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United Nations investigators have accused the US-led coalition of breaking international law in an air strike on territory held by the Islamic State (IS) group near Raqqa in March last year.
The investigators, from the Independent International Commission of Inquiry on Syria, said the strike at al-Mansoura on the night of March 20 killed "at least 150" people, as US-backed forces closed in on Raqqa, the defacto capital of the so-called caliphate.
"The international coalition failed to take all feasible precautions to protect civilians and civilian objects, in violation of international humanitarian law," they said in a statement issued overnight in Geneva.
The strike was almost immediately controversial.
While the coalition said it had killed 30 IS members, local reports alleged there were a large number of civilian victims.
Subsequent investigations by the monitoring group, Airwars, as well as Human Rights Watch, backed those claims.
The coalition maintained its own investigations did not point to civilian casualties, but the UN investigators found the coalition's targeting team should have known a large number of civilians had taken shelter at the school.
In a conclusion that casts doubt on the way the coalition investigates reports of civilian casualties, the inquiry also found "the subsequent investigation conducted by the international coalition should have been able to identify the high number of civilian casualties resulting from this incident".
"The area … was liberated almost a year ago. The coalition has had every opportunity to go and do this kind of field work itself," Chris Woods, the director of Airwars, said.
"They look like they are not responding to credible reports of civilian harm."
The coalition did not respond to requests for comment.
The investigators also identified a likely Russian air strike at Aitarib on November 13 as another breach of international law.
The attack killed "at least 84 individuals including six women and five children," the investigators said.
"All information available indicates that a Russian fixed-wing aircraft that took off from Humaymim airbase conducted the strikes," the statement said.
While there was no evidence the Russians deliberately targeted civilians, the investigators say they used unguided or "dumb" bombs in a densely populated area.
"This attack may amount to the war crime of launching indiscriminate attacks resulting in death and injury to civilians," they said.
"As with the [US-led] coalition that has been pressed to investigate, the Russian authorities also ought to be investigating, now that we brought this to light," Commission member Hanny Megally said.
In their report covering the six months to January this year, the investigators tracked the Syrian Government's tightening siege of the rebel-held region of Ghouta, east of Damascus.
Even before the intense bombardment and ground attack which is now underway, the lack of food and medicine had led to acute malnutrition with several children dying of preventable diseases, including organ failure made worse by malnutrition.
The report documents cluster bomb attacks hitting schools and kindergartens.
Some of those injured in regular bombardments died because the few hospitals and clinics could not cope.
\In May, the Government all but banned medical evacuations.
Prior to that, the rebels imposed hardline Islamic rules, requiring women and girls who needed treatment to be accompanied by a male guardian.
Hundreds of people have been killed in air strikes in Ghouta since the UN Security Council, including Russia, which is the Syrian Government's most powerful ally, demanded a ceasefire more than a week ago.
Nearly 400,000 people have been besieged there for four years.
Government officials barred medical kits from a shipment of food and other supplies for 27,500 people on Monday.
Another shipment is scheduled for tomorrow.
But how much of it will get through to the victims and how much will be "confiscated"?
A Syrian rebel group has accused Government forces of launching a deadly chemical attack on civilians in a rebel-held town in Eastern Ghouta, and a medical relief organisation said 35 people had been killed in the area.
Syrian state media denied Government forces had launched any chemical attack and said rebels in the Eastern Ghouta town of Douma were in a state of collapse and spreading false news.
The US State Department said it was monitoring the situation and that Russia should be blamed if chemicals were used.
Reuters could not independently verify reports of a chemical attack.
The Syrian Government has recaptured nearly all of Eastern Ghouta from rebels in an offensive that began in February, leaving just Douma in the hands of an insurgent group, Jaish al-Islam.
Russian-backed Syrian government forces resumed the assault on Friday afternoon with heavy air strikes after days of calm.
The Syrian Observatory for Human Rights said 11 people had died in Douma as a result of suffocation caused by the smoke from conventional weapons being dropped by the Government. It said a total of 70 people suffered breathing difficulties.
