Field activists documenting last week's deadly chemical attack outside Damascus describe the symptoms of the victims, many of whom were women and children.
By Waleed Abu al-Khair for Southeast European Times in Cairo -- 28/08/28
A woman weeps over children killed in a chemical attack Syrian opposition forces are blaming on the Syrian regime. [AFP]
Syrian activist Mohammad al-Baik said he will never forget the horrific images of children hurt in the chemical weapon attack in Ghouta on the outskirts of Damascus last week.
In the immediate aftermath of the August 21st attack, al-Baik, a member of the local co-ordination committee in eastern Ghouta, went to field hospitals in Irbin, Jisrain, Hammuriyeh and Harasta to monitor and document the casualties.
"There generally was no blood, except in rare cases, but the voices and screams of the injured were terrifying," he said. "The majority of patients were convulsing, felt nauseated, were thirsty and were unable to see or breathe, with swelling on their lips and around their eyes."
"What affected me the most was the sight of the wounded children and the screams of mothers who lost family members," al-Baik said.
On Tuesday (August 27th), the UN team in Syria tasked with investigating the attack delayed its second trip to the Damascus suburbs for safety reasons.
Also on Tuesday, French President Francois Hollande issued strong warnings that the perpetrators will be held to account, as chemical weapons are internationally banned and many of the victims were women, children and unarmed civilians.
France is "ready to punish" those behind the attack, he said, adding that the conflict threatens world peace.
"What we saw in Syria last week should shock the conscience of the world," US Secretary of State John Kerry said Monday.
"It defies any code of morality," he said, describing the attack as "inexcusable" and "undeniable."
Syria Foreign Minister Walid Muallem denied Tuesday that his government used chemical weapons.
An estimated 400,000 Syrians are living as refugees in Turkey, which shares a 900-kilometre border with Syria. Turkey Foreign Minister Ahmet Davutoglu harshly criticised the chemical attack.
"Leaving unpunished leaders and regimes which resort to such practices undermines the deterrence of the international community," he told the Milliyet daily. "Those who commit war crimes and crimes against humanity must definitely be punished."
The Unified Medical Revolutionary Office of Eastern Ghouta reported that 1,302 were killed in the attack, about 70 percent of whom were women and children, al-Baik said.
At least 9,838 others were wounded, he said.
In a Saturday report, the Foundation for Defence of Syrian Human Rights claimed the regime used chemical weapons 28 times between July 13th and August 21st. There were 23 incidents in and around Damascus, most recently the attack in Eastern and Western Ghouta, which killed a total of 1,845 and injured 9,924, it said.
The report pointed to "the use of fighter jets, helicopters, rocket launchers and artillery in the attacks, 85 percent of which involved sarin gas," and pointed to "clear indications of the use of ammonia and CS3 in the recent attack on Ghouta."
"Field doctors pronounced children dead at a rapidly increasing pace as their small bodies could not bear inhaling the deadly toxic gases," al-Baik said.
He said he saw "a foamy white substance at the mouths of the deceased" and "some bodies that bloated incredibly quickly, as if they had been dead for days."
Rescue teams and specialised and volunteer medical teams in Syria are not equipped to deal with such cases, many of which result from inhaling toxic gases, al-Baik said.
Many of the injuries he saw "were suffered by townspeople who rushed to help those whose homes were shelled -- thinking it was a conventional artillery attack -- and were hurt in the process," he said.
The shelling began after midnight, as most people slept, and caused widespread confusion, he said.
In Irbin, a paramedic told al-Baik the medicine needed to treat such cases is either unavailable or only available in small quantities, so paramedics had to make do with washing those hurt in the shelling with water.
Dr. Moussa al-Kurdi, an oncologist who volunteers at a hospital in northern Syria with the Union of Syrian Medical Relief Organisations, said the situation in Ghouta is "tragic" on every level.
"Medical capabilities are non-existent, whether in terms of the number of paramedics and doctors, or medical supplies and equipment," he said, noting that there also have been power and telecommunication outages in a number of areas.
Syrian Observatory for Human Rights director Rami Abdel Rahman said the observatory has documented hundreds of deaths and injuries, around half of them women and children.
The Observatory has obtained in-person testimonials and medical documentation that confirm these people died from exposure to toxic gases, he said.
It also has "obtained numerous videos showing that most bodies have no traces of blood on them, and were therefore definitely killed by non-conventional weapons," he said.
The observatory has contacted all international bodies concerned with the chemical weapons issue to request they examine the collected evidence, in addition to doctor testimonies and videos, Abdel Rahman said.
"Toxic gas injuries, particularly sarin gas injuries, vary from one case to another depending on the extent of exposure and condition, and the resistance and age of the injured person's body," said Dr. Magdy Abdel Nour, a neurologist at Qasr al-Aini Hospital in Cairo.
"Sarin gas is stored as a colourless and tasteless liquid, and spreads quickly in the air in the event of an explosion," he said. "Injury by it is quick because it is absorbed through pores in the skin and the respiratory system. Its effect remains on the body for a long time especially in the nervous system, and results in instant death if it enters the lungs."
Symptoms of injury include eyesight failure, full-body convulsions and loss of control, on top of sweating, diarrhoea, a semi-coma and in some cases a coma, he said. Resulting severe muscle cramps may also cause death, Abel Nour said.
"Children's immune systems are weaker than those of adults, so they are more vulnerable to injury, particularly since inhaling half a milligram of sarin is enough to kill an adult," he said.
In the event of an attack, the injured person's clothes should be removed and burned within 90 minutes of exposure as they carry traces of gas that can cause injury to others, Abdel Nour said.
The victim should then be washed with decontaminants or soap and water, and all their body hair should be shaved to limit their exposure to the chemicals, he added. Measures also include immediate injection of sarin gas antidotes, typically Valium, pralidoxime and atropine, according to Abdel Nour.
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