A mural outside the Kimouwee chemical weapon cemetery in Zamalka, Syria Credit Susan Schulman in Damascus 8:00am BST“Unfortunately, I am still alive,” says Mohammed Suliaiman Abo Alkair, his green eyes heavy and distant.

The 38-year-old steps from his living room onto the roof and gestures towards a cluster of trees – a lone patch of green in a sea of grey rubble. It was there, at two in the morning 13 years ago that the whistle of a rocket ended not in an explosion but a thud.

For a moment, there was relief; the feeling of being spared. But then came a cloud of the nerve agent sarin.

Almost everyone around Mohammed died. His family and one small boy in a neighbouring house were the only ones to survive.

That August night, as Damascus slept, forces loyal to the Syrian President Bashar al-Assad launched eight sarin-filled rockets at the opposition-held districts of Zamalka, Ein Tarma and Jobar. The US government estimated that 1,429 people were killed, including 426 children. Other estimates put the number at 1729.

For more than a decade, nobody was held to account. Mr Assad denied the attack, shielded those responsible and later used sarin again – at Khan Sheikhoun in 2017, and in at least ten further attacks documented by the Organisation for the Prohibition of Chemical Weapons.

Only after Mr Assad fled Syria in December 2024 did the prospect of justice emerge. Investigators for Syria’s new government have since uncovered previously undeclared chemical-munitions caches, and the authorities have detained 18 suspects. None has yet been tried or punished.

But as attention turns at last to justice, the survivors remain invisible, absent from the reckoning. For now at least they remain largely invisible.

Mohammed Suliaiman Abo Alkair with his daughter Rita on the roof of their apartment in Zamalka, close to where sarin bombs were dropped“People think we should have moved on. That it’s over,” Mohamed says. “They don’t understand. We are living in a nightmare that has never ended.”Mohammed sits on a couch beneath a patch of concrete covering most of the wall behind him.

His daughter Ritaj, 8, bounces into the room. She cuddles up to him, beaming with a mischievous twinkle in her eye. As he tries to pull her close, she laughs and darts away as quickly as she arrived.

“Imagine. All your friends, all the people you know, everyone around you. Whole families. Children playing outside. All of them dead. And then you find yourself alone.”Mohammed’s father was initially laid among the corpses until somebody saw his finger move.

“I walk around every day, and all I see are dead bodies – my relatives, my friends, my neighbours,” he says. “I wish I’d never come back to this house. The memories never fade.”Mohammed’s wife, Naeema Ashoush, pours coffee and sits down with us. She was a healthy, energetic 18-year-old that night, with their eight-month-old son Siraj asleep beside her. The rocket woke her with a sound she had never heard before. “Like an old washing machine,” she says.

Then came the smell of rotten fruit – and the choking. Naeema could not breathe. Her vision clouded over. Siraj was struggling to breathe too. She pulled him against her chest, trying to shield him, but he fought her hands, desperate for air.

Afterwards, Siraj began having convulsions. His eyes would roll back; his hands clench and his body turn blue before going limp.

“Like dead,” his mother recalls. “Like a piece of wood.”Almost everyone around Mohammed died in the attacks As the boy grew old enough to describe what he could and could not see, it became clear that his eyesight had also been damaged.

Nearly thirteen years later, the convulsions still come, though less often. His eyesight is impaired and he is easily winded, unable to play football for long before stopping to catch his breath.

Naeema lives with many of the same health problems. She too struggles for breath. A short walk leaves her wheezing; even simple housework exhausts her. But she says the attack changed more than their bodies.

“Our voices changed. We changed,” she says. “You can’t tolerate anyone saying even a word. Always upset. Always tense. Always this trembling – like a shaking that comes over you.”Her nails are digging into her hands as the sound of TV drifts in from the next room.

“My mind knows there is no bombing,” she continues. “But we’ve absorbed it. It’s tied to my subconscious, my memory. There’s always fear.”Mohammed and Naeema never sleep at the same time. They take the nights in shifts.