Rami Abdulrahman, the Observatory director, said he could not confirm if chemical weapons had been used.
Medical relief organisation Syrian American Medical Society (SAMS) said a chlorine bomb hit Douma hospital, killing six people, and a second attack with "mixed agents" including nerve agents had hit a nearby building.
Basel Termanini, the US-based vice president of SAMS, said the total death toll in the chemical attacks was 35.
"We are contacting the UN and the US Government and the European governments," he said by telephone.
The political official of Jaish al-Islam said the chemical attack had killed 100 people.
US President Donald Trump says there will be a "big price to pay" for a suspected chemical attack against a besieged rebel-held town in Syria where medical aid groups reported dozens of people were killed by poison gas.
The Syrian state denied government forces had launched any chemical attack and Russia, President Bashar al-Assad's most powerful ally, called the reports bogus.
A joint statement by the medical relief organisation Syrian American Medical Society (SAMS) and the civil defence service, which operates in rebel-held areas, said 49 people had died in the attack late on Saturday in the town of Douma. Others put the toll even higher.
The United Nations Security Council is likely to meet on Monday afternoon over the chemical attack at the request of the United States and several other members, diplomats said.
Writing on Twitter, Mr Trump hit out at Russia and Iran for their support of Mr Assad's Government.
The Russian Foreign Ministry warned against any military action on the basis of "invented and fabricated excuses", saying this could lead to severe consequences.
One of Mr Trump's top homeland security advisers said the United States would not rule out launching another missile attack.
"I wouldn't take anything off the table," White House homeland security and counterterrorism adviser Thomas Bossert said in a television interview.
"We are looking into the attack at this point," he said, adding that the photos of the incident were "horrible".
In one video shared by activists, the lifeless bodies of about a dozen children, women and men, some of them with foam at the mouth, were seen.
"Douma city, April 7 … there is a strong smell here," a voice can be heard saying.
Reuters could not independently verify the reports.
There is every reason to believe that Israel was behind Monday's airstrike on a Syrian military base, and not the United States, as Syria at first claimed.
Syria's state-run news agency SANA reported an early morning missile attack on the Tiyas (T-4) air base at Homs, about 100 kilometres north-east of Damascus.
It immediately blamed "likely" US aggression — understandable given the US condemnation of a suspected chemical attack days before on a rebel enclave at Douma outside Damascus.
US President Donald Trump had even warned of a "big price to pay" for the chemical attack, which killed at least 49 people.
Officials in Washington were working to verify claims by non-government organisations and Syrian opposition activists that the Assad regime was behind the poison attack.
However, the Pentagon denied responsibility for attacking the T-4 base, despite striking similarities to another air strike a year ago, when the US targeted Syria's Shayrat military base — also in Homs province — after another chemical attack in Idlib.
Denying the US was behind the T-4 airstrike, the Pentagon said the US supported diplomatic efforts to hold those who use chemical weapons accountable.
Hours later Russia and Syria both said Israeli warplanes had launched the attack. An Israeli spokesperson offered no comment.
And indeed all the evidence for the airstrike points to Israel, which launched a similar bombing raid at Tiyas earlier this year.
In February Israel accused the Syrian regime of allowing Iran to operate the Tiyas base to supply advanced weaponry to Shiite militia groups in the region, including the Lebanese-based Hezbollah, which has long waged war against Israel.
It was from this same airbase that Israel says Iran launched a military drone that flew into Israeli airspace in mid-February.
Israeli warplanes shot the drone down and launched raids against Iranian drone installations at Tiyas.
But an Israeli F-16 fighter plane was in turn shot down by Syrian forces.
Whether or not Israel was behind the Tiyas airbase attack, the US is considering its own response in Syria.
Only last week Mr Trump said he wanted to bring home the 2,000 US troops still on the ground in Syria after the fight against Islamic State militants.But a senior White House official would not rule out another US missile attack, s
Russia's Ambassador to the United Nations says Moscow has warned the US of "grave repercussions" if it carries out an attack against Syrian government forces over reports of a deadly gas attack.
