Hysteria diagnosis doubted in Chechen outbreak


SHELKOVSKAYA, Russia -- It started just after the midafternoon recess. As they lined up to return to class, Zareta Chimiyeva saw a girl in front of her collapse and begin convulsing wildly. A few minutes later, Zareta was at her desk when she said she smelled "a bad smell," and started feeling ill.

She rushed out of the classroom but made it only as far as the stairs. "Darkness surrounded me, and there was darkness in my eyes, and I fell," said the 12-year-old from this small town in eastern Chechnya.

When Zareta woke up in a hospital, it took three adults to hold her down. She was thrashing and clutching her throat, unable to get a breath, screaming in terror. She wasn't alone. Thirteen other girls were in nearby hospital rooms, also claiming they were unable to breathe, many of them shrieking and crying.

The next day, 23 students and seven teachers in a neighboring village fell ill with similar symptoms. About the same time, four dozen children in two towns a little farther away also began clutching their throats, screaming and convulsing.

They have yet to heal. Although the outbreak began Dec. 16, doctors and parents say the children are still suffering fits day and night. The list of victims has grown to 93, including several teachers and janitors, with a small number of cases reported as far away as the Chechen capital, Grozny, and Urus-Martan, 60 miles to the southwest.

With the diagnosis caught up in the suspicion, politics and fear that surround most of what happens in this fractured separatist republic, the answer to what happened to Shelkovskaya's children might never be known fully.

What is clear, officials say, is that a new generation has fallen victim to the unexpected and devastating effects of a war that began before many of them were born.

After exhaustive chemical and radiation tests, authorities with the Moscow-backed government announced that the culprit was not poison, but a form of mass hysteria. The whole episode was triggered, most doctors now believe, by the extreme and chronic levels of stress among children who have experienced a war with Moscow that lasted more than 10 years and its devastating economic aftermath.

Yet with Chechen rebel leaders issuing proclamations that the Russian military secretly has poisoned the schools with nerve gas and public health officials at a loss to explain why after months of treatment the children are getting worse, parents -- and some local physicians -- are not ready to accept the official diagnosis. Very few are willing to send their children back to the schools where they were first afflicted.

"The fact is that the children are getting worse. No treatment helps them," said Khazman Bachayeva, principal at School No. 2 here, where only 30 of 998 students showed up for school recently. "And as of today, nobody has given us a concrete explanation. All they say is, it's psychological stress. Well, the parents don't buy that, and I don't buy it either."

Sultan Alimkhadzhiyev, Chechnya's deputy health minister, said it was difficult to explain to parents that their children had become living specimens of what it means to grow up with the constant threat of violence and chronic joblessness and poverty.

"Our children have seen bombings, artillery attacks, large-caliber bombardment. They saw houses, schools and hospitals burning. They lost parents, brothers, sisters, neighbors," he said. "And they still see tanks and armored vehicles every day in the street.

"In this case, what we have seen are not symptoms of poisoning ... but of psychosis. A state of panic. Children are feeling constant fear, a premonition of tragedy."

The ability of the human mind to convert psychological stress to genuine physical symptoms, officially known as "mass sociogenic illness" or "conversion disorder," is well documented but not completely understood. Why, for example, are chiefly girls affected? Only four of the Chechen victims were boys.

In Grozny, where Shelkovskaya victims were transferred in December, doctors tried music therapy and set up concerts in the basement of the main children's hospital for as long as seven hours a day for two weeks. The fits improved, but when a television journalist began filming one of the sessions, 12 girls immediately had seizures.

Next, the victims were moved to a clinic in Stavropol, outside of Chechnya. Doctors there treated some of the patients with medication they refused to identify that caused some of the girls to gain as much as 19 pounds in three weeks.

For many patients, the number of fits was substantially reduced, or even eliminated. But many others returned home in mid-February only to begin having nosebleeds and hallucinations.

On Feb. 22, just when parents were beginning to feel confident enough to send their children back to School No. 2, three teachers fell ill with symptoms slightly resembling those of the original victims. The school quickly emptied again.

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