Ghouta chemical attack

The Ghouta chemical attack occurred on 21 August 2013 during the Syrian civil war, when several opposition-controlled or disputed areas of the Ghouta suburbs of the Markaz Rif Dimashq district around Damascus, Syria, were struck by rockets containing the chemical agent sarin. Hundreds were killed in the attack, which took place over a short span of time in the early morning. Estimates of the death toll range from 281 to 1,729 fatalities, not less than 51 of whom were rebel fighters. Many witnesses reported that none of the victims they saw displayed physical wounds, and videos purporting to show victims of the chemical attack were widely disseminated on YouTube and other websites. Even if only the lower number for the death toll is confirmed, the incident would be the deadliest use of chemical weapons since the Iran–Iraq War.

The United Nations investigated several attack sites, which were mere kilometres from the temporary quarters of UN inspectors who had arrived at the Syrian government's invitation to look into alleged chemical weapons use prior to the Ghouta attack. The UN requested access to sites in Ghouta the day after the attack. On 23 August, government and rebel forces clashed in Ghouta, the Syrian military continued to shell Ghouta, and the UN called for a ceasefire to allow inspectors to visit the Ghouta sites. The Syrian government granted the UN's request on 25 August. Inspectors worked from 26 to 31 August investigating sites of the attack.

After completing the investigation three weeks later, the UN reported that it had confirmed the use of sarin in the Ghouta attack. The Mission "collected clear and convincing evidence that surface-to-surface rockets containing the nerve agent sarin were used in the Ein Tarma, Moadamiyah and Zalmalka in the Ghouta area of Damascus." The report's lead author, Åke Sellström, said that the quality of the sarin used in the attack was higher than that used by Iraq in the Iran-Iraq war, implying a purity higher than the Iraqi chemical weapons program's 45–60%. Based on analyses of the UN's evidence, Human Rights Watch and The New York Times concluded the rockets that delivered the sarin were launched from areas under government control. Specifically, the inspectors listed the precise compass directions of flight for two rocket strikes and these pointed to the government's elite centre in Damascus, Mount Qasioun,

The Syrian government called reports of a massacre untrue and the Syrian government and opposition blamed each other for the attack. Many governments, mostly in the Western and Arab worlds, said the available evidence showed the attack was carried out by the forces of Syrian President Bashar al-Assad, a conclusion echoed by the Arab League and the European Union. The government of Russia sided with the government's characterisation of the attack as a false flag operation by terrorists to draw foreign powers into the civil war on the rebels' side. The attack sparked debate in France, the United Kingdom, the United States, and other countries about whether to intervene militarily against government forces. In September 2013, the Syrian government declared its intention to join the Chemical Weapons Convention.

Background
The Ghouta area is composed of densely populated suburbs in the Markaz Rif Dimashq District of the province of Rif Dimashq. Al-Ghouta is a primarily conservative Sunni region, and home to most of Damascus' three million inhabitants. Since early in the civil war, civilians in rebel-held Eastern Ghouta have almost entirely sided with the opposition to Syria's government. The opposition have controlled much of the eastern part of the Rif district since 2012, partly cutting off Damascus from its hinterland. Parts of the area had been under government siege for months, including Moadamiyah since April 2013. The Ghouta and neighbouring areas have been the scene of continuing clashes for more than a year, and regime forces have launched repeated missile assaults trying to dislodge the rebels. On the day of the attack, the Syrian government launched an offensive to capture opposition-held Damascus suburbs.

The attack came one year and one day after US President Barack Obama's Monday 20 August 2012 "red line" speech, in which he warned "the Assad regime – but also to other players on the ground" that chemical weapons use in Syria, which is one of five non-signatories to the 1997 Chemical Weapons Convention, would trigger American intervention. Since his speech, and prior to the chemical attacks in Ghouta, chemical weapons were suspected to have been used in at least four attacks in the country.

On 23 March 2013, the Syrian government unusually requested the UN send inspectors to investigate an incident in town of Khan al-Assal, where it said opposition forces had used chlorine-filled rockets. The Syrian government later refused to allow the UN investigation to be expanded to places outside Khan al-Assal. On 23 April 2013, the New York Times reported that the British and French governments had sent a confidential letter to the United Nations Secretary General, claiming that there was evidence that the Syrian government had used chemical weapons in Aleppo, Homs, and perhaps Damascus. Israel also claimed that the Syrian government had used chemical weapons on 19 March near Aleppo and Damascus. On 24 April, Syria refused to allow UN investigators to enter Syria, though Jeffrey Feltman, UN under-secretary for political affairs, said that a refusal would not prevent an inquiry from being carried out. On 25 April US Secretary of Defense Chuck Hagel stated that US intelligence showed the Assad government had likely used chemical weapons – specifically sarin gas. However, the White House announced that "much more" work had to be done to verify the intelligence assessments.

UN Independent International Commission of Inquiry on the Syrian Arab Republic member Carla del Ponte stated in May 2013 that 'According to the testimonies we have gathered, the rebels have used chemical weapons, making use of sarin gas'.

After clandestinely spending two months in Jobar, Damascus, several reporters for the French news media Le Monde personally witnessed the Syrian army's use of chemical weapons on civilians in the Jobar chemical attacks. French intelligence later said that samples from the Jobar attack in April had confirmed the use of sarin.

On 4 June 2013, a U.N. report stated that there are "reasonable grounds" to believe that limited amounts of chemical weapons have been used in at least four attacks in the civil war, but more evidence is needed to determine the exact chemical agents used or who was responsible. Stating that it has not been possible "to determine the precise chemical agents used, their delivery systems or the perpetrator." On 22 June the head of UN human rights investigation, Paulo Pinheiro, said the UN could not determine who used chemical weapons in Syria after the evidence had been delivered by the United States, Britain and France. However, the commission reported that there were "reasonable grounds to believe that chemical agents have been used as weapons".

