The warning from the front lines came by walkie-talkie. An Islamic State artillery position had boomed to the east, signaling that an incoming round was whistling toward Marea, a town on northern Syria’s agricultural flatland.
“One shell fired!” the voice on the radio said. “Be careful!”
Inside the house he shared with his family, Abu Anas Ishara, a rebel fighter defending his hometown, knew the routine. Usually 10 to 15 seconds passed before shells landed and exploded.
But Marea had been struck so often that Abu Anas had wearied of it all. He did not seek cover. Nada, his wife, kept feeding their infant daughter, Sidra, delivered by cesarean section five days before.
The shell hit the roof of their home.
As the couple were enveloped by dust and foul-smelling smoke, Shahad, their 3-year-old daughter, cried out.
Abu Anas and Nada staggered outside, each carrying a child, all seemingly unharmed. It was the morning of Aug. 21. Their descent into the confusion and scorching pain of a chemical warfare attack had begun.
Struck from afar by a blister-agent shell, the family would suffer from an agonizing form of violence that since the 1990s, when the Convention on Chemical Weapons took force in much of the world, had seemed to fade into the past, only to be revived by the Islamic State.
Since the spring, the group has used two types of chemical weapons in Iraq and Syria multiple times, according to international arms analysts, victims, local activists and Western officials, joining Syria’s government as a party in the conflict that has used chemical weapons.
The weapons have included improvised bombs containing chlorine, a toxic industrial chemical that Sunni militants in Iraq have crudely weaponized in vehicle and roadside bombs for roughly a decade, and artillery or mortar projectiles containing a blister agent that appeared this summer after being fired from Islamic State battlefield positions.
These projectiles have delivered sulfur mustard, an internationally banned chemical warfare agent, according to American officials familiar with the analysis of soil samples, ordnance and victims’ clothing collected after several attacks. Two American officials said items analyzed from the Aug. 21 attack on Marea were among those that confirmed the agent’s use.
Chlorine and sulfur mustard are typically less lethal than high-explosive ordnance and other common instruments of battlefield violence. But they are difficult to defend against and fundamentally indiscriminate. Moreover, because they are regarded by their victims as poisons that can be carried on air, the outrage and fear surrounding their use lends them potent psychological and political power.
The appearance of distinctly different chemical weapons across a long section of Islamic State territory has led private and government analysts to venture that the world’s most violent jihadist organization has developed at least a small-scale chemical weapons program, and may have manufactured low-quality blister agent or obtained chemical arms from undeclared or abandoned government stocks.
How much chemical warfare capacity the Islamic State has organized, and its militants’ ambitions for its use, remain publicly unknown. Often boastful, the group has offered little clear and verifiable insight into its unconventional weapons. But a commonly held view is that it could attack with such weapons again, perhaps in more spectacular fashion.
Many chemical attacks to date have been against Syrian rebel or Kurdish militia positions. The attacks on Marea, which began on Aug. 21 and continued intermittently into the next week, were more complicated.
Incoming chemical shells sailed past rebel lines and landed in neighborhoods, medical officials and activists in Marea said. Some struck homes.
As is common in areas of Syria beset by fighting, most houses in Marea were empty. The town’s former residents had abandoned them, choosing the indignities and uncertainties of life as refugees over the dangers and dimming prospects for peace at home.
Several dozen of Marea’s remaining residents were exposed, many of them mildly, local medical officials said.
Abu Anas and Nada, and members of their extended family, agreed to be interviewed about their much heavier exposure on condition that their surnames not be published, because they feared retaliation from the Islamic State.
Abu Anas, a Syrian former police officer who provided Turkish medical documents and three photo identification cards that showed his full name, is a member of the 13th Division, a rebel group that has received support from Turkey and several Arab and Western nations, including the United States.
The last word in the name he is known by in Marea, Ishara, is not a surname; it means “signal,” a reference to his duties until the chemical attack as a battlefield spotter and tactical radio specialist.
A Different Kind of Attack
In the minutes after Nada and Abu Anas dashed from their home with their children, the astonishment of being in a small building struck by an artillery shell gave way to relief, then to curiosity.
The war in Syria was past familiar. In the bloody years since the uprising began in 2011, the Sunni rebels who organized in Marea had fought Syrian government forces and Shiite militias, then the Islamic State. The town’s people had seen many kinds of violence.
They had survived crackdowns, tanks, infantry attacks, airstrikes and cluster munitions. Ballistic missiles had slammed down on nearby fields, shaking the earth and heaving towers of soil into the air.
Abu Anas had heard of the evidence and allegations of previous chemical use, including of nerve agent and chlorine, by the government of President Bashar al-Assad. He had not suspected the militants of having chemical weapons, too.
Something about this shell was different. It hit the roof’s slab of reinforced concrete, but only smashed a pear-shape hole a few feet across. It did not explode, as most shells do. The flash of fire, pressure and hot shrapnel, which together can instantly kill people, had not occurred.
Instead, Abu Anas said, as the dust fell on him, he felt as if he had been coated in warm sand. Soon an odor filled the home. It smelled, he said, like “rotten eggs or rotten garlic, something rotten.” It rose from his clothes, too.
Sulfur mustard causes burns that can damage the skin, eyes and respiratory tract. Carcinogenic and extremely toxic, it can also cause invisible internal damage, including to bone marrow, reducing blood-cell production. Heavy exposure can cause death within days.
But its effects are not immediate. Symptoms usually appear after an hourslong delay.
