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WASHINGTON (AP) — An internal review submitted to Congress Thursday says the State Department had “insufficient resources” to support long-term care following mysterious health incidents in Cuba.

However, the Accountability Review Board, convened by former Secretary of State Rex Tillerson, also says the department’s Bureau of Medical Services “provided competent and professional response to an unprecedented situation.”

The review recommended mandating medical screening before and after assignments or temporary duty in Havana.

Twenty-five embassy workers in Cuba have been affected by mysterious health incidents, suffering a range of symptoms and diagnoses including mild traumatic brain injury, also known as concussion.

The board’s mandate was to examine the State Department’s response, including the adequacy of security.

The department says it has implemented half the board’s recommendations and is working to complete the rest.