“One person stays awake while the other sleeps, out of fear it might happen again,” she says. “We keep watching, listening, waiting for something we can’t even name.”She laughs bitterly.

“How much sweeter were the [conventional] airstrikes. At least you knew a plane was overhead. But this – what is it?”Destroyed, sarin-gassed suburbs of Damascus Pancaked slabs of concrete, dangling rebar, and mounds of rubble still line the empty streets of Jobar. It’s a neighborhood of skeleton buildings. Yet in the silent streets, an occasional line of laundry fluttering on a balcony gives a hint of life.

The stairwell leading up to the apartment Rodina Abdelhadi, 37, and husband Mohammed Mnfak,47, live in with their children is still strewn with rubble. They are the only occupants in a heavily damaged building and the only ones living in the neighborhood.

Inside, everything is immaculate, the furniture carefully arranged, the floor spotless. A crack running down one wall is the only reminder of the war from within.

The couple’s son Nebras races through the sitting room, a mobile phone clutched in both hands. Never taking his eyes off the screen, he darts from room to room, his movements quick and jerky, always smiling but never making eye contact.

Nebras was born on the morning of the Ghouta sarin attack.

It had been a difficult pregnancy: a caesarean section had been scheduled for the morning of August 21. Fearing government checkpoints might prevent them reaching the hospital, the family spent the night near the highway. At around two o’clock that morning, the rockets landed.

When Nebras was delivered three hours later, the nurses did not bring him to her. No one explained why.

Rodina Abdelhadi remains deeply traumatised by the attack Nebras, now 13, was born hours after the sarin attacks in Jobar Fifteen days later, still recovering from surgery and carrying a newborn who rarely stopped crying, she and husband Mohammed returned to Jobar.

“The whole place was empty,” she says. “There was no life. No people.”They began asking after those they knew.

“We would ask about someone, and they would say, ‘He is dead.’ Then someone else, and they would say, ‘He is dead too.’ After a while, we became afraid to ask.”Nebras never settled. At three months, doctors diagnosed thyroid insufficiency. As his first year passed, the difference between him and other children became impossible to ignore.

“I watched the other children,” Rodina says. “They began to walk. They began to talk. They understood people. He was not doing any of those things.”Nearly 13 now, Nebras cannot go anywhere alone or look after himself. He is minimally verbal. His understanding is that of a six-year-old.

A tattered Syrian flag flies over Zamalka, one of the districts hit by the chemical attack While severe oxygen deprivation in a mother can deprive a foetus of oxygen and cause neurological injury, no specialist has conducted the investigation that might establish what happened to him.

“But I cannot separate what happened to him from what happened that night,” she says.

He has received no sustained developmental treatment, rehabilitation or specialist follow-up“For his condition,” his father, Mohammad, says, “There has been nothing. Nothing at all.”The family encouraged their eldest son to travel through Libya to Europe, hoping he might be able to help Nebras obtain treatment abroad.

“When I sent him, I felt I was sending my son to death,” Rodina says. “But it seemed the only choice.”He reached Europe but has not been able to secure help for his brother. Now, he does not want to return to Syria, a place he associates with horror. Rodina does not know when she will see him again. Tears roll down her face. ‘It was like being in a coffin’A few months ago, Samah Mahmoud Al-Bassar tried to end her life.

“People think that is strange,” she says. “But what is normal? Someone watches their family die. Lives through war. Lives through chemical attacks. Lives through years of pressure. And people expect them to be normal?”

People urge her to just move on. But “How?” she asks. “You cannot erase it.”On the night of August 21, 2013, Samah woke to her four-year-old asking for water. Someone shouted for everyone to open their doors and leave the fans running. She gathered her children in the bathroom and poured water over them, trying to wash away whatever was in the air. Then she began to choke. Her children began to choke.

She grabbed the three children – a six-week-old baby, a two-year-old and the four-year-old – and fled. Her uncle and four of his children were already dead.

