Iran Still Haunted and Influenced By Chemical Weapons Attacks

The brutal assaults during the Iran-Iraq war killed tens of thousands — and increased Iran's feeling of isolation

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Newsha Tavakolian / Polaris for TIME

Hit by Iraqi mustard gas in 1985, Ahmad Zangiabadi now struggles to breathe.

Hassan Hassani Sa’di has been dying from chemical weapons for almost 30 years. The Iranian still remembers the moment he realized Iraqi warplanes were dropping more than regular bombs. “I knew,” he says, “because of the smell of garlic.” It was the pungent and telltale aroma of mustard gas.

Death from mustard gas is gruesome; so is survival. It hideously disfigures skin, sears lungs and mucus membranes, and often blinds. Unlike nerve gas, there’s no antidote. Sa’di, then an 18-year-old fighting in the Middle East’s grisliest modern war — the 8-year conflict between Iran and Iraq — survived the Iraqi attack on the strategic Fao Peninsula in 1985. Within hours, his body was badly blistered, and he had gone blind. “The last thing I remember is vomiting green,” he says, during an interview at the Tehran Peace Museum, a facility dedicated to education and the documentation of weapons of mass destruction.

Iran is today the world’s largest laboratory for the study of the effects of chemical weapons, in part because of the sheer numbers of Iranian victims, but also because of a little-studied phenomenon called low-dose exposure. In 1991, a declassified CIA report estimated that Iran suffered more than 50,000 casualties from Iraq’s repeated use of nerve agents and toxic gases in the 1980s. Mustard gas — in dusty, liquid and vapor forms — was used the most during the war. It was packed into bombs and artillery shells, then fired at frontlines and beyond, including at hospitals.

Years after the war, however, Iranian doctors noticed that respiratory diseases with unusual side-symptoms — corneal disintegration, rotting teeth and dementia, a combination synonymous with mustard gas — had started killing off veterans who had not always been on the frontlines. Civilians were also dying.

So in 2000, the government launched a media campaign urging people who had been in certain areas during the war to report for check-ups. The ads didn’t specify why.

The troubling pattern was soon diagnosed as secondary contamination to mustard gas. “We may only have seen the tip of the iceberg. We may not yet have seen the majority of victims,” Dr. Farhad Hashemnezhad told me in 2002. “At least 20 percent of the current patients are civilians who didn’t think they were close enough to be exposed.”

Numbers have since soared from the lingering, and unanticipated, effects of mustard gas. Dr. Shahriar Khateri, Iran’s leading expert on chemical weapons victims, now says 70,000 are registered, many from low-dose exposure that is now killing them.

“We now know that the latency period can be 40 years,” says Khateri, who is unsure of his own fate. Khateri volunteered to fight at age 15 after his brother was killed in the war. He was gassed in 1987 during the battle for southern port of Khorramshahr. After the war, he went to medical school and co-founded the Society for Chemical Weapons Victims Support.

Iranian doctors say the final toll of Iraq’s chemical weapons could ultimately rival the 90,000 who died from toxic gases in World War I.

In the meantime, Iran has struggled to tend to victims. Sa’di has had 8 surgeries to transplant or repair both corneas, but still has to hold his watch to his face, and sunlight is painful. He takes multiple medications to help breathe, but has a hacking cough. He does not work — the state gives him disability allowance — although he volunteers as an occasional docent at the Tehran Peace Museum to tell his story.

In Tehran, chemical weapons victims often end up at Sasan Hospital, a grim facility that had been the American Hospital of Tehran before the 1979 revolution. Abolfazl Afazali is one of 22 patients struggling for life at Sasan when I visit in December. “One of my wishes,” he says, “is to be able to take a deep breath.”

U.S. sanctions have complicated treatment, Iranian doctors say. Humanitarian goods are technically exempt, but international banks have often been unwilling to conduct financial transactions with Iran, even when legal, for fear of repercussions.

Ahmad Zangiabadi represented Iranian victims at the 2013 conference of the Organization for the Prohibition of Chemical Weapons, which won the Nobel Peace Prize last year. He is no longer mobile, however. He sleeps sitting upright on the floor of his small apartment because the exertion of lying down and getting up is too much for his lungs. He is kept alive on an Airsep New Life Alert oxygen machine, which pushes oxygen into his lungs and makes a thudding sound with every breath. But he has had increasing trouble getting inhalers made by Spiriva and Glaxo Smith Kline. “Life has become a prison the past four months,” he says.

The lingering impact of a war that ended in a 1988 truce, at a cost of an estimated 1 million Iranian and Iraqi casualties, still defines Iran’s worldview. It has been as important as economic sanctions in pushing Tehran to the negotiating table with the world’s six major powers on its nuclear program. As a result of the war, Iran suffers from “strategic loneliness,” explained Nasser Hadian, a University of Tehran political scientist.

The primary lesson learned, he said, was that Iran had no allies even when it was a victim of weapons banned since World War I by international norms.Tehran felt a sense of isolation and betrayal after the United Nations verified Iraq’s repeated use chemical weapons, but the outside world still almost unanimously sided with Saddam Hussein. Iran’s neighbors aided him. Europeans and Russians sold him arms.

The United States was complicit too. Washington provided Baghdad with intelligence on Iran’s equipment and troops strengths to help Iraq retake the Fao Peninsula in 1988. Iraq made widespread use of chemical weapons to win it back.

The final tally of the war may still not be known for years, Khateri says. “Most of the men exposed to chemical weapons were not registered casualties at the time,” he says. “So almost every day there are new cases — 30 years after the war.”