On a bed in what had once been Tehran’s American hospital, Magid Azam’s gaunt body shudders horribly with each breath he draws.
Plastic tubes inserted through his nostrils drizzle oxygen into lungs that are little more than scabrous husks.
For the 27-year-old medical student, it has been like this for nearly two years.
He is on a list for a lung transplant in Britain, but the list moves slowly. Without a transplant, doctors say Azam can live for no more than another year.
Azam and thousands of others were poisoned by Saddam Hussein’s mustard gas during the 1980-88 Iran-Iraq War. Yet government officials and ordinary Iranians are surprisingly ambivalent about the dangers posed by their neighbor, and unsympathetic toward U.S. efforts to do something about it.
Iranian propaganda during the war claimed the U.S. gave the Iraqis chemical weapons. The tendency still is to blame the West for introduction of weapons of mass destruction to the region.
“It’s unlikely the less developed countries would ever have developed these weapons on their own. They got the technology from more advanced countries in the West,” said Dr. Farzad Panahi, a doctor who specializes in the care of chemical weapons victims.
The Iraqi side deployed mustard gas and nerve gas throughout the war.
At first, the Iraqis unleashed chemical weapons selectively and in small quantities as a tactical deterrent. Later, when the tide turned against them, the banned weapons were applied massively to beat back Iranian “human wave” offensives. In one 1985 attack, an estimated 11,000 Iranian soldiers were exposed to chemical weapons, according to Iranian medical authorities.
Despite the high number of casualties, the international outcry was muted.
On another occasion in 1988, Saddam used chemical weapons to annihilate the civilian population of Halabja, a Kurdish town in Iraq. An estimated 5,000 were killed.
Azam was exposed to Iraqi gas in January 1987 after Iranian troops had routed the Iraqis from the Iranian border town of Shalancheh, near Basra.
The retreating Iraqis left behind an invisible mist of mustard gas. Azam, a 16-year-old “volunteer” with virtually no military training and no gas mask, walked right into it along with several hundred other soldiers.
“Right away we started vomiting. Then I became unconscious and fell into a coma for several hours,” he said, his story spilling out in painful gulps.
Dozens of soldiers died outright, never regaining consciousness. Others died slow, agonizing deaths over a period of weeks and months. Azam was treated in a military hospital and, after several weeks of convalescence, appeared to make a significant improvement.
A few years later, he was suffering from some gradually worsening side effects, but was apparently well enough to begin university studies.
He completed four years of medical school before his condition worsened to the point where he had to be permanently hospitalized.
“No human being should have to live like this, especially a young person,” said Azam, who knows that even a lung transplant may not significantly improve his chances.
Doctors understand little more than they did 80 years ago about treating patients for the long-term effects of chemical weapons.
“It seems we can’t do much for these patients. Even European doctors who have some experience with these kinds of problems are unable to help,” said Dr. Panahi, a surgeon with the Janbazan Foundation.
“Right now, all we can do is try to keep them in humid places, away from the dust,” Panahi said. The Janbazan Foundation operates several sanitariums along the Caspian coast, in northern Iran, where the cool sea air seems to be beneficial to those with respiratory problems.
Medical statistics in Iran are sketchy. Officials at the Janbazan Foundation estimate that up to 100,000 Iranian soldiers may have been exposed to chemical weapons. Approximately 40,000 were treated immediately, and over the last 10 years some 30,000 have received treatment for recurring or delayed reaction to chemical weapons.
“About 1,000 cases are considered very serious. From among those, we had about 20 patients die in the last two years,” Panahi said.
“Four or five patients have had lung transplants, but so far we have no guarantees that such transplants do anything,” he said.
In addition to respiratory problems, the most common ailments related to mustard gas and nerve gas exposure are progressive blindness and corneal ulcers.
“Unfortunately, we have found there is no benefit from corneal transplants. The result is more aggresive recurrences,” Panahi said.
A growing body of evidence accumulated by Iranian medical officials also suggests a link between exposure to chemical weapons and sterility, certain kinds of cancer, birth defects and low IQs among the children of those exposed.
Doctors in Iran say they have no idea how they - or anyone else in the region - would cope with the new generation of even more deadly chemical and biological weapons that Iraq is believed to be trying to produce.