On 13 June, the United States announced that there is definitive proof that the Assad government has used limited amounts of chemical weapons on multiple occasions on rebel forces, killing 100 to 150 people. US officials stated that Sarin was the agent used, with no 'reliable' evidence that the opposition had access to such weapons. Deputy National Security Advisor Ben Rhodes did not confirm whether this proof showed that Syria had crossed the "red line" established by President Obama by using chemical weapons. Rhodes stated that: "The president has said that the use of chemical weapons would change his calculus, and it has." Tests conducted by France confirmed the United States conclusions, according to the French government. Russian Foreign Minister Sergei Lavrov said that "the accusations of Damascus using chemical weapons put forth by the USA are not backed by credible facts." Larov stated that it makes no sense for Syrian government to use chemical weapons when the government already maintains a military advantage over the rebel fighters. On 9 October, a US spokesman stated the administration lacks the "irrefutable, beyond-a-reasonable-doubt evidence" some American voters are seeking but that a "common-sense test" implicates Assad.

The attacks
The attacks reportedly occurred between 02:00 and 05:00 in the morning on 21 August 2013, in the rebel-held and mostly Sunni Ghouta agricultural area, just east of Damascus. The area had been under an Army siege backed by Hezbollah for months. The attacks had affected two separate opposition-controlled districts in Damascus Suburbs, located 16 kilometres apart. According to local residents, the Zamalka neighbourhood in Eastern Ghouta was struck by rockets at some time between 2 and 3 a.m., and the Moadamiya neighbourhood in Western Ghouta was struck by rockets at about 5 a.m., shortly after the completion of the Muslim morning prayer.

Syrian human rights lawyer Razan Zaitouneh, present in Eastern Ghouta, stated, "Hours [after the shelling], we started to visit the medical points in Ghouta to where injured were removed, and we couldn't believe our eyes. I haven't seen such death in my whole life. People were lying on the ground in hallways, on roadsides, in hundreds." Several medics working in Ghouta reported the administration of large quantities of Atropine, a common antidote for nerve agent toxicity, to treat victims.

Doctors Without Borders said three hospitals it supports in the eastern Damascus region reported receiving roughly 3,600 patients with "neurotoxic symptoms" over less than three hours on after the morning, when the attack in the eastern Ghouta area took place. Of those, 355 died. The Local Coordination Committees of Syria claimed that of the 1,338 victims, 1,000 were in Zamalka, among which 600 bodies were transferred to medical points in other towns and 400 remained at a Zamalka medical centre. Some of the fatalities (at least 51) were rebel fighters. According to a spokesman for the Free Syrian Army, at least six medics died while treating the victims. The deadliness of the attack is believed to have been increased due to Syrians fleeing the regime bombardment by hiding in basements, where the heavier-than-air chemical agents sank to these lower-lying, poorly ventilated areas. Some of the victims died while sleeping.

According to Robert Fisk, the chemical attacks in the night of 21 August were part of "one of [the Syrian army's] fiercest bombardments of rebel areas. In 12 separate attacks, it tried to put special forces men inside the insurgent enclaves, backed up by artillery fire. These included the suburbs of Harasta, and Arbin." A Syrian journalist embedded with government troops described the reaction of troops in Moadamiyeh at seeing the first images of attack victims, concerned that they would need to fight in affected areas. The day after the chemical attacks, 22 August, the Syrian army bombarded the Ghouta area.

Timing
The BBC News interpreted darkness and prayer calls in videos to be consistent with a pre-dawn timing of the attacks. (There are five daily prayers in Islam, including a dawn prayer, a sunset prayer, and a nighttime prayer.) BBC News considered it significant that the "three main Facebook pages of Syrian opposition groups" reported "fierce clashes between FSA rebels and government forces, as well as shelling by government forces" at 01:15 local time (UTC+3) on 21 August 2013 in the eastern Ghouta areas that were later claimed to have been attacked with chemical weapons.

Abu Sakhr, a paramedic interviewed by the VDC, estimated chemical weapons to have first been delivered by mortars at about 02:00. Another interviewee, Maher, said that Ein Tarma had been hit by chemical weapons before 02:30.

BBC News stated that three Syrian opposition Facebook pages reported the first claims of chemical weapons use within a few minutes of one another. At 02:45 UTC+3, the Ein Tarma Co-ordination Committee stated that "a number of residents died in suffocation cases due to chemical shelling of the al-Zayniya area [in Ein Tarma]." At 02:47, the Sham News Network reported an "urgent" message that Zamalka had been attacked with chemical weapons shells. At 02:55, the LCC made "a similar report." The Los Angeles Times timed the attacks at "about" 03:00.

Motivation
There has been some debate about the motivation for the attacks. According to military experts, both sides are locked in a political and military stalemate, and the opposition cannot win without western military intervention or support. Given previous US comments about the use of chemical weapons constituting a "red line" prompting intervention, the opposition would have an incentive to stage an attack and make it appear that the Syrian government had crossed the line. The Syrian government, on the other hand, would more straightforwardly have the motivation to use chemical weapons as tactically required if it believed that the US threat was an empty one.

Government attack
Some have questioned the motive and timing behind the alleged Syrian government involvement in the Ghouta attacks, since a team of United Nations chemical weapons inspectors were staying in a hotel just a few miles from the attack. However, since the agreement the Syrian government reached with UN inspectors limited their mandate to three specific sites to establish if a chemical attack took place, but not who was responsible, the attack might simply have been launched in an area designated as off-limits.

The French newspaper Le Monde reported in the months before the Ghouta attacks that its journalists embedded among opposition fighters had personally witnessed several chemical attacks on a smaller scale by the Syrian Army against rebel positions. Der Spiegel reported a suspicion by a gas expert that minimal use of chemical weapons was seen by the Assad regime as the best way get the West used to its deployment, triggering an ongoing international dispute over whether nerve gas was being used at all. Saying that at some point, "the commotion over the use of chemical weapons per se" would "have dissipated.". Former US intelligence officer Joseph Holliday wrote in a study that "Assad has been extremely calculating with the use of force", "introducing chemical weapons gradually.".

