(New York) – Witnesses in Eastern and Western Ghouta, outside Damascus, described symptoms and delivery methods consistent with the use of chemical nerve agents during attacks by government forces on August 21, 2013. The attacks killed several hundred people and injured hundreds more.
Seven residents and two doctors who were first responders told Human Rights Watch that hundreds of people, including many children, appeared to have been asphyxiated in the attacks that began in the early hours of August 21. The killing of civilians on a large scale in a single incident raises concerns that serious crimes were committed. The government denied on its state TV channel that it had used chemical weapons in Eastern Ghouta, an area largely controlled by the opposition.
“A huge number of people in Ghouta are dead, doctors and witnesses are describing horrific details that look like a chemical weapons attack, and the government claims it didn’t do it,” said Joe Stork, acting Middle East director at Human Rights Watch.” The only way to find out what really happened in Ghouta is to let UN inspectors in.”
Whether or not chemical weapons were used, the attack left a large number of civilians dead, and those responsible for unlawful killings should be held to account, Human Rights Watch said. The government should give the United Nations chemical weapons inspection team currently in Damascus immediate access.
The witnesses told Human Rights Watch that residents in several towns appeared to have been affected by what they believe were chemical weapons delivered by missiles launched from government-controlled parts in Damascus city. The affected towns include Zamalka, Ayn Tarma, and Moadamiya.
“There was a big cloud of smoke covering the area,” an activist from Ayn Tarma told Human Rights Watch. “Most of us had masks to cover our mouth but they didn’t protect our eyes. Everybody was coughing and some were suffocating.”
Based on its review of satellite imagery, Human Rights Watch found that the affected neighborhoods are predominantly residential with some warehouses, markets, and assorted commercial facilities on the periphery, adjacent to the main highways. There are no apparent chemical, electrical, or other industrial facilities in the area, nor are there believed to be any large military bases or installations, indicating that the casualties did not result from conventional weapons striking such a facility.
Human Rights Watch identified one pharmaceutical plant, Tameco Pharmaceutical, with nine small high-pressure storage tanks probably used for compressed gas or liquid. However, the plant is located more than two kilometers south of Ayn Tarma. It seems unlikely that this could have been the source of a large chemical release.
Two doctors told Human Rights Watch that affected people consistently showed symptoms including suffocation; constricted, irregular, and infrequent breathing; muscle spasms; nausea; frothing at the mouth; fluid coming out of noses and eyes; convulsing; dizziness; blurred vision; and red and irritated eyes and pin-point pupils. These symptoms are consistent with nerve agent poisoning.
The doctors and other first responders said they were running out of medication to treat residents suffering from these symptoms, including Atropine, epinephrine, hydrocortisone, and dexamethasone.
The US Centers for Disease Control and Prevention lists Atropine and pralidoxime chloride as antidotes for nerve agent toxicity; however, pralidoxime chloride must be administered within a few hours following exposure for it to be effective. Acute exposure to nerve agents can be extremely toxic and treatment must be administered promptly to be effective. Emergency response teams risk serious exposure if they lack the proper protective equipment.
Government forces have besieged opposition-controlled towns in Eastern Ghouta in the Damascus countryside since early 2012. According to opposition activists, the area’s approximately one million residents have long endured shortages of electricity, water, fuel, and food. The government should immediately allow food, medical supplies, and trained and equipped emergency response teams into Eastern and Western Ghouta.
The United Nations Mission to Investigate Allegations of the Use of Chemical Weapons in the Syrian Arab Republic (the UN Mission), led by Ake Sellstrom, began its mission on August 19. Under the reported terms of its agreement with the Syrian government, the UN mission has permission to visit three sites where chemical weapons have allegedly been used during the conflict, including Khan al-Asal in Aleppo governorate.
The Syrian government should give the mission access to Eastern and Western Ghouta to assess whether chemical weapons have been used, Human Rights Watch said. The government should also give access to and fully cooperate with the UN Independent International Commission of Inquiry on Syria, led by Paulo Pinheiro, to assess who was responsible for the attack.
Following its emergency meeting on Syria, the UN Security Council should demand that the Syrian government and opposition forces allow immediate access to the sites to UN investigators and provide full cooperation with their inquiry. Human Rights Watch also repeated its call on the UN Security Council to refer the Syria situation to the International Criminal Court (ICC) to ensure accountability for all war crimes and crimes against humanity.
Syria is not among the 189 countries that are party to the 1993 Convention on the Prohibition of the Development, Production, Stockpiling, and Use of Chemical Weapons and on their Destruction. Any use of chemical weapons is unconscionable and contradicts the standards set by the Chemical Weapons Convention. There is absolutely no justification for the use of these heinous weapons by any actor, anywhere, for any purpose, Human Rights Watch said.
“If the Syrian government has nothing to hide it should let the inspectors visit the sites of the reported chemical attacks immediately while evidence can still be collected,” Stork said.
Statements from doctors and residents
A doctor working in the medical center in Erbeen, a town in Eastern Ghouta, told Human Rights Watch that the attack there began at 3 a.m. on August 21. He said that at the time there was no fighting taking place between government forces and opposition fighters. Activists in the area told him that 18 missiles, carrying what they said was a chemical agent, fired from the direction of the October War Panorama, a military museum in Damascus city, and of Mezzeh military airport, hit Zamalka, Ayn Tarma, Douma, and Moadamiya.
