After this act of war exactly 65 years ago, America came to the aid of citizen responders...now, the U.S. owes care to those who rallied when the twin towers were attacked.

No sooner had Japan's planes left the smoke-filled skies over Pearl Harbor 65 years ago today than Americans began to fight back. Among them were brigades of ordinary people - civilians - who joined in recovering the dead and salvaging the sunken fleet.

It was difficult work performed under dangerous conditions. Much of the effort took place underwater, with divers patching holes in bombed-out hulls and bringing live explosives to the surface. Trapped in many of the ships were flammable gasoline vapors, toxic hydrogen sulfide gas and waterlogged bodies. Oil coated everything. A diver was killed when his air hoses were severed.

As the war moved across the Pacific, more civilians stepped up in service to the nation. And America recognized that it had obligations to these citizen responders. Secretary of War Henry Stimson so stated in a letter to Congress dated July 2, 1942:

"Many cases of personal injuries and deaths of employees of government contractors already have occurred, particularly at Pearl Harbor, Wake Island and in the Philippines. It is believed that relief for such injured persons and dependents of those sustaining death should be afforded by the Congress."

Five months later, Congress passed the War Hazards Compensation Act, providing the wounded with health care and reimbursement for lost wages, and blunting the pain of fatalities with family death benefits. The law was made retroactive to Dec. 7, 1941.

Hardly a single federal lawmaker holding office today would find fault with the decision to do right by those who had served and suffered for their country. Now, after another unprovoked attack on America, Washington must tend to the needs of another group who answered the call for their country, performing difficult, dangerous work amid jagged metal and toxic substances: the forgotten victims of 9/11.

The White House and Congress must stand behind the principle that in a time of war, the United States, as a nation, has a duty to ease the tolls borne by people who have put the national interest above their own. And the U.S. must do so in this instance by guaranteeing medical care for the more than 40,000 firefighters, police officers, construction workers, volunteers and others who served at Ground Zero.

The afflictions are concentrated naturally where the act of war was perpetrated, but the illnesses extend across the country because thousands of Americans rallied from at least 35 states to do their part. Citizens from California, Florida, Texas, Oregon and points in between labored shoulder to shoulder with citizens from the metropolitan area in the poisonous cloud that was released by the collapse of the World Trade Center. Falsely assured, like New Yorkers, that the air was safe, they are just as sick as the local responders. And, dispersed to home, they are perhaps even more forgotten.

Dorothy Hall, 70, a Red Cross volunteer from Burns, Tenn., worked for six weeks at Ground Zero and now suffers from interstitial lung disease - the same type of ailment that killed Trade Center responders Detective James Zadroga, Officer James Godbee, Firefighter Stephen Johnson and AT&T Wireless technician Mark DeBiase.

Nancy Hachmeister, 50, a search-and-rescue dog handler from Bountiful, Utah, spent 10 days with her German shepherd Ivey scouring The Pile for signs of life and human remains. Ever since, Hachmeister has been plagued by sinus infections and a persistent cough, sometimes hacking so violently that she vomits. Ivey died last year of cancer at the age of 9.

Hachmeister wants Washington, including Health and Human Services Secretary Michael Leavitt, a former Utah governor, to dedicate research dollars toward 9/11-related diseases. "He needs to know there is a definite problem, and not just for the New Yorkers who were there," Hachmeister said. "They need to be aware and do what they can as far as putting money into research to figure out what's going on here."

The focus on Leavitt is spot-on. It has been three months since the secretary - caught in the glare of the fifth anniversary of the terror attack - assigned his "A-team" to formulate what, if anything, his agency would do for the forgotten victims of 9/11. Since then, Leavitt and his aides have relapsed into the torpor that has become a hallmark of their record.

Slow to recognize that debilitating asthmas, potentially fatal lung-scarring diseases, chronic coughs and other respiratory illnesses are prevalent among Trade Center responders, they have provided only piecemeal aid - and only under determined prodding by Sen. Hillary Clinton and Reps. Carolyn Maloney and Vito Fossella.

It was only in October that HHS finally delivered federal funding to actually provide care to stricken rescue and recovery workers - $40 million that will allow specialists at the Fire Department and Mount Sinai Medical Center's World Trade Center clinics to treat, rather than simply screen and monitor, the ill. The money was, of course, appreciated, but at present rates of spending it will likely run out next summer.

