In the early hours of 21 August 2013, rockets carrying sarin struck opposition-held areas of Ghouta, in the suburbs of Damascus. The lowest counts record at least 281 people killed. Other counts run far higher, into the hundreds and beyond. Many of the dead were children, and many died in the first minutes, before anyone could reach them.
Sarin blocks the enzyme that clears acetylcholine from the nerve endings, so the signal to a muscle or a gland never switches off. The treatment is atropine, given early and often, alongside airway support. The clinics and field hospitals of Ghouta had very little atropine and very few ventilators. Doctors, nurses and volunteer rescuers worked through the night with what they had, and a number of them were injured by contact with the people they were carrying.
A United Nations inspection team led by Professor Åke Sellström was already in Damascus, sent to look into earlier allegations. It reached Moadamiyah and then Zamalka in the days that followed, taking environmental and biomedical samples and interviewing survivors and medical staff. Its report confirmed that surface-to-surface rockets containing sarin had been used against civilians, including children. Thirteen years on, the names of the dead are held by their families.
The burials that week were done in haste and in daylight, many in shared graves, with the washing of the dead shortened or left undone because the bodies still carried the agent. Families who could not follow the rites they knew did what they could, and stayed with their dead as long as they were able.
Ada, thank you for this. The Sellström team's mandate was narrow by design, to establish whether chemical weapons had been used and not to assign responsibility, and that limit is why its findings held. Syria acceded to the Chemical Weapons Convention within weeks of that August.