See also VideoCast with TRT World: The US and Assad’s Chemical Attacks on Douma

UPDATE 1845 GMT: The Douma Civil Committee has reportedly confirmed the agreement for forcible displacement of civilians and rebels from Douma to northern Syria.

UPDATE 1800 GMT: A media official of the Jaish al-Islam faction says rebels have reached a deal with Russian negotiators to evacuate with their families, following the intense bombardment and chemical attacks that reportedly killed at least 225 civilians and wounded more than 1,000 this weekend.

The representative said that Jaish al-Islam has not officially announced the deal.

A pro-opposition journalist adds:

Civil defense reported the casualty toll. “It’s a catastrophe,” Mansour Abu al-Kheir, a rescuer said. “No words or pictures can describe what civilians have lived through these past two days.”

More than 400 Russian and regime airstrikes hit Douma since Friday, the Outer Damascus Civil Defense said.

Douma’s remaining doctors and emergency personnel are “almost totally paralyzed before the massive numbers of injured”, said doctor Muhammad a-Shami.

“Only a handful of doctors remain,” Fahad Hanan, a doctor and Douma resident, told Syria Direct on Sunday. “We’ve been working in the hospital for two days straight. It’s a disaster.”

From residents, journalist Elizabeth Tsurkov narrates some of the death and destruction:

Pro-opposition Qalaat al-Mudiq summarizes the strategy of the chemical attacks that appear to have succeeded in forcing surrender:

UPDATE 1420 GMT: Using Twitter, Donald Trump has pledged a US military response to the chemical attacks.

Trump — breaking his pattern of no criticism of Vladimir Putin — said, “President Putin, Russia and Iran are responsible for backing Animal Assad. Big price to pay!”

Trump did not propose any specific steps apart from opening the area for investigation.

UPDATE 1400 GMT: Without referring to the chemical attacks, State news agency SANA is declaring, through an “official source”, an agreement for the departure of all Jaish al-Islam rebels to Jarablus in northern Syria within 48 hours.

UPDATE 1000 GMT: The Syrian-American Medical Society has issued a statement describing the initial chemical attack on Douma.

The report summarizes that following the attack — suspected to be by chlorine — more than 500 people, the majority women and children, were treated for symptoms of exposure to chemical agents, including respiratory distress, central cyanosis, oral foaming, corneal burns, and the emission of a chlorine-like odor.

One person was declared dead on arrival.

The second, more serious attack followed.

Video of one of the munitions:

UPDATE 0945 GMT: Russia’s Defense Ministry has issued its standard denial of any chemical attack.

The head of the Russian “Center for Reconciliation”, Maj. Gen. Yuri Yevtushenko, called the reports, photographs, and video “fake news”:

We strongly reject this information and confirm readiness after Douma is liberated from militants to send Russian specialists in radiation, chemical and biological protection to collect data to confirm that these statements are fabricated.

Russian State outlet Sputnik is spreading disinformation through its Twitter headline, “Militants Use Staged Chemical Attack to Curb Syrian Army’s Success.”

Moscow’s response has been much quicker today than over the Assad regime’s sarin attacks on East Ghouta in August 2013, when the Russians scrambled for hours before putting out the false claim that rebels had attacked the area with “homemade weapons”.

Syrian State outlet SANA has now organized the line for its English-language site, saying that “media affiliates” of rebels “are repeating the allegations of using chemical weapons in order to accuse the Syrian Arab army, in a blatant attempt to hinder the Army’s advance”.

In a bizarre denial, the pro-Assad outlet Al-Masdar writes: “The Syrian Arab Air Force (SyAAF) halted their airstrikes over the Jaysh Al-Islam stronghold of Douma after the Syrian Arab Army (SAA) scored several advances on Saturday, a military source [said] this morning.”

