BEIRUT, Lebanon — The deadliest chemical weapons attack in years in Syria killed dozens of people in northern Idlib province on Tuesday morning, including women and children, and sickened scores more, according to medics, rescuers and witnesses in the rebel-held province, who said the gas had been delivered by a government airstrike.
A few hours later, according to several witnesses, another airstrike hit one of the clinics treating victims, who had been farmed out to smaller hospitals and maternity wards because the area’s largest hospital had been severely damaged by an airstrike two days earlier.
It was the first major atrocity attributed to the Syrian government since President Trump took office. Only on Friday, administration officials stressed that ousting Syria’s president, Bashar al-Assad, was no longer a priority, and that Washington’s main goal was to fight the Islamic State.
On Tuesday, the White House blamed the Syrian government for the attack, which it called a “reprehensible” act “that cannot be ignored by the civilized world.”
Sean Spicer, the White House spokesman, further told reporters that “these heinous actions by the Bashar al-Assad regime are a consequence of the last administration’s weakness and irresolution.”
Mr. Spicer declined to respond to questions about Mr. Trump’s declaration that his administration’s policy in Syria is not regime change.
“He is not here to telegraph what we are going to do, but rest assured he has been speaking with his national security team this morning,” Mr. Spicer said, adding later: “The statement speaks for itself.”
Mr. Spicer added that “there is not a fundamental option of regime change” in Syria because of the “political reality” in the country. He said the White House would look “silly” if it pursued regime change in the face of that reality.
“There is almost an acknowledgment of the reality politically speaking,” Mr. Spicer said.
Numerous photographs and graphic videos posted online by activists and residents showed children and older adults gasping and struggling to breathe, or lying motionless in the mud as rescue workers ripped off victims’ clothes and hosed them down. The bodies of least 10 children lay lined up on the ground or under a quilt.
Rescue workers from the White Helmets civil defense organization said that many children were among at least 50 dead and 250 wounded. Radi Saad, who writes incident reports for the group, said that volunteers reached the site not knowing a chemical was present, and that five of them suffered from exposure to the substance.
The European Union and President Recep Tayyip Erdogan of Turkey condemned the attack and blamed the Syrian government. France called for an emergency meeting of the United Nations Security Council.
While chlorine gas attacks have become almost routine in northern Syria, this one was different, medical workers and witnesses said. Chlorine attacks usually kill just a few people, often those trapped in an enclosed space, and the gas dissipates quickly.
This time, people collapsed outdoors, and in much larger numbers. The symptoms were also different: They included the pinpoint pupils of victims that characterize nerve agents and other banned toxins. One doctor posted a video of a patient’s eye, showing the pupil reduced to a dot. Several people were sickened simply by coming into contact with the victims.
Yasser Sarmani, a rebel fighter in the area, said he collapsed while rushing to the scene on his motorcycle to help victims.
“It became a routine for us that when we hear an airstrike to rush to the scene and try to rescue people,” he said via an online call. “I woke up to the sound of an explosion, but it was not as loud as usual.”
“Driving against the wind, my eyes started burning and I felt I was being suffocated,” he continued. “People were running away from the site and falling on the ground. It was a cruel scene. At that point I fainted.”
He said he woke up an hour later at a clinic, after receiving injections and oxygen. “Kids were all over the floor, some dead and others struggling to breathe,” he said. “The noise of them trying to breath was loud, with foam all over their faces.”
The director of Idlib’s Health Department said in a video that he had been in a field hospital at 7:30 a.m. when more than 100 people arrived wounded or sickened; many others, he said, were scattered to other clinics.
“The patients are in the corridors and on the floors of the operation rooms, the E. R.s and in the patient rooms,” he said. “I saw more than 10 deaths due to this attack,” he said.
Symptoms, he said, included suffocation, fluid in the lungs with foam coming from the mouth, as well as unconsciousness, spasms and paralysis.
“It’s a shocking act,” he said. “The world knows and is aware of what’s happening in Syria, and we are ready to submit evidence to criminal laboratories to prove the use of these gases.”
The attack appeared to be the largest and deadliest chemical attack in Syria since August 2013, when more than 1,000 people were killed in the Damascus suburbs by the banned toxin sarin. Under threat of United States retaliation, Mr. Assad agreed to a Russian-American deal to eliminate his country’s chemical weapons program, which until that time it had denied having, and to join an international treaty banning chemical weapons.
But the operation took far longer than expected and raised questions about whether all the materials were accounted for. The head of the international monitoring body, the Organization for the Prohibition of Chemical Weapons, complained in an internal report about misleading statements from Damascus and expressed concern about possible undeclared chemical weapons activities.
Since then, the organization has found that the Syrian government used chlorine gas as a weapon three times in 2014 and 2015, violating the treaty. Rebel fighters, doctors and antigovernment activists say there have been numerous other chlorine attacks, including at least two in the past week, in one case killing a doctor as he worked.
The government denies that it has used chemical weapons, arguing that insurgents and Islamic State fighters use toxins to frame the government or that the attacks are staged.
A pro-government journalist, Hussein Mortada, posted on his Facebook account that a military source had told him there had been an accidental explosion at a Qaeda facility containing chemical weapons. He mocked the victims and suggested that opposition groups had poisoned their own children, saying that the images of rows of youngsters being laid out in shrouds were coming to resemble “a Turkish soap opera.”
Leith Abou Fadel, the editor of a pro-government news site, presented a different version. Also citing military sources, he wrote that the Syrian military had bombed a weapons factory belonging to insurgents, causing the release of the chemicals.
The Organization for the Prohibition of Chemical Weapons has also accused the Islamic State militant group of using banned mustard gas in Iraq and Syria. But the area where the attack on Tuesday took place, the town of Khan Sheikhoun, is not held by the Islamic State but by other insurgents — Qaeda-linked militants and a variety of other rebel groups.
A chemical weapons attack, if carried out by the government, would be a brazen statement of impunity, coming during a major international meeting in Brussels that is debating whether the European Union and others will contribute billions of dollars for reconstructing Syria if it is presided over by a government run by Mr. Assad.
“Today’s chemical attack was a direct insult to the #EU,” Fadi Halisso, a Syrian former priest who runs Basmeh and Zeitooneh, a humanitarian organization that aids Syrian and Palestinian refugees said in a Twitter post. “Assad is telling them you will pay and I will continue killing,” he added from Brussels, where he was attending the meeting. “You can do nothing.”
There had already been debate about whether the European Union and other Western countries would be willing or able to insist on a significant political transition, or at least power sharing, as a condition for supplying reconstruction funds.
The town of Khan Sheikhoun, where the attack took place, is not far from the front lines of the battle in neighboring Hama Province between government forces and a mix of insurgents, including United States-backed groups and Qaeda-linked fighters.
Seen on The New York Times