A CNN reporter pointed to the fact that government forces did not appear to be in imminent danger of being overrun by opposition in the areas in question, in which a stalemate had set. He questioned why the army would risk such an action that could cause international intervention. The reporter also questioned if the Army would use sarin gas just a few kilometres from the center of Damascus on what was a windy day. While an EA Worldview reporter, James Miller, pointed to the fact that the affected area had strong opposition leanings, and was a major supply route to the front lines in the fighting in east Damascus. Miller added that "Assad's forces in both Mt Qassioun and in the Mezzeh airport have this area very zeroed in for rocket (typically Grads) and artillery strikes." Richard Guthrie, quoted in the New Scientist, stated that the day of the attack was the one day that week when the wind blew from government-held central Damascus towards the rebel-held eastern suburbs.

Several reporters also pointed to the timing of a purported assassination attempt against Assad earlier in August, suggesting the attack on the rebel enclaves came as a reprisal for the assassination attempt. A former Syrian intelligence officer claimed the attack came due to "internal reasons", to holding the "thinned-out front around Damascus" and "strengthening the morale of the fanatics in their ranks", following weeks of rebel attacks on Assad's home province of Latakia.

A reporter for The Daily Telegraph also pointed to the questionable timing given government forces had recently beaten back opposition in some areas around Damascus and recaptured territory. "Using chemical weapons might make sense when he is losing, but why launch gas attacks when he is winning anyway?" The reporter also questioned why would the attacks happen just three days after the inspectors arrived in Syria. Der Spiegel questioned this analysis, arguing that Assad's forces have been losing ground for several months and may have been motivated to use chemical weapons to forestall rebel advances in the Damascus suburbs.

Syrian human rights lawyer Razan Zaitouneh, who is a member of the Syrian opposition, also argued that the Assad government would launch a chemical attack because "it knows that the international community would not do anything about it, like it did nothing about all the previous crimes." Israeli reporter Ron Ben-Yishai stated that the motive to use chemical weapons could be the "army's inability to seize the rebel's stronghold in Damascus' eastern neighbourhoods," or fear of rebel encroachment into Damascus with tacit civilian support,.

Capability
Syria was not a party to the Chemical Weapons Convention during the Ghouta chemical attack, which prohibits the development, production, stockpiling, transfer, and use of chemical weapons, although in 1968 it acceded to the 1925 Geneva Protocol for the Prohibition of the Use in War of Asphyxiating, Poisonous or Other Gases. In 2012 Syria publicly stated it possessed such weapons. According to French intelligence, the Syrian Scientific Studies and Research Center (SSRC) is responsible for producing toxic agents for use in war. A group named "Branch 450" is allegedly responsible for filling munitions with chemicals and maintaining security of the chemical agent stockpiles. As of September 2013, French intelligence puts the Syrian stockpile at 1,000 tonnes, including Yperite, VX and "several hundred tonnes of sarin".

Western intelligence agencies have publicly dismissed the possibility of rebel responsibility for the attack in Ghouta, stating that rebels are incapable of an attack of its scale.

UN investigation
Two days before the attack, a UN team headed by Åke Sellström arrived in Damascus with permission, from the Syrian government, to investigate earlier alleged chemical weapons use. On the day of the attack, UN Secretary General Ban Ki-moon expressed "the need to investigate [the Ghouta incident as] soon as possible," hoping for consent from the Syrian government. The next day, UN High Commissioner for Human Rights Navi Pillay urged government and opposition forces to allow investigation, and Ban requested the government provide immediate access. On 23 August, clashes between rebel and government forces continued in and around Ghouta, government shelling continued, and UN inspectors were denied access for a second day. United States officials told The Wall Street Journal that the White House "became convinced" that the Syrian government was trying to hide the evidence of chemical weapons use by shelling the sites and delaying their inspection. Ban called for a ceasefire to allow the inspectors to visit the attack sites. On 25 August the government agreed to cease hostilities with the presence of UN inspectors, and agreements between the UN, government and rebel factions were reached for five hours of cease-fire each day from 26 to 29 August.

Early in the morning of 26 August several mortars hit central Damascus, including one that fell near the Four Seasons hotel the UN inspectors were staying in. Later in the day the UN team came under sniper fire en route to Moadamiyah in western Ghouta (in the south of Damascus), forcing them to return to their hotel and replace one of their vehicles before continuing their investigation four hours later. The attack prompted a rebuke from Ban toward the fighters. After returning to Moadamiyah the team visited clinics and makeshift field hospitals, collected samples and conducted interviews with witnesses, survivors and doctors. The inspectors spoke with 20 victims of the attacks and took blood and hair samples, soil samples, and samples from domestic animals. As a result of the delay caused by the sniper attack, the team's time in Moadamiyah was substantially shortened, with the scheduled expiry of the daily cease-fire leaving them around 90 minutes on the ground.

On 28 and 29 August the UN team visited Zamalka and Ein Tarma in eastern Ghouta, in the east of Damascus, for a total time of five and a half hours. On 30 August the team visited at a Syrian government military hospital in Mazzeh, and collected samples.

UN report
The UN investigation into the chemical attacks in Ghouta was published on 16 September. The report stated that "the environmental, chemical and medical samples, we have collected, provide clear and convincing evidence that surface-to-surface rockets containing the nerve agent sarin were used in Ein Tarma, Moadamiyah and Zamalka in the Ghouta area of Damascus". The inspectors were able to identify several surface-to-surface rockets at the affected sites as 140mm BM-14 rockets originally manufactured in Russia and 330mm rockets probably manufactured domestically. U.N. Secretary General Ban Ki-moon called the findings "beyond doubt and beyond the pale,” and a clear evidence of a war crime. "The results are overwhelming and indisputable [-] A majority of the rockets or rocket fragments recovered were found to be carrying sarin." The report, which was "careful not to blame either side", said that during the mission's work in the rebel controlled Zamalka/Ein Tarma, " individuals arrived carrying other suspected munitions indicating that such potential evidence is being moved and possibly manipulated. The areas were under rebel control, but the report did not elaborate on who the individuals were. The UN investigators were accompanied by a rebel leader: "A leader of the local opposition forces [...] was identified and requested to take 'custody' of the Mission [...] to ensure the security and movement of the Mission, to facilitate the [sic] access to the most critical cases/witnesses to be interviewed and sampled by the Mission and to control patients and crowd in order for the Mission to focus on its main activities."