Nada, too, wondered what had happened. She suffered no early symptoms. After taking shelter with a neighbor, she and her husband returned to the house several times to gather belongings, not realizing the risks. Abu Anas recorded a cellphone video of the broken ceiling and pocked walls, as if they were lucky to be alive.
But as hours passed, Nada could not console Sidra, her newborn, though she found no marks or bruises on the child. The baby was falling ill, and Nada did not know why. “I tried to wash her little body,” she said. “I washed her face and her body, but she kept crying.”
In the afternoon, other residents visited and asked to see where the shell had hit. Abu Anas stepped inside again to show them the hole in the ceiling. The stink was so intense it drove him back. “I threw up in the street,” he said.
By then his eyes were starting to burn. He showered at a neighbor’s home, he said. In what he now knows was a mistake, he dressed again in the same clothes.
As the afternoon passed the family became unmistakably unwell. Shahad complained of pain in her throat. The baby fell quiet, awake but disturbingly sluggish, almost still. Abu Anas’s eyes were searing. Tears ran down his face. He felt nauseated.
Abu Anas and Nada gathered the children and set out for help.
Blisters and Unbearable Pain
Late that afternoon, the staff at a field hospital in Marea examined the baby and urged the family to seek better care; an ambulance carried them to a hospital in nearby Tel Rifaat. There, Nada and Abu Anas said, a manager told them that they had been exposed to chemical weapons, and that they needed treatment in Turkey. He ordered the driver to rush them north.
By the time the family crossed the border, it was night. At the first hospital, in Kilis, they were given face masks and assessed.
Blisters had risen on Sidra, the baby, and were starting to appear on Shahad, who was coughing. The medical staff began decontaminating them, trying to scrub them clean, Abu Anas said. The little girls cried and wailed uncontrollably. Unable to console them or relieve their pain, he felt helpless.
The doctors told Nada and Abu Anas their children were very sick, then separated the family and began examining the adults.
“They cut my clothes off, so I was naked, and began to spray me” with a pressure washer that forced water through a wide nozzle, Abu Anas said.
Doctors found fresh blisters coating part of his upper back, apparently where a chemical agent had soaked through his clothes.
Until then, he said, he had not realized he had been burned. But as the water hit him, he felt excruciating pain. He vomited again.
Nada’s burns were more extensive, spreading over much of her body and limbs.
The doctors admitted the children and transferred the couple to a larger hospital in this city, where, over Abu Anas’s objections about pain he did not think he could endure, he and his wife were decontaminated a second time.
Overcome by exhaustion, by being separated from her children and by painful treatment for intensifying wounds at the hands of people speaking a language she did not know, Nada lost consciousness in the night.
When she woke she pleaded to see her baby. The doctors refused, she said, telling her the child was O.K.
Nada’s symptoms grew worse. Blisters erupted, the surface of her eyes burned, her breathing became raspy. Her husband had been burned less, but he developed a deep, wet cough and struggled to see.
They never saw their baby again. For almost two weeks the doctors withheld details of Sidra’s condition, Abu Anas and Nada said, as the child slipped from life.
She had died on Sept. 4. The hospital staff showed Nada a photograph of her baby, swollen and burned. Much of the child’s hair seemed to have been scalded away. “They told me she is dead, and now she is one of the birds in paradise,” she said.
Nada had carried Sidra for nine months only to lose her within days. The time had been too short, Nada said, even to absorb clear memories of how her daughter looked. “Her eyes were always closed,” she said, “as if she didn’t want life.”
A Simple Burial
On Sept. 7, the hospital released the dead child to two of Abu Anas’s brothers, who were driven with the body to a cemetery beside Gaziantep’s airport.
Sidra was wrapped in a white shroud, a bundle that one of the brothers, Mahmoud, said he held gently on his lap in the car.
At the cemetery’s mosque, a woman washed the body according to Islamic ritual. No other family members were present. An imam administering another funeral saw the men alone, brought guests from that funeral to their side, and led prayers in Turkish. Sidra’s uncles, who speak only Arabic, did not understand them.
The two men buried their niece in a shallow grave, roughly two feet long, near the top of a hill overlooking the mosque. It was identified by small concrete markers and a five-digit number.
By mid-September, the three survivors’ burns had scarred over. Shahad, burned across her abdomen, arms, back and legs, but healing, was reunited with her parents. The family moved from hospital beds to mattresses on a cramped apartment rented by Nada’s father, Adel, an auto mechanic who is also a refugee.
Adel said he did not understand why the Islamic State would fire into neighborhoods instead of at places where rebels congregated. “The bases are known, the positions are known,” he said. “What was the purpose of targeting a home?”
But he spoke of forgiveness, not vengeance. “God will not have mercy on us until we have mercy on each other,” he said, over tea, as his son-in-law coughed beside him in one room and the sounds of his daughter’s coughs could be heard from the next room.
The family had almost no clothing. Their possessions had been contaminated in the attack. Abu Anas had managed to save little more than his cellphone, which he washed in alcohol and dried in the sun.
Wincing, weak and short of breath, wearing sunglasses inside as he rested beside a plastic bag of phlegm-soaked tissues, Abu Anas was waiting for space in a Turkish refugee camp.
There they would need many more months to heal, he said, for burned skin to stop tingling and itching, for breathing to become easy and clear, for eyesight to be restored. Then they might wait out Syria’s ceaseless war, minus Sidra, struck by sulfur-mustard agent before the end of her first week of life.
“God loved her,” Adel said, and so he took her to spare her more of a suffering that no one should bear.