Robert E Bartholomew, Stephanie Lockery, Abdul Fattah Najm. Skeptic. Volume 21, Issue 3. 2016.
For the past eight years, annual reports of Taliban atrocities involving the mass poisoning of Afghan schoolgirls have caused outrage around the world. In 2009, The Statesman proclaimed: “Afghan schoolgirls targeted in ‘Taliban gas attack.'” The next year, the International Herald Tribune reported: “Poison Gas Sickened Afghan Schoolgirls.” In 2012, The Hindustan Times stated: “Taliban Suspected of Poisoning 120 Afghan Schoolgirls.” During August 2015, the New York Daily News published the headline: “More than 100 Afghan Schoolgirls, Teachers Poisoned in Suspected Taliban Attack.” In May 2016, the Afghan newspaper the Pajhwok Reporter carried the story of nearly 200 students who were supposedly poisoned after smelling an unfamiliar odor in Zaranj, despite no evidence of poison and the girls rapid recovery.
Between 2009 and 2016, several thousand casualties have been reported in dozens of schools in at least seven Afghan provinces: Balkh, Bamyan, Farah, Herat, Khost, Nimroz, and Takhar. During this period, numerous suspects have been arrested and charged with carrying out these attacks, while Afghan newspapers have called for harsh penalties for the perpetrators. Yet, the further one delves into these claims, the more dubious they become.
The WHO Report
In 2012, the World Health Organization (WHO) investigated reports of mass poisonings at 22 girls’ schools over the previous four years. Among the symptoms were nausea, vomiting, headaches, dizziness, fainting, and weakness. Curiously, not a single patient died and all recovered rapidly. While the domestic folk theory attributed the incidents to Taliban militants intent on preventing girls from going to school, in line with their ultra-conservative religious views, WHO concluded that these were cases of mass psychogenic illness. Episodes were typically preceded by a foul odor, which gave rise to a belief that their school was the subject of a chemical or biological attack. Some incidents were triggered by rumors that the water supply had been poisoned. Classic psychogenic indicators included the rapid spread of transient and benign symptoms, a quick recovery, poisoning rumors, high states of anxiety (feeling shaky, rapid heartbeat), the absence of environmental or biological agents, and a preponderance of female victims.
While a one-page summary of the WHO findings was published in 2012, the full report has never been publicly released. Afghan journalist Matthieu Aikins obtained a statement from a WHO spokes-person familiar with the report, who noted that there was “No conclusive evidence of deliberate poisoning” based on blood, urine and water samples. In 2013, Aikins became aware of unreleased reports indicating that the United Nations, WHO and the International Security Assistance Force “had investigated the incidents for years and had never found, despite extensive laboratory tests, any evidence of toxins or poisoning-a fact that may explain ISAF’s conspicuous silence on the issue.”
A search of over 1,300 newspapers, news websites and blogs from leading newspapers around the world, has failed to identify a single confirmed report of a mass poisoning incident at an Afghan school. The Global Terrorism Database operated by the Department of Homeland Security and the University of Maryland has collected 140,000 cases of terrorism since 1970. The database lists numerous reports of “mass poisonings” in Afghan schools, but has failed to document a single instance involving a fatality or serious harm. The first known poisoning claim associated with an Afghan school was in Khost Province in 2004 and involved three girls who became ill after eating biscuits. Curiously, while the initial report made headlines and was condemned by then Afghan president Hamid Karzai, no follow-up story ever appeared in the global media. Karzai called the alleged perpetrators “beasts” and said: “I will not call anyone an Afghan or a Muslim who poisons an eight-year-old child because she is schoolgoing.” Interestingly, a Taliban spokesman said he agreed with Karzai and strongly denied any responsibility. On numerous occasions since, Taliban officials have repeatedly and vehemently denied involvement, condemning such acts as un-Islamic and violations of Sharia law.
In June 2012, the international media reported that the Afghan government had announced the arrest of 15 people including three students and a teacher for their alleged involvement in the “attacks.” This occurred a month after the WHO summary implicating psychogenic illness was published. In July 2012 it was reported that Afghanistan’s national security agency had released videotaped confessions of several suspects including two 17 year-old pupils. The United Nations Human Rights Unit challenged the validity of the confessions to the Afghan government.
The 2015 Outbreak
Between August and September 2015, Herat Province was the scene of a series of reported mass poisonings at girls’ schools, either by airborne poison or tainted water. The incidents were confined to the Provincial capital city of Herat. The first incident occurred on August 31, when girls and teachers were reportedly poisoned at the Habib-Al-Mustafa Girls’ School. Initial reports of 94 pupils and teachers affected were later raised to 140.
