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Syrian-American Doctor: Medical Workers Among Those Killed in Gas Attack

A survivor from what activists say is a gas attack rests inside a mosque in the Duma neighborhood of Damascus, Aug. 21, 2013.
United Nations chemical weapons inspectors continue their investigation into reported nerve gas attacks in the Damascus suburbs last week and say they will need another four days to complete their inquiry. Born in Homs, Zaher Sahloul is a physician and president of the Syrian American Medical Society, which has been very active in supporting physicians and hospitals inside Syria, as well as refugees affected by the ongoing crisis.

Sahloul was reached by telephone in Chicago, where he practices pulmonary medicine, and provided an update.

"Since last Wednesday [August 21], we have had continuous communication with the doctors in the east Ghouta area. This is the area where most of the attacks happened, and we actually set up a situation room to deal with the situation. We have physicians from here and from our regional offices in Jordan and Turkey, in addition to doctors in east Ghouta communicating about their response, the complications that they face and what they are lacking, and how to improve their response, and also what is the contingency plan in case we have attacks like that in the future—especially in light of the expected strike on Syria and what may follow as retaliation from the regime using chemical weapons or chemical weapons."

So what we are seeing there, is it consistent with the use of nerve agents?

Zaher Sahloul
Zaher Sahloul
"Yes. The symptoms that the doctors are describing are consistent with exposure to phospho-organic chemicals--or what’s called 'nerve gas.' Symptoms include respiratory complaints, increased secretions, chest tightness, shortness of breath, respiratory failure. Patients stop breathing, so many of them require intubation and mechanical ventilation. And also they have neurological symptoms, like convulsions and delusions. And also they have eye symptoms—constricted or pinpoint pupils. And these symptoms are consistent to nerve gas or sarin gas.

Of course there’s no way to confirm that for sure because there are no labs in that area—or in Syria—to confirm that use, but I know that physicians took samples -- blood and hair and urine samples and also, from the clothing of the patients – and they will probably share them with the U.N. investigation team.

Also, patients responded to the antidote to nerve gas, which is Atropine, which would probably indicate that the problem they are dealing with was nerve gas exposure."

So you are saying if it were not nerve gas exposure, the Atropine wouldn’t be effective?

"That’s correct. The other thing that also pointed to nerve gas exposure was the fact that many of the medical personnel, whether they were nurses, doctors or medics who were the first responders who participated in taking care of the patients, they had symptoms also. And unfortunately, one of the physicians died. Three nurses and one of the medics also died, and we had about 15 to 20 medical personnel who developed symptoms. Some of them required injections of antidote. Some of them required intubation and admission to the intensive care unit. We are still waiting for the final tally of medical personnel who had either symptoms or died due to the exposure. But this also points to exposure to nerve gas."

One hears that the symptoms vary by the concentrations that people are exposed to. What have you heard about how it was delivered—in other words, what kind of exposure are we talking here?

"What we heard is that we had several shells that fell and exploded in an area that is very concentrated with civilians. This is a relatively small area, but very congested. There are about 1.5 million civilians who live in the east Ghouta area, but according to the physicians there, the activists, there were about 26 missiles that were used to deliver chemical weapons, and the difference between this incident and other incidents, of course, besides the number of missiles used is that it looks like a higher concentration of the nerve gas that led to many deaths amongst civilians. Also, the wider area that this attack that happened in east Ghouta--it targeted Zamalka, Ein Tarma and Jobar, so these are larger areas than the previous attacks, with lots of civilians.

A U.N. chemical weapons expert wearing a gas mask carries samples collected from one of the sites of an alleged chemical weapons attack in the Ain Tarma neighbourhood of Damascus August 28, 2013. U.N. chemical weapons experts investigating an apparent gas
A U.N. chemical weapons expert wearing a gas mask carries samples collected from one of the sites of an alleged chemical weapons attack in the Ain Tarma neighbourhood of Damascus August 28, 2013. U.N. chemical weapons experts investigating an apparent gas
And unfortunately, people panicked and the response was not what we would like to have in an incident like this. This is to be expected. This is a third world country, and people are not used to responding to chemical weapons attacks on that scale. Resources are very limited. You know, this area has been under siege for the past year, and even if you were to send them everything they need, it’s very difficult to get things in."

What do you say to those people who argue that the regime did not send these missiles, that it was the rebels themselves?

"That’s crazy. This theory that rebels did that is laughable, to say the least. The rebels do not kill their children or their families to prove a point or something. Another thing that one of the physicians over there told me –because I asked the same question, you know, the first night. I asked them the same question: 'How come the regime is using this now that you have the United Nations investigators only a half an hour away from this area?'

And their response was, first of all, the regime never cared about the United Nations one year ago, when the U.N. came to Syria, when the Houla massacre was committed. And the U.N. investigation team when there and they saw with their own eyes what happened in the Houla village, around Homs. And the other thing that they said is that this area [Ghouta] was very strategic in terms of location, and the regime troops were trying to retake it using conventional methods and ground troops for the past seven or eight months and failed to do so. So that’s probably why they used chemical weapons.

And the third thing: If you look at the regime media, they initially denied it completely, which doesn’t make sense. I mean, can we not believe our own eyes—and all these victims—and then their media? And then after that, they blamed it on the rebels. So if the rebels had used it, why wouldn’t the regime propaganda have accused them from the beginning?"