Epidemiological findings of major chemical attacks in the Syrian war are consistent with civilian targeting: a short report

Abstract

Evidence of use of toxic gas chemical weapons in the Syrian war has been reported by governmental and non-governmental international organizations since the war started in March 2011. To date, the profiles of victims of the largest chemical attacks in Syria remain unknown. In this study, we used descriptive epidemiological analysis to describe demographic characteristics of victims of the largest chemical weapons attacks in the Syrian war.We analysed conflict-related, direct deaths from chemical weapons recorded in non-government-controlled areas by the Violation Documentation Center, occurring from March 18, 2011 to April 10, 2017, with complete information on the victim’s date and place of death, cause and demographic group. ‘Major’ chemical weapons events were defined as events causing ten or more direct deaths.As of April 10, 2017, a total of 1206 direct deaths meeting inclusion criteria were recorded in the dataset from all chemical weapons attacks regardless of size. Five major chemical weapons attacks caused 1084 of these documented deaths. Civilians comprised the majority (n = 1058, 97.6%) of direct deaths from major chemical weapons attacks in Syria and combatants comprised a minority of 2.4% (n = 26). In the first three major chemical weapons attacks, which occurred in 2013, children comprised 13%–14% of direct deaths, ranging in numbers from 2 deaths among 14 to 117 deaths among 923. Children comprised higher proportions of direct deaths in later major chemical weapons attacks, forming 21% (n = 7) of 33 deaths in the 2016 major attack and 34.8% (n = 32) of 92 deaths in the 2017 major attack.Our finding of an extreme disparity in direct deaths from major chemical weapons attacks in Syria, with 97.6% of victims being civilians and only 2.4% being combatants provides evidence that major chemical weapons attacks were indiscriminate or targeted civilians directly; both violations of International Humanitarian Law (IHL). Identifying and quantifying chemical weapons violations requires inter-disciplinary collaboration to inform international policy, humanitarian intervention and legal action.

Qualitative accounts from Syrian health professionals regarding violations of the right to health, including the use of chemical weapons, in opposition-held Syria

“…9 Syria is unique, in part because of the number of sustained attacks on hospitals now numbering over 500 in a period of 7 years, alongside the rising number of chemical attacks. 37 As has been found in other conflicts, 31 38–40 our findings show that in Syria violence against healthcare has bred a climate of fear and insecurity, with devastating impacts on health-seeking behaviours and access including, civilian difficulties in reaching medical aid or avoidance of health facilities altogether. Participants described how their work to treat a suffering population was severely impeded by a lack of availability of essential equipment, facilities and treatments for chronic and infectious disease.…”

Quantitative T2 MRI is predictive of neurodegeneration following organophosphate exposure in a rat model

“…An in-house built restraining system including ear bars and a bite bar that was used to secure the head and prevent motion artifacts. Scanning protocol involved a multi-slice multi-echo T 2 sequence: TR = 6,534 ms, 32 echoes were collected with 10 ms echo spacing, 1 average, 20 slices, field of view = 30 × 30 mm 2 , and matrix size = 128 × 128, voxel size = 0.23 × 0.23 × 0.8 mm 3 . Respective baseline images were obtained for each rat followed by either saline or soman injection (Fig.…”

“…More potent forms of OPs include nerve agents that have been developed as chemical warfare agents. Confirmed usage of nerve agents in Syria, in 2013 and 2017, accounted for the death of hundreds of civilians whilst injuring thousands 3 . Nerve agents including tabun, sarin, soman, and VX continue to pose a threat to both civilians and military personnel.…”

Revisiting the Battle of Solferino: The Worsening Plight of Civilian Casualties in War and Conflict

“…[16][17][18] Banned chemical weapons, primarily chlorine, have been used by Syria against civilians on at least 15 occasions in 2018 compared with 10 incidents in 2017, including the banned chemical sarin, which was confirmed to have been used at least once on a Syrian town in 2013. 19,20 Armed actors flagrantly violate international humanitarian law, which is increasingly ignored with civilians suffering the major consequences. Civilians who have not, or could not, flee, often bear the brunt of the violence.…”