An August Scientific American article had described difficulties that could arise when attempting to identify the manufacturer of sarin from soil or tissue samples. UN lead investigator Sellström told the UN Security Council that the quality of the sarin was higher than that used by Iraq in the Iran-Iraq war, implying a purity higher than the Iraqi chemical weapons program's 45–60%. (By comparison, Aum Shinrikyo used nearly pure sarin in the 1994 Matsumoto incident. ) According to Human Rights Watch, hundreds of kilograms of sarin were used in the attack, which it said suggested government responsibility, as opposition forces were not known to possess significant amounts of sarin.

The UN investigation noted that the azimuth of two of the rockets could be determined based on their position embedded into the ground and/or the pattern of craters they created as they impacted the ground at a low angle. It drew no conclusions from this.

Responses
Independent analysts concluded that the two azimuths determined by the report intersect deep in Syrian-government-controlled territory, near Mount Qasioun, noting that this region has been the target of Israeli airstrikes against chemical weapons-capable surface-to-surface rocket launchers. Based on analyses of the azimuths provided by the UN report, Human Rights Watch and The New York Times concluded the rockets that delivered the sarin were launched from areas under government control. Specifically, the inspectors listed the precise compass directions of flight for two rocket strikes and these pointed to the government's elite centre in Damascus, Mount Qasioun. The two azimuths were calculated from impact sites of two different rockets – a 140mm rocket and a 330mm one. Human Rights Watch conceded that while the 140mm rocket was known to have a maximum range (9.8 km) such that Mt Qasioun was just in range of the impact site 9.6 km away, the range of the other, a 330mm rocket, was unknown.

The Russian government dismissed the initial UN report after it was released, calling it "one-sided" and "distorted". On 17 September, Russian Foreign Minister Sergei Lavrov reiterated his government's belief that the opposition carried out the attacks as a "provocation". The United Nations high representative for disarmament affairs, Angela Kane, stated that the inspection team would review Russia's objections.

Russian defence expert Ruslan Pukhov said that the code, found by the UN investigators on the M-14 munition, showed it had been produced in 1967 by the the Sibselmash plant in Novosibirsk for a BM-14-17 multiple rocket launcher. He said that these weapons had been taken out of service by Syria and replaced with BM-21s. He stated that the second projectile identified by weapons inspectors looked to be ‘home made’. Blogger Eliot Higgins has written that Syrian army videos show munitions that "clearly match" those linked to the August 21 attack, concluding, "it now seems undeniable that the Syrian military has been using this family of munitions for at least the past 10 months." Journalist Robert Fisk has written that, according to information circulating in Damascus, unpublished Russian evidence includes export papers for these missiles showing that they had been sold to South Yemen, Egypt, and Libya. The OPCW said in September 2011 that Libya's chemical weapons stockpiles had remained secure since February 2011, when its inspectors had to leave due to the Libyan civil war. Libya's declaration to the OPCW of chemical weapons to be destroyed did not include sarin, although it did include sarin precursors.

An Iranian chemical weapons expert, Abbas Foroutan, said in October 2013 that the UN should publish more details about the investigation than were provided in the report, including victims' pulse rates and blood pressure and their response to the atropine treatment, the victims' levels of acetylcholinesterase (sarin is an acetylcholinesterase inhibitor), and more technical details on the lab testing process.

The UN inspection team returned to the Damascus area to continue investigations into other alleged chemical attacks in late September 2013. A final report on Ghouta and six other alleged attacks (including three alleged to have occurred after the Ghouta attack) is expected to be released on late October 2013.

Aftermath
The continuous fighting has severely limited the quality of medical care for injured survivors of the attack. A month after the attack, approximately 450 survivors still required medical attention for lingering symptoms such as respiratory and vision problems. By early October 2013, the 13000 citizens of Moadhamiya, one of the places targeted in the August attack, had been surrounded by pro-government forces, and under siege for five months, severe malnourishment and medical emergencies become pressing, as all supply lines had stopped. Care for chronic symptoms of sarin exposure had become, "just one among a sea of concerns."

As counties such as the United States and the UK debated their response to the attacks, they encountered significant popular and legislative resistance to military intervention. In particular, David Cameron's request to the House of Commons to use military force was declined by a 285–272 margin, a vote that Richard Haass described as "nothing less than stunning". The relatively unexpected defeat of this motion was reported as a political defeat to Cameron and a possible indicator that the UK's foreign policy was becoming increasingly isolationist.

Within a month of the attacks, Syria agreed to join the 1993 Convention on Chemical Weapons.

Capabilities

 * Two types of chemical rockets were used: a 140mm rocket made in the Soviet Union in 1967 and and exported to Syria, and a modified 330mm rocket.


 * The UN inspectors suggested that Soviet BM-14-17 (MLRS) rocket launchers were used. The attacks were sophisticated, requiring large amounts of nerve agent, specialised procedures to load the warheads with the nerve agent, and specialised launchers to launch the rockets. The attacks were also "large-scale", involving at least 12 rockets targeting two different neighbourhoods situated 16 km apart, and surrounded by major Syrian government military positions. According to the United States, the scale of the attack is consistent within Syrian government capabilities, but likely not rebel capabilities.


 * Jonathan Marcus of BBC News reported that Syrian rebels have captured significant stockpiles of regular government weaponry, although the rebels are not known to be in possession of the weapons systems used in the Ghouta attack.

Other Evidence

 * The attacks targeted rebel-held areas. Government-controlled potential launching sites were within range of the targets.


 * Many of the munitions and their fragments had been moved; however, in two cases, the UN could categorise the likely trajectories. Triangulating rocket trajectories pinpoints the origin of the attack as within government-held territory. Consideration of missile ranges provides additional evidence the rockets originated from the triangulated government-held region.


 * The Syrian government did not provide immediate access to Ghouta, saying it could not guarantee inspectors' security due to ongoing fighting. The Syrian government granted UN's request on 25 August, and UN inspectors worked from 26 to 31 August investigating sites of the attack.


