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A Doctor in Syria

AP Photo via AP video
Volunteers practicing treating casualties of a chemical weapons attack, Aleppo, Syria, September 18, 2013

While I was submitting a report for the Syrian-American Medical Society (SAMS) on how our hospitals in Syria handled the April 4 chemical weapons attack on the town of Khan Shaykhun, I was struck by how familiar the aftermath is: journalists asking the same questions, pictures of the children killed, mothers looking for their kids among the unidentified bodies, Western leaders threatening retaliation, and the international media make a huge noise but without any effective action from the international community. All of this came to my mind.

Strikes by Donald Trump on military bases in Syria are no more effective than the redlines drawn by Barack Obama. UN mechanisms are dead and inactive. UNSC resolution 2118, passed in September 2013, declared that under chapter 7 of the UN charter, punitive measures would be imposed on the Syrian government in the event of further use of chemical weapons. Since then, hundreds of chemical strikes have occurred in Syria, killing at least 260 people, and the UN has done nothing. I am still answering the same questions from the same journalists.

Witnessing this week’s attack, I was reminded of some thoughts I wrote down last summer, for the anniversary of the August 21, 2013 chemical attack:


August 19, 2016

“Could you tell us a story still fixed in your memory from the night of the chemical attack? A story of a casualty or a victim that caught your attention more than the others?” asked the journalist.

Every year, on this date, journalists come with the same questions about the chemical attack that occurred in eastern Ghouta, in the Damascus countryside. I have given hundreds of interviews about it.

Journalists want a human story—far beyond numbers and statistics—in order to attract readers. I was always asked questions like: “Is the reaction to chemical attacks different from the reaction to conventional weapons?” Here I explain the special challenges of treating victims of chemical attacks, which requires a well-ventilated building, unlike the places where we work, which are almost all underground to avoid the systematic aerial attacks of the Syrian regime on health facilities. There is a risk of inhaling chemical gases that have been absorbed by the clothes and bodies of the victims. Here a journalist interrupts me to ask: “Is death by chemical attack different from death by other weapons?”

I lose my temper completely. “Of course there is a difference. Mr. Journalist, let me show you a victim of a chemical attack and a victim of barrel bomb. From them you will easily be able to tell the difference. But before that you should ask God to enable you to contact the dead, who can explain to you the difference better than I can.”

Journalists avoid talking about statistics. Cold numbers usually bore readers and make them want to stop reading, so the journalist asks the following question: “Would you please tell us the details of that night? What were you doing when you received the alarm?”

I don’t like to talk about it, though. The attack took place in the early hours of August 21, coinciding with the birthday of my wife, which is on August 20. We were talking on Skype; she was ten kilometers away from me, in Damascus, while I was stuck in Eastern Ghouta, which had been under continuous siege by the regime. I hadn’t seen her for months. That is, we were a family of Skype addicts. It was painful for me to recall that night, so I avoided details. I said: “I was talking by Skype”—here the smart journalist interrupts me, saying, “But as far as I know there are no communications with Ghouta?”—I replied, “We were using satellite net,” and I lost my train of thought.

Today, on the third anniversary, i.e. the fourth time I have retold the story of the chemical attack, you can’t take me back to that night again. Ever since 2013, I have missed celebrating my wife’s birthday because I’ve been busy talking about the massacre, which Bashir al-Assad committed the same night.

We go on with the interview. The journalist tries to highlight the size of the massacre: “How many beds are there in the emergency unit in your city? And how many casualties did you receive that night ?” Again I feel agitated: “We assigned two of our team to count the casualties. We asked them to do nothing but count the dead and the wounded and to be exact in counting, because we need an exact number to give to the press.”

The smart journalist doesn’t realize that I am kidding. He opens his eyes wide and asks: “If you asked two of the medical team to do this documentation, how many total were on the medical team in your city?”

The faces of all my colleagues, faces of all the people of my city, flashed through my memory. They all became members of the medical team, helping us, offering their vehicles and services. Journalists believe that at such moments we can set aside two of these people just to provide news organizations with the correct number of victims.

Here I answered: “The local council estimates that the population of Eastern Ghouta is more than 500,000 people.” The journalist interrupts me: “But I am asking about the number of people on the medical team.” I answer: “I don’t know, all of them were on the medical team.”

