The OPCW Douma Investigation: Redactions and Manipulation of Key Toxicology and Related Information Regarding Alleged Victims between the Original Interim Report and the Final Report
Published November 2021
Dr Piers Robinson,
Convenor, Working Group on Syria, Propaganda and Media
This report, reviewed by three experts, has been extracted from a larger report analysing the OPCW Douma investigation and which will be published in full at a later date. For comments, further information and corrections please contact Dr Piers Robinson at email@example.com, firstname.lastname@example.org or email@example.com
Table of Contents
This report is extracted from a larger report, in progress, which systematically documents the alterations and redactions observed across the OPCW Fact Finding Mission reports- The Original Interim Report, the Secretly Redacted Interim Report, the Published Interim Report and the Final Report. The focus of this report is on critical information regarding the 43 victims at Douma who are reported to have been killed as a result of the alleged chlorine chemical weapon attack in Douma, 7 April 2018. No traces of any nerve agent such as sarin were found. As is now known, the Final OPCW report has been challenged by a significant number of experts whilst two former OPCW scientists involved with the investigation have reported what amounts to malpractice and fraud during the OPCW investigation.
This report shows how potentially significant information relating to the Douma victims has been manipulated with no apparent justification through alterations or redactions between the Original Interim Report and the Final Report. At the very least this manipulation of information indicates that the circumstances surrounding the deaths are far from clear. At worst the manipulations indicate an attempt to conceal the truth about what happened to the civilians. Key findings are as follows:
- A toxicology assessment by four NATO toxicologists/pharmacologists with expertise in chemical weapons poisoning which ruled out chlorine gas as a cause of death was reported in the Original Interim Report but omitted from the Final Report.
- Information questioning the feasibility of a fatal build-up of gas, especially in the basement of the alleged attack site at Location 2, although clearly set out in the Original Interim Report, was omitted from the Final Report.
- Unexplained witness testimony relating to the discovery of large numbers of deceased in a basement at the alleged attack site ‘Location 2’, although detailed in the Original Interim Report, is excluded from or obfuscated in the Final Report.
- Witness accounts indicating a much higher number of victims (150-300), as well as who was responsible for burying them, is clearly reported in the Original Interim Report but absent come the Final Report.
- Divergent witness testimony between ‘Damascus’ witnesses and ‘Country X’ witnesses, with only the latter reporting symptoms associated with both chlorine gas and nerve agent poisoning, is clearly demarcated in the Original Interim Report but obfuscated and unresolved in the Final Report.
- Information regarding the ‘repositioning’ of bodies through the course of the night 7-8 April 2018, evident in open-source images circulated by activists, is clearly stated in the Original Interim Report but downplayed in the Final Report.
- Information raising question marks over the authenticity of foam-like material observed on some of the victims, whilst mentioned in the Final Report, is left unexplored and unresolved.
The implications of these manipulations are discussed more fully in Section 7. Briefly, the exclusion of the key toxicology assessment ruling out chlorine gas, which indicates that the victims were not killed by chlorine gas at Location 2, is significant because it obfuscates the fact that no clear explanation for cause of death could be established. As such, the deaths of 43 civilians remains unexplained. Information indicating that alleged witnesses in ‘Country X’ were reporting inexplicable claims – decedents in the basement at Location 2 and nerve agent symptoms – is concerning and, when combined with the downplaying of information relating to the ‘re-positioning’ of bodies and possibly inauthentic foam-like material observed on some of the decedents, indicates that the Final Report elided information potentially relevant to a finding that at least some of the events at Location 2 were manipulated or staged and, therefore, that the alleged attack did not in fact occur. Finally, the absence of information indicating a much higher number of deceased, their burial in a mass grave along with other victims, as well as obfuscation of exactly who buried the deceased, reinforces the concern that the circumstances surrounding the civilian deaths in Douma on 7 April 2018 have been obfuscated in the Final Report.
Having established from results of chemistry analysis that no evidence of a nerve agent such as sarin had been found, and that results showed only that samples had been in contact with a substance or substances containing a reactive chlorine atom, the Original Interim Report proceeds to identify important principal inconsistencies – the suggestion of almost instantaneous occurrence of pulmonary oedema and associated frothing at the mouth and the apparent immediate collapse and death of the victims – which according to the investigators rule out chlorine gas being the cause of death at Location 2 (see Image 1).
