The international community sat aghast on Tuesday as images emerged of Syrian children choking to death after a suspected chemical attack killed dozens of people in the rebel-controlled northern province of Idlib.
According to reporting, at least 60 were killed and hundreds more are being treated for exposure. Survivors of the attack said that war planes dropped toxic gas at dawn over the village of Khan Sheikhun, where, the Guardian notes, "there are thousands of refugees from the nearby province of Hama who have fled recent fighting" between government forces and the Islamic State (ISIS).
Medics reported that "nearly a third of the casualties they have seen are children, presenting at hospitals pale and unconscious or struggling to breathe after rockets were dropped from the air," according to Save the Children, which estimated that at least 11 children have died.
The Edlib Media Centre, which Al Jazeera describes as "a pro-opposition group," circulated images on social media of people being treated by medics as well as what appear to be dead bodies including many children (Warning: disturbing images).
There were also reports shortly afterwards that an aerial bombardment targeted a hospital treating victims of the gas attack.
Meanwhile, Save the Children is reporting that a second gas attack struck the area again midday. "A further rocket releasing a currently undetermined chemical substance was alleged to have been dropped in the same area at lunchtime today and many families are said to have fled north, desperate to escape a further attack," the charity said.
In a press statement, Sonia Khush, the organization's director in Syria, described the scene.
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"Doctors at a health clinic run by our partner Syria Relief told us they received three children under six years old today," Khush said. "They were struggling to breathe and barely conscious, with running noses and contracted pupils—doctors say these symptoms are consistent with the use of nerve agents such as sarin."
Khush further noted that if use of such a banned substance is confirmed, "this would be in clear violation of international law and a worrying indication that not all chemical weapons have been destroyed in Syria as UNSCR 2118 reached in September 2013 demanded." Both Save the Children and Amnesty International are calling for an immediate and impartial investigation into the attack.
Similarly, the UN Commission of Inquiry on Syria issued a statement Tuesday condemning the attack and noting that "[b]oth the use of chemical weapons, as well as the deliberate targeting of medical facilities, would amount to war crimes and serious violations of human rights law."
"It is imperative," added the independent panel led by Brazilian expert Paulo Pinheiro, "for perpetrators of such attacks to be identified and held accountable."
Meanwhile, western leaders, including U.S. President Donald Trump and Secretary of State Rex Tillerson, rushed to place blame on Syrian President Bashar al-Assad, though both the Syrian government and allied Russian forces denied responsibility.
Numerous outlets and organizations have compared Tuesday's gas attack to the August 2013 in Ghouta, Syria, which the United Nations later confirmed included the use of sarin. Médecins Sans Frontières (MSF) estimated at the time that 355 were killed while thousands more suffered the effects of neurotoxic poisoning.