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"A Yellow Mushroom Cloud"

Tuesday, April 5, saw an area of northern Syria held by rebels transformed by bombings into a deadly kill zone. The chemical bombings cast toxic chemicals, possibly nerve agents, into the air, killing dozens and prompting international outrage. Doctors, rescue workers, and other witnesses who survived the deadly attack saw a “yellow mushroom cloud,” as 14-year-old Mariam Abu Khalil described it to The New York Times. “It was like a winter fog,” she said. She saw people arrive in a car to help the wounded, but “[w]hen they got out, they inhaled the gas and died.”

Witnesses saw dozens of people, including children, die after breathing in the gas. They described them choking, foaming at the mouth, gasping, and writhing, and graphic video footage confirms these accounts. The toxic fumes spread outward in the early morning hours — a time previously thought safer by civilians leaving home to study or pray, like Mariam Abu Khalil was — after warplanes dropped bombs. Among the dead were rescue workers who collapsed from being too close to the bodies as they tried to help.

“It was like a winter fog...when they got out [of the car], they inhaled the gas and died.”

Nerve agents are extremely toxic chemicals that interfere with the signaling of the nervous system. Sarin is perhaps the best-known variety of nerve agent. It was first deployed in the 1995 Tokyo subway attacks by the Aum Shinrikyo doomsday cult, which used it to kill 12 people. Other types of nerve agents include VX, tabun, and soman, all derived from pesticides and potentially deadly.

These nerve agents are part of a class of chemicals called organophosphates. These substances allow acetylcholine, the nerve-signaling molecule, to run wild by binding to the enzyme that normally turns it off. Without the enzyme, acetylcholine stimulates nerve cell receptors ceaselessly. The specific receptors stimulated determines the body's response.

Organophosphate pesticides typically work within glands, causing excessive release of fluids. This is why exposure to them causes excessive tears, salivation, sweat, urination, diarrhea, and constricted pupils, all leading to fluid in the lungs and pulmonary edema, which can be fatal. Organophosphate nerve agents target the junctions between muscles and nerves instead, leading to excessive twitching and eventual paralysis as the victim's muscles fail to manage basic motor activities like breathing. Too much active acetylcholine in the brain can also cause seizures.

There are antidotes to nerve agents, such as atropine, which blocks acetylcholine receptors, and pralidoxime (2-PAM), which stops acetylcholine buildup by removing the organophosphate from the enzyme. However, both antidotes must be administered within around 10 minutes of exposure, or it's too late for them to have an effect.

The symptoms displayed by the victims of this week's attack were consistent with exposure to organophosphorus chemicals including nerve agents, according to the World Health Organization (WHO). The WHO also confirmed that it was shipping atropine to Syria via Turkey. Doctors from Médecins Sans Frontières, who treated some of the victims, said that they showed symptoms consistent with exposure to sarin or a similar compound. They also said the victims smelled like bleach, which could indicate that the attack was a targeted mixture of chlorine gas and nerve agent(s).

The Idlib Province Health Department, located in the opposition-run area where the attack was focused, initially provided a list of 69 names of victims to the NYT. However, humanitarian groups say more than 100 are dead, and some are still unidentified in the chaos. The White Helmets, a civil defense organization, has stated that numerous children are among the wounded and dead and that five of their rescue workers are ill, suffering from exposure to the toxic gas.

Notably, while people on the ground in northern Syria acknowledge that chlorine gas attacks have almost become a tragic part of life, witnesses and medical personnel agreed that this attack is different. Chlorine gas dissipates quickly and usually kills fewer people, just those trapped in a closed space. This week's attack killed many, even those in open areas outdoors and those who came into contact with victims.

International Condemnation

International shock over Tuesday's incident is high. Although this is not the first time the Syrian government has been accused of deploying nerve agents during the country’s six-year war, this appears to be among the worst incidents anywhere to date, not just as an act of war, but as a government's actions against its own citizens. For many in the international community, it is a sign of dangerous gains in government impunity.

Humanitarian groups have expressed outrage over the chemical attack and demanded that the United Nations Security Council take action. Since 2011, when the conflict in Syria began, partisan divides on the council have made decisive action elusive. The five permanent members of the council are China, France, the Russian Federation, the United Kingdom, and the United States. The ten non-permanent members are each elected for two-year terms and have changed significantly throughout the conflict's duration.