Speaking at an emergency meeting of the UN Security Council, Vassily Nebenzia reiterated Russia's claim that there was no chemical attack over the weekend in the town of Douma near the Syrian capital Damascus.
Medical workers and rebel fighters in the area have said around 50 people died in the rebel-held town when a helicopter dropped a container of poison gas.
US Ambassador to the United Nations Nikki Haley said Washington would respond to the attack on Douma, a rebel-held town in Syria, regardless of whether the Council acted or not.
But Mr Nebenzia accused the US of moving the world towards a "dangerous threshold".
And he accused Britain, France and others of "blindly" following the US line on Syria, using "slander, insults, hawkish rhetoric, blackmail, sanctions and threats to use force against a sovereign state".
Mr Nebenzia said a fact-finding mission from the Organisation for the Prohibition of Chemical Weapons (OPCW) should go to Damascus, and would be protected by Russian and Syrian soldiers.
"There was no chemical weapons attack," Mr Nebenzia said.
"Through the relevant channels we already conveyed to the US that armed force under a mendacious pretext against Syria where — at the request of the legitimate government of a country, Russian troops have been deployed — could lead to grave repercussions.
The OPCW has opened an investigation to determine what exactly happened in Douma.
"We have reached the moment when the world must see justice done," Ms Haley told the Council.
"History will record this as the moment when the Security Council either discharged its duty or demonstrated its utter and complete failure to protect the people of Syria.
"Either way, the
Fears of full-scale war are spreading on Twitter, in the wake of Donald Trump's taunts to Russia to "get ready" for missiles to be fired at its ally Syria.
Meanwhile, Britain has begun moving submarineswithin missile range of Syria, in readiness for a potential strike. And British Prime Minister Theresa May has called a cabinet meeting widely expected to result in the UK joining a military response against Syria.
The White House says President Trump has not set down any timetable for a military strike, and that all options remain on the table.
But what are Donald Trump's options, and what would happen next?
The easiest, most likely option for the US is to launch a short-term, symbolic air attack, as it did a year ago following a chemical weapons attack at Khan Sheikhoun that killed 90 people.
About 60 US Tomahawk missiles targeted the Shayrat airbase where the Syrian warplanes that dropped the chemicals had taken off.
It was the first direct US assault against the Syrian regime, and destroyed an airstrip, aircraft and fuelling stations. For a brief time there was speculation the US might enter the war on a bigger scale and change the war's direction.
But the impact of that strike was short lived. The damage was mostly confined to a single airbase. A year on, the Assad regime remains in power, in an even stronger position than before. Syrian forces have tightened their control over the country and ousted rebel fighters from key strangleholds.
There's no reason to believe another token strike this time would be any different.
With Russian forces continuing to prop up the Assad regime and Iranian-backed militias on the ground, it would take far more than a single barrage of US missiles to have any impact on the war.
A broader and more sustained assault would cause greater damage to the Assad regime by destroying key military and government infrastructure. It might finally force the regime to stop its sporadic chemical attacks on civilians in rebel held areas, albeit even as those areas shrink and rebel fighters are ousted.
But such a move risks bringing the US and Russia into direct warfare, which could lead to an escalation of the conflict outside Syria's borders.
And given the US reliance on Kurdish fighters, it would further inflame the conflict between Kurdish groups and Turkey, which has already sent troops into northern Syria to fight Kurdish forces.
"Any strike large enough to carry substantial costs for Assad risks undermining the only remaining semblance of state in Syria and creating more chaos," tweeted Emma Ashford, a research fellow at the Cato Institute in Washington.
"You'll solve 'chem' weapons attacks, but likely prolong civil war."
"Assad's actions are abhorrent, but there is no practical military option here unless you are willing to effectively collapse the Syrian state and re-escalate the civil war."
Without a doubt such a scenario would cause even greater bloodshed on the ground, where Syrian civilians have paid the highest price for the war. Those Syrians saved from gassing might simply die by other means. The loss of lives, homes, hospitals and schools would continue indefinitely.