Image1: Photograph taken of some of the victims at Location 2 and distributed via Opposition Media
These principal inconsistencies were confirmed at a meeting held with NATO chemical warfare toxicologists in early June 2018). Based upon the original interim report and minutes written at a later date, the assessment of the NATO toxicologists and the investigators can be reconstructed as follows:
1) Profuse foaming as a result of pulmonary oedema is a delayed effect of ‘choking agents’ such as chlorine which cause acute inhalation injury. If the victims of exposure to such an agent had lived long enough for the airways to be filled with foamy oedema fluid sufficient to cause the profuse foaming observed in some victims and reported by others, they would have been able to escape and would not have collapsed “gathered in piles” on the spot.
2) Massive exposure to chlorine can cause immediate asphyxiation, but in this situation there would not be time for pulmonary oedema to develop and cause profuse foaming at the mouth and nose to occur.
3) Cholinesterase inhibitors (nerve agents) [plus opiates] could have caused instant collapse and also rapid onset of excessive bronchial and oral secretions, but known agents were ruled out by the negative results from laboratory analysis.
Minutes written up for toxicology meeting conclude by stating ‘that the key “take-away message” from the meeting was that the symptoms observed were inconsistent with exposure to chlorine, and no other obvious candidate chemical causing the symptoms could be identified’. These minutes were confirmed by the other OPCW officials who had attended. These principal inconsistencies are set out clearly in the opening summary section of the Original Interim Report as follows:
‘Some of the signs and symptoms described by witnesses and noted in photos and video recordings taken by witnesses, of the alleged victims are not consistent with exposure to chlorine-containing choking or blood agents such as chlorine gas, phosgene or cyanogen chloride. Specifically, the rapid onset of heavy buccal and nasal frothing in many victims, as well as the colour of the secretions, is not indicative of intoxification from such chemicals.
The large number of decedents in the one location (allegedly 40 to 50), most of whom were seen in videos and photos strewn on the floor of the apartments away from open windows, and within a few meters of an escape to un-poisoned or less toxic air, is at odds with intoxication by chlorine-based choking or blood agents, even at high concentrations.’ (Original Interim Report [Summary]; paras 1.10-1.11, p. 3)
In the ‘Epidemiology’ section of the same report (paras 7.70-7.91; pp: 26-29) it is first noted that the apparent rapid onset of symptoms and death are consistent with a fast-acting nerve agent such as sarin:
‘A highly debilitating agent, in the opinion of the FFM team, would have to have been released in order to cause the rapid onset of symptoms described by witnesses and observed in the videos where large numbers of decedents are concentrated in different apartments at Location 2. The rapid onset of heavy salivation and frothing from the mouth would be more consistent with exposure to a highly toxic nerve agent than a chocking (sic) agent such as chlorine or phosgene. However, analytical results showed no indication of organophosphorus nerve agents or their degradation products present in samples collected at the scene of the alleged attack or in biomedical samples from victims’. (Original Interim Report: para 7.81; p. 27)
a) Pulmonary edema [sic] and excessive frothing from the mouth have been reported in cases of exposure to lethal doses of chlorine gas or other toxic chlorine-based agents such as phosgene or cyanogen chloride   . However, indications are that pulmonary edema, particularly in the case of phosgene, is a late pathological effect of exposure and in cases of high exposure levels death can result before pulmonary edema develops  . The white of light-cream colour of the froth presented by victims is not in keeping with exposure to choking agents, where secretions are characteristically pinkish in colour when frothing does occur,
‘The rapid, and in some reported cases, immediate onset of frothing described by victims is not considered consistent with exposure to chlorine-based choking or blood agents. The opinion of a number of toxicologists, specialists in chemical-weapons-related intoxication supported this assessment’. (Original Interim Report: para 7.82; pp. 26- 27)
b) In order to produce such rapid incapacitation that victims would be unable to escape the toxic gas from the location of the alleged chemical attack (see 3D layout of the building and description), a respiratory irritant such as chlorine or phosgene would almost certainly need to have rapidly accumulated to very high concentrations. It is considered unlikely, given the location of the suspected source of the toxic chemical as well as the configuration and condition of the building, that such concentrations would not have been attained, particularly in the basement. Moreover, if such high concentrations had developed, as mentioned above, reports suggest that asphyxiation would have been the likely cause of death before pulmonary edema and frothing could develop . (Original Interim Report: para 7.83; p. 27)
c) ‘It should be expected that on encountering the irritant gas, victims would instinctively have retreated and exited the building, which was within a few metres away.’ (Original Interim Report: para 7.84; p. 27)
d) ‘Based on the above observations, expert opinions of toxicologists specialized in chemical weapons exposure, and published scientific knowledge in this area, the FFM team considers that chlorine gas or other reactive chlorine-containing toxic agents such a phosgene or cyanogen chloride would not have resulted in the severe and rapid frothing symptoms reported by witnesses and observed in video footage and photos.’ (Original Interim Report: para 7.85; p. 27)
However, whilst the Original Interim Report communicates clearly the findings that both the arrangement of bodies and the observed symptoms are not compatible with chlorine poisoning, the Final Report obfuscates this finding as follows.
