascular diseases, and arthritis. Although some of these symptoms occur normally in any population group, I believe that in the case of ex-prisoners of war who were captive for more than 3 years under the most extreme conditions, there is an obvious question of connection of those conditions with imprisonment. My bill would resolve that question in favor of the veteran.

In this connection the following statements from the effects of malnutrition are of great interest:

A provocative observation which cannot be fully evaluated at this time is that the men who reported vague symptoms alone on the questionnaires distribute themselves as to state of health in the same way as those with specific disorders. The implication seems to be that these vague symptoms, although unaccompanied by any objective sign of illness or disability, may have some validity.

And later on the same report states:

The real problems involve disabilities or stated disabilities which are difficult or impossible to detect by objective measurements or tests, or which cannot be demonstrated to be a consequence of malnutrition or the type of hardships to which these people were exposed. These considerations apply particularly to the large body of complaints which are so frequent in both former prisoners of war and civilian internees, that is, complaints involving the central nervous system, such as nervousness, insomnia, excessive worry, inability to adapt to civilian life, inability to hold a job, nervous breakdown, poor memory, or impaired mental efficiency and others, such as weakness and undue fatigue, vague gastrointestinal disorders, and low resistance to a variety of infections. Involved also are a group of diseases and conditions such as cancer, cardiovascular diseases, arthritis, and accidents which occur normally in an appreciable incidence in any population group. When such conditions develop in a former prisoner of war or internee, an obvious question of connection with imprisonment or internment develops * * *

The effects of malnutrition report strongly recommended that a compresensive study of the type completed by the National Research Council and VA be repeated after another 8 or 10 years. It is now almost 11 years from the National Research Council-VA study and I am happy to say, as the members of the committee probably know, that a new study is underway. I had hoped, at the time I introduced my original bill last year, that by the time hearings were held the new National Research Council-VA report would be completed. The follow-up study was urged by the American Legion in 1963, and I understood that both the National Research Council and the VA were contemplating one at that time. However, it was not until July 1964 that the draft of the study was developed and not until February 1965 was the final protocol devised. I am attaching to my statement à copy of a letter from the VA Administrator to the American Legion, dated August 5, 1963, as exhibit 3, and a copy of a letter from the VA Administrator to the American Legion, dated February 11, 1965, as exhibit 4. Both letters concern the matter of the new study.

In view of this, I would like to respectfuly ask the committee that: first, the National Research Council and the Veterans’ Administration be asked to complete the new study of ex-prisoners of war at the earliest possible time; and second, that final action on my bill, H.R. 1027, be deferred until such time as the new study is completed and reviewed by the committee. In making this request I assume that the study will be completed before the end of the 89th Congress.

Again, I wish to thank the committee for its patience and attentiveness, and for allowing me to appear before you today.

(The documents referred to are as follows:)

EXHIBIT 1

ASSISTANT SECRETARY OF DEFENSE,

Washington, D.C., April 21, 1965. Hon. HENRY B. GONZALEZ, House of Representatives.

DEAR MR. GONZALEZ: This is in reply to your letter of April 9, 1965, requesting information relating to U.S. military personnel who were prisoners of war during World War II and the Korean war.

1. The figures on U.S. military prisoners of war during the 2 wars are as follows:

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Answers to questions 2 and 3 of your letter are provided below only with reference to personnel captured and subsequently returned to U.S. control. Meaningful data concerning time served as prisoners of war cannot be provided for those who died while captured because information as to the dates of their deaths is generally unavailable.

2. Of the 114,692 personnel captured and subsequently returned to U.S. control during World War II, it is estimated that 18,500 were held as prisoners for 36 months or more. The corresponding estimate for the Korean war is 400 held as prisoners 36 months or more out of the 4,453 captured and subsequently returned to U.S. control.

3. Again with reference to personnel captured and subsequently returned to U.S. control, it is estimated that 25,000 were held as prisoners for 24 months or more during World War II and 3,800 during the Korean war.

4. Information relating to casualties of World War II and the Korean war currently on file in the headquarters of the Department of Defense does not indicate how many persons were prisoners of war in both of these engagements, Records which might provide this information have been retired to dead storage. Sincerely,

CHARLES J. HITCH, Assistant Secretary of Defense.