More money will be crucial because Mount Sinai projects that its patient census will grow from 2,000 today to 13,000. The Fire Department also will expend its funding, and responders who are scattered across the country require care - and their unaddressed needs are beyond dispute.

In Menlo Park, Calif., Frank Fraone, 46, copes with permanently damaged lungs after working at The Pile 12 hours a day for 12 days as a member of a FEMA Urban Search and Rescue team. In Kittery, Maine, ironworker Bob Glancy, 51, developed Reactive Airways Distress Syndrome, a form of asthma, after he cut Trade Center steel for a month. In Huron, Ohio, the Rev. Stephen Petrovich, 55, an Eastern Orthodox priest, lives with shortness of breath and coughs up a half cup of phlegm a day, conditions that began after he spent 11 days at Ground Zero's morgue.

As Dr. Robin Herbert, director of Mount Sinai Medical Center's World Trade Center Medical Monitoring Program Data and Coordination Center, put it in September when a study showed that almost 70% of responders in her program had new or worsening lung conditions: "There should no longer be any doubt about the health effects of the World Trade Center. Our patients are sick and will need ongoing health monitoring and treatment for the rest of their lives."

These facts should be well known to Leavitt because they are well known to Dr. John Howard, director of the National Institute of Occupational Safety and Health, who served as the secretary's 9/11 health coordinator for seven months before that "A-team" took over and promptly receded into the mists. In light of this abdication, Congress must act.

Clinton, Maloney and Fossella must continue to lead the way toward providing first-class, long-term medical care to Trade Center responders. They have urged President Bush to include a line for funding in the federal budget, and Clinton has pressed the Senate to approve a five-year $1.9 billion appropriation. Her long efforts bore fruit Tuesday: California Sen. Barbara Boxer, who will head the Senate's environment committee when the Democratic majority takes over in January, got foursquare behind Clinton's proposal.

Referring to the Ground Zero workers, Boxer said: "We definitely owe them the help to get well, yes, because they were down there because we were attacked."

Precisely.

Full-scale congressional hearings are the next order of business in compelling Leavitt to fulfill the responsibility of designing and implementing a complex, fully robust health care program. One that covers a broad range of defined illnesses; provides outpatient and inpatient services; takes care of diagnostic tests and medications; treats patients without regard to health insurance; monitors for the anticipated arrival of cancers linked to exposure to Ground Zero carcinogens for years to come, and serves patients across the country through affiliated clinics staffed by the most knowledgeable specialists. Mount Sinai's program could well be the model.

There is clear precedent for a congressional inquiry of this nature. It is to be found in the history of what happened after an earlier generation of Americans stepped to the fore in response to an act of war. On Sept. 17, 1942, Subcommittee No. 1 of the House Judiciary Committee convened to delve into the national obligation to the thousands of civilians who joined the cause of World War II, starting at Pearl Harbor.

In that zone of devastation, brigades of men in the employ of contractors helped raise five sunken ships and recover weapons and equipment from two more. Of the 5,000 dives during the two-year salvage effort, half were performed by civilians.

"The Navy was fortunate indeed to once again have the personnel and the experience of the Pacific Bridge Co.," wrote retired Vice Adm. Homer Wallin in "Pearl Harbor: Why, How, Fleet Salvage and Final Appraisal," a ship-by-ship account of the salvage effort published by the Navy in 1968. "Without them the work could not have been done."

But as civilians, the responders were not entitled to military benefits when they were injured, disabled or killed. At the same time, they were excluded from workers' compensation, which covered only employment in their home states. Appeals for help rose as the battle zone expanded.

Subcommittee No. 1, chaired by Rep. Emmanuel Celler, who represented Brooklyn in Congress for half a century, confronted the question of duty in testimony by Lt. Col. Reese Hill of the War Department's Quartermaster Corps. As Rep. Earl Michener of Michigan put it, "Colonel, we appreciate your problem exactly and I am sure we all want to help, but you can see where the burden falls. It comes back to Congress."

And, indeed, it did. After a dissection of benefit regulations and a discussion of who should bear the cost of aiding the wounded, captured and killed, Hill responded, "It is a responsibility which, in my personal opinion, should be borne by the people as a whole, since it is a part of the war activity."

True then, true today, true timelessly.