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Zaher Sahloul is a Syrian-American physician, and former president of the Syrian American Medical Society

On April 4, I thought I was still asleep. In my nightmare, I watched the horrific videos and pictures of the victims of the Khan Sheikhoun gas massacre. Flaccid children gasping their last breaths, patients foaming at the mouth, dead bodies littering the street. There was chaos in small field hospitals, overwhelmed by the number of victims, where doctors performed CPR on young, naked children trying hopelessly to resuscitate them. But it was not a nightmare: It was another gas attack in Syria, number 175.

I have often wondered how a medically trained person can do this to his people. Bashar al-Assad, an average student without unique leadership qualities, was trained at my medical school. We were classmates for six years. Right after he became President, he met with a group of us during a medical conference. "I would rather be a doctor than the President," he said. No one believed him, but no one expected him to be this brutal.

He has since broken every ethical code of medicine, violated the Geneva convention and many rules of war. How can a doctor target doctors and hospitals? How can a doctor justify starving children to death? How can a doctor mutilate bodies with barrel bombs? How can he gas them to death?

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In my dozen medical missions to Syria, I have treated young children, such as Ahmad, 5, who was pulled from under the rubble of his destroyed home. Abdallah, 12, whose lung was penetrated by shrapnel from a barrel bomb. Hamzah, 3 years old, was shot by a sniper. Fatima, 12, was bleeding in her brain after a missile attack. I spoke to the doctors who tried in vain to resuscitate Sarah, 3, Aisha, 2, and Mohammad, 1, victims of chlorine attacks in the city of Sermin.

After each massacre in Syria, the world is apparently caught by surprise. Innocent children die because of a shortage of antidotes, ventilators, oxygen and hospitals.

After 175 attacks in Syria with chemical agents, the World Health Organization and the Organisation for the Prohibition of Chemical Weapons, which is responsible for enforcement of chemical weapons protocols, still have no process to confirm which chemical agent was used to kill innocent Syrian people.

Today, I practice medicine in one of the best hospitals in Chicago. Our doctors and nurses use every tool we have to try to save every life. I tell my students that saving one life is as if you saved the whole of humanity. In Syria, my homeland, patients die for trivial reasons. They die because there is no doctor to operate on them, no antibiotics to cure simple infections, no inhalers for asthma and no blood products for transfusion. They die inside hospitals that are bombed.

Hospitals should be the safest places in town, not targets of air strikes. Pregnant women die because there is no fuel or cars to take them to hospitals. Newborns die because there is no electricity or incubators to warm their little bodies in the winter. Children starve to death under siege by their own government. They are gassed to death by nerve gas or choked to death by chlorine gas.

Last year, my organization, the Syrian American Medical Society, published a report titled A New Normal, Ongoing Chemical Weapon Attacks in Syria. We detailed 161 attacks with chemical agents since December, 2012. Two thirds of them occurred after the stockpile of the chemical weapons was supposed to have been destroyed in September, 2013. Most of the recent attacks were with chlorine gas. Most of them did not make the news.

In the past three weeks, and after rebel advances in Hama and Damascus, there was a sharp rise in the frequency of chemical attacks – including nerve gas. It has not been used since August, 2013. But one week before the Khan Sheikhoun massacre, a nerve agent was used in Latamneh, north of Hama, and 175 affected people were admitted to hospital. Few deaths occurred. Only social-media junkies paid attention.

I testified at the United Nations Security Council multiple times about chlorine attacks, slow death from sieges, attacks on medical facilities and about my last medical mission to Aleppo. UN ambassadors had tears in their eyes as I spoke. There were strong words of condemnation. There were multiple resolutions and hundreds of reports. There were joint investigating missions that assigned clear responsibility at the Syrian regime and the Islamic State for several chemical attacks.

But two things were lacking: the implementation of UNSC resolutions and accountability. More important, there were no improvements on the ground. Syrians continued to suffer and children continued to die unnecessarily.

One day before this week's chemical attack, the largest nearby hospital, operated by the Syrian American Medical Society, was bombed out of service by Syrian and Russian jets: A sinister plan to cause as many deaths as possible by first taking hospitals out of service.

On Thursday, U.S. President Donald Trump approved a missile attack directed at the airfield from which the Syrian jets took off to drop nerve gas on the civilians of Khan Sheikhoun while they slept. I am no fan of Mr. Trump, but what he said was right on target: "Assad choked out the lives of helpless men, women and children. Even beautiful babies were cruelly murdered. No child should ever suffer such horror."

I, like many, hope that all Syrian children will finally have the chance to dream of a day when they can play in the streets, go to school and breathe fresh air.

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