Chemical warfare – Crossing the red line

“I didn’t set a red line; the world set a red line. The world set a red line when governments representing 98 percent of the world’s population said the use of chemical weapons is abhorrent and passed a treaty forbidding their use even when countries are engaged in war.” – President Barack Obama, Stockholm, 4 September 2013

Modern chemical warfare began on the battlefields of World War I, during which 124,000 tonnes of chemical agents, especially chlorine and mustard gas, were used. This resulted in the indiscriminate killing of approximately 100,000 civilians and over 1 million soldiers. Death was torturous, with the blistering of mouths, lungs and skin.

The horrors of watching another succumb to chlorine gas is encapsulated in Wilfred Owen’s Dulce et Decorum est:

As under a green see, I saw him drowning.

In all my dreams, before my helpless sight,

He plunges at me, guttering, choking, drowning.

Chemical warfare created deformed landscapes, transforming them into uninhabitable wastelands of toxic shell holes and trenches, destroying plant, animal and human life alike. The devastation caused by chemical warfare in WWI led to the 1925 Geneva Protocol, which banned the use of chemical and biological weapons in war.

In 1997, the Organisation for the Prohibition of Chemical Weapons (OPCW) was formed to implement the Chemical Weapons Convention. Countries that sign the treaty agree to ‘chemically disarm’ by destroying production facilities and any stockpiled weapons. Despite this, chemical weapons have continued to bring harm, terror and death throughout the world.

In perhaps the most catastrophic chemical attack in recent history, 1,300 civilians were killed during an attack on rebel-controlled areas outside the Syrian capital of Damascus. It is widely believed that the Syrian government was responsible for these attacks, however, there remains some controversy as the Assad regime never formally claimed responsibility. If carried out by the Syrian government, the attack, occurring in August 2013, would violate their agreement with the OPCW which they had signed less than a year earlier.

Skip forwards to the early hours of April 4th, 2017. Planes are flying over the rebel-controlled city of Khan Shaykun in north-western Syria. Missiles filled with nerve gas drop on sleeping families, killing at least 86 people, including 30 children.

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Whilst Russia attributed the source of the attack to Syrian rebels, the U.S. placed responsibility on Bashar al-Assad and the Syrian government, describing his actions as ‘unabashed barbarism’.

Sarin gas was the chemical agent used in the attack. It has a toxicity 20 times greater than cyanide. Sarin, an organophosphate compound, was first made by the Nazis in 1938. It can penetrate the body directly via the eyes, exposed skin or through clothes; and may also be breathed in, or ingested through contaminated water supplies.

Sarin overactivates the nervous system, causing muscles to go into spasm. Symptoms of toxicity include diarrhoea, nausea, vomiting, convulsions, foaming of the mouth, and blurred vision. At higher doses and for vulnerable groups, such as children, survival rates are low, as victims lose control of vital functions and die via asphyxiation within minutes.

For many, there is also the question of whether they will receive treatment. “There is very little treatment for any of these, and certainly would not have been available in a remote setting,” Joe Schwarcz, director of McGill University’s Office for Science and Society, said in response to the attack n Khan Shaykun. “I don’t think that anything could have been done.”

For treatment, the CDC recommends that clothing should be removed and bodies should be washed to remove the toxin from the skin. Gold standard treatment involves ‘antidotes’, the most common being atropine, which blocks the nervous system effects of sarin.

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Several issues stand in the way between health workers and successful treatment of victims. Firstly, doctors themselves must overcome the innate fear of death, as they watch bodies being lined up. Secondly, the issue of resources is further complicated by the destruction of clinics.  Two days before the 2017 sarin attack in Khan Sheikoun, the town’s hospital was severely damaged. Following the attack, Syrian forces then bombed clinics treating the survivors. This then begs the question – should doctors protect their own lives or stay with their patients?

Atropine itself is in significant shortages in rebel-held areas and has its limitations. It has a small therapeutic window and may not enter the brain effectively or in high concentrations. Its use, as well as washing bodies, cannot reverse or prevent long-term damage caused by sarin.

But why use a chemical agent to cause death in the first place? Why affect the body in such a way instead of using bullets?

There have been more than 200 chemical attacks in Syria during the six years of civil war. The key advantage of chemical warfare is its psychological impact that compounds its horrific physical effects. Sarin, like many other compounds used in such attacks, is odourless, colourless and tasteless. It is impossible to detect and can easily evaporate and spread through air.

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Fear is acutely elicited within communities as death occurs without warning. It is as though the Angel of Death swoops upon a city and indiscriminately kills anyone in its path. This fear is then wielded and exploited for political means.

The 29th of April 2017 marked the 20th anniversary for OPCW. Over the past 20 years, 95% of chemical weapons have been destroyed and 192 nations have committed themselves to the Chemical Weapons Convention.

But there is still much more to be done, as chemical weapons continue to be used as an act of terrorism against innocent civilians, inhumanely killing and disabling all in its path. From the thousands killed in Syria in 2013 to the many smaller examples of more recent years, chemical warfare is simply unacceptable.

As Obama pointed out four years ago, the world has set its ‘red line’. Now we need to abide to it.

The views and opinions expressed in this article are those of the author and do not necessarily represent those of the Doctus Project.