I believe journalists are confused about what attracts the reader more, numbers of casualties or a human story. When there is a humanitarian issue the subject is no longer a personal one. Personal stories do not end, if you think from a humanitarian view point. You will see in every victim a father, a brother or a sister. Deaths of relatives and friends are painful any time, regardless of the reasons for their deaths, because we know the personal story.

Do you think I can tell you the stories of the more than 1,500 people who were killed, and the 10,000 who were wounded, by chemical weapons over the past three years? These numbers are of great importance because they represent human beings like us.

The journalist asked intelligently: “Would it have been possible to save more human lives if Ghouta had not been besieged?” Or “If you had had the necessary equipment and services would you have had better success in treating the victims? Tell me how you can work without electricity and communications.”

I already had the answer. These questions had been asked several times by other journalists with good intentions. They had always tried to give their readers an idea about how things are in Ghouta. I used to tell them that every medical team is in a different situation. Even the best-equipped teams will say: “If we had such and such, we would have saved more lives.” I believe even the medical teams in New York said the same after 9/11.

The question is a painful one; but only doctors will feel its true potency. Could I have saved one more life if I hadn’t been talking on Skype with my lovely wife Dima at that moment? Did that delay my attention? She hates her birthday because it always reminds us of the massacre. Would it have been possible to save more lives in the difficult conditions we face in Ghouta if we had been more alert?

I wish journalists would stop asking such questions because the world, which didn’t care about what happened then, will not care about what will happen tomorrow or the day after tomorrow. Those who are really concerned about what is happening in Syria already know all the necessary details. So there is no need to embarrass them and to remind them of Ghouta or the air raids on hospitals.

I wish that those who are not concerned about Syria—those who believe that Obama achieved victory by declaring his red lines on chemical weapons, and by the 2013 UNSC resolution calling for the destruction of Syrian chemical weapons—will be alarmed when I tell them about 2015. In 2015 there were more chemical attacks in Syria than ever.

I hope politicians and international officials will be concerned to learn that 77 percent of the chemical attacks took place after the UNSC resolution was issued on December 13, 2013. A full third of these attacks occurred after UN Security Council resolution 2209 of March 6, 2015, which criminalized the use of chlorine as a poisonous gas.

Those who doubt these facts might claim that the 161 chemical strikes that have been documented by the Syrian-American Medical Society are exaggerated. I wish they would review our methods for gathering information and investigating these attacks. They might respond differently if they knew that out of a total of about three hundred strikes in Syria since 2013, most of them have taken place in areas under the control of the opposition factions. They were systematically implemented by the regime forces. The number 161 is the number of strikes whose documentation was deemed to meet UN standards of investigation. Those people won’t care for personal humanitarian stories.

“What happened on the day after the massacre?” the journalist continues. There is a span of several hours that I can’t remember. It seems that my mind has tried not to remember those twelve hours. It is very painful to remember that day. So please stop asking me about it.

On August 7, 2015, a “Joint Investigation Mechanism” was formed by the UN Security Council to determine responsibility for the use of chemical weapons in nine strikes in Syria. I don’t know how these cases were chosen, but I know that our doctors in Aleppo had treated three dead and dozens of wounded just a few days before, and the international community is still postponing, for political reasons, holding the perpetrators to account. The Ghouta massacre was not among the nine attacks I mentioned above, because the committee in charge of the investigation had dropped it under the pretext that the weapons used in it had been destroyed. They forgot that the perpetrator still had other weapons in his bag.

Returning to numbers, I can tell you that there are six million Syrian refugees who have fled the country, more than 500,000 dead, more than 1.5 million wounded, and more than 12 million Syrians who need humanitarian aid—half of them have lost their homes.

The question that nobody can answer is, Until when? Until when I will keep celebrating chemical birthdays with my wife?


A real change means accountability. A real change means seeing perpetrators in jail, and stopping this killing machine. This is what the leaders of the world should do, regardless of the bureaucracy of the UNSC. Several mechanisms have been created to investigate war crimes and human rights violations in Syria, dozens of reports have been written, but there has been no tribunal. American strikes will not do this. Since there have now been 180 chemical attacks in Syria and counting, you can imagine how many Syrians have chemical birthdays.