EXHIBIT 2

PUBLIC LAW 744

TITLE II SEC. 201. As used in this title

(a) The term “prisoner of war” has the meaning assigned to it by section 6 of the War Claims Act of 1948, as amended ; and

(b) The term "civilian American citizen" has the meaning assigned to it by subsection (a) of section 5 of such Act.

Sec. 202. The Secretary of Health, Education, and Welfare, in cooperation with, and with the assistance of, the Administrator of Veterans' Affairs, the Secretary of Labor, and the Secretary of Defense, shall conduct a study of —

(1) the mortality rates among prisoners of war and civilian American citizens, with a view to determining whether their abnormally high mortality rate is directly attributable to the malnutrition and other hardships suffered by them while held as prisoners of war, hostages, internees, or in any other capacity ;

(2) the mental and physical consequences of the malnutrition and other hardships suffered by prisoners of war and civilian American citizens while so held; and

(3) the procedures and standards which should be applied in the diagnosis of the mental and physical condition of prisoners of war and civilian Amer

ican citizens. SEC. 203. Not later than one year after the date of enactment of this title, the Secretary of Health, Education, and Welfare shall report the results of such study to the President for transmittal to the Congress.

Approved August 31, 1954.

EXHIBIT 3

VETERANS' ADMINISTRATION,
OFFICE OF THE ADMINISTRATOR OF VETERANS AFFAIRS,

Washington, D.C., August 5, 1965.
JOHN J. CORCORAN,
Director, Rehabilitation Commission,
The American Legion, Washington, D.C.

DEAR JOHN: With your letter of July 16, 1963, you forwarded a copy of Resolution No. 36 of the national executive committee meeting, May 1-2, 1963, recommending a study by the National Research Council in cooperation with the Veterans' Administration of former prisoners of war.

In June 1963, the Chief Medical Director requested information regarding a further study of World War II and Korean prisoners of war. At that time, Dr. Gilbert Beebe, Director, Follow-Up Agency, National Research Council, indicated he had been cont plating such a study, but, because of the death of Dr. Bernard M. Cohen who conducted the original study, he was unable to proceed at the present time. Dr. Nefsinger of Dr. Beebe's group is well qualified to conduct the project, but he now is in Japan and will not be available until the early part of 1964.

A meeting has been arranged for the Chief Medical Director, the Chairman, Division of Medical Science, National Research Council, and two members of the National Research Council Committee on Veterans' Medical Problems, to discuss this project and other activities of the Follow-Up Agency. With cordial good wishes, I am, Sincerely,

J. S. GLEASON, Jr., Administrator.

EXHIBIT 4

VETERANS' ADMINISTRATION,
OFFICE OF THE ADMINISTRATOR OF VETERANS AFFAIRS,

Washington, D.O., February 11, 1965.
Mr. JOHN J. CORCORAN,
Director, Rehabilitation Commission,
The American Legion, Washington, D.O.

DEAR MR. CORCORAN: Thank you for your letter of January 27, 1965, concerning our exchange of letters on Resolution No. 36 of the spring 1963 national executive committee, and your inquiry as to the status of the design of a second study of World War II and Korean conflict prisoners of war.

The draft of a protocol for the prisoner of war study was developed in July 1964 and the final protocol was devised as of February 1, 1965.

Since Dr. M. Dean Nefzger is not expected to return from Japan until the first of March, Dr. Gilbert W. Beebe, Division of Medical Sciences, National Academy of Sciences, National Research Council, has been moving this study along in the interim. In January of this year Dr. Beebe obtained cards from the military providing information on 6,000 to 7,000 Korean prisoners of war. A sample from this group is being selected for the proposed survey. The next step will be development of a deustionnaire to be used in contacting both World War II and Korean prisoners of war.

It is our understanding that the organization of the study is well underway but the actual collection of information for the questionnaire from the veterans, as yet, has not begun. Thank you for your continued interest in this study. Sincerely,

W.J. DRIVER, Administrator. Mr. DORN. Thank you, sir. The subcommittee will be adjourned, subject to the call of the Chair.

(Whereupon, at 11 a.m. the subcommittee adjourned, subject to the call of the Chair.)

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