Police suspected that an air freshener sprayed in the classrooms had inadvertently triggered the event. “Our investigation is ongoing to determine if it was an act of sabotage or poor quality spray,” a police spokesman stated. On September 2, 68 more students at the school fell ill, while the following day, 115 students were reportedly poisoned at another Herat school. Media reports exacerbated fears by proclaiming that the students and their teachers had been poisoned, even before an investigation could be conducted.
Placebo ‘Cures’ and the Search for Scapegoats
The “poisonings” continued to spread to other schools, and by September 5, the Health Division of the Afghan Education Directorate, having been unable to identify any chemical or biological agents, and noting the rapid onset and recovery of patients, concluded that the cause was psychogenic. Those affected recovered rapidly at the hospital with bed rest and the injection of a placebo serum-standard treatment in Afghanistan when a diagnosis is unclear, to reassure families that some medical intervention is underway.
On September 6,151 students and three teachers from Baba Haji School for girls became ill. The girls were taken to hospital, treated with a placebo serum and bed rest, and were discharged within 24 hours. On the 7th, 419 students in grades 4 through 10, were stricken at several more girls’ schools: Navin (210 students), Tabish (83 students, four teachers), Gafaslan (60 students, three teachers), Aboul Walid (44 students), and Omar Farooq (23 students). The media continued to describe the outbreaks as “poisonings.” In an effort to contain the spread of such claims, government officials instructed principals not to report outbreaks, and ordered the treatment of students on site, rather than transporting them to a hospital for examination.
On the 10th, 50 students from two more Herat schools were reportedly poisoned: Abdul Alisha Tokhi (34 students, three teachers) and Kamaldain Bahezad (16 students). The information was concealed from the media and the girls were returned to their classrooms. At the Kamaldain Bahezad school, the students and parents requested that they be allowed to go to the hospital, but the government doctor denied permission and instead administered a placebo injection of saline to each patient and returned them to their classes.
Separate investigations by the Afghan Ministry of Education and the International Assistance Mission (IAM) concluded that the cause of these incidents was mass psychogenic illness. Neither report has been made public because of internal political issues. On September 8, government officials announced that foreign agents were behind the poisonings and that two suspects were under arrest. No further information as to who was arrested, their motives, or if they were prosecuted was ever publicly provided.
Now that public concern over the incidents has subsided, it is important to make these findings public in hopes of informing the handling of future outbreaks. The total number of those affected in the 2015 outbreak was approximately 800,90% of whom were students between the ages of 6 and 20. All the students were female and in grades 4 to 10.33 Alternative explanations for outbreaks of psychogenic illnesses are common in war-torn settings where fear is already elevated. The pattern of identifying scapegoats to demonstrate that action was being taken continued in 2015 with the arrest of suspects without waiting for the outcome of the Ministry of Education findings of psychogenic illness.
Breaking the Cycle of Fear
In addition to highlighting what has become, in recent years, an annual problem, the Herat outbreak raises troubling issues: the continued arrest of persons wrongfully accused of perpetrating poison gas attacks, and the ethics of using placebos in treating victims. While placebo interventions have been effective in alleviating individual psychosomatic symptoms, applying this strategy to outbreaks of collective psychogenic illness serves to reinforce community poisoning fears and creates a backdrop for potential future “poisonings” as mass psychogenic illness results from shared interpretations of events and communal fears. In this instance, the fear was that the students had been poisoned by the Taliban. The placebo intervention reinforced the medical model along with community fears of poisoning, leaving the mindset in place for future poisoning scares and ongoing suspicion.
What is the best strategy to handle future episodes of psychogenic illness in Afghan schools? First, each episode should be promptly and thoroughly investigated to eliminate the possibility of real poisoning, either intentional or inadvertent. It is unacceptable to assume that mass illness outbreaks are simply psychological and to treat patients on site. This is in line with the Education Ministry’s own internal report, which recommends that if students exhibit symptoms, “they need to take them to hospitals or health centers as soon as possible.” Once an environmental cause has been eliminated, the findings should be released in order to reassure the public and thus reduce anxieties over the likelihood of future “attacks.” Ordering education administrators to deny the existence of incidents, and attempting to placate the public by dispensing placebo “serums” that are allegedly designed to counteract the “poison,” should be abolished. Such strategies undermine the credibility of medical authorities, perpetuate the belief in terror-motivated poisoning as the cause, raise ethical concerns, and are not part of the Education Ministry’s recommendations. Afghan political analyst Suzanne Schroeder observes that in the wake of many school poisoning claims, initial media reports often describe students as critically ill, highlighting the importance of accurate updates on the students’ condition, as invariably they fully recover a short time after the supposed poisoning.
