Statement

WHO is deeply alarmed by reports of the suspected use of toxic chemicals in Douma city, East Ghouta.

According to reports from Health Cluster partners, during the shelling of Douma on Saturday, an estimated 500 patients presented to health facilities exhibiting signs and symptoms consistent with exposure to toxic chemicals. In particular, there were signs of severe irritation of mucous membranes, respiratory failure and disruption to central nervous systems of those exposed.

More than 70 people sheltering in basements have reportedly died, with 43 of those deaths related to symptoms consistent with exposure to highly toxic chemicals. Two health facilities were also reportedly affected by these attacks.

WHO reminds parties to the conflict of their obligation to refrain from attacking medical facilities and personnel as per Security Council Resolution 2286 (2016). Any use of chemical weapons to cause harm is illegal under international law. Global norms against chemical weapons reflect a particular abhorrence to their disproportionate harm to the eldest, the most infirm, and the youngest among us.

"We should all be outraged at these horrific reports and images from Douma,” said Dr. Peter Salama, WHO Deputy Director- General for Emergency Preparedness and Response. “WHO demands immediate unhindered access to the area to provide care to those affected, to assess the health impacts, and to deliver a comprehensive public health response.”

WHO is currently coordinating the health cluster response for people displaced from East Ghouta and stands ready to provide more assistance to newly-accessible areas of East Ghouta as soon as access is granted.

WHO and partners are providing trauma care; medicines, medical supplies and personal protective equipment; mental health support; medical consultations and integrated reproductive health services; antenatal and obstetric care; vaccinations; and support for disease surveillance.

Note to editors

Since 2012 there have been sporadic reports of chemical events in Syria. WHO has no formal role in the forensic investigation of the use of chemical weapons. When an event is reported, WHO’s role is to conduct epidemiological investigations and implement public health emergency response measures, as necessary. Prior to an event, WHO helps to put in place preparedness measures to ensure that needed medical supplies are on hand, and health workers are prepared, protected, trained and equipped to respond. WHO has been engaged in public health preparedness for chemical weapons use in Syria since 2012, when the first reports of their use emerged.

– WHO maintains strategic stocks of protective equipment for healthcare workers and antidotes that have been distributed alongside training to reference hospitals inside Syria.
– Over 800 Syrian clinicians have received advanced chemical training from WHO hubs in Damascus and Gaziantep, including 80 clinicians in northern Syria in the last quarter of 2017.
– Since 2014, antidote for nerve agents has been distributed in WHO shipments. In 2017 inter-agency convoys to besieged areas of rural Damascus, including Douma, have also included atropine, an essential medicine for nerve agent treatment. No antidote for chlorine or blister agents exists, and treatment is symptomatic.
– Beginning in June 2017, WHO started shipping medical kits to northern Syria for comprehensive treatment of chemical exposures. The kits include atropine, oximes, salbutamol, and other medicines.
– In 2017, WHO prepositioned and distributed 1,500 sets of Personal Protective Equipment at reference hospitals. In 2014, WHO also distributed 450 escape hoods to NGOs providing health services across Syria
– In areas that are inaccessible to WHO, we work alongside NGO partners to provide technical expertise and guidance, including through remote technical support and operational plans developed with and implemented by partners.
– In view of the substantial risks to humanitarian staff in Syria, WHO issued self-protection advice publically and standard operating procedures to its staff.