Poison, AIDS or infection?

Yasser Arafat died at an advanced age after living for several years in a narrow room without ventilation. He was under tremendous mental pressure as the leader of the PA and the PLO and in his last years was often in danger of his life, under the off-and-on siege which Israel imposed on him. Nevertheless, every senior PA figure we talked to suspects that the Rais did not die a natural death but was poisoned. "Israel wanted to liquidate Abu Amar and in the past already poisoned Khaled Meshal. Why should it not try again?" they say.

The official French medical report rules out the poisoning option almost completely. A separate toxicological report attached to the medical report shows that all the tests for toxins that were carried out in three toxicological laboratories turned up negative results. The report lists a series of well-known toxins (paracetamol, cannabis, cocaine, amphetamine, methadone and others) which the toxicological laboratories in France looked for in Arafat's blood. Of course, they had no way of searching for poisons with which they were not familiar. All the tests were done under false names. The results of the toxicological tests in the separate report appear under the name of Etienne Louvet," born 1932. On the other hand, the report does not state with certainty the cause of Arafat's illness.

"The toxicological tests that were carried out and consultations among specialists in several fields do not confirm that poisoning constitutes the explanation for the patient's condition," the summarizing report of the intensive care unit states, in the section dealing with the tests for toxins. France, by the way, initially refused to make the report available to the PA, on the grounds that only family members were entitled to receive it. As a compromise, it was decided that the report would be given to Nasser al-Kidwa, the nephew. Al-Kidwa made the report available to the prime minister, Abu Ala, and to the Palestinian minister of health.

The report and the reconstruction of Arafat's last days raise a number of questions. The blood samples taken and the biopsies performed by the Tunisian medical team in the Muqata were sent to the PLO embassy in Jordan. From Amman, they were supposed to be taken to Tunis and Paris, but all trace of them was lost. The report also fails to mention the blotches on Arafat's face. Equally difficult to explain is Suha Arafat's refusal to allow a liver biopsy to be performed on her husband. Israeli physicians who have seen the report say that their impression is that the document is more detailed than necessary, almost as though it had been "doctored," so to speak - edited with a view to the possible implications of its publication.

Most puzzling of all, though, is the fact that the report, which covers hundreds of pages and cites every medicine, test and possible illness that might be connected with Arafat's death, does not mention or even hint at the possibility that Arafat had AIDS, or that he was given a test to rule out that possibility. A senior Israeli physician maintains that Arafat contracted AIDS shortly before his death. The physician heard from a close friend of his - a French physician who was part of the team that treated Arafat in his final days - that the Rais had AIDS. Israeli security sources confirm that the report about AIDS reached them but refrain from stating whether there is anything to it.

There are also some on the Palestinian side who know, and also confirm, the AIDS theory, but believe it is related to poisoning. "I know that the physicians in Paris found the AIDS virus in Arafat's blood," says Dr. al-Kurdi, "but this is material that was introduced into his body in order to camouflage the poisoning," he says. Al-Kurdi, who was kept away from his patient in Arafat's last weeks, will not say how he obtained this information.

Prof. Gil Lugassi, the hematologist, who read the French report, says that the symptoms it describes could be characteristic of AIDS. "An infection that begins in the digestive tract and deteriorates very quickly into the collapse of the blood clotting system is typical of AIDS. What is simply inconceivable and appears very bizarre is that the possibility of AIDS was totally ignored. The report mentions dozens of diseases that were checked, or bacteria, but there is no evidence of HIV tests and not even any mention that the subject was discussed. "I can only assume that if there had been an AIDS test with negative results, there would have been no problem saying so in the report."

Still, Prof. Lugassi does not jump to the conclusion that it was AIDS. "There is definitely a possibility that the digestive tract became infected as a result of a bacterium in food that was not kept well, such as meat that spoiled, and the bacterium brought about the clotting problem. It is possible that with a bit of antibiotics the infecting bacterium disappeared - thus explaining why no source for the infection was found. But because of the late identification, it was no longer possible to cure the disease that it caused, the thrombocytopenia."

Similarly, a senior physician and AIDS specialist at a large hospital in Israel says that the fact that the report totally ignores the AIDS possibility raises serious questions, as does its failure to mention any expert in infectious diseases (and AIDS specialist) in the long list of physicians who treated Arafat.

Still, he says, the probability that Arafat contracted AIDS is not high. The AIDS specialist, who went over the medical report, says it is not likely that an illness that lasted for two weeks (until the move to the Paris hospital), with serious diarrhea, vomiting and damage to the digestive tract, and led to a grave clotting problem, was caused by AIDS.