The Summary section of the Final Report contains no reference to the principal inconsistencies and the ruling out of chlorine gas. Instead, the summary section makes reference to both (a) witness observations alleging 43 decedents at Location 2 and that the FFM did not examine the bodies (Final Report [Summary]: para 2.10; p. 3) and (b) that ‘many of the signs and symptoms reported … indicate exposure to an inhalant irritant or toxic substance’ (Final Report [Summary]: para 2.11; p. 4). It then concludes: … based on the information reviewed and with the absence of biomedical samples from the dead bodies or any autopsy records, it is not currently possible to precisely link the cause of the signs and symptoms to a specific chemical’ (Final Report [Summary]: para 2.11; p. 4). The formulation of words used avoids making any explicit statement ruling out chlorine, thus leaving the possibility that chlorine might have been a cause. As such, the key conclusion that chlorine gas was not likely to have been the cause of death, confirmed during the June 2018 consultation with NATO toxicologists, is absent from the Final Report summary.
Furthermore, in an apparent attempt to strengthen the suggestion that the victims were killed in a chemical attack, the Final Report summary (para 2.10; p. 3) claims that ‘[a] United Nations agency also reported cases of death by exposure to a toxic chemical’ and references two UN (Human Rights Council [HRC]) reports. This claim is misleading in that neither of the UN reports, both written while the OPCW’s Douma investigation was still ongoing and which rely primarily on witness testimony, state any firm conclusions regarding cause of death:
The Commission of Inquiry has been investigating this incident. The available evidence is largely consistent with the use of chlorine, but this in and of itself does not explain other reported symptoms, which are more consistent with the use of another chemical agent, most likely a nerve gas. The Commission’s investigations are on-going. (Report A: p. 14).
And in a section of the HRC report headed ‘Ongoing Investigations’:
‘… the Commission cannot make yet any conclusions concerning the exact cause of death, in particular on whether another agent was used in addition to chlorine that may have caused or contributed to deaths and injuries’ (Report B: p. 17).
As such, nothing substantive can be drawn from the cited UN reports as they, in fact, cite clear reservations about the cause of death that undermine the Final Report’s conclusion of chlorine being the likely cause of death. This is a misleading move and one that is reinforced by repeated referencing of the two UN reports in the conclusion section of the Final Report (para 9.5: p. 30-31). Furthermore, it is notable that the latest report from the UN HRC on this issue does not include Douma as one of its 38 cases of chemical weapons use in Syria, because it did not meet the evidentiary threshold necessary to conclude an attack had occurred.
The principal inconsistencies and ruling out of chlorine gas are also expunged from the body of the Final Report. Specifically, the Epidemiology section does at least include the important observation that only a fast-acting nerve agent would explain the apparently immediate collapse and death of victims at Location 2:
‘The victims do not appear to have been in the midst of attempting self-extrication or respiratory protection when they collapsed, indicating a very rapid or instant onset. This type of rapid collapse is indicative of an agent capable of quickly killing or immobilizing’ (Final Report: para 8.96; p. 29).
However, the principal inconsistencies identified in the Original Interim Report that lead to the conclusion that chlorine gas was unlikely the cause of death at Location 2 – immediate appearance of pulmonary oedema and associated visible frothing plus the rapid collapse of victims in piles – are absent. Instead, the ‘Epidemiology Analysis’ spends several paragraphs describing, amongst other things, the various symptoms observed in media and reported by witnesses before concluding that ‘it is not currently possible to precisely link the cause of the signs and symptoms to a specific chemical’ (Final Report: paras 8.70-8.103; pp: 25-30). Again, as with the summary section, the formulation of words used avoids committing to any explicit statement either ruling out or affirming chlorine use, thus leaving the possibility that chlorine might have been a cause. Via this apparent linguistic sleight of hand, the original finding, that ‘symptoms observed were inconsistent with exposure to chlorine’, is elided.
