AUTHOR:
Christine M. Gosden
INSTITUTIONAL AFFILIATION:
Dr. Goden is Professor of Medical Genetics, University of Liverpool, United
Kingdom. Excerpt from testimony before the Senate Judiciary Subcommittee on
Technology, Terrorism and Government and the Senate Select Committee on Intelligence
on "Chemical and Biological Weapons Threats to America: Are We Prepared?," April
22, 1998.
SOURCE:
Published in Super Terrorism: Biological, Chemical, and Nuclear,
by Yonah Alexander and Milton Hoenig, Editors. Transnational Publishers, Inc.,
2001
TEXT:
Introduction
I have recently witnessed the long-term effects of the chemical weapons attack on the large civilian population in Northern Iraq, in the town of Halabja. My experiences of the devastating power of these weapons have emphasized the importance of protecting individuals and nations against chemical and biological weapons attacks. This journey and the horrifying findings have shocked and devastated me to an extent that I had not believed possible.
At first glance, it might not appear that Saddam Hussein’s use of poison gas against his own people in 1988 has much relevance to today’s issue of domestic preparedness in the United States. However, I believe there are at least three "lessons learned" from Halabja.
-- First, national plans for responding to chemical or biological weapons incidents in the United States (or the United Kingdom for that matter) must take into account the possibility that multiple types of chemical and biological agents may be used in the attack, greatly complicating an effective response;
-- Second, that treating immediately the victims of chemical attack is absolutely critical not only for saving lives, but for preventing long-term radiation-like medical and genetic problems; and
-- Third, and most important, given that technological and other barriers against chemical weapons use have fallen away, it is vitally important that each of our nations maintain adequately funded national medical preparedness programs to treat potential chemical weapons casualties, both civilian and military.
The Attack on Halabja
The poison gas attack on the Iraqi town of Halabja was the largest-scale chemical
weapons (CW) attack against a civilian population in modern times. Halabja was
a bustling city in Northern Iraq with a population that was predominantly Kurdish
and had sympathized with Iran during the Iran-Iraq war in the 1980s. The population
at the time of the attack was about 80,000 people. Troops from the Kurdish Patriotic
Union of Kurdistan (PUK) entered Halabja on 15th March 1988 amidst heavy resistance
from Iraqi security
and military forces.
Halabja fell to the PUK troops (accompanied by Iranian revolutionary guards) four hours later. The Iraqis responded with heavy artillery fire and an early wave of six aircraft bombarded an area near Halabja with ordinary high explosives. The civilians had been prevented from leaving the town by the PUK, hoping that the Iraqis would not attack a town with civilians in it ? thus providing a human shield.
The CW attack began early in the evening of March 16th, when a group of eight aircraft began dropping chemical bombs, and the chemical bombardment continued all night. According to Kurdish commanders on the scene, there were 14 aircraft sorties during the night, with seven to eight planes in each group, and they concentrated their attack on the city and all the roads leading out of Halabja. The chemical attacks continued until the 19th. Iraqi planes would attack for about 45 minutes and then, after they had gone, another group would appear 15 minutes later.
This was not the first chemical attack by Saddam Hussein. Previous attacks had been launched by Iraqi aircraft against 20 small villages in 1987. However, the scale and intensity of the chemical campaign against Halabja was entirely different?this was the first time that chemical weapons had been used on a major civilian population of this size. The victims of the attack included women, children and the elderly.
Saddam Hussein’s Chemical "Cocktail"
There is something else that sets Halabja apart from other known chemical weapons attacks?including the Aum Shinrikyo attack on the Tokyo subway in 1995. The Halabja attack involved multiple chemical agents?including mustard gas, and the nerve agents SARIN, TABUN and VX. Some sources report that cyanide was also used. It may be that an impure form of TABUN, which has a cyanide residue, released the cyanide compound. Most attempts directed to developing strategies against chemical or biological weapons have been directed towards a single threat. The attack on Halabja illustrates the importance of careful tactical planning directed towards more than one agent, and specific knowledge about the effects of each of the agents.
The demands of developing effective treatment regimes for children, the elderly and infirmed are daunting. And the task is ever more daunting when having to treat a chemical weapons "cocktail."
Saddam Hussein clearly intended to complicate the task of treating the Halabja victims. At a minimum, he was using Halabja as part of the Iraqi CW test program. Handbooks for doctors in Iraqi military show sophisticated medical knowledge of the effects of CW. The Iraqi military used mustard gas in the "cocktail" for which there is no defense or antidote. And it is also worth noting that Saddam did not use the nerve agent SOMAN. This is noteworthy because it shows that Hussein’s experts were also well aware that pyridostigmine bromide?one of the chief treatments against nerve agent?is relatively ineffective against TABUN, SARIN and VX, but highly effective against SOMAN when given as a preventive.