 * The US government cited as yet unverified classified intercepts of communications it said were between Syrian officials, which have not been released to the public, supposedly proving Syrian government forces carried out the chemical attack. Russian Foreign Minister Sergei Lavrov described the American, British and French intelligence reports as "unconvincing" and maintained before and after the release of the United Nations report in mid-September that the rebels carried out the attack.


 * The UN report said that during the mission's work in rebel-held areas, inspectors reported seeing unknown individuals carrying "suspected munitions", suggesting "such potential evidence is being moved and possibly manipulated".

Symptoms
Doctors Without Borders who were operating three hospitals in the eastern Damascus region, which received roughly 3,600 patients over less than three hours on after the attack, reported seeing "large number of patients arriving with symptoms including convulsions, excessive saliva, pinpoint pupils, blurred vision and respiratory distress." Symptoms reported by Ghouta residents and doctors to Human Rights Watch included "suffocation, muscle spasms and frothing at the mouth."

Witness statements to The Guardian about symptoms included "people who were sleeping in their homes [who] died in their beds," headaches and nausea, "foam coming out of [victims'] mouths and noses," a "smell something like vinegar and rotten eggs," suffocation, "bodies [that] were turning blue," a "smell like cooking gas" and redness and itching of the eyes. Richard Spencer of The Telegraph summarised witness statements, stating, "The poison ... may have killed hundreds, but it has left twitching, fainting, confused but compelling survivors."

On 22 August, the Center for Documentation of Violations in Syria published numerous testimonies. It summarised doctors' and paramedics' descriptions of the symptoms as "vomiting, foamy salivation, severe agitation, [pinpoint] pupils, redness of the eyes, dyspnea, neurological convulsions, respiratory and heart failure, blood out of the nose and mouth and, in some cases, hallucinations and memory loss".

Analysis of symptoms
Dr. Amesh Adalja, a senior associate for the Center for Biosecurity at the University of Pittsburgh Medical Center, said what the group of doctors in Syria is reporting "is what a textbook would list to say nerve-agent poison." Symptoms like incredibly small pupils help say it is not agents like mustard gas or chlorine gas, but instead more like sarin, soman, VX and taubun.

Médecins Sans Frontières (MSF) Director of Operations Bart Janssens stated that MSF "can neither scientifically confirm the cause of these symptoms nor establish who is responsible for the attack. However, the reported symptoms of the patients, in addition to the epidemiological pattern of the events – characterised by the massive influx of patients in a short period of time, the origin of the patients, and the contamination of medical and first aid workers – strongly indicate mass exposure to a neurotoxic agent."

Gwyn Winfield, editorial director at the magazine CBRNe World, which reports on chemical, biological, radiological, nuclear or explosives use, analysed the videos and wrote on the magazine's site: "Clearly respiratory distress, some nerve spasms and a half-hearted washdown (involving water and bare hands?), but it could equally be a riot control agent as a (chemical warfare agent)."

Delivery method
Abu Omar of the Free Syrian Army stated to The Guardian that the rockets involved in the attack were unusual because "you could hear the sound of the rocket in the air but you could not hear any sound of explosion" and no obvious damage to buildings occurred. Human Rights Watch's witnesses reported "symptoms and delivery methods consistent with the use of chemical nerve agents." Activists and local residents contacted by The Guardian said that "the remains of 20 rockets [thought to have been carrying neurotoxic gas were] found in the affected areas. Many [remained] mostly intact, suggesting that they did not detonate on impact and potentially dispersed gas before hitting the ground."

Some analysts speculated on 21 August that a stockpile of chemical agents may have been hit by shelling, whether controlled by the opposition or the government. New Scientist also noted that there appeared to be no government troop casualties from the attack.

CNN noted that some opposition activists claimed the use of "Agent 15," also known as BZ, in the attacks, for which some experts expressed doubt the Syrian government possesses, and the symptoms caused by said chemical are very different from the symptoms reported in this attack.

According to CBS News, chemical and biological weapons experts have been relatively consistent in their analysis, saying only a military force with access to and knowledge of missile delivery systems and the sarin gas suspected in Ghouta could have carried out an attack capable of killing hundreds of people. Additionally British and US officials stated that there is no credible evidence that any opposition group to conduct a chemical weapons attack on this scale.

According to Human Rights Watch report, two types of projectiles were used in the Chemical attacks. The first was a 330mm rocket "that appears to have a warhead designed to be loaded with and deliver a large payload of liquid chemical agent". The second was a Soviet-produced 140mm rocket that can deliver three possible warheads, one of them specifically designed to carry 2.2 kg of sarin. Adding that "Human Rights Watch and arms experts monitoring the use of weapons in Syria have not documented Syrian opposition forces to be in the possession of the 140mm and 330mm rockets used in the attack or their associated launchers."

Eliot Higgins has looked at the munitions linked to the attack, as reported in The Guardian, and analysed footage of the putative launchers, inside government territory.

Communications
Two purported intercepts of communications that appeared to implicate the Syrian government received prominent media coverage. One was a phone call allegedly between Syrian officials which Israel's Unit 8200 was said to have intercepted and passed to the US. The other was a phone call which the German Bundesnachrichtendienst said it had intercepted, between a high-ranking representative of Hezbollah and the Iranian embassy, in which the purported Hezbollah official said that poison gas had been used and that Assad's order to attack with chemical weapons had been a strategic error. On 29 August the Associated Press reported that "two intelligence officials and two other U.S. officials" said the US intercept was a conversation between "low-level" Syrian officials, with no direct link to the upper echelons of the government or military.

The Bild am Sonntag newspaper subsequently reported that German intelligence indicated that Assad had likely not personally ordered the attacks. According to Bild, "intelligence interception specialists" relying on communications intercepted by the German vessel Oker said that Syrian military commanders had repeatedly been asking permission to launch chemical attacks for around four months, with permission always being denied from the presidential palace. The sources concluded that 21 August attack had probably not been approved by Bashar al-Assad personally.

