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Casualties continue to mount in Syria's eastern Ghouta

The situation in the besieged eastern Ghouta area continues to deteriorate with shortages of medical supplies, the regime shelling on medical facilities and use of low concentration doses of chlorine.

EASTERN GHOUTA, Syria — Dr. Hamza, who declined to provide his last name for safety reasons, is exhausted. He has been sleeping for four or five hours a day over the past 10 weeks. Speaking to Al-Monitor, he said, “The medical supplies from the last United Nations convoy on March 5 were very limited. They got stuck in Douma because the road has been cut off from the rest of Ghouta.” Thirteen dialysis patients are being treated at the medical center where he works and where only 50 kits remain for hemodialysis. There are major shortages in surgical supplies and anesthesia. According to Dr. Basel Termanini, the vice president of the Syrian American Medical Society (SAMS), the health service capacity in Ghouta today is, at best, at 40%.

SAMS and other activists reported chlorine gas attacks on the besieged population of eastern Ghouta. US Defense Secretary James Mattis said March 11, “It would be very unwise for them [Syrian government forces] to use weaponized gas,” while specifically mentioning that “there’s an awful lot of reports about chlorine gas use or of symptoms that could be resulting from it.” On the face of it, the statement might be interpreted as a warning against the use of chlorine and possibly triggering a US military response. Yet practically, an intervention is highly unlikely, unless chemical weapons were to be used by the Syrian regime.

The Syrian regime, under the impetus of Russia, has been very careful not to violate the 2013 deal that specifically addressed the use of nerve gas agents — VX, sarin and mustard — as red lines that the United States and Europe would not tolerate. For this reason, according to some experts, low concentration doses of chlorine have been used in eastern Ghouta to avoid being qualified as weapons of mass destruction (WMD). Eastern Ghouta has been bombed with internationally prohibited munitions such as napalm, cluster bombs and barrel bombs, but these are not WMDs (nuclear, chemical and biological). Doctors on the ground are documenting that they are treating severe burns caused by napalm and other prohibited munitions.

The international community has been incapable of halting the humanitarian catastrophe in eastern Ghouta, and with the situation on the ground worsening rapidly, it has become increasingly difficult to interview civilians there. Some of the doctors Al-Monitor interviewed just a week ago are now unreachable, and direct contact with sources is becoming more limited. The work of activists and medical organizations outside Ghouta, such as SAMS, is proving to have a significant role in documenting what is happening on the ground and communicating it to the media.

“There is no black market now, all roads are cut off. People are eating whatever food they were able to store. We are eating soup in order to have the supplies last as long as possible,” said Deana, an American woman who asked that her last name not be disclosed for safety reasons. She told Al-Monitor, “We do not have a way to cook or a bathroom in the basement, so we have to go upstairs.” Deana met her husband at the University of Michigan and moved to Ghouta about 18 years ago. When asked what keeps her going at such horrific times, she said, “I keep going because life is sacred, I believe in that. I have a husband and eight children. Thank God they are safe, I hope they stay that way.”

She added, “I live day and night the horror of these crimes, but I still have a glimmer of hope that our voices will be heard."

Deana then explained her daily life under siege, saying, “We sit in the basement during the day and sleep there during the night to protect ourselves from the bombings. The aid convoys were a drop of water in the sea, particularly since the medical supplies were not allowed into eastern Ghouta — not even aspirin. Two days later, the food was eaten and gone.” They have now resorted to generators for electricity, which is very expensive, and stored diesel when the road was still open. Most people, however, cannot afford this.

Deana also noted that people in Ghouta want a cease-fire and do not want to be relocated. They blame the Syrian regime and the Russian war planes for bombing them daily. “We were terrified once when they [the regime] took my husband in but luckily he was released. Everyone here supports the opposition. For sure not all of them are looking after our interests, but you cannot believe the Syrian regime. We cannot trust them,” she added.

The advancement of the Syrian army in the past four days has effectively separated the enclave into three parts: Douma, its biggest town, and towns in the north; western Harasta; and the remainder of the territory in the south. In one instance on March 11, some civilians were tortured and humiliated by the regime forces as they were trying to get through the "safe areas" as proposed by Syrian President Bashar al-Assad. As noted by civilian sources on the ground that witnessed and filmed the incident, it remains unconfirmed whether or not these men were part of the opposition or just civilians. On March 13, SAMS documented heavy shelling in eastern Ghouta that killed 70 people, including 17 children and 12 women.

Termanini, who is not in the enclave, said that two of SAMS’ medical facilities in Ghouta — a maternity center and an emergency care clinic — and several ambulances were attacked with barrel bombs on March 11. This brings the total number of attacked SAMS facilities to nine (out of 13) since Feb. 19.

Between Feb. 19 and March 6, 968 people have been killed and 3,556 others injured, as noted by the statistics bureau at the United Relief Office of eastern Ghouta. In the midst of the heavy bombardments, the residents are often buried in mass graves.

According to SAMS, 170 civilians were evacuated to Damascus from eastern Ghouta on March 13. The medical society reported today that another group of 25 patients is being prepared for evacuation with their families. The local branch of the Syrian Arab Red Crescent has told local medical staff to help locate patients.

Of note, 78 patients were listed as medical priorities in eastern Ghouta, but because of the situation, many families no longer have any means of communication and it is hard to locate them.

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