A widespread awareness-raising campaign aimed at educating the population about the history of pseudo-poisonings and the nature of psychogenic illness would also be of benefit. This information should decrease the likelihood of further incidents by offering alternative explanations to explain the symptoms. It would also give the government more credibility when in the future they explain the incident as psychogenic rather than poisoning, and would relieve the public pressure on the government to identify a criminal source.
The practice of arresting alleged poisoners and refusing to comment on their status, should be abolished. During the 2012 outbreak, the Afghan government was aware of separate reports by the WHO and the UN, and their findings of psychogenic illness, yet they still publicly assumed a criminal motivation. In 2015, a similar strategy was applied by the government, arresting suspects even though their own Education Ministry had concluded that the outbreaks were psychogenic in nature. Other effective symptom-reduction strategies should involve reassurance by staff, isolating affected individuals from each other, and temporarily closing the school. Above all, government officials should address future pseudo-poisonings with transparency.
The “Attacks” Continue
On April 23, 2016, it was reported that over 100 schoolgirls had been poisoned in the city of Farah in western Afghanistan. The girls quickly recovered. Many media accounts of the incident noted that in 2015 hundreds of schoolgirls in Herat had been poisoned, and that at the time officials believed “the girls may have inhaled a toxic gas.” In reality, no poison was ever found. The Afghan newspaper Khaama Press observed: “This is not the first time the school girls have been poisoned during the school hours but numerous incidents have taken place in the past.” By mid-May, more attacks were reported, in the absence of any confirming evidence. 47 None of the press reports on these incidents mentioned the separate investigations into the Herat incidents and their conclusions of mass psychogenic illness as they were never made public.
A Brief History of Poison Gas Scares
Mass hysteria is prevalent in locations of geopolitical strife as it is fostered in an atmosphere of anxiety and uncertainty. Political conflict, ethnic and religious tensions, and war zones are common incubating environments that provide a backdrop. The fear of poisoning has been a common trigger of outbreaks since the first widespread use of chemical weapons during World War I. It is estimated that during that conflict, for every allied soldier exposed to poison gas on the Western Front, two more exhibited pseudo-symptoms mimicking gas exposure for which there was no evidence. Terms such as “gas neuroses,” “gas mania” and “gas hysteria” were used to describe both individual and collective incidents. Symptoms included breathing difficulty, chest pain, coughing, burning or tingling sensation in the throat, blurred vision, and itchy eyes. In one event, over 500 battle-tested soldiers reported to military medics at aid stations over an eight-day period following intermittent gas shelling. While their symptoms were consistent with exposure to poison gas (shortness of breath, chest pain, fatigue, headaches, ambiguous eye ailments, sensations of burning on the skin), following an examination of the patients the divisional gas treatment specialist found no evidence of exposure.
The interwar period was characterized by significant media coverage of attempts to ban the use of chemical weapons, etching the fear of poison gas into the Western public consciousness. In 1922, the Washington Arms Conference resulted in the U.S. restricting the possible use of poison gas for defensive purposes only and sparking public debate. Chemical weapons expert Frederick Brown would later describe 1922 as the year when “gas had become the cause célèbre of World War I memories.” One highlight of the decade was the Geneva Gas Conference of 1925 at which leaders debated whether or not to renounce the use of gas in wartime, with many veterans groups staunchly opposed to any treaty either prohibiting or restricting the use of gas by the U.S. military. Among the opponents were the Veterans of Foreign Wars, the Reserve Veterans Association, Spanish-American War Veterans, and the Military Order of the World War. By the early 1930s, many books appeared discussing the issue of chemical warfare. This led military historian Elvira Fradkin to describe this period in American history as “the poison gas scare.”
This national preoccupation with poison gas gave rise to reports of pseudo gas attacks. For instance, between December 1933 and January 1934, dozens of residents in Botetourt and Roanoke counties in Virginia, reported being gassed by a phantom gasser who melted into the night. Symptoms included fainting, dizziness, nausea, a choking sensation, weakness, numbness, and eye irritation. Police eventually concluded that the “attacks” resulted in “mass hysteria” that was triggered from a variety of mundane odors, from backed-up chimney flues to exhaust from passing cars. The episode occurred after an initial high profile incident received sensational media coverage when it presented the existence of the “gasser” as a certainty. On April 22,1936, a mysterious malady swept through the East Highland Grammar School in Columbus, Georgia, sickening 19 pupils and a teacher. The “attack” occurred shortly after an airplane had flown near the school, leading to the theory that it had sprayed the building with toxic chemicals. The plane was later identified and shown not to have released any aerial agents.