No explanation or justification for this expunging of an unequivocal expert opinion can be identified in the Final Report. Whilst the report does refer to later consultations with toxicologists in September and October 2018, it provides no information about what they said that might help to explain or justify the suppression. It is also notable and concerning that the Final Report makes no mention of the original consultation with the NATO toxicologists; the only consultations shown in the report timeline are those obtained during the Autumn of 2018 (Final Report: Annex 3; pp; 40-41).
Regarding the feasibility of gas concentration reaching lethal levels, a section titled ‘Analysis of the possible route of dispersion of the alleged toxic chemicals or chemicals in Location 2’, included discussion of likely dispersion routes for gas at Location 2 (Original Interim Report: paras 7.24-7.26; pp. 15-16, including Images 2 and 3). In this section the report noted that each level on the staircase had a ‘tall glass-shattered window’ (Original Interim Report: para 7.19; p. 13) which provided routes ‘for horizontal dissipation of the toxic gas towards the exterior’ (Original Interim Report: para 7.25; p. 15). It is also noted that no direct route could be identified through which chlorine gas from the cylinder, which had landed on a balcony several floors up from ground-level, could directly reach the basement: ‘It would also appear that for chlorine to reach lethal concentration in the basement, the gas dispersion would almost certainly need to have come from the exterior, given the absence of a clear dispersion path from within the building’ (Original Interim Report: para 7.25; p. 15).
Images 2 & 3: Sample of diagrams from Original Interim Report relating to building layout and dispersion routes.
Drawing upon this analysis, the Original Interim Report then notes in the Epidemiology Section that:
In order to produce such rapid incapacitation that victims would be unable to escape the toxic gas from the location of the alleged chemical attack (see 3D layout of the building and description), a respiratory irritant such as chlorine or phosgene would almost certainly need to have rapidly accumulated to very high concentrations. It is considered unlikely, given the location of the suspected source of the toxic chemical as well as the configuration and condition of the building, that such concentrations would not [sic] have been attained, particularly in the basement. (Original Interim Report: para 7.83; p. 28)
Unlike the Original Interim Report, the Final Report contains no discussion of possible dispersion routes and the feasibility of dangerous concentrations of gas having built up so rapidly. The existence of glass-shattered windows on the staircase at each level plus the absence of any direct route for gas to pass into the basement are mentioned (Final Report: paras 8.24 and 8.25; pp. 15-16), but no analysis is provided, unlike in the Original Interim Report, as to what these facts mean with respect to the likely dispersion of any chlorine gas. Also of relevance here is the fact that the Original Interim Report documents significant inconsistencies in witness testimony regarding reports of victims in the basement at Location 2 and elsewhere.
Witness testimony regarding the presence of deceased in the basement at Location 2, and information regarding the number of deceased and their burial, are facts present in the Original Interim Report but removed from the Final Report.
The Original Interim Report noted significant variations in witness testimony relating to the finding of deceased in basements. Specifically:
there were variations … in the numbers of bodies and their distributions throughout location 2 as observed in video footage and photos, compared to the numbers provided by witnesses who were interviewed. According to statements from witnesses, “many people they presumed dead, were lying on the floor of the basement”. (Original Interim Report: para 7.69; p. 23).
The Original Interim Report sets out these discrepancies in a table identifying four witnesses (Witnesses 1919, 1742, 1753 and 1920) who claim to have seen between ‘some’ and ’40-50’ decedents in the basement at Location 2 (Original Interim Report: p. 24 and see Image 4).
Image 4: Table detailing ‘Country X’ witness reports regarding location of mortal victims (Original Interim Report: p. 24)
However, no evidence could be found to corroborate the claims bodies had been found in any basements:
The FFM did not obtain any video footage or photos of dead casualties lying in the basement of location 2 or being removed from there. There were also no photos or video footage available to the FFM team of the other two basements or of decedents, where three witnesses interviewed claimed to have been exposed to chlorine’ (Original Interim Report: para 7.69; pp. 23- 24)
This information is important because it highlights the question of how the victims could have been poisoned and killed in the basement of the building at Location 2 by gas from a cylinder that had landed on a balcony four floors above. As noted above in Section 3 – Redaction of Information Concerning Gas Dispersion and Build Up – the basement only had an entrance from the street. This implied that the chlorine would need to have descended inside the building gone out on to the street and re-entered the basement in lethal concentrations, an unproven and unlikely scenario.
