“I tried to scream, but I couldn’t take a deep breath. No one noticed when I tried to scream — everyone was overwhelmed by the number of victims.”
I sat with my colleague Moustafa, a nurse in his early 20s, at a field hospital in Sarmin, Syria, as he described the chaos in his hospital on March 16, when barrel bombs filled with chemical gas struck.
At around 9 p.m. that day, the hospital received a wave of people experiencing chemical exposure symptoms — difficulty breathing, burning eyes, mouth secretions. He described washing and desperately trying to treat a small boy, Mohammad, who was foaming at the mouth. His sisters lay dead on top of their dead grandmother nearby. Moustafa says that as he treated the boy, he began to cough and was struggling to breathe. He rushed outside to breathe fresh air, but the air smelled like bleach. He passed out and woke up inside the hospital, receiving oxygen.
He survived the chemical exposure. Baby Mohammad did not. He died along with his two sisters, his grandmother, and his parents.
I decided to take the dangerous trip last month to Sarmin and Binnish in the suburbs of the northern city of Idlib, a major battleground in recent months, to speak with the brave doctors and nurses there. There are believed to have been at least six more similar attacks since the one in March, in addition to daily bombing and shelling using “conventional” weapons.
Barrel bombs filled with choking agents have not been as deadly as those filled with shrapnel and explosives, but are particularly dangerous in that they spread fear, panic, and confusion.
I interviewed more than 30 doctors, nurses, civil defense volunteers, and regular citizens about the chemical attacks and inspected the Sarmin field hospital and the site of the March 16 attack. It was springtime in northern Syria — the flowers and grassy countryside were a stark contrast to the buildings that lay in rubble.
After years of barrel-bombing in many areas of Syria, everyone, including children, can identify not only the sound of helicopters but also of jet fighter aircraft, air-to-surface missiles, and mortar shells. Many people I spoke with about the chemical attacks described hearing the sound of barrels hitting the ground without explosion. People typically celebrate when a barrel bomb does not explode in Syria, but in these cases, initial joy turned into a nightmare.
Patients young and old that I saw presented similar symptoms, consistent with exposure to a choking agent — shortness of breath, wheezing and coughing, burning eyes, nausea, and vomiting. Some developed pulmonary edema and choked to death. When a choking agent is inhaled, it reacts immediately with the normal water droplets in the linings of the nose, throat, and lungs to form acid, which burns the lung tissues and dissolves the cells, causing the lungs to fill with fluid. The victims suffocate.
Medical staff and civil defense members developed similar symptoms after close contact with patients. None had proper protective equipment and had used primitive masks that we use in hospitals to prevent inhalation of bacteria, not chemical agents.
On April 16, four days after my visit to Sarmin, I spoke about these attacks, along with my Syrian colleague Dr. Tennari who directed the only makeshift field hospital in Sarmin, in front of the U.N. Security Council in a special closed session. U.S. Ambassador to the U.N. Samantha Power said after the meeting that, “If there was a dry eye in the room, I didn’t see it.” However, after four years of relentless killing, the Syrian people deserve more than emotion. They deserve action.
My organization, the Syrian American Medical Society, and other nongovernmental groups have collaborated on a chemical weapon preparedness and response program. The program included training of medical staff, distribution of antidotes, like Atropine, and public awareness materials, and the establishment of decontamination treatment centers in dozens of locations across Syria.
Sadly, these preparedness efforts continue to be necessary. Helpless locals expect more ghastly attacks resulting in many more casualties. Strangely enough, there seems to be no chemical weapon preparedness and response program in government-controlled areas.
The Organization for the Prohibition of Chemical Weapons (OPCW) Fact Finding Mission, designed to investigate allegations of chemical weapons use, has not yet entered Idlib, and it took OPCW more than five months to confirm the use of Chlorine in Syria with “high confidence” last year. Meanwhile, the Security Council has passed two resolutions about Syria that are largely being ignored. Syria gave up some of its chemical weapons, but the attacks continue.
The reality is that it is not enough to send another fact finding mission to prove that chlorine has been used. The children who suffocated to death while asleep in their basement are painful enough proof of what has been going on.
Having seen its so-called redline crossed frequently, the U.S. government should lead the Security Council to implement its own resolutions on Syrian chemical weapons, assign responsibility for the recent attacks and hold the culprits accountable in court. In addition, the U.S. should work with its allies in the region, especially Turkey and Jordan, to establish protected zones for civilians and displaced people in northern and southern Syria to prevent further dropping of chemical agents — and barrel bombs — from helicopters. If this is not done quickly, the United States and the United Nations will risk losing what is left of their credibility in the eyes of Syrians and in the region. Extremists will rejoice at the new opportunity to recruit desperate youth.
As I sat with Moustafa, I asked him and the other members of the hospital and volunteer teams what they wanted me to tell the ambassadors in the U.N. Security Council? They all chose the words “protect us.” or “Himayah” in Arabic.
And that is what we should do.
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