Video
Murad Abu Bilal, Khaled Naddaf and other VDC and local co-ordination committee (LCC) media staff went to Zamalka to film and obtain other documentary evidence of the attacks immediately after they were known, early on 21 August. Almost all the journalists died from inhalation of the neurotoxins apart from Murad Abu Bilal, who was the only Zamalka LCC media member to survive. The videos were published on YouTube, attracting world-wide media attention.

Experts who have analysed the first video said it shows the strongest evidence yet consistent with the use of a lethal toxic agent. Visible symptoms reportedly included rolling eyes, foaming at the mouth, and tremors. There was at least one image of a child suffering miosis, the pin-point pupil effect associated with the nerve agent Sarin, a powerful neurotoxin reportedly used before in Syria. Ralph Trapp, a former scientist at the Organisation for the Prohibition of Chemical Weapons, said the footage showed what a chemical weapons attack on a civilian area would look like, and went on to note "This is one of the first videos I've seen from Syria where the numbers start to make sense. If you have a gas attack you would expect large numbers of people, children and adults, to be affected, particularly if it's in a built-up area."

Some experts, among them Jean Pascal Zanders, initially stated that evidence that sarin was used, as claimed by pro-rebel sources, was still lacking and highlighted the lack of second-hand contaminations typically associated with use of weapons-grade nerve agents: "I remain sceptical that it was a nerve agent like sarin. I would have expected to see more convulsions," he said. "The other thing that seems inconsistent with sarin is that, given the footage of first responders treating victims without proper protective equipment, you would expect to see considerable secondary casualties from contamination – which does not appear to be evident." However, after Zanders saw footage imminently after the attack, he changed his mind, saying: "The video footage and pictures this time are of a far better quality. You can clearly see the typical signs of asphyxiation, including a pinkish blueish tinge to the skin colour. There is one image of an adult woman where you can see the tell-tale blackish mark around her mouth, all of which suggests death from asphyxiation." Zanders however cautioned that these symptoms covered a range of neurotoxicants, including some available for civilian use as pest control agents, and said that until the UN reported its analysis of samples, "I can't make a judgement.. I have to keep an open mind."

According to a report by The Daily Telegraph, "videos uploaded to YouTube by activists showed rows of motionless bodies and medics attending to patients apparently in the grip of seizures. In one piece of footage, a young boy appeared to be foaming at the mouth while convulsing."

Hamish de Bretton-Gordon, a former commander of British Chemical and Biological counterterrorism forces, told BBC that the images were very similar to previous incidents he had witnessed, although he could not verify the footage.

Foreign government assessments
Intelligence agencies in Israel, the United Kingdom, the United States, France, Turkey, and Germany concluded that the Syrian government was most likely responsible for the attacks. Intelligence reports that assessed the government had orchestrated the attack presented suggestions as to why it might have used chemical weapons, focusing on the idea that the Syrian military was concerned about opposition strength in the Damascus suburbs and frustrated with its difficulty in dislodging rebel fighters. The French intelligence included satellite imagery showing the attacks coming from government-controlled areas to the east and west of Damascus and targeting rebel-held zones and observed that "Assad's forces had since bombed the areas to wipe out evidence".

Western intelligence agencies agreed that video evidence is consistent with the use of a nerve agent, such as sarin. Laboratory tests showed traces of sarin, in blood and hair samples collected from emergency workers who responded to the attacks. Britain put the number of fatalities at least 350. France confirmed 281 fatalities based according to video footage they studied, acknowledging up to 1,500 total. The US preliminary assessment was much higher, with Secretary of State John Kerry claiming 1,429 people were killed, including at least 426 children.

Meanwhile, the Russian and Syrian governments accused the Syrian opposition of responsibility for the attacks. According to The Guardian, as of 3 September neither had "publicly produced any evidence to support their claims." Russian officials criticised the American and European intelligence reports, saying they failed to prove their governments' claims that Syrian President Bashar al-Assad carried out the chemical attacks.

France
On 2 September, the French government published a nine-page report blaming the Syrian government for the Ghouta attacks. An unnamed French government official told Fox News that the analysis was carried out by the Directorate-General for External Security (DGSE) and Direction du renseignement militaire (DRM), and "was based on satellite imagery, video images, and on-the-ground sources – plus samples collected from the alleged chemical attacks in April." The report said analysis of samples collected from two separate April attacks had confirmed the use of sarin. The report also described the Syrian chemical weapons programme and command structure.

Germany
The Bundesnachrichtendienst said it intercepted a phone call between a Hezbollah official and the Iranian Embassy in which the Hezbollah representative criticised Assad's decision to attack with poison gas, apparently confirming its use by the Syrian government. German newspaper Der Spiegel reported on 3 September that BND President Gerhard Schindler told them that based on the agency's evidence, Germany now shared the United Kingdom, United States, and France's view that the attacks were carried out by the Syrian government. However, they also said the attack may have been much more potent than intended, speculating that there may have been an error in mixing the chemical weapons used.

Israel
Without going into detail, Israeli Intelligence Minister Yuval Steinitz said on 22 August that Israel's intelligence assessment was that the Syrian government used chemical weapons in the Damascus area. Defense Minister Moshe Ya'alon said the Syrian government had already used chemical weapons against the rebels on a smaller scale multiple times prior to the Ghouta attacks. United States news outlet Fox News reported that Unit 8200 "helped provide" intelligence to the United States, Israel's closest international ally, implicating the Syrian government in the attacks. Prime Minister Benjamin Netanyahu said at the General debate of the sixty-eighth session of the United Nations General Assembly that Syrian used the chemical weapons against its own people.

Russia
Russian officials asserted that there was no proof that the government of Syria had a hand in the chemical attacks. Russian Foreign Minister Sergei Lavrov described the American, British and French intelligence reports as "unconvincing" and said at a joint news conference with his French counterpart Laurent Fabius after the release of the United Nations report in mid-September that he continued to believe the rebels carried out the attack. Russian President Vladimir Putin said he wanted to see evidence that would make it "obvious" who used chemical weapons in Ghouta.