Notably, the Secretly Redacted Interim Report redacts information concerning the lack of evidence for witness claims regarding observing deceased in the basement at location 2. The paragraph cited immediately above is altered in the Secretly Redacted Interim Report to read:
Three of the seven casualties were purportedly exposed at two buildings, the exact locations of which were not known or visited by the FFM team. No photographs or videos of the locations or victims of the alleged attacks at these locations were available to the FFM team. (Secretly Redacted Interim Report: para 7.29; p. 15)
As such, the Secretly Redacted Interim Report obfuscates the key discrepancy noted in the Original Interim Report about the contradiction between witness claims that deceased had been seen in the basement at Location 2 and there being no obvious explanation for how chlorine gas could have entered that basement and reached lethal concentrations. No mention of this issue is made in the Published Interim Report which states only that ‘[a]nalysis of the testimonies is ongoing’ (para 8.17; p. 11).
The issues raised by these particular witness claims remain unresolved in the Final Report which continues to exclude the detailed table (see Image 4) that appeared in the Original Interim Report. In particular, the problematic claim made by four witnesses that bodies were seen in the basement at Location 2 is obfuscated in the Final Report: Whilst the Final Report refers to some witnesses ‘seeing decedents in the basement of the building’ [at location 2] (Final Report: para 2.10 p. 3 and para 9.5; p. 30), at another point it makes no mention of deceased in the basement at Location 2: ‘Witness accounts place the deceased lying on the stairs, inside apartments on multiple levels of Location 2, inside basements of neighbouring buildings across the area, on rooftops and on the streets’ (Final Report: para 8.62; p. 24). As with the Secretly Redacted Interim Report and Published Interim Report, no mention is made of the fact that the FFM ‘did not obtain any video footage or photos of dead casualties lying in the basement of Location 2 or being removed from there’ (Original Interim Report: para 7.69; p. 23-24).
These obfuscations are not trivial. As already explained, there was no plausible explanation established for how chlorine gas could have travelled down several flights of stairs at location 2, to then move out onto a street and then re-enter the building to enter the basement, and then build up sufficient concentration to cause multiple deaths. A possibility raised by these inconsistencies is that witness reports of there having been deceased in the basement are untrue.
In the Original Interim Report two witnesses (1787 & 1780) report 150-300 total dead (Original Interim Report: p. 24 and see Image 4). In addition, the report also states that the ‘SCD’ [‘Syrian Civil Defence’/White Helmets] were in charge of burying the deceased in co-ordination with the local council. Most of the witnesses reported to be unaware of the location of the burial sites’ (Original Interim Report: para 7.50; p. 21). The Original Interim Report also notes that ‘Witnesses who were involved in burial preparations recounted that the victims of the alleged chemical attack were buried in a mass grave with other casualties’ (para 7.66; p. 23). Additionally, in a 2019 interview with ‘civil society leaders’ from Douma it is claimed, according to the translation, that there were 187 bodies found in ‘bunkers’. As pointed out by Adam Larson, one of the individuals in the 2019 interview was also recorded during the 2013 alleged sarin attack in East Ghouta:
In the subsequent reports there appears to be no further mention of either the higher death toll claims or the reference to burial in a mass grave alongside other victims. The closest the Final Report comes to mentioning the reports of higher death toll is in the following paragraph:
The FFM could not establish the precise number of casualties; however some sources reported that it ranged between 50 and 500. Other sources denied the presence of chemically -related casualties. (Final Report: para 8.73; p. 26)
But here it is unclear whether ‘casualty’ means injured are deceased. In the Final Report it is no longer clarified who was responsible for burying the victims and says instead:
Prior to the military campaign, the SCD was in charge of burying the deceased in coordination with the local council. A number of witnesses reported that they were unaware of the location of the burial sites. (Final Report: para 8.47; p. 22)
This alteration obfuscates whether or not the SCD were responsible for burying the deceased. At the time of the alleged attack in Douma, a British journalist, Jose Ensor, reported that those responsible for the burial were ‘local residents and members of Jaish al-Islam [the militant opposition group in Douma]’ and that the intent was to preserve evidence. Recently, Raed Saleh (Head of the ‘SCD’/White Helmets) was interviewed by the BBC and he stated [according to the BBC translation]:
The dead were buried in one place. It was a mass grave. It wasn’t the first time we buried people like that. Because when these attacks happen, we don’t have enough cemeteries all the time. There are too many dead. We didn’t gather evidence from the bodies themselves. We took samples from things like animal corpse and clothes and other effects. We told investigators location of the grave and met with investigators at the Turkish border to hand over the evidence we had gathered. (BBC ‘Mayday’, Episode ‘The Cylinder on the Bed’).