Other medical chemical countermeasures designed to increase protection may
be unavailable or ineffective. The drug atropine, the most commonly used for
treatment of nerve agent exposure, ameliorates muscarinic effects (shortness
of breath, troubled breathing, wheezing or tightness in chest, slow heartbeat;
unusual tiredness or weakness), but has little effect on nicotinic effects,
such as muscle twitching. And oximes, which also are used to treat nerve gas
exposure, are useful in counteracting nicotinic effects but will
not function without atropine.
Long Term Effects on the People of Halabja
There had been no systematic and detailed research study carried out in Halabja in the 10 years since the attack. The novel effects such as those on reproductive function, congenital malformations, long term neurological and neuropsychiatric effects, (especially on those who were very young at the time) and cancers in women and children are of special importance. There is no knowledge about the ways in which the serious and long term damage caused by these weapons can be treated.
What we found is sobering, if not frightening. It must serve as a wakeup call about the need for improving our medical preparedness and national and international response plans to chemical weapons attack. For example, eye, respiratory and neuropsychiatric problems do not appear to respond to conventional therapy. It may be necessary to develop new methods of research and treatment.
Severe respiratory problems
These require assessments of lung function, trials of drugs that may be of help and consideration of the possibility of lung transplants for the most severely affected.
Cancers
The cancer risks in this population are high and the people are dying very young of large, aggressive, rapidly metastasizing tumors. There is a need for improved diagnosis, surgery, pathology and better imaging (CT, MR, and bone scans). Methods of chemotherapy and radiotherapy for these chemical weapons induced cancers may be different from those of other cancers and require knowledge of the types of mutations which lead to these cancers.
Congenital malformations
The types and range of congenital malformation are extremely extensive, although certain major effects can be seen. These include congenital heart conditions, mental handicap, neural tube defects and cleft lip and palate. The is a need for pediatric surgeons to repair heart defects, cleft palate etc, improved diagnosis and imaging and many other forms of professional help ( e.g., speech therapy, occupational therapy and specialist teaching for the handicapped).
Neurological and psychiatric problems
These are among the most alarming of the effects of these weapons and are also the most difficult to quantify scientifically and diagnose. They are the problems that make the people feel extremely desperate. Many try to commit suicide and there are many examples of failed suicides, the surgeons frequently have to remove bullets from people who have unsuccessfully tried to shoot themselves. Conventional antidepressant drugs may have severe side effects on those with nerve gas or organophosphage poisoning.
Skin and eye problems
The effects of mustard gas burns may persist for life and cause much pain and suffering. Radical forms of therapy, such as corneal grafting for eye problems and skin grafting for severe skin burns, may be the only real forms of effective treatment.
Infertility
Miscarriages, stillbirths, neonatal and infant deaths.
Many of the people in Halabja have two or more major problems. The occurrences of genetic mutations and carcinogenesis in this population appear comparable with those who were one to two kilometers from ground zero in Hiroshima and Nagasaki, and show that the chemicals used in the attack have a general effect on the body similar to that of ionizing radiation.
All the people who were bombarded with this awful cocktail of weapons do not have identical problems. They received different doses; some were drenched in liquid mustard gas and nerve agents, others breathed in vapor; some people were outside, others were inside; and some were wrapped in clothing or wet sheets or washed off the chemicals quickly. It is important to note that people vary in their ability to detoxify and this is genetically determined. Finally, the DNA target for the mutagenesis is the whole of the human genome. Many different genes may be affected; in the body, conferring risks of cancer or disease; and, in eggs or sperm, causing congenital abnormalities or lethality in offspring.
A great deal remains unknown. The long term effects such as those on fertility and congenital malformations are not well characterized. The most effective ways of treating the long term problems are not known.
The Need for Enhanced Medical Preparedness to Treat CW Casualties
In order to provide effective defense against chemical and biological weapons
attacks, there is a need for a good comprehensive working knowledge of the chemical
and biological weapons. This has to be coupled with an understanding of the
principal ways of deploying each of the different types of weapons and the likely
civilian and military targets against which they might be deployed. The principal
methods of defense against each of these weapons, such as decontamination methods,
antidotes and methods of treating casualties to prevent long term effects are
extremely important.
PROMOTION:
This article has been extracted from Super Terrorism: Biological, Chemical,
and Nuclear, by Yonah Alexander and Milton Hoenig, Editors. Transnational
Publishers, Inc., 2001.
The complete book, in print or e-book format, can be purchased from TerrorismBooks.com and is also available online through your TerrorismCentral Reference Library subscription.
PUBLICATION TYPE:
Book Article
COPYRIGHT:
Copyright © 2001 by Transnational Publishers, Inc.