The scenes have become strangely familiar by now.

The latest videos and pictures, streaming since Saturday from war-torn Syria, show the dead bodies of children and women, crowded in basements and littering the stairs of shelters. White foam covers their mouths and noses. They look asleep, but they are dead. There are no external wounds to explain why they are dead, a hallmark of exposure to chemical agents.

Another suspected chemical attack has occurred in Syria.

Bushra is a medical student who has been working nonstop at the site of this latest attack, in Douma, just outside of Syria’s capital, Damascus. She works in a hospital supported by my organization, and I got to know Bushra (for her safety, we are only using her first name) through the recent crisis and have communicated with her through WhatsApp. Most doctors were forced to leave the enclave. She is working as a nurse, doctor and even a surgeon because of the severe shortage of health care professionals there.

The main hospital in Douma was bombed by an airstrike the same day as the gas attack. Her small hospital was flooded with injured patients. “They were choking” she said. “They smelled bleach.” All had respiratory symptoms -- coughing, wheezing, foaming, vomiting and tearing in their eyes. Some of them were having convulsions. She also felt tightness in her own chest. She did not have proper protective gear.

Bushra told me about the chaotic scenes of nurses using water hoses to wash petrified children who were screaming or traumatized by what they witnessed. Her underground hospital was overwhelmed by the number of victims. She described flaccid children gasping their last breaths. She cried telling me how she performed CPR hopelessly on small children, trying to resuscitate them.

What has happened in Douma is not new in Syria. A year ago, a similar attack with sarin nerve gas in Khan Sheikhoun in the north led to the deaths of about 100 people, including 33 children.

Syrian President Bashar Assad, with the help of his allies Russia and Iran, has been bombing Douma after the breakdown of negotiations with the rebel group, Jaish al-Islam, which controls the city. Douma had a population of 500,000 before the crisis. The location is not far from the infamous nerve gas attack in August 2013, when 1,400 people suffocated to death after exposure to sarin gas. The Syrian regime was blamed for the attack.

At that time, President Barack Obama did not follow through on his 2012 warning that there would be consequences if the Syrian government crossed a “red line.” The red line referred to use of chemical weapons and was meant to prevent Assad from using those internationally prohibited weapons against his people. Well, the red line was crossed, not one time, but more than 200 times, according to a recent report by the Syrian Network for Human Rights.

There has been no accountability. Instead, the use of chemical weapons has been normalized, and the lack of accountability has set a dangerous precedent. It probably gave the green light to other regimes and dictators to use chemical agents with impunity against their foes. The nerve agent VX was used to assassinate North Korean leader Kim Jong-un’s half brother in Malaysia in February 2017. And recently, the nerve agent Novichok was used to poison former Russian spy Sergei Skripal and his daughter, Yulia, in southern England -- the first time chemical weapons have been used in Europe since World War II.

After so many attacks in Syria with chemical agents, the World Health Organization and the Organization for the Prohibition of Chemical Weapons, which is responsible for enforcement of chemical weapons protocols, still don’t have in place a process to confirm quickly which chemical agent has been used in an attack.

In response to the Khan Sheikhoun attack in April 2017, the United States fired a few long-range missiles onto the Syrian airfield used by the fighter jets that dropped their loads of nerve gas in that attack.

It was more of a slap on the wrist to prevent further use of the illegal agents and to affirm the norms of war. But apparently the message was not heard in Damascus. There have been multiple uses of chemical agents directed at rebel-controlled areas since last year.

President Donald Trump has a responsibility to prevent further normalization of the use of chemical weapons -- especially on the heels of his recent comments about a possible early US withdrawal from Syria that may have emboldened the brutal regime and its allies. He can also lead in bringing an end to the ongoing Syrian genocide that has destabilized our allies in the region and in Europe, and caused a global refugee crisis. He can do that by pressuring all parties, particularly Russia, to accept political transition away from the current brutal regime.

I asked the medical student Bushra what she wants. “Stop the hell raining on us from the skies,” she said. Bushra wants to finish her medical school training and become a pediatrician. She and her colleagues are dreaming of a day when all Syrian children are able, once again, to get out from their shelters, play in open-air parks, go to schools built above ground and breathe the air without choking.


Zaher Sahloul
Dr. Zaher Sahloul is a Syrian-American critical care specialist at Christ Advocate Medical Center in Oak Lawn, Ill., and president of MedGlobal, a nonprofit organization that sends medical missions to disaster areas. This was written for the Chicago Tribune. -- Ed.

(Tribune Content Agency)