Given that the deaths of the 43 deceased are unexplained (see Section 2 above), it is a matter of concern that, if the witness testimony is correct, up to 250 more civilians were killed in Douma on 7 April 2018. This would potentially amount to 300 unexplained civilian deaths. Alterations and inconsistent claims as to the total number of deceased and who was responsible for burying the civilians inevitably means that key events surrounding the deaths in Douma have been left unclear in the Final Report.
5. Obfuscation and Failure to Resolve Unexplained ‘Country X’ Witness Testimony Regarding Nerve Agent Symptoms
Witnesses interviewed in Damascus present a narrative whereby, on April 7 around the time of the alleged chemical attacks, casualties arrived at Location 1 displaying symptoms commensurate with asphyxiation from dust and fumes as a result of bombing. The symptoms included dysponea [sic], cough and asthmatic exacerbation secondary to exposure to smoke and dust. Witnesses and victims interviewed in Country X describe symptoms that included shortness of breath, a burning sensation in the chest, oral hypersecretion, ocular irritation, visual disturbances, lacrimation, dysphonia, nausea, vomiting, pruritus, and in the case of some surviving victims, constricted pupils. (Original Interim Report: para 7.77; p: 26-27)
‘Country X’ witnesses are witnesses interviewed in Turkey, believed to have been arranged via the ‘SCD’/White Helmets, whilst ‘Damascus’ (including Douma) witnesses were interviewed in Syria and had been provided via Syrian government authorities.
The symptoms reported by Country X witnesses include those indicative of both chlorine poisoning and nerve agent poisoning (especially ‘constricted pupils’ and [immediate/rapid] oral hypersecretion) whilst those from Damascus indicate symptoms consistent only with dust and fumes. The Final Report, however, blends together reports from Damascus and Country X witnesses thus obfuscating this important divergence:
Broadly, patients were reported to display shortness of breath, burning sensation in the chest, oral hypersecretion or foaming, and occular [sic] irritation. Additional complaints were visual disturbance, lacrimation, dysohonia [sic], nausea, vomiting and pruritus. A non-specific number of patients classified as severe manifested with seizure activity described as flexion of arms and wrists. Medical personnel reported the absence of any signs of external trauma. (Final Report, para 8.79; p. 26)
Furthermore, the fact that Country X reports included symptoms associated with nerve agent poisoning is inconsistent with the fact that no evidence of any nerve agent was ever found. This obvious inconsistency is left unresolved in the Final Report.
It is noted in the Epidemiology section of the Original Interim Report that: ‘[t]he white or light-cream colour of the froth presented by victims is not in keeping with exposure to choking agents, where secretions are characteristically pinkish in colour when frothing does occur’ (Para 7.82; p. 27). A related issue regarding the authenticity of events at Location 2 concerns the finding that, based on analysis of media, ‘it is apparent that some of the victims have been moved and re-positioned between video recordings’ (Original Interim Report: para 7.69; p. 24). According to Stephen MacIntyre, at least one of the re-positioned victims, indicated by analysis of publicly available video footage, appears to show profuse white foaming only after repositioning:
In another film placed online a boy with profuse foaming is shown being moved the following day and here the foam-like material has clearly persisted and is rigid (See here
The Final Report does appear to reflect some doubt about the authenticity of the white foam seen on some of the victims noting that ‘[m]any of the victims present with white, foam-like oral and nasal secretions, similar in appearance to fulminate pulmonary oedema but in multiple cases much more profound and seemingly persistent’ (Final Report: para 8.90; p. 28). It also notes that ‘[w]hen comparing adult and paediatric groups, there does not appear to be any correlation in secretion presence, absence or amount’ (Final Report: para 8.70; p. 28). In paragraph 8.98 the Final Report states that:
The airways secretions seen in many cases are similar to those seen with exposure to some chemical weapons, toxic industrial chemicals and toxic does of pharmaceutical agents but are more profound and seem to have a consistency more like viscous foam than secretions typically originating from the upper or lower airways. Notably, there are casualties both with and without secretions that are in very close proximity to one another. (Final Report: para 8.98; p. 29)
However, no analysis of these inconsistencies is offered and the matter is seemingly dismissed by the vague assertion that ‘[i]n general, the presence and context of the airways secretions indicate exposure to a chemical substance’ (Final Report: para 8.98; p. 8.98).
