When the Bhopal tragedy took place in December 1984, the world knew about it almost instantly. The world’s worst industrial disaster took thousands of lives and continues to kill today through its long-term after-effects. But it happened at one place and one time and it was disaster from day one.
By contrast, some 27 years before the tragedy another equally appalling tragedy was “inaugurated” with fanfare and trumpets in a small town in Germany, an innocuous little pill touted as a miracle cure-all. By the time it was banned in 1961 the cure had exacted a toll of at least 10,000 with uncounted thousands in the decades to follow as it morphed from one avatar to another. Its spread, moreover, was global, from Europe to the Americas and further places. This was Thalidomide, a word that’s now synonymous with pain, disfigurement, death, and worse.
Grünenthal in German means green valley and the town of Stolberg, Germany, is certainly a pretty sight even though some of its associations are unsavoury. Chemie Grünenthal, a small company relatively new to pharmaceuticals, introduced Thalidomide on October 1, 1957, as a “wonder drug” for insomnia, coughs, cold and headaches. Most fatefully, it was recommended for pregnant women to prevent morning sickness. It was an instant and sensational success. Thousands of women and men were taking millions of the wonder pill every year in some 46 countries within a year of launch, unaware of its side effects. Grünenthal almost instantly became a poster boy of the German economic miracle, making tens of millions for its owners, the Wirtz family who had virtually owned Stolberg for four generations. Grünenthal was started in 1946 by Hermann Wirtz, the fourth of that name.
Not everyone was convinced by the success of the new drug, however. Two of the notable exceptions were William McBride, an Australian obstetrician and Widukind Lenz, a German paediatrician, who suspected that it was causing birth defects. In the United States of America, Thalidomide was never licensed thanks to Frances Oldham Kelsey, MD and pharmacologist, who refused FDA approval. However, the company distributed one million pills free of cost and an unknown number of women, possibly thousands, took it. The number of official Thalidomide babies in the US is thus a mere 10, though the actual number could be much higher.
The term phocomelia, like many medical terms, is opaque to the ordinary reader, but understanding it is key to what Thalidomide does. The symptoms of phocomelia syndrome are undeveloped limbs and absent pelvic bones and other abnormalities. Usually the upper limbs are not fully formed and sections of the “hands and arms may be missing”, the medical definition soberly states: “Thalidomide binds to and inactivates the protein cereblon, which is important in limb formation” and thus leads to defects ranging from minimal to severe.
In layman’s terms, it means a pregnant woman taking Thalidomide could give birth to a child without legs or arms or with foreshortened limbs. The baby could be deaf and blind, have a curved spine or heart or brain damage.
The German miracle became the world’s nightmare as Widukind Lenz proved beyond doubt in 1961, though even two years earlier reports had begun surfacing of adults suffering from peripheral neuritis damaging the nervous system. As profits kept rolling in, Chemie Grünenthal suppressed that information, bribing doctors and pressuring critics and medical journals, just like the tobacco industry.
In any case by then it was too late for thousands of families. One estimate suggests that there were over 90,000 miscarriages apart from the thousands of deformities.
It was only last month, over 54 years after the pill began its deadly dance that Grünenthal finally apologised to the victims for the catastrophe.
On August 31, their new CEO Harald Stock said, “We ask for forgiveness that for nearly 50 years we didn’t find a way of reaching out to you from human being to human being. We ask that you regard our long silence as a sign of the shock that your fate caused in us.”
But that is not the end of the story. Thalidomide was later suggested for treatment of leprosy after an Israeli specialist found some promise in that area. In 1998, the FDA approved the drug’s use in the treatment of ENL, a painful skin condition, one of the complications of leprosy. It has also been suggested as a treatment for AIDS and for cancer of the plasma cells. In the latter case, a cocktail of thalidomide and other drugs is now one of the most common regimens for patients with newly diagnosed plasma cell cancer.
The Roll of Horror
Grünenthal was founded in 1946, just after World War II, during which Germany’s extermination programme provided slave labour for its industrial machine and research facilities. Many famous companies, such as IG Farben, Krupp, the Todt organisation and others set up plants next to the death and concentration camps to take advantage of free labour. Many of its scientists also conducted experiments on humans, subjecting them to painful and often fatal tests. Some of Grünenthal’s leading drug developers had long associations with the camps.
Heinrich Mückter, a former army physician invented Thalidomide. During the war he worked at the German Supreme High Command institute for virus and typhus research in Kraków, Poland, to produce a vaccine against epidemic typhus. The culture can’t live outside a body, so it was kept alive by injecting it into prisoners. The researchers then tried out the vaccines to see if they worked. Mückter’s experiments were reportedly carried out in Auschwitz, Buchenwald, and Grodno as well as at Kraków. Poland was the site of some of the most notorious death camps, Auschwitz, Treblinka, Belzec, Sobibor, Chelmno and Majdanek.
Otto Ambros was one of the four inventors of the nerve gas sarin. A senior figure in IG Farben, the giant chemical and pharmaceutical cartel involved in numerous war crimes, he set up a forced labour camp at Dyhernfurth to produce nerve gas before creating the Auschwitz-Monowitz chemical factory to make synthetic rubber and oil. In 1948 Ambros was found guilty at the Nuremberg war crimes trials of mass murder and enslavement. He was sentenced to eight years in prison. Four years later, he was set free to aid the Cold War effort, working for Dow Chemical and the US Army Chemical Corps. He chaired Grünenthal’s advisory committee during the development of Thalidomide.
Prof Werner Schulemann of Bonn University, developer of the first synthetic anti-malaria drug was the probable “chemical brain” behind Thalidomide. Schulemann is reported to have carried out human experiments in field hospitals and in the camps. He was officially de-Nazified in 1950, which means a complete rehabilitation and restoration of his status.
One other name deserves mention. Grünenthal employed Heinz Baumkötter, chief concentration-camp doctor at Mauthausen and Natzweiler-Struthof, and, from 1942 chief medical officer in Sachsenhausen. Sentenced to life imprisonment by the Soviet Union, in 1956 he was returned to Germany.