Some of the medications Samah now has to take following the attack Samah’s 15-year-old son Ghaith has been left permanently altered by the attack By then, she could barely see. “I looked towards the light and couldn’t see anything,” she says. “I saw shadows of people on the ground and shadows of people moving. I could hear voices but couldn’t see. It was like being in a coffin.”Carrying all three children, she followed the moving mass of shadows.

Thirteen years later, bright sunlight still triggers crushing headaches. Severe exhaustion, chronic leg and throat pain deplete her. If she walks more than a few minutes or works too hard, she struggles to breathe.

People tell her it was a long time ago. “But for me it isn’t,” she says.

Sometimes, it all comes back. Earlier this year, while she was at work, her oxygen levels suddenly dropped and her vision blurred. In an instant, she was back in that night – the smell, the suffocation, the terror of not being able to breathe.

People tell her stress may make it worse. ‘Maybe,’ she says, ‘But my body remembers.’A mural outside the chemical weapons cemetery depicting the attack A chart listing victims of the sarin attack by name and age Her eldest son, Ghaith, is now 15. When he runs, his lips turn blue. He tires quickly. His hands shake, and he suffers convulsions. He is old enough to understand that other children can do things he cannot.

“Why can’t I study like my brothers?” he asks. “Why can’t I play like other children?”He sees his friends run on after he has been forced to stop. He notices. For his mother, that is the hardest part.

There is little she can say to comfort him. So she does what she can: cleaning houses to pay for her children’s education, helping them with their schoolwork, and shielding them from the terror, despair and depression that threaten to overwhelm.

“What hurts is that people think if someone survived, then they recovered,” she says. “No. People survived and stayed injured. People survived and stayed afraid… People survived and then had to live.”Rafat Yassir Abboudia, a survivor and campaigner Today, survivors of Assad’s chemical attacks call Rafat Yassir Abboudia, a survivor and campaigner for justice.

Rafat, now 30, survived the sarin attack on Khan Sheikhoun on April 4, 2017. His mother also survived only to be arrested by the regime. She developed kidney failure in prison and died in 2022. His brother was killed fighting in the Free Syrian Army in Hama.

After the fighting, Rafat began documenting chemical attacks and supporting survivors through the Justice for Victims Association and a network of volunteers. He records testimonies, gathers evidence and presses the authorities to investigate the long-term health effects of sarin.

But most of those who call him are looking for something more immediate: a doctor, treatment, help for the terror haunting their lives.

Rafat understands. His physical injuries eased in the weeks after the attack but the trauma did not. Even now he can’t return to Khan Sheikhoun. “Every time I remember the massacre, I feel like it happened just now,” he says.

In Zamalka – another district that was hit – the ruins run to the horizon. Nearby, the bent frame of a children’s swing rises from the rubble. The streets have been cleared just enough for a bicycle, sometimes a car to pass.

An abandoned children’s playground in one of the areas targeted by the chemical attack Kimouwee, the chemical-weapons cemetery in Zamalka At the edge of the town, facing an empty expanse where houses stood and children played, is the cemetery known as the Kimouwee – chemical weapons cemetery.

Black balloons are painted on its walls, limp bodies hanging beneath, the yellow symbol for chemical danger adjacent. Beside them is a chart listing victims of the sarin attack, each by name and age.

In English, someone has written ‘Don’t Suffocate Truth.’The recent arrests of some of those believed to have been involved in the sarin attacks have been welcomed. Survivors hope their planned trials will provide some closure.

No trial date has yet been set, but the first hearings are expected to start soon. In an address to the UN Security Council on 6 September, Syria’s UN envoy, Ibrahim Olabi, said the country was preparing to hold its first court hearing.

But there is anger: at former US President Barack Obama for the “red line” he drew but never acted on; for the shelter Mr Assad and his family have been given in Russia; and for the injuries and trauma that the attacks caused – harms that will never be cured. Protect yourself and your family by learning more about Global Health Security