This period of the subcommittee on civilian, security, democracy, human rights and global womens issue sz going to come to order. And the u. S. Tax on cuba oversight. We have one Government Panel testifying with it following three witnesses here. The acting assistant secretary of state for the bureau of western hemisphere affairs. International programs that department of state and dr. Charles, the medical director at the bureau of medical services for the department of state. Thank you all again for being here on this important topic. There are two goals. The first is to establish the facts. And of what has occurred and the second is to conduct oversight over the conduct and the activities of the United States state department. Here are the facts as will be testified to today by our panel. In late 2016 staff at the United States embassy in havana began complaining of strange noises and among it descriptions they complained of, high pitched beam of sound, incapacitating sound, akin to driving with windows partially open in the car or just intense pressure in one ear. At the time of this report the posts leadership and the supporting office here in washington d. C. Viewed this activity as harassment from forces hostile to the United States or to u. S. Presence in cuba. Later there was information gathered from aditional individuals, including some that suggested the complaints to november. The initial events that were reported occurred at diplomatic residents. But later these events occurred individuals first visited the medical unit at the embassy in september 2016 and january of 2017. From february of april 2017. And to what you would see in patients that quote have a mild traumatic brain injury or concussion. And the test results up to that point. And they arrived at a consensus and the consensus is and i quote the patterns of injuries were most likely related to trauma from a nonnatural source. And they reevaluated embassy employees that were reporting symptoms and incidents prior to april 2014 were added to the list of confirmed cases. Subsequently two additional individuals reported exposure in midaugust of last year. And those cases were medically confirmed as well, bringing the total number of cases to 24. All while the symptoms may vary, all the medically confirmed cases, all 24 of them have described some combination of the following symptoms. Dull headaches, ringing in one ear, vert go, visual focusing issues, nausea and extreme fatigue. As weve said earlier the timeline of the reported incidents are as follows. The initial waver may have begun as early as november 2016 and occurred from march 2017 through late april of 2017 there was a sporadic period of reported incidents and then they stopped. And then two additional reports happen in close proximity in august of last year. They were medically confirmed in september. These are the facts that will be testified to today by our panel and with that i turn to the Ranking Member. Thank you, mr. Chairman and im appreciate that were starting the new year with a much needed hearing. The braiszen attacks on our diplomats in cuba. Its unfortunate that since the news of these bazar and vicious attacks broke late last summer we have not seen more public out cry against the cuban government for whatever scope of ownership it has over these attacks or more accountability for the health and well being of our diplomats, some who continue to suffer lingering Health Effects. The castro regime has proved time and time again its not a responsible act. The regime cant be counted upon to uphold its responsibilities or commitments and it has no regard for individual human rights, security or human dignity. The cuban government may or may not at the end of the day be directly responsible for attacking our diplomats. But as someone who has personally witnessed the motes apron day of the cuban government, its they were not aware of these attacks. If senior cuban officials did not directly order these attacks, they must have been given approval to foreign agents to operate in cuba. The scope is too specific. So i hope to hear more sound explanations from our witnesses today. Now our own diplomats have born the burden of a simple truth and that is that being in a foreign location in terms of your duty runs risks and in this particular case no amount of playicating, pandering or diplomatic overtures is going to change that. The cuban government has tried to undermine their dangerous and irresponsible behavior by undermining the validity of our diplomats. Why would a regime that has demonstrated its ability to opress and harm its own citizens give creedance to our concerns about the well being of americans . They accuse the United States of fabricating the attacks because we have not released the names or diagnoses of the effected people. Of course the castro regime doesnt understand in a democratic and free country citizens have a right to privacy and to a government that would prioritize their privacy and health over using them as political tools and finally turning to our witnesses you cannot be held accountable for the behavior of the cuban government or those responsible for this but you are responsible both for the appropriate diplomatic response and the health and safety of our diplomats and from what i can see the reactions on both counts are simply insufficient and unacceptable. Despite much rhetoric from the president about policy changes, the reality is it enjoys many of the benefits it receives. It grandmothered in all contracts. Further more because the administration took so long to actually announce these guidelines. Major companies were able to finalize deals and their implementation. That enforcement level, the department of foreign assets control with the understanding that no further staff will be hired. The president has not even nominated an assistant secretary for western hem hads fear affairs. Failing to put staff in place in appropriate agencies undermines our ability to protect citizens abroad. Completely abricated its obligations