13 April 2018
The international community needs to face the reality that these attacks are not an exception but a critical part of the regime’s strategy.
Dr Abdulkarim Ekzayez

Dr Abdulkarim Ekzayez

Academy Fellow, Centre on Global Health Security
Rachel Thompson

Rachel Thompson

Research Associate, Centre on Global Health Security

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Civil defence members remove the remnants of a rocket on the outskirts of Douma in February. Photo: Getty Images.
Civil defence members remove the remnants of a rocket on the outskirts of Douma in February. Photo: Getty Images.

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Only days after a supposed ceasefire was declared in eastern Ghouta, at least 100 people were reportedly killed, and many more injured, by what appears to be a chemical attack in Douma city.

Local medical sources reported more than 500 cases with symptoms indicative of poisoning by a chemical agent. The symptoms are consistent with an organophosphorous compound, which is the basis of sarin and other nerve agents. Some reports also suggest that the weapon may have contained chlorine.

The already shattered health system in Douma city struggled to manage this mass casualty incident: it was difficult to identify the exact chemical used and the sparse medical supplies there were insufficient to treat injuries and reverse neurological symptoms.

Since the offensive on eastern Ghouta began in February, civilians and their infrastructure have been repeatedly targeted. In what has been described as the systematic destruction of healthcare, more than 30 health facilities in eastern Ghouta have been reportedly damaged in the last six weeks. Besiegement over the last five years has prevented the transport of essential medical supplies into these areas. A further two health facilities were reportedly attacked on Saturday.

Targeting civilians and health facilities in this way could be a strategy to force displacement. As a result of these attacks, most opposition armed groups in eastern Ghouta agreed to surrender. Populations have been pushed out of their homes, either to the opposition-held areas in the north or to regime-held areas where they face an unknown fate.

However opposition groups in Douma continued to resist and remained in the city despite the bombardments. Douma is the biggest city in eastern Ghoutta and has many densely built-up areas, which gives underground structures – including shelters, warehouses and hospitals – some protection from aerial attacks. A different strategy was therefore needed in Douma.

Chemical agents create chaos and fear, and force people to leave underground locations and surrender. Only a few hours after the attack, with hundreds of civilians apparently poisoned, the main opposition group in Douma, Jaish al-Islam, announced their surrender of the city to the regime. The following day, more than 50,000 people left Douma for Jarablus in the Aleppo governorate. The remaining residents are expected to evacuate the city soon.

There are precedents to support this argument that chemical attacks are a strategy of last resort: in eastern Aleppo, specifically in the Bustan Al Qasr neighbourhood, chlorine gas forced people from underground shelters and hospitals, resulting in the surrender of the area.

Chemical attacks are, of course, illegal, banned under customary international law. They are also prohibited by the 1925 Geneva Protocol and the Chemical Weapons Convention – (CWC), both of which bind Syria.  Following the 2013 Sarin attack, Syria became a party to the CWC and thus agreed to the destruction of its chemical weapons stockpile and production facilities, under the supervision of the Organization for the Prohibition of Chemical Weapons (OPCW). However, reports from Douma and elsewhere suggest that the regime has not maintained its commitment to the CWC and neither of its backers, Russia and Iran, have the ability or the willingness to hold the regime accountable to this commitment. This shows the difficulties faced by the OPCW in verifying compliance with its mandate.

The continued attacks also reflect the ineffectiveness of foreign military action to dissuade Assad from chemical weapons use, such as when the US attacked the Al Shayrat airfield last year.

Furthermore, these examples suggest that, as with attacks on healthcare, chemical attacks in Syria should not be considered exceptional, but as a tactic in this conflict. Chemical attacks could even be considered a typical response to strong pockets of resistance in Syria. Considering the ineffectiveness of the OPCW mechanisms, and the inability of the international community to deter these attacks, why would the Assad regime, or any other parties, stop using chemical weapons in Syria?

Chemical attacks are prohibited because of their inhumane effects and humanity’s universal abhorrence and revulsion to their use. Their indiscriminate nature means there are limited options to protect civilians from their impact. Sadly this is unlikely to be the last chemical attack in the conflict. In the meantime, the protection of civilians in Syria continues to fail.

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