In addition, the media evidence showing that bodies were reposition during the course of the night of 7-8 April 2018, whilst clearly referenced in the body of the Original Interim Report (‘it is apparent that some of the victims have been moved and re-positioned between video recordings’ (Original Interim Report: para 7.69; p. 24), is relegated to the annex of the Final Report and with the wording altered to: ‘[f]rom the various videos showing the deceased victims throughout the interior of Location 2 some of the victims had been moved between video recordings’ (Final Report: Annex 11; p. 103). As noted above, at least one of the victims, shown in the publicly available video footage, does not show the appearance of white foaming until after the body had been re-positioned. As such the Final Report, through deletions and obfuscations, suppresses information which indicates that certain aspects of events at Location 2 were questionable.
A scenario in which up to forty-three civilians died almost immediately from chlorine gas poisoning at Location 2 was clearly questioned by the FFM Douma team and then corroborated via a consultation with NATO toxicology experts. The fact that the toxicological assessment ruling out chlorine gas at Location 2 as a possible cause of death was expunged from the Final Report, without any explanation or justification, is of serious concern and indicates that there was an attempt within the OPCW to censor doubts, based on scientific analysis, that the civilians were killed by chlorine gas at Location 2. As detailed in Section 1, it is notable that UN (HCR) reports from 2018 has also raised question marks over the cause of death and their recent 2021 report has not included Douma as one of its established cases of chemical attack.
This unexplained redaction is made more worrying by the absence of detailed discussion regarding the likelihood of lethal gas concentrations particularly in the basement at Location 2 – discussion present in the Original Interim Report but absent from the Final Report – and unexplained and uncorroborated witness testimony relating to the finding of deceased in the basement at Location 2 and in other basements. Furthermore, witness testimony reporting a much higher death toll and the burying of civilians in a mass grave along with other decedents is absent from the Final Report. At the same time, identification of who was responsible for burial of the deceased is obfuscated in the Final Report. Inexplicable reports of nerve agent symptoms, de-emphasizing information regarding the ‘repositioning’ of some of the deceased, and failing to evaluate fully the questionable white, foam-like material on victims, further contribute to a pattern in which contradictory or ‘inconvenient’ information is being redacted, obfuscated or left unresolved come the Final Report.
In summary, important information which casts doubt on the plausibility of the scenario in which chlorine gas killed 43 civilians at Location 2 – a toxicology report ruling out chlorine gas as a cause of death, analysis of gas dispersion routes questioning the likelihood of a lethal concentration of gas – have been removed from the Final Report with no obvious justification. At the same time, information indicating unreliable or inconsistent witness testimony – reporting of deceased in basements and nerve agent-like symptoms – has been removed and/or obfuscated whilst information indicating possible fabrication – ‘re-positioning’ of bodies and questionable white foam-like material appearing on some of the victims – is downplayed. As such, information that might have contributed to a finding that no attack had occurred – stated in the Original Interim Report as the possibility that ‘b. The fatalities resulted from a non-chemical-related incident’, has been sidelined or is absent from the Final Report, with no supporting scientific justification. At the same time, this apparently selective use of evidence does appear to be consistent with the following claim made in the Final Report:
The FFM team based its findings on whether there were reasonable grounds to believe that chemical weapons were used, based on a reliable body of evidence consistent with other information tending to show that an incident or event happened (Final Report: Footnote 9; p. 8)
This statement suggests that the drafters of the Final FFM report were primarily interested in gathering evidence which supported the allegation that a chemical weapon attack occurred. Such an approach would likely lead to the sidelining counter-evidence and, therefore, is neither objective nor robust and falls short of basic investigative and scientific standards.
