Robert Bartholomew: Caution warranted over ‘poisoned’ Iranian schoolgirls

A demonstration against human rights violations in Iran marches to the Iranian embassy in Madrid. Photo / Getty Images

OPINION

A column by Kat Eghdamian (NZ Herald, March 17), “Iranian schoolgirls need support, not gaslighting”, is critical of assessments that the most plausible explanation for the outbreak of mysterious symptoms in Iran since November is a psychogenic illness.

She asserts that making such claims is “gaslighting” – a form of psychological manipulation that causes victims to question their own experiences.

Accusing someone of gaslighting for offering a dissenting perspective in their area of expertise is an attempt to snuff out dissent – the very issue that she purports to be fighting for in Iran.

She is convinced that 7000 girls have been poisoned by the government and describes a group of female students smelling a strange odour, being hospitalised, and requiring “assistance to breathe”.

There has not been a single verified claim of a girl requiring ventilation or death over the past four months.

Nearly all of those affected have rapidly recovered. While many girls have exhibited difficulty breathing, headaches, nausea, dizziness and fatigue, these are classic symptoms of anxiety. While the death of Fatemeh Rezaei, 11, has been allegedly linked to poisoning, her father told journalists that she died of a kidney condition, and was never exposed to any gas.

Eghdamian writes: “They say it’s all in your head - that nothing made you sick” and it is “typical of girls”.

Mass psychogenic illness is a collective stress response based on a belief and elicits real symptoms. Psychologists have long known that if people believe they have been exposed to a toxin, they can feel sick. It’s called the nocebo effect. You can literally think yourself unwell.

There are numerous examples in New Zealand. For instance, in September 2018, a foul odour enveloped a Wairarapa primary school as nearly three dozen children exhibited headaches, dizziness, nausea, skin irritation and vomiting. Several were hospitalised. All quickly recovered.

The odour was traced to a harmless smell from a nearby compost pile.

In 3000 reports collected over the past 35 years, 99 per cent were majority female.

Eghdamian claims the regime admits it used the attacks to stop girls from attending school. The official position of the Iranian Government is that none of the incidents in question involved harmful gas.

I have communicated with Western toxicologists, including Dr Alastair Hay at Leeds University, who have examined tests of sickened girls. The results are unrevealing, and there is no evidence of nerve gas.

The Iranian Health and Education Ministries believe that up to 95 per cent of all reports stem from anxiety, and the rest are from stink bombs.

The Government arrests are for people who were allegedly involved in a campaign to weaken the regime by implicating it in the supposed poisonings. This occurred after an incident at a school in Qom on November 30 when students ignited a stink bomb as a prank.

This case appeared in the local press as a possible poisoning by the Government as retribution for the girls’ participation in recent protests. This resulted in girls across the country becoming hypervigilant to odours in their surroundings, as they perceived themselves as possible targets.

An Iranian official told me that they believe that some students may have then used stink bombs as a form of protest, which was later encouraged by opposition groups.

The outbreak in Iran is consistent with psychogenic illness, which is known to follow social networks and occur in small, socially cohesive groups under stress. The initial outbreak spread from older, higher-status students to younger, lower-status people.

Most of those affected were adolescent females who exhibited a rapid onset and recovery of benign symptoms. The most common trigger of cases is the presence of an odour, and the most common location is a school – the exact situation in Iran.

Robert Bartholomew.

Similar outbreaks of mysterious illness that were attributed to gas poisoning have occurred in Islamic schoolgirls living under authoritarian regimes in Afghanistan between 2009-2016, and the disputed West Bank region in 1983. Each episode involved more than 1000 girls and spread amid a backdrop of rumours that they were being targeted with toxic gas.

Subsequent investigations published in mainstream medical journals concluded that both outbreaks were psychogenic in origin.

Kat Eghdamian has been a tireless advocate for human rights and has my respect, but in the case of the Iranian “poisonings”, we need to exercise caution and avoid jumping to conclusions until a full and transparent investigation is completed.

- Dr Robert Bartholomew is an honorary senior lecturer in the Department of Psychological Medicine at the University of Auckland and is the author of several books on the history of mass psychogenic illness, and two book chapters on outbreaks in adolescent Islamic schoolgirls.