The most effective response to the nerve gas attacks in Damascus would be to arm the people with antidotes and information

THE horrors of the Iran-Iraq war, in which tens of thousands were killed by chemical weapons, leave no doubt of the danger Syrians face from further atrocities like last week’s in Damascus.

Now that the line has almost certainly been crossed, further attacks seem likely. Syrian President Bashar al-Assad’s regime is thought to be holding stockpiles of the nerve agent sarin, and clearly there is willingness (from whichever side) to use it.

If, as also seems likely, the West decides to intervene, what action should it take? It is highly improbable that the threat can be reduced by bombing the stockpiles (see “Wind and rockets key clues in Syrian chemical puzzle” and “Iraq offers grim lessons for Syrian gas survivors“). Giving people the means to protect themselves is much better.

Iranian toxicologists who studied the victims of the Iran-Iraq war in the 1980s found that administering antidotes to nerve agents – mainly atropine and pralidoxime injected into muscle – in the hours and days after a sarin attack can save lives and reduce the chances of chronic symptoms in survivors. Even cheap alternatives such as sodium bicarbonate and magnesium sulphate can help.


Advising people on what to do during a sarin attack makes a huge difference, too. Many people died in Damascus because they hid in basements, when they would have been safer on the top floors: sarin vapour is heavier than air. For those who have been exposed, the medical advice is clear. Remove clothing, wash with soap and water – and seek out an antidote.

Many people died in Damascus because they hid in basements: sarin vapour is heavier than air

Atropine and pralidoxime are not expensive or hard to administer. They are freely available in Western countries and are standard issue for British and US soldiers in the Middle East. But there is a dire shortage in Syria, and until recently they were not included in emergency medical packages distributed by the WHO and other humanitarian agencies.

Amid the calls for military action, it is easy to lose sight of what would most benefit the Syrian people. In the short term, Western governments are likely to save most lives by supplying the antidotes and educational materials that people desperately need – either by persuading Assad to open supply routes, or by dropping medical parcels and leaflets rather than bombs.

This article will appear in print under the headline “Drop medicine not bombs”