"Even if he was injected with AIDS viruses at a later stage [as Arafat's personal physician maintains], it is improbable that such rapid and severe damage was done to the digestive tract. In addition, a few days after the disease erupted, Arafat's immune system had not yet been seriously damaged [the lymphocyte count, an element in the immune system, was not especially low.]"

According to a senior Israeli physician who read the report carefully, the symptoms it describes, which appeared about four hours after the dinner he ate on October 12, 2004, raise a reasonable suspicion that this was the most critical meal in the life and death of Yasser Arafat.

"It is a classic case of food poisoning, which is taught in medical school," the physician explains. According to the description in the medical file, he notes, it is less likely that this is a regular and familiar type of food poisoning which is caused by a bacterium that secretes toxins. That sort of poisoning would have been detected in the series of tests Arafat underwent while he was still in the Muqata, and would have been contained with the help of the antibiotics.

It is definitely probable, the senior physician says, that Arafat's food had poison in it, which caused the outbreak of the unknown disease. This physician cites a possible toxin, one that causes the exact symptoms which afflicted Arafat, and which was not examined by the medical team in Paris. The toxin is called ricin; it can be introduced into food and was used as a biological weapon in the attack on the Tokyo subway.

How do you explain the fact that the physicians found no trace of the poison?

"The physicians in Paris looked for toxins, but that was more than two weeks after the dinner, and it is probable that if poison was present in the food it was absorbed quickly into the body, did serious damage and was then excreted - in other words, it disappeared. Moreover, the toxicological laboratories in Paris looked for familiar poisons and could not have looked for something they were not familiar with."

Still, the same physician says, the less likely possibility, of a natural bacterium in the food, cannot be entirely ruled out, "if we assume that the blood tests that were done in Ramallah produced imprecise results because of the lengthy time in getting to Tunisia and that the antibiotics he received came too late."

The Palestinians also prefer the poisoning theory. According to Nasser al-Kidwa, "Every expert we consulted explained that even the simplest poison manufactured by a middling scientist would be difficult to identify for a brilliant scientist."

Al-Kidwa adds, "I cannot say with certainty that Israel murdered him, but I can also not rule out that possibility. After all, the doctors themselves did not rule it out. It is the most reasonable possibility. There are large questions about what happened."

Jibril Rajoub agrees: "Arafat's death was not natural and I do not think that Israel is innocent. Arafat did not die by chance. Someone wanted him dead and took action to cause it." Mohammed Dahlan believes that "Arafat did not die a natural death. The possibility that he was poisoned definitely exists. Whoever wanted to get to him could have done so easily."

Arafat's aides note that the security arrangements around the Rais were pitiful. He received sweets (such as chocolate and halva) from hundreds of visitors, as well as medicines. Arafat was vulnerable to being hurt by pins which people affixed to his clothing and gladly received gifts without any control. After his death, the Palestinian Presidential Guard conducted an investigation to examine the possibility that he had been poisoned.

Among those who were questioned were the cooks who prepared Arafat's food and the officials who had access to him. The investigation ruled out the possibility that his food was poisoned, because many others also partook of the portions that were prepared for the Rais. However, the possibility of poisoning by means of the sweets or the medicines he received was not ruled out. In the light of the many rumors about poisoning, the PA decided to establish a special commission of inquiry to investigate the circumstances of Arafat's death, but as of the summer of 2005 its conclusions had not been published.

There are some Palestinians who suspect that it was not necessarily Israelis who were responsible for Arafat's death. "I refused to cooperate with the commission of inquiry," says Arafat's personal physician, Dr. al-Kurdi. "It was clear to me that the establishment of the commission of inquiry was in fact an attempt to prevent or delay the publication of the conclusions. The most basic method that could have been used to discover the circumstances of death was an autopsy. That was not done, and those circumstances are very suspicious. I continue to believe that Arafat was poisoned - all the symptoms attest to that."

'Doing a Meshal' on Arafat In the years preceding Arafat's death, an intensive debate was conducted in Israel about the possibility of kidnapping and expelling the Rais. At a later stage, plans to liquidate him were also contemplated. Ariel Sharon himself discussed with senior IDF officers the operational plans to expel Arafat and was present at exercises at which the possibilities were dramatized.

The plans were never authorized, because the commanders of Sayeret Matkal, the ultra-elite commando unit that devised them, declined to promise that Arafat would not be hurt during the kidnapping: Sharon was apprehensive about the reactions in the Arab world if Arafat were to be killed.

