Several U.S victims of alleged "health attacks" in Cuba have hired a lawyer out of concern over how the U.S. government will handle their long-term medical treatment.
"That's not at all clear," said lawyer Mark Zaid, who represents eight of the at least 24 U.S. diplomats, intelligence officers and relatives affected by the incidents in Havana. "Some already had to spend their own money" on treatment, he added, mostly because of State Department bureaucratic regulations, presumably designed to save money.
"For example if you have an appointment at 3 p.m. at the University of Pennsylvania (UPenn) and a follow-up visit the next day, the rules say that you have to drive or take the train (home) and return the next day," he said. "That's ridiculous."
Zaid, who specializes in national security cases, said he was hired by the victims within the past two months. He wrote to Secretary of State Mike Pompeo last week asking for a meeting, but has not received a reply.
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He said the people he represents are not clear on the kind of treatment they are receiving.
"Are they being treated or are they being studied? It's not entirely clear what is happening," the lawyer said, adding that some of the victims had problems accessing their medical records at the UPenn treatment center because the records are government property. "They are doctors working for the U.S. government."
UPenn sent the following statement: "We are continuing to work with the Department of State to evaluate and treat personnel who have reported audible phenomena experiences. We are not able to provide specifics about different patient groups at this time."
On Thursday, the State Department issued a statement confirming that affected employees have been referred to UPenn for care but said that medical providers at the university were not under contract with the U.S. government. The department also said that "patients have access to their own medical records that are created and maintained by the Department of State.
"The safety and security of our employees and their families is the Department’s top priority. In response to the health incidents, some of the world’s foremost experts in the relevant fields are providing treatment to affected individuals," said the statement, sent by email to the Miami Herald. "The Federal Employees’ Compensation Act (“FECA”), which is commonly referred to as workers’ compensation and administered by the Department of Labor, provides for medical treatment for federal employees with work-related injuries or illnesses. The affected employees have been encouraged to file FECA claims and have been given assistance in doing so."
Zaid said none of his clients returned to Cuba after they were evacuated — although some wanted to complete their tours of duty at the U.S. Embassy. Some are working in third countries elsewhere in the Western Hemisphere. All have been returning to UPenn for their appointments.
"All of them wanted to go back to work," he said. "They are very dedicated people."
Zaid added that the uncertainties tied to the cases have placed the government in a predicament because of the mystery not just on the so-called attacks but the injuries experienced. For example, federal employees who have been injured by incidents such as explosions, "the wounds have been specific and concrete, not strange brain and neurological damages. It's much more complicated."
In a separate case, another Zaid client — Mike Beck, a retired National Security Agency counterintelligence officer — suffered a "potentially similar attack" in the 1990s when he traveled to an unidentified country. Years later, Beck and a companion on the trip were found to be suffering from Parkinson's disease. A confidential report convinced him that his illness was linked to a covert attack with a weapon that used microwaves, Beck told The Washington Post last year.
"My gut is that this has been going on for a while," said Zaid. "The NSA has revealed to me in an unclassified setting that a foreign power has used a microwave weapon against people."
Doctors at UPenn who treated 21 of the patients from the U.S. Embassy in Havana concluded that they have symptoms of concussions even though none suffered blows to the head, according to an article published in the Journal of the American Medical Association (JAMA). Months after they experienced strong sounds or vibrations, described by some of the victims as coming from a specific direction, most of the victims suffered cognitive, visual, auditive and balance problems. The symptoms have persisted over time and the patients received rehabilitation therapy, the article added.
"It really looks like concussion without the history of head trauma," Dr. Douglas Smith, one of the authors of the article and director of the Center for Brain Injury and Repair at Upenn, said in a separate interview published in JAMA. "The thing that we are pretty certain is it was not the sound itself that caused the injury."
The Cuba incidents have baffled both experts and politicians. U.S. officials say there's been no determination of what damaged the health of the American victims. And doctors don't know how long the patients were exposed to whatever allegedly caused the symptoms. Part of the problem, Zaid said, is that different people can react in different ways.
"Some are suffering more than others," Zaid said of his clients. One has symptoms so severe that the client is considering taking early retirement, the lawyer said.
"The symptoms vary. Some have problems keeping their balance, looking at the computer or thinking clearly. Some have returned to full-time work, but others have problems working three or four hours a day," he said. The lawyer said he could not independently confirm whether any of his clients suffered the kind of brain damages described in the JAMA article because he's been unable to see the medical records. But he insisted that the symptoms are real.
"CAT scans don’t lie. To think that a big number of U.S. diplomats are going to make up symptoms for some reason is laughable when you know diplomats," he said. "Diplomats are among the most devoted, dedicated people."
A JAMA editorial urged caution in assessing the value of the UPenn preliminary report, and other specialists have questioned the methodology used. But the UPenn doctors, as well as Dr. Michael Hoffer, a University of Miami specialist who traveled to Havana to treat some of the people affected, also ruled out a suggestion by a Cuban government team that the symptoms were psychosomatic.
"This is just not the picture that you see with mass psychogenic illness," Smith said. "And again, these patients want nothing more than to go back to the service of our country."
The incidents, initially described as "sonic attacks" and later as "health attacks" or "health incidents," took place between November 2016 and May 2017 at the homes of U.S. diplomats and Havana hotels. Another incident was reported last month and two possible new victims are being evaluated at UPenn. The State Department didn't respond to the Miami Herald's question on the status of the two new possible victims.
However, on Thursday, the Associated Press — citing an unnamed State Department source — reported that one of the cases has indeed been medically confirmed as suffering the same symptoms tied to the "health incidents," raising the count to 25. The Canadian government also has reported that 10 of its diplomats and relatives in Havana, including some children, were affected during a similar incident in May 2017.
Sen. Marco Rubio, a Florida Republican who heads a foreign relations subcommittee on Western Hemisphere affairs, has said that the FBI is closer to understanding the technology that may be behind the incidents. Although many in Washington have pointed to Russia as the possible culprit, reports of another recent incident at a U.S. consulate in China have complicated the issue.
A U.S. delegation that met with Cuban government officials last week in Washington said it "reiterated the urgent need to identify the source of the attacks on U.S. diplomats and to ensure they cease." The U.S. government believes Cuba knows what is causing the incidents but refuses to admit it.
"After more than a year and a half of rigorous investigations by Cuba and the United States, there's been no evidence," Carlos Fernández de Cossío, who headed the Cuban delegation at the meeting in Washington, told the island's Prensa Latina news agency.
"The effects those people claim to have suffered cannot be said to be the result of a sonic attack, of any sort of deliberate attack, or that they have been victims of someone's actions," Fernández de Cossío added. "We are in the face of an event that has been politically manipulated."
The State Department has not clarified whether an Accountability Review Board (ARB) investigation into reports that the department may have mishandled its initial reaction to the cases had been completed. The report was ordered in January by Pompeo's predecessor, Rex Tillerson. In late May, Pompeo created a special Health Incidents Response Task Force to coordinate investigations of the Cuba and China incidents.
"The Cuba ARB was not asked to determine the cause of the health issues or medical symptoms," the department said in a statement. "If the ARB finds reasonable cause to believe USG [U.S. government] personnel or contractors engaged in misconduct or unsatisfactorily performed duties of employment, significantly contributing to the incident under investigation, the Board will transmit that finding to the head of the appropriate federal agency."
This story was updated Thursday to include a statement issued by the U.S. Department of State.
Follow Nora Gámez Torres on Twitter: @ngameztorres