In a commentary published in The New York Times on 11 September, Putin asserted that "there is every reason to believe [poison gas] was used not by the Syrian Army, but by opposition forces," without going into detail. Lavrov said on 18 September that "new evidence" given to Russia by the Syrian government would be forthcoming, although he did not elaborate.

Turkey
The Turkish government's Anadolu Agency published an unconfirmed report on 30 August, pointing to the Syrian 155th Missile Brigade in Kufeyte and the 4th Armored Division on Mount Qasioun as the perpetrators of the two attacks. It said the attack had involved 15 to 20 missiles with chemical warheads at around 2:45 am on 21 August, targeting residential areas between Douma and Zamalka in Ghouta. It claimed that the 155th Missile Brigade had used 9K52 Luna-M missiles, M600 missiles, or both, fired from Kufeyte, while other rockets with a 15- to 70-kilometer range were fired by the 4th Armored Division from Qasioun. The agency did not explain its source.

United Kingdom
A report on the attacks by the United Kingdom's Joint Intelligence Committee was published on 29 August prior to a vote on intervention by the House of Commons of the United Kingdom. The report said it was "highly likely" that the attacks had been carried out by the Syrian government, resting in part on the firm view that the Syrian opposition was not capable of carrying out a chemical weapons attack on this scale, and on the JIC's view that the Syrian government had used chemical weapons in the Syrian civil war on a small scale on 14 previous occasions. Analysis of the Ghouta attacks themselves was based largely on reviewing video footage and publicly available witness evidence. The report conceded problems with motivation for the attacks, saying there was "no obvious political or military trigger for regime use of CW on an apparently larger scale now". British officials said they believe the Syrian military used chemical weapons, including the nerve agent sarin, on a small scale against the opposition multiple times prior to the Ghouta attacks, on at least 14 occasions from 2012 onward, and described "a clear pattern of regime use" of the nerve agent.

The report was met with substantial scepticism in the British media, with the Daily Mail explicitly comparing it with the "dodgy dossier" the UK government had published in 2003 prior to the Iraq War. A vote in the House of Commons to approve UK participation in military action against Syria was narrowly rejected, with some MPs arguing that the case for Syrian government culpability was not sufficiently strong to justify approving action. Prime Minister David Cameron himself had been forced to concede that "in the end there is no 100 percent certainty about who is responsible".

United States
A US government assessment of the Ghouta attacks was published by the White House on 30 August, with a longer classified version made available to members of Congress. The report blamed the chemical attacks on the government, saying rockets containing a nerve agent were fired from government-held territory into neighbourhoods in the early morning, impacting at least 12 locations. It dismissed the possibility that evidence supporting the US government's conclusion could have been manufactured by the opposition, stating it "does not have the capability" to fabricate videos, eyewitness accounts, and other information. The report also said that the US believed Syrian officials directed the attacks, based on "intercepted communications". A major element, as reported by news media, was an intercepted telephone call between a Syrian Ministry of Defence official and a Syrian 155th Brigade chemical weapons unit commander in which the former demanded answers for the attacks. According to some reports, this phone intercept was provided to the US by Israeli Intelligence Corps Unit 8200.

The US government assessment also suggested a motive for the attack, describing it as "a desperate effort to push back rebels from several areas in the capital's densely packed eastern suburbs." The report then states that evidence suggests "the high civilian death toll surprised and panicked senior Syrian officials, who called off the attack and then tried to cover it up." Days later, Secretary of State John Kerry announced that attack hair samples and blood samples, and later soil and cloth samples from the attack had tested positive for sarin or its immediate breakdown product.

At least three members of the Congress, including at least one member of President Barack Obama's Democratic Party, expressed scepticism about the US intelligence report, calling ¬the evidence circumstantial and thin. Obama's request that Congress authorise military force was not put to a vote of either the House of Representatives or the Senate, and the president ultimately admitted that "I wouldn't say I'm confident" that he could convince Congress to support strikes against Syria.

Democratic Party Representative Alan Grayson offered some details regarding the classified report, which he described as 12 pages long, and criticised both the four-page public summary and the classified report. Grayson said the unclassified summary relied on "intercepted telephone calls, 'social media' postings and the like, but not one of these is actually quoted or attached … (As to whether the classified summary is the same, I couldn't possibly comment, but again, draw your own conclusion.)" Grayson cited as a problematic example the intercepted phone call between a Syrian Ministry of Defence official and the Syrian 155th Brigade, the transcript of which was not provided in the classified report, leaving Grayson unable to judge the accuracy of a report in The Daily Caller that the call's implications had been misrepresented in the report.

Some acting and former intelligence officials were critical of the report, the AP quoting unnamed officials stating the report's evidence was "not a slam dunk". IPS news analyst Gareth Porter questioned why the report was released by the White House as a "government assessment," quoting former intelligence officials who said the report was "evidently an administration document" and who also suggested evidence was "cherry-picked" to support the conclusion that the Syrian government carried out the attacks. The AP also characterised the evidence released by the administration as circumstantial and said the government had denied its requests for more direct evidence, including satellite imagery and communications intercepts cited in the government assessment. A report in the IPS news service quoted former intelligence officials who suggested evidence in the government report was "cherry-picked" to support the conclusion that the Syrian government had carried out the attacks.

Attack
At the time of the attack, Syria was not a member of the 1993 Convention on the Prohibition of the Development, Production, Stockpiling, and Use of Chemical Weapons and on their Destruction (Chemical Weapons Convention).

Human Rights Watch argues that the Ghouta chemical attack was illegal:

"'Syria is a party to the 1925 Geneva Gas protocol, which bans the use in war of asphyxiating, poisonous or other gases, and of all analogous liquids, materials or devices. The use of chemical weapons is also prohibited as a matter of customary international humanitarian law, or the laws of war. The prohibition on the use of chemical weapons applies to all armed conflicts, including so-called non-international armed conflicts such as the current fighting in Syria. The International Criminal Tribunal for the former Yugoslavia, in the Tadic case, stated 'there undisputedly emerged a general consensus in the international community on the principle that the use of [chemical] weapons is also prohibited in internal armed conflicts.''"