The chairman was constantly surrounded by bodyguards and aides, and the concern was that it would not be possible to seize him without opening fire in the crowded bureau. The decision-makers, for their part, declined to take the risk of ordering the soldiers not to respond with fire even if they were fired on. And because Arafat always carried two pistols, intelligence personnel did not rule out the possibility that he would prefer to go down in history as having died a hero's death, in an exchange of fire with his foes, rather than yield to the Israeli scheme to expel him from Palestine.

Senior security sources confirm that the more intense Sharon's loathing for Arafat became, and the more the Rais was portrayed as the major obstacle to progress, the more serious the discussion about his liquidation became. Is it possible that Israel secretly worked to "do a Meshal" on Arafat - to poison him without leaving traces? According to the sources, the answer is negative. The risk, in the event that Israel's responsibility would become known, was too high - the more so as Sharon gave his word to President Bush not to kill Arafat. Too many people would have had to share in the secret of such an operation, the sources say. Sooner or later, someone would have been liable to talk and Israel's involvement would have been exposed - and Sharon could not take a risk of that magnitude. In response to Palestinian allegations of poisoning, the Prime Minister's Bureau stated that this is "nonsense. The matter was checked in the past and found to be untrue."

The case for poisoning A senior Israeli physician: Most of the indications in the medical report suggest that Arafat was poisoned by way of the dinner he ate on the evening of October 12, 2004.

  • In the past, Israel considered the possibility of liquidating Arafat.

  • In the past, Israel used an unidentified poison in an attempt to assassinate Hamas senior official Khaled Meshal.

  • The failure of France's finest physicians to identify the cause of Arafat's mysterious disease might indicate highly sophisticated poisoning.

  • Most of the symptoms, including the accelerated destruction of the blood platelets, could indicate poisoning of some kind.

  • During his many months under siege, Arafat was not guarded carefully and received food, sweets and medicines from many visitors.

    The case against poisoning The French physicians ran dozens of toxicological tests on Arafat in an attempt to identify any known poison, but found no sign of poisoning.

  • The destruction of the platelets and the other symptoms might also indicate infection or failure of the immune system.

  • The tests done by the Palestinian security establishment found nothing to substantiate a claim of poisoning by Israel.

  • The Prime Minister's Bureau denies any Israeli involvement in Arafat's death.

    The case for AIDS Arafat's personal physician: "I know that the physicians in Paris found the AIDS virus in Arafat's blood [but in my opinion he was poisoned]."

  • An Israeli physician heard an identical report from a French physician who was involved in the efforts to save Arafat. Sources in the Israeli defense establishment are familiar with the report.

  • Some of the findings of the tests that were administered to Arafat in France are consistent with AIDS symptoms. Blotches that appeared on Arafat's face resemble the description of Kaposi's sarcoma, a rare skin cancer, which is associated with AIDS.

  • Even though Arafat underwent dozens of tests of different kinds to identity his illness, the obvious test for AIDS is not mentioned in the report drawn up by the French medical team.

    The case against AIDS Arafat's personal physician maintains that the AIDS virus was not found in a test for the disease which he administered to Arafat in the Muqata three months before the deterioration in his condition. It is not reasonable that Arafat contracted the disease in the last three months when he was under siege in the Muqata.

  • According to his personal physician, the Tunisian medical team that examined Arafat shortly before he left for Paris also claimed to have run a test for AIDS, which turned out negative.

  • The symptoms of Arafat's illness are also consistent with non-AIDS infection.

  • The lesions on Arafat's face might have been due to a clotting deficiency and were not necessarily an indication of Kaposi's sarcoma.

  • There is no definite proof in the record that supports the AIDS theory.

    The case for infection The substandard sanitary conditions in the Muqata, Arafat's advanced age and his poor health made him vulnerable.

  • Even though no bacteria were found in his blood, the president of the Israeli Society of Hematology explains that the bacterium that caused the fatal disease could have been destroyed by the antibiotics and thus not identified in the tests, but the disease it caused was already irreversible.

  • The symptoms of the disease could fit this possibility.

    The case against infection The French physicians found no indication of bacterial infection in the dozens of tests they administered.

  • The Egyptian and Tunisian medical teams that examined Arafat in the Muqata, before he was taken to France, also ruled out the possibility of infection.

  • A senior Israeli AIDS specialist says that the antibiotics, and Arafat's body itself, should have been able to cope successfully with infection caused by spoiled food, for example.