Idlib, northwest Syria – It has been 10 years since the chemical attacks in eastern Ghouta, on the outskirts of the capital, Damascus, and Umm Yahya – a nurse at a local hospital at the time – still cannot forget the images of people convulsing and foaming at the mouth.
Shortly after midnight on August 21, 2013, the Syrian regime attacked the towns of Zamalka, Ein Tarma, and Irbin in the Ghouta countryside with a nerve agent.
According to the Syrian Network for Human Rights (SNHR), a total of 1,127 people were killed in the attacks. Nearly 6,000 others suffered from suffocation and respiratory problems.
The SNHR said gassing people in their sleep demonstrates that the attacks were “premeditated and deliberate”.
“The weather in the region had been forecast to be relatively cool and calm between 02:00 and 05:00 that night, meaning those responsible knew that the air would be still and the heavy poison gas would naturally drift downwards and settle at ground level rather than blowing away,” a statement by the rights group said.
At the time, Umm Yahya had finished her shift at the hospital at about 1am. She noted that, unusually, she was short of breath, and went home. But a few minutes later, an ambulance driver she knew – Abu Khaled – was knocking on her door, telling her there were many injured people.
That surprised her, as she had not heard the sound of shelling or missile attacks.
“I went down to the ambulance and found that Abu Khaled had brought people – men, women and children – foaming at the mouth, suffocating,” Umm Yahya recalled, speaking at a memorial in Idlib that marked a decade since the Ghouta attacks.
The Sunday memorial was attended by activists, witnesses, and civil defence volunteers, who had gathered as part of the “Don’t Suffocate the Truth” campaign. They carried slogans and demanded accountability for the perpetrators of the chemical attack.
For Umm Yahya, that night in 2013 was long and painful, mired in chaos, and the body count continued to grow to the point where her hospital could no longer accommodate any more patients and victims.
“All we could see were people choking and convulsing,” she said. “We did not understand what was happening. Someone came and told us to spray the injured with water, then a doctor said to give them atropine. I didn’t know what to do, and I had nothing but oxygen to administer to them.”
Atropine is used to treat a slow heartbeat in an emergency. It is also used to reduce saliva and fluid in the respiratory tract during surgery.
It was only at dawn that the hospital staff realised the cause of the suffocation was a chemical weapon, Umm Yahya said.
“I cannot forget the gasps coming out of the suffocating children, the foam coming out of their mouths, the terrified look in their eyes. In the morning, the hospital floor was full of dead bodies.”
The nurse counted 300 dead and asked for the bodies of the women and children to be separated from the men’s. The hospital staff began wrapping them in shrouds, but there were not enough to go around.
The ordeal did not end there. While the surviving families and hospital staff were transporting some of the bodies for burial, they were attacked by warplanes.
“Those families who were killed by the chemical weapon had a merciful death, compared with those who were killed by the warplanes,” Umm Yahya said bitterly. “As a result of the bombing, there were amputated limbs and blood everywhere.”
Among the dead were paramedics and Dr Abdul Ghani, who worked at the hospital and was killed along with his son. There were so many dead people that it was decided to dig a mass grave for them instead of individual ones.
Three days after the attack, people came to the hospital to say they had not heard or seen their neighbours for days. Umm Yahya, ambulances, and a monitoring committee made their way there and were greeted by the macabre sight of whole families lying lifeless in their homes.
“Honestly, there wasn’t a door in Zamalka and Ein Tarma that we opened without finding entire families dead,” she said. “We stood helpless, not knowing what to do.”
In one of the houses, she found a bride and a groom, whose wedding she had attended just days earlier, lying lifeless near the door, as if they were trying to escape. In another house, a family of seven were found dead.
The dead were covered in nylon bags because the funeral shrouds had run out. Six days after the attack, there were still a few houses that had not been checked, their dead inhabitants still inside.
“What I saw there was horrible. The features of someone killed by chemical weapons change after five or six days. Believe me, they had no recognisable features left,” Umm Yahya said.
Some of the surviving family members would not claim their relatives because of their distorted faces, leading the nurse to record many of the dead as anonymous.
The ordeal took a great toll on Umm Yahya, and for two weeks, she was unable to work or even move her body.
“I keep remembering how the children were sobbing, and how a father begged me to save his child, and all I could tell him was that I couldn’t do anything,” she said.
“I can take care of people who are wounded, or take out shrapnel from a bombing, but I couldn’t do anything for the victims of the chemical attack. We did everything we could.”
Umm Yahya hopes there will be justice for the families and victims, and that Syria’s President Bashar al-Assad and his government are held accountable one day.
“I just hope that people will not forget Assad’s criminality, and to support us with their hearts and souls,” she said.
The SNHR has documented a total of 222 chemical weapon attacks in Syria since the first recorded use of chemical weapons on December 23, 2012, up until August 20, 2023.
“Approximately 98 percent of all these attacks have been carried out by Syrian regime forces, while approximately 2 percent were by ISIS [ISIL],” the group said.
Referring to the 2013 Ghouta attacks as “the largest chemical weapon attack in the modern age”, SNHR said the al-Assad regime is still protected by impunity and called on the United Nations to impose economic, political, and military sanctions on the Syrian government.