Two and a half years later, the infamous War of the Worlds radio drama directed by Orson Welles from the studios of WABC in New York City, resulted in an estimated 1.3 to 1.7 million Americans being frightened or panicking under the belief that Martians were attacking Earth. Syndicated on stations across the U.S. and Canada, one study found that 20 percent of listeners interviewed who accepted the “attacks” were real, believed that the announcer had misinterpreted what he was seeing, and that the “Martian attack” was, in reality, a poison gas raid conducted by the German military. One respondent observed: “The announcer said a meteor had fallen from Mars and I was sure that he thought that, but in the back of my head 1 had the idea that the meteor was just a camouflage…and the Germans were attacking us with gas bombs.”
During World War II, the fear of gas attacks continued. The most prominent episode transpired in September 1944 when a second “mad gasser” terrorized residents of Mattoon, Illinois. After dozens of reports over a two-week period, police concluded that the “gasser” was entirely imaginary, and that the symptoms-palpitations, dry mouth, nausea, vomiting, difficulty walking, and a burning sensation in the mouth-were psychogenic in origin. As in the Virginia episode of the previous decade, authorities would eventually blame the outbreak on alarmist media coverage following a dramatic initial incident, in conjunction with an array of mundane odors from such diverse sources as flowerbeds, decaying gardens, industrial waste, and picnic fires. These pseudo gas attacks occurred among a population that was preoccupied with fears over the potential use of chemical warfare.
Contemporary “Poisoning” Episodes in Conflict Settings
In March and April of 1983, in the disputed Israelioccupied West Bank, 947 Palestinians were reportedly poisoned by Israeli agents. The victims, mostly schoolgirls, complained of blurred vision, headaches, stomach pain, weakness and temporary blindness. Many fainted. While Palestinian physicians at Djenin Hospital concluded that different types of poisons had been used, these claims were later shown to have been without foundation. Two separate investigations concluded that the outbreak was psychogenic in nature and was triggered by an odor from a latrine at the Arrabah school. The same investigations found that poison gas rumors in the media played a significant role in triggering the outbreak. The episode occurred amid the long-standing Palestinian mistrust of Israelis.
During a period of political unrest in the former Soviet Republic of Georgia in 1989, authorities sprayed chloropicrin gas to disperse an anti-government rally, the use of which received heavy media coverage. Soon after, 400 girls at several nearby schools, exhibited the symptoms of gas poisoning after rumors circulated that they may have breathed in the irritant. Their symptoms were consistent with symptoms that had been described in the media: burning eyes, skin irritation, dry throat and stomach pain. After being treated at nearby hospitals, they recovered rapidly and were released.
Two years later during the Gulf War there was widespread speculation that Iraq might launch scud missiles containing chemical weapons. While severed dozen scuds were fired, no gas attack occurred. But media reports underscoring that possibility generated fear. At a Rhode Island elementary school, when a student fainted and classmates detected a strange smell, a wave of anxiety swept through the pupils and staff, who feared that they had been the subject of a poison gas attack. Four teachers and 17 students experienced headache, dizziness, and nausea. They were examined and quickly recovered at a nearby hospital.
On March 20, 1995 the Japanese Aum Shinrikyo religious cult carried out five separate attacks on the Tokyo Subway System using Sarin nerve gas, resulting in the deaths of five civilians. Of 5,150 patients who were eventually treated for the symptoms of exposure, about 85 percent were assessed to have been psychogenic in origin.
In December 2005, reports of mass poisonings at schools in the Shelkovsk region of the breakaway Republic of Chechnya were attributed to Russian agents. Symptoms included convulsions, spasms, headaches, asphyxia, and numbness. The outbreaks prompted rumors that Russian agents intent on destabilizing the country were to blame. The Russian government concluded that the “poisonings” were psychogenic in nature. In fact, they occurred amid longstanding political conflict with Russia that flared up in the early 1990s with the disintegration of the former Soviet Union, as separatists waged a violent campaign to create an independent Islamic state, generating distrust of Russian authorities.
In late 2013, dozens of schoolchildren in the Darfur region of Sudan were reported to be suffering from a “mystery illness.” Their symptoms included pain, spasms, twitching, difficulty walking and speaking. By early February 2014, the Sudanese Health Ministry released the results of their investigation, concluding that they were suffering from “mass hysteria.” Not surprising, the area had been engulfed in civil war.
The pseudo attacks that have plagued Afghan schoolgirls over the past decade continue to cause ongoing fear, disrupting lives and syphoning valuable resources in an already impoverished country. Even though these events are psychological in nature, for the students, teachers and parents who experience them, they are real, and continue to cause enduring pain and suffering as they live under the fear of future ‘attacks.’ If we are to bring some measure of relief to the weary schoolgirls of Afghanistan, Afghan health practitioners and members of the public need to be aware of the pattern of pseudo-poisonings.