The alterations between the Original Interim Report and the Final Report are made more concerning by the fact that some ‘Country X witnesses’, as well as others, report a much higher number of deaths as well as burial of large numbers of deceased in a mass grave. As such, the issues documented in this report pertain not simply to flawed handling of evidence and analysis by those responsible for the Douma FFM Final Report, but also to the fact that there are significant concerns with respect to the true circumstances in which a very large number of civilians came to be killed.
With these points in mind, the following steps should now be taken:
1. The OPCW must explain the grounds for removing the original conclusion, offered by four NATO toxicologists, that the deceased at Location 2 were unlikely to have been killed by chlorine gas. If it cannot do so, an updated Douma Report needs to reinstate this important conclusion.
2. The mechanism by which there could ever have been sufficient build-up of chlorine gas to kill the victims, apparently immediately, in any part of Location 2, needs to be fully evaluated and then reported.
3. Inconsistent and uncorroborated witness testimony pertaining to the presence of large numbers of deceased in basement areas and the reporting of nerve agent symptoms needs to be revisited and a determination made as to whether these witnesses can be considered reliable.
4. Evidence of ‘re-positioning’ of bodies and the questionable white foam like material needs to be evaluated in detail via an expert-led systematic review of the available photographic images and video footage.
5. More generally, the methodology employed by the team drafting the Douma Final FFM Report needs to be critically evaluated in order to determine the extent to which a pre-determined objective – finding of reasonable grounds to conclude the alleged attack occurred- was obtained through systematic selective use of evidence.
6. In addition, and given the uncertainty regarding the numbers of deceased and their burial, clarification is necessary as to both who was responsible for burying the deceased and the numbers buried. The location of the mass grave(s) should be identified with a view to possible exhumation as part of a war crime investigation. It can be noted that the OPCW FFM team who deployed to ‘Country X’, the leadership of the ‘SCD’/White Helmets, Syrian government authorities and Local Leaders from Douma, amongst possible others, would all be expected to assist with these important clarifications. Both the International Criminal Court and the Independent International Commission of Inquiry on the Syrian Arab Republic (UNHRC) should be kept updated on all these issues.
 The reports are available at https://wikileaks.org/opcw-douma/document/FirstdraftInterimReport/, https://wikileaks.org/opcw-douma/document/RedactedInterimReport/, https://www.opcw.org/sites/default/files/documents/S_series/2018/en/s-1645-2018_e_.pdf, and https://www.opcw.org/sites/default/files/documents/2019/03/s-1731-2019%28e%29.pdf. Download date 3 June 2021.
Minutes of the meeting, written several months after the consultation, are available here: https://wikileaks.org/opcw-douma/document/actual_toxicology_meeting_redacted/. Download date 14 September 2020.
 See https://wikileaks.org/opcw-douma/document/correctly_redacted_emails_re_toxicology_minutes/page-3/#pagination. Download date 15 September 2020.
 REPORT A: United Nations Human Rights Council (HRC) – Independent International Commission of Inquiry on the Syrian Arab Republic – report, 38th Session, 20 June 2018 (A/HRC/38/CRP.3) and REPORT B: HRC – Independent International Commission of Inquiry on the Syrian Arab Republic report to the General Assembly, – 39th Session, 10 – 28 September 2018 (A/HRC/39/65).
 It is notable that a New York Times article published on 20 June 2018 reported that the Commission had doubts about the cause of death and withheld information from the official report issued the same day. It quotes an official as saying “with the April 7 attack in particular, more information was needed, including precisely what killed the 49 people. If we’re not sure what the cause of death was, we may be looking in the wrong place”. See https://www.nytimes.com/2018/06/20/world/middleeast/un-syria-eastern-ghouta.html.
 See A/HRC/46/54, https://documents-dds-ny.un.org/doc/UNDOC/GEN/G21/014/36/PDF/G2101436.pdf?OpenElement. Download date 3 June 2021.
 The Final Report does mention mass burial in paragraph 7.8, p. 10, but excludes information claiming that the deceased were buried alongside other decedents.
 The reporting of ‘constricted pupils’, a key sarin/nerve agent indicator, is removed from the list in paragraph 8.79 and discussed in the next paragraph: ‘An unknown number of patients were reported to have manifested miosis or mydriasis. Although interviewed medical staff or physicians did not directly observe miosis, one support staff stated that four casualties who were classified as severe were directly observed to be presenting mydriasis’. (Final Report: para 8.80; p. 27).
 https://climateaudit.org/2018/04/24/douma-videos-and-photos/. Download date 2 May 2021.