International Criminal Court referral
Human Rights Watch stated that the UN Security Council should refer the Syria situation to the International Criminal Court (ICC) "to ensure accountability for all war crimes and crimes against humanity." Amnesty International also said that the Syria situation should be referred to the ICC because "Long term, the best way for the United States to signal its abhorrence for war crimes and crimes against humanity and to promote justice in Syria, would be to reaffirm its support for the Rome Statute establishing the International Criminal Court." However as the amendment to the Rome Statute of the International Criminal Court explicitly making it a war crime to use chemical weapons in an internal conflict has not been ratified by any major state nor Syria, the legal situation is complex and reliant on being a part of a wider war crime.

Domestic
Information Minister Omran al-Zoubi was quoted by the official state news agency, Syrian Arab News Agency, as saying that "the government did not and would not use such weapons – in the case they did not even exist. Everything that has been said is absurd, primitive, illogical and fabricated. What we say is what we mean: there is no use of such things (chemical weapons) at all, at least not by the Syrian army or the Syrian state, and it's easy to prove and it is not that complicated." SANA called the reports of chemical attacks as "untrue and designed to derail the ongoing UN inquiry." A Syrian military official appeared on state television denouncing the reports as "a desperate opposition attempt to make up for rebel defeats on the ground." Deputy Foreign Minister Faisal Mekdad declared it a tactic by the rebels to turn around the civil war which he said "they were losing" and that, though the government had admitted to having stocks of chemical weapons, stated they would never be used "inside Syria". Democratic Union Party leader Salih Muslim said he doubted that the Syrian government carried out the chemical attack.

The National Coalition called the attack a "coup de grace that kills all hopes for a political solution in Syria." In a statement on Facebook, the Coventry-based Syrian Observatory for Human Rights, an anti-government activist network, blamed the attack on the Syrian military and said of the incident that "we assure the world that silence and inaction in the face of such gross and large-scale war crimes, committed in this instance by the Syrian regime, will only embolden the criminals to continue in this path. The international community is thus complicit in these crimes because of its [polarisation], silence and inability to work on a settlement that would lead to the end of the daily bloodshed in Syria."

International
The international community condemned the attacks. United States President Barack Obama said the US military should strike targets in Syria to retaliate for the government's purported use of chemical weapons, a proposal publicly supported by French President François Hollande, but condemned by Russia and Iran. The Arab League stated it would support military action against Syria in the event of UN support, though member states Algeria, Egypt, Iraq, Lebanon, and Tunisia opposed it.

At the end of August, the House of Commons of the United Kingdom voted against military intervention in Syria. In early September, the United States Congress began debating a proposed authorisation to use military force, although votes on the resolution were indefinitely postponed amid opposition from many legislators and tentative agreement between Obama and Russian President Vladimir Putin on an alternative proposal, under which Syria would declare and surrender its chemical weapons to be destroyed under international supervision.

In contrast to the positions of their governments, polls in early September indicated that most people in the US, UK, and France opposed military intervention in Syria. One poll indicated that 50% of Americans could support military intervention with cruise missiles only, "meant to destroy military units and infrastructure that have been used to carry out chemical attacks." In a survey of American military personnel, around 75% said they opposed air strikes on Syria, with 80% saying an attack would not be "in the U.S. national interest". Meanwhile, a Russian poll suggested that most Russians supported neither side in the conflict, with less than 10% saying they supported Assad.

Early opinions
In the interval between the attacks on 21 August 2013 and the UN's initial report on 16 September, there was significant speculation in the media and by public officials regarding alternate theories surrounding the attack. Early reports, later discredited, that the casualties were caused by leaking, accidentally opened, or intentionally released canisters of chemical weapons stored by rebel forces in tunnels were widely reported. Veteran Intelligence Professionals for Sanity reported in an open letter on 6 September that stated, "There is a growing body of evidence from numerous sources in the Middle East – mostly affiliated with the Syrian opposition and its supporters – providing a strong circumstantial case that the August 21 chemical incident was a pre-planned provocation by the Syrian opposition and its Saudi and Turkish supporters." and "We are unaware of any reliable evidence that a Syrian military rocket capable of carrying a chemical agent was fired into the area." Upon investigation, the sources for this story were from the web sites Infowars and the Centre for Research on Globalization. These articles, in turn, were both based on a single article published by Mint Press News in a report described by author and intelligence analyst Muhammad Idrees Ahmad as "implausible" and debunked by Syrian war analyst Eliot Higgins.

Some unnamed US intelligence officials speaking to Associated Press at the end of August raised the possibility that rebels staged the attack "in a callous and calculated attempt to draw the West into the war." Russian president Vladimir Putin said that the use of chemical weapons was a rebel provocation performed to trigger a foreign-led strike. A number of US commentators have similarly made claims that the attacks might have been a "false flag" operation designed to give western powers an excuse to intervene. These include former Congressman Ron Paul, his son Senator Rand Paul, conservative commentator Pat Buchanan, and former US representative Dennis J. Kucinich. (Rand Paul later acknowledged that "in all likelihood the al-Assad regime has used chemical weapons to kill civilians.") These reports of accidental or false flag operations by rebel groups in co-operation with outside groups were popularised by Rush Limbaugh and mentioned in blogs run by Michael Moore and Pamela Gellar.

The claims of two European writers held hostage by the rebel Abu Ammar Brigade also attracted some attention. After being released in early September 2013, Pierre Piccinin, a writer from Belgium, and Domenico Quirico, a journalist from Italy, said they overheard a captor and two unknown individuals on Skype describe the attacks as a rebel "provocation". Piccinin considered it proof of rebel responsibility, but Quirico is unsure of their credibility and characterised it as "hearsay".

As newspaper budgets for field reporters have decreased and Syria has become dangerous for reporters, non-governmental advocacy groups have played an increasing role in reporting; and news organisations have been less capable of independently evaluating their claims. As noted by Carroll Bogert of Human Rights Watch, "We do feel that as journalism has ebbed, we have a responsibility to flow."