Past uses of chemical weapons in Syria have gone unaddressed by the Security Council due to its inability to agree on a response. The divide primarily exists between China and Russia, who have not wanted to condemn Syria's acts or its leadership, and France, the United Kingdom, and the United States, who have stated that the use of chemical weapons cannot be condoned and should not go unpunished.

This latest attack has prompted another meeting of the Security Council. France, the U.K., and the U.S. are pushing for the adoption of a resolution that would condemn the attack and order the Syrian government to provide detailed information about it to international investigators, including the names and flight logs for everyone involved in the attack, from the commanders to pilots. The draft resolution has already been circulating and may be up for a vote this week.

U.S. Ambassador Nikki Haley has called upon the other permanent members of the Security Council to unify based on the attack, threatening unilateral action by the U.S. should the U.N. fail to act. This is not the first such threat from the U.S. The August 2013 attack prompted a threat of American retaliation as well. At that point, Syrian President Bashar al-Assad agreed to eliminate the Syrian chemical weapons program and ban chemical weapons under an international treaty. Until that point, the Syrian government had denied having a chemical weapons program at all.

While this was a success on paper, the Organization for the Prohibition of Chemical Weapons, who led the international monitoring body during this process, remained concerned. The slow speed of the operation and possibly misleading responses from Damascus raised questions about whether all materials were in fact accounted for. The organization has continued to investigate, and along with the United Nations, it has found that the government of Syria has violated the chemical weapons treaty at least three times more — with chlorine gas and sarin. Others working on the ground, including doctors and activists, say there have been far more attacks.

Ending Use of Nerve Agents

Short of open war, it's not entirely clear what the United Nations and individual countries such as the U.S. can do to effectively end the use of chemical weapons in Syria. If the Syrian government is responsible for these attacks, then it has clearly violated the chemical weapons treaty. Generally, when nations sign treaties and then violate them, it is up to the international community to deal with the problem, first through the U.N. Security Council. However, experts seem to believe that the council will remain divided. Even if China comes to agree with the majority position that action should be taken against Syria, Russia is unlikely to follow suit.

According to Middle East expert Dr. Rodger Shanahan of the Lowy Institute, although Russia and Syria have long been allies, theirs is a complex relationship. Russian President Vladimir Putin relies upon Syria for geopolitical leverage in the region — something the country can't afford to lose. Iran, Syria's other key ally, is in a similar position. Both nations have supported Syrian troops in the war, while Turkey has supported opposition troops.

Now, the U.K. and other U.N. member-states are characterizing these latest attacks as not only violative of the chemical weapons treaty, but as war crimes as well. If the U.N. could come to an agreement on this point, it could act as a unifying force in the region with troops. The question would then be whether Syrian forces, backed by Russia and Iran or not, would dare to continue the fight, bringing it to bear against U.N. forces.

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If the U.S. does take unilateral action in Syria, we would be at war with a foreign power that appears to have no compunctions about using chemical weapons in-country against its own people — a deeply concerning prospect. We may also be taking action against Syria's allies, Russia and Iran, as a matter of fact, if not intent.

This might then lead senior American strategists to choose some sort of covert ops tactic, possibly supported by allies such as Israel. If the U.S. attempts to simply remove Assad, several scenarios are likely.

A security vacuum, such at that created in Iraq after the 2003 invasion or in Libya after the overthrow of Qaddafi, would be one potential outcome of such a tactic. Another possible outcome would be that the chemical weapons, which are obviously present in Syria, would be loose and unaccounted for. They could then be used by whichever new government or terrorist groups crop up. Finally, even longer, bloodier civil and regional conflicts could ensue as the outcome of cutting the head off the snake, as the entire region may be destabilized.

Ultimately, this sad situation presents no simple answers. Unified international pressure is one of the only ways, short of violent conflict, that typically yields results in situations like this, because no single country can go on forever isolated from international trade, cooperation, and partnership.

Given the devastating damage wreaked by nerve agents, each nation will have ample reason to consider backing such a plan. The long-term health effects of nerve agents are well-studied and have been known since World War I. Since that time, they have become even more potent. Furthermore, chemical weapons often persist in the environment. In cold weather, nerve gases can stay in our atmosphere for as long as one year, blowing around indiscriminately. Hopefully, these will be reasons enough for countries to unite and apply the pressure needed to stop these attacks, because responsive attacks or military operations may not have the desired effects.

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