to protect our diplomats is laughable. The fact that somehow its managed to paint a narrative that there were no attacks at all is pretty outrages. To achieve pairty with a number that have to be removed from havana for safety hardly a bold move. The administration stressed they were not in response to the attack on personnel. And then turning to the impacted Foreign Service officers themselves, i appreciate the officer over view thats been provided. It departments response was simply bureaucratic, inadequate and troubling. I will have a number of questions later. But let me start by saying the stories we were are shocking. Failure of leadership at the department in that post. The sluggish reaction to aflicted personnel, the aloof response of the medical team, silence from the security to the rest of the department is starring. The members of the u. S. Foreign service made a commitment to serving overseas. They agree to spend their lives, often taking their families with them in the pursuit of helping americans abroad. Some serve in combat zones, and sometimes on communist islands. According to accounts from those who suffered directly, when diplomats reported symptoms they were rebuffed. It is also our understanding that upon finally accepting that they were suffering life altering health consequences, they took months to arrange for the appropriate care. It was almost a year before they put on status and only after reports surfaced in the media. Its our understanding they did not warn diplomats for permanent or temporary assignments about the risk of their health and their families. As their colleagues were evacuated they failed to notify it rest of the department. Those who have been suffering physically also have remaining questions about whether they will receive appropriate care for the rest of their careers and their lives. This lack of leadership and responsibility is shocking and unacceptable. I sincerely hope this panel can give us answers to a myriad of other questions. They must be held had accountable for its failure and failure to protect american diplomats. They must be held had accountable for the appropriate policies and response and insuring the safety and health of the Foreign Service. Thank you and well begin with our witnesses. Welcome to the committee. Chairman rubio, Ranking Member menendez and distinguished members of the committee, thank you for the opportunity to speak about the department of states efforts in response. I want to thank you for your concern for the safety and security of our diplomatic personnel in havana. As you know this is secretary tillersons top priority. It is mine as well. Im pleased to be here today with my colleagues from the bureau of Diplomatic Security and medical services with whom the bureau of western hem hads fear affairs has worked closely on this issue. I would also like to emphasize up front that the investigation is ongoing. We have the best experts in the government working to help us understand it. And every step in our response to these events we have worked closely with our medical and technical experts in evaluating Health Conditions and the nature of the attack. Ill walk you through a timeline which will describe our diplomaticing engagement then i will defer to my colleagues to address the security and medical issues. In late 2016, some servicing complained about hearing strange noises and a variety of unexplained physical symptoms. As the department investigated, we began to see signs suggesting that these events initially and diplomatic residents and later at hotels may have begun as early as november 2016. As soon as we identified a pattern, connecting these unusual events with Certain Health symptoms u. S. Officials approached the cuban government in midfebruary to demand it meets its obligations under the Vienna Convention to protect our personnel. The cubans denied involvement, offered their cooperation and opened their own investigation. Since then we have engaged the cubans more than 20 times from the working level to the highest level of the cuban government both here in washington and in havana. In addition to our diplomatic efforts, dr. Rosen farb will provide you with additional details. Separately we launched a governmentwide effort to find the cause and culprits behind these attacks. Apart from the investigation we have met with u. S. Interagency partners more than a dozen times to discuss and refine our response to the attacks. The attacks initially appear to curb in clusters. But starting in late march, spurattic attack continued until late april and then seemed to stop. Beginning in midapril we allowed anyone serving at Embassy Havana who did not feel safe at post to return to the United States. We also expelled two cuban diplomats in may in order to underscore the cuban governments responsibility to protect our personnel. After a period without any attacks there were two additional attacks reported in close proximity in late august which were medically confirmed in september. Secretary tillerson ordered the departure of nonemergency personnel on 29th. They assessed this was it only way to reduce the risk to the diplomats and their families. We expelled 15 more cuban diplomats in october to insure equity and the impact on our respected operations and to underscore to cuba its obligation to stop the attacks. These decisions both to jar down our personnel at Embassy Havana and to expel cuban diplomats did not signal a change from president trumps policy. Prior to the decision to implement order departure, our embassy held 17 town Hall Meetings with embassy staff. Since the return of u. S. Diplomats to washington, we have held a number of meetings with them. Secretary tillerson explained his decision to institute order departure and we have organized a number of meetings to address eeevacuees concerns. The well being of the 24 confirmed victims as well as the well being of all of our evacuees and those remaining in havana continues to be our priority as does the ongoing investigation. With that i