https://crsreports.congress.gov
Updated September 2, 2021
Presumptive Service Connection: Former Servicemembers of
Camp Stronghold Freedom at Karshi-Khanabad (K2) Airbase
In recent years, exposure to potentially toxic hazards, like
open-air burn pits, has gained congressional attention. In
the 117
th
Congress, the House and Senate Veterans’ Affairs
Committees have indicated ongoing interest in examining
the association of illnesses with exposure to certain toxic
hazards during military service. Congress has debated
multiple legislative proposals to establish presumptive
service connection for veterans potentially exposed to toxic
hazards while conducting military operations or while
stationed at specific military installations. One proposal
specifically includes those formerly stationed at Camp
Stronghold Freedom and who have since developed certain
health issues or disabilities.
What is Camp Stronghold Freedom?
In October 2001, the U.S. military established Camp
Stronghold Freedom at Karshi-Khanabad (K2) Airbase in
Uzbekistan (see Figure 1). Located on a former Soviet-era
air base, Camp Stronghold Freedom served as an
intermediate staging base to support logistics and air base
requirements for Operation Enduring Freedom and other
military operations in the region. In November 2005, at the
request of the Government of Uzbekistan, the U.S. military
departed Camp Stronghold Freedom. The Department of
Defense (DOD) estimates 15,767 servicemembers deployed
to Camp Stronghold Freedom between 2001 and 2005.
Figure 1. Karshi-Khanabad Airbase, Uzbekistan
Source: CRS graphic.
Were harmful or toxic substances present at K2?
Between 2001 and 2005, DOD conducted three classified
“occupational and environmental surveys” of K2.
Unclassified summaries of these surveys described the
presence of underground jet-fuel plumes, asbestos-
contaminated surface dirt, trace amounts of depleted
uranium, and periodic high levels of dust and other air
particulate matter. DOD noted that military officials
implemented mitigation efforts (e.g., covering contaminated
soil and declaring off-limits areas) to reduce the
environmental health risks and determined that health
effects from the short-term, low-dose exposures present at
K2 were “unlikely.”
What concerns do former K2 servicemembers and
veterans have?
Former K2 servicemembers and veterans have expressed
concerns about ongoing or potential health issues or
disabilities that may be associated with their service at
Camp Stronghold Freedom. Though the Department of
Veterans Affairs (VA) has acknowledged a connection
between certain respiratory conditions associated with
service at K2 and other locations, veterans (including those
with other health conditions) may still believe there could
be challenges with accessing VA health benefits or
disability compensation.
What DOD or VA benefits are available to
servicemembers and veterans who served at K2?
Health Benefits. Current servicemembers and military
retirees who served at Camp Stronghold Freedom, and
elsewhere, are eligible for health benefits through DOD’s
TRICARE program. Individuals enrolled in a TRICARE
health plan may receive care at military treatment facilities
or from participating civilian health care providers.
Veterans, including military retirees, may be eligible for
VA health care if they have documented service-connected
disabilities, are Medal of Honor or Purple Heart recipients,
or were exposed to certain toxic substances or
environmental hazards (e.g., Agent Orange). After VA
health care eligibility is determined, veterans may formally
enroll in VA’s health care system to receive services.
Occasionally, Congress has granted special eligibility for
health care to those veterans possibly exposed to toxic
substances and environmental hazards under special
treatment authorities. For instance, Congress addressed the
health concerns of Vietnam-era veterans in 1981 with the
passage of the Veterans’ Health Care, Training, and Small
Business Loan Act (P.L. 97-72). Similarly, Congress first
authorized priority health care for Persian Gulf War
veterans with potential, service-related conditions through
P.L. 103-210 in 1993. Veterans returning from current
combat theaters of operations may enroll in VA health care
for five years from the date of their discharge without the
need to demonstrate a service-connected disability or
satisfy a means-test requirement. Veterans eligible under
this condition may be assigned to Priority Group 6 and are
generally not subject to any VA cost sharing requirements.
After the five-year period ends, these veterans may be
reassigned to a different priority group depending on other
eligibility requirements.