UPDATE 0925 GMT: A well-placed local observer assesses the chemical assault on Douma:

Well established regime tactic. Hell of bombs, a few CW [chemical weapons] attacks to increase panic among civilians. Some civilians will flee and hinder rebel military to defend the area. Then ground assault on the weakest points.

All while rockets and airstrikes destroy evidence of CW attacks.

Pro-Assad bombing continues this morning:

UPDATE 0830 GMT: There appear to have been two separate chemical attacks on Douma, the first during the day with chlorine gas and the second at night with a stronger, deadlier agent.

Matching accounts that talk of a strike on first responders to prevent rescues, local sources say the chemical assault was preceded by barrel-bombing.

Urgent treatment of a young victim:

The English-language site of State news agency SANA is silent about the attack. Instead, it declares, “BREAKING NEWS: Official source — Terrorists of the so-called ‘Jaish al-Islam’ seek negotiations with the Syrian state. Negotiations to begin within two hours”.

UPDATE 0730 GMT: The head of the White Helmets civil defense, Raed al-Saleh, has updated, “Seventy people suffocated to death and hundreds are still suffocating.”

Saleh said the death toll is expected to rise with many people were in critical condition.

He echoed reports that chlorine gas, as well as an unidentified but stronger agent, were used: “White Helmet volunteers are trying to help the people but all what we can do is evacuate them to another areas by foot because most of the vehicles and centres went out of service.”

Pro-Assad forces have killed dozens of people in a chemical attack on the last opposition-held town in East Ghouta, near Syria’s capital Damascus, according to a pro-opposition medical organization and local activists.

The Syrian American Medical Society (SAMS) said 41 people wer killed. Other claims from Douma, including from White Helmets rescuers, put the toll as high as 150.

The SAMS said a chlorine bomb hit the Douma hospital, killing six people. A second attack with “mixed agents” struck a nearby building, killing 35, most of them women and children.

A witness from the Syrian Arab Red Crescent pointed to a deliberate attack on first responders as well as the chemical strikes, “The shelling was carried out by two guided missiles and several barrels from a helicopter….The point went out of service immediately in addition to all of the ambulances. Now there is only the civil defence [White Helmets] left to transport the wounded.”

Videos showed the bodies of a dozen children, women, and men, some of them with foam at the mouth. Activists and medics noted that, given chlorine is relatively inefficient at causing deaths, it is likely a stronger chemical agent was used in the assault.

The Assad regime and Russia, as with all cases of chemical attacks, have denied the reports. They said the population in Douma — which has endured more than five years of siege and bombardment and the pro-Assad assault of the past two months — is in a state of collapse and spreading false news.

State news agency SANA declared that Jaish al-Islam, the rebel faction in Douma, was the actual culprit, as it was making “chemical attack fabrications in an exposed and failed attempt to obstruct advances by the Syrian Arab army”.

The Assad regime and Russia have used warnings of “false flag” attacks in the past to cover the regime’s use of chlorine throughout Syria.

In January and February, the regime used chlorine on at least seven occasions on East Ghouta, in preparation for the offensive which has now killed about 1,800 people, wounded thousands, and displaced tens of thousands.

The US State Department said the reports are “horrifying” and, if confirmed, “demand an immediate response by the international community”.

Spokeswoman Heather Nauret recalled the Assad regime’s sarin nerve agent attack on Khan Sheikhoun in northwest Syria in April 2017, which killed up to 92 people and wounded hundreds:

The Assad regime and its backers must be held accountable and any further attacks prevented immediately.

The United States calls on Russia to end this unmitigated support immediately and work with the international community to prevent further, barbaric chemical weapons attacks.

The Assad regime and Russia have taken all other East Ghouta towns, held by the opposition since 2012, in their two-month offensive. The assault on Douma had eased earlier this week; however, it resumed on Friday with more than 40 killed, after talks between Russia and Jaish al-Islam failed to yield a capitulation agreement and the departure of the rebel faction.

See Syria Daily, April 7: Regime & Russia Resume Mass Killing in East Ghouta