will turn it to my colleagues to discuss their areas of expertise and then i will be happy to answer your questions. Thank you. Mr. Brown. Good morning. Chairman rubio and other distinguished members of the committee. Thank you for your invitation to discuss health had attacks involving u. S. Personnel in their families. I share your concerns regarding the safety and security of our personnel in cuba and welcome any discussion that may lead to a better ntdsing of this issue and stronger safeguards for our employees. From a security and investigative standpoint we continue to work at Embassy Havana to counter, mitigate and better understand who or what are causing injuries to our dip wlumatic staff. Unfortunately this remains a perplexing case. Our regional officer first became aware of attacks involving personnel in late december 2016. In the early stages of trying to understand what may be occurring, post leadership and supporting offices in washington believed it was likely a form of harassment by forces hostile to the United States and our presence in cuba. As more incidents were reported in early 2017 and greater awareness of the seriousness of symptoms became known our level of concern and mitigation efforts rose exponentially. After meetings with cuban officials in february outlining cubas responsibility to protect diplomats under the geneva convention, we received information that the cuban government was conducting its own investigation into the matter. Senior officials met frequently as part of our ongoing attempt to better understand the nature of the apparent attack and protect staff. Amung other things the embassy deployed devices in an effort to better identify or capture the possible source behind the threat. As many victims had had associated the attack with an acoustic event. After further investigative attempts an expert analysis failed to identify the perpetrator, the federal bureau of investigation opened a case in early may. An fbi case has since visited and the fbis investigation has conducted surveys of the residents and hotel rooms. However the investigation remains ongoing and we would refer all specific questions concerning the investigation to the fbi. Thank you. Ill be glad to answer any questions you may have. Thank you. Good morning. Chairman rubio, Ranking Member menendez. Thank you for the opportunity to testify on a departments response to the recent health had attacks in havana. Ill be describing what we currently know about the Health Effects. From the individual and Public Health perspective, managing this is challenging. They describe a multitude of symptoms, many of which are not easily attributable to any specific cause. The sharing of information has helped identify more personnel but as with any Community Outbreak can complicate a situation. However, the most challenging factor is the lack of certainty and therefore the precise mechanism of the injuries suffered. Individuals first visited our medical unit starting in late december 2016 and january 2017 reporting various symptoms including air pain, diziness and hearing problems. They associated the onset to their exposure with oddatory sensations. An incapacitating sound, or just an intense pressure in one ear. Since the symptoms first reported primarily effected oodatory functions was aidentified to perform additional assessments. Between february and april of last year, this specialist evaluated 80 members of the embassy community. 16 were identified to have symptoms and pedically verifiable clinical findings similar to what might be seen following a mel traumatic brain injury or concussion. In july reviewed the case histories and test results gathered to date. They identified some of the symptoms could be caused by other things such as previous head trauma, aging and stress. The consensus was the patterns of injuries were most likely lated to a trauma of an unlikely source. The nationally recognized Brain Injury Center at the university of pennsylvania was identified those with prior exposures and new exposures. As a result of further evaluations, additionally individuals with exposures prior to april 24th were added to the list of confirmed case said two other individuals that reported exposures in midaugust were also medically confirmed, bringing the total number to 24. I now like the describe the Health Effects identified so far. All medically confirmed cases have described some combination of the following symptoms with ginning within minutes to hours of the event. Dull unilateral headache, ringing in one ear, vertigo, visual focusing issues, disorientation, nausea and extreme fatigue. They seem to resolve in days and weeks but other Health Issues emerge. These have included difficulty with concentration, working memory and attention. High frequency unilateral hearing loss and imbalanced walking. The duration and severity have varied widely. Defining the prognosis is extremely difficult since no precise an log exists. Some patients remain symptomatic months after their exposure. They have improved to varying degrees in some individuals. However, some over time without treatment. 10 of the 24 have returned to participation of duty. However, at this time we are unable to state whether or not it could result in functional abilities. All government personnel now receive a detailed medical briefing including base line audio grams and testing. The centers for Disease Control performing a broader and to the american public. Discussions have also been held with the national instut of Neurological Disorders and stroke regarding its participation in ongoing medical investigations. I look forward to your questions. Thank you. Doctor, ill start with you. Is it fair to say may 1st or early may we were aware that at least 16 u. S. Government employees and or dependents had had suffered a serious if hadjury while working in havana for the u. S. Government . Its fair to say we were aware they had suffered some type of injury. Was it serious . In some individuals it was more serious than others. Was ther