The doctor said he left home for the medical center at 3:30 a.m. He estimated that by 1 p.m. the hospital had received the bodies of 78 people who had been killed. He believed these individuals were civilians and not opposition fighters; the majority of those killed, he said, were children and women. Most of the dead and injured came from Zamalka, close to Erbeen. He said that the patients he saw were suffering from suffocation, constricted and irregular, infrequent breathing, and had pin-point pupils. He said that after receiving treatment some patients vomited. He had the patients remove their clothes, then washed them off, and gave them Atropine, hydrocortisone, and dexamethasone. He said that first responders did not have protective clothing and many of those treating the wounded also began exhibiting the same symptoms.
A second doctor at the Erbeen medical center also told Human Rights Watch that the shelling began at 3 a.m. He said that the center received 150 injured people, including 65 children between the ages of 5 and 17. He said many other injured were women, with very few adult men among the casualties. He said that 35 of the 150 died from their injuries. He said the injured came from Erbeen, Zamalka, Ayn Tarma, Kafer Batna, and Jobar, and that they were suffering from throat constriction, vomiting, muscle spasms, and frothing, with saliva coming out of their mouths, and shortness of breath. The medical team treated the injured with Atropine, the doctor said, but the clinic then ran out of supplies. He said that the clinic also received 50 to 65 bodies of people who died from asphyxiation. He believed all of those treated in the hospital were civilians.
A local resident who was in the field hospital in Zamalka at 7 a.m. told Human Rights Watch that he saw about 300 injured and the bodies of approximately 400 people in the field hospital. Human Rights Watch is not able to verify the casualty numbers. He said the victims had shortness of breath, fluid coming out from their nose and eyes, red and irritated eyes, and convulsions.
A media activist in the town of Ayn Tarma told Human Rights Watch that the attack there began between 2:30 and 3 a.m. He said that around 2:30 a.m., he and others saw a missile launched from the direction of the October War Panorama in Damascus city. At the time, he said, he was at home with friends. He described what he thought was a surface-to-surface missile striking nearby and releasing a chemical substance:
I was with my friends when we heard a very big explosion. The explosion shook the house. We went to the site and we saw a very big explosion that destroyed several buildings. The buildings were on the ground [had been leveled]… Paramedics quickly arrived and people were in a state of hysteria. There was a big cloud of smoke covering the area. Most of us had masks to cover our mouth but they didn’t protect our eyes. Everybody was coughing and some were suffocating. My eyes became red and itchy for hours.
He told Human Rights Watch that over the course of the next several hours he visited field hospitals in Ayn Tarma, Hamourie, Zamalka, Saqba, Douma, Kafr Batna, and Erbeen, where he saw hundreds of people who appeared to be suffering from a chemical attack, including patients experiencing restricted breathing. He estimated that he saw at least 50 injured in each clinic, including children and women. Human Rights Watch is not able to verify these casualty figures.
He shared with Human Rights Watch a video that he took in one of the field hospitals showing residents suffering from suffocation, throat constriction, and an accelerated heart rate. He believed all of those injured were civilians and said that opposition fighters are not located in the part of Ayn Tarma where the attack took place. He said there were no factories or weapon depots in the area.
Another media activist from Kafr Batna also told Human Rights Watch that he saw residents from Ayn Tarma who appeared to have been subjected to a chemical attack. He also said that the areas that were hit in these towns were residential and that no military bases or chemical factories were present.
An activist with the human rights office in Moadamiya, which documents human rights violations there by the government, told Human Rights Watch that they documented 103 civilian deaths of Moadamiya residents, apparently from suffocation. They said the dead included 15 children and 20 women, and about 625 injured. Those injured were suffering from nausea, frothing from the mouth, convulsions, shortness of breath, blurred vision, and dizziness. Medical staff treated them with Atropine, epinephrine, and hydrocortisone and washed them with a disinfectant. The activist said they had run out of Atropine and first responders had also suffered from these symptoms. He said there were no chemical plants or military bases other than the Mezze military airport and the Syrian army’s 4th Division in the area.
Another activist from the Moadamiya media center gave Human Rights Watch a similar account of the symptoms afflicting the injured. He said the area most affected was around Zeytouna Street, Ruweida neighborhood, and the main street. He said opposition fighters were on the outskirts of the city at the time of the attack.
A resident of Daraya who was in the Daraya field hospital after the attack told Human Rights Watch that he saw the bodies of 103 civilians brought from Moadamiya, including 15 children and 20 women. All of the victims appeared to be civilians. Human Rights Watch has not been able to verify the number of fatalities in Moadamiya.
In Douma, a resident told Human Rights Watch that the field hospital there received hundreds of injured people from Eastern Ghouta, including Jobar, Erbeen, and Ayn Tarma. He said that 64 of these people, primarily children, the elderly, and women, died during the day while he was there because they were not responsive to Atropine treatment. The symptoms he observed included throat constriction, muscle spasms, red eyes, fluid coming from the nose, and vomiting.