In the year since a major chemical weapons attack in Syria, President Bashar Assad has handed over all of the declared arsenal and the U.S. says it has destroyed the weapons.
However, this has not fundamentally weakened Assad. He remains firmly entrenched in the capital, Damascus, though his army has lost ground to the Islamic State, the extremist group that now holds large parts of the north and the east of the country.
The chemical weapons attack, carried out with sarin gas, took place in Eastern Ghouta, a suburb of Damascus, on Aug. 21 last year and killed more than 1,400 people. Survivors say the destruction of the Syrian chemical arsenal is no consolation for the loss of loved ones or the harsh, ongoing military siege by Assad's army.
Majd Al Deek, 26, a photographer and activist, was in the Eastern Ghouta area when he got word that there had been a chemical attack. He and his friends rushed to the affected towns in the sprawling rebel-held suburbs.
"We didn't realize at first that the gas would affect us too," Deek says, adding that he lost seven out of eight of his fellow activists. They died, he says, after handling the toxic bodies and ferrying those with the weakest heartbeats to medical clinics.
Deek photographed the victims body-by-body in repeated, frantic trips to the scene. He calls the event a turning point in Syria's revolt against Assad that began in 2011.
"The air was poison," he says. "When we went to the locations where the bodies were gathered, I couldn't even fit them all in my camera frame."
Syrian Government Blamed
Entire neighborhoods were wiped out, leaving no one to identify the victims who were buried in mass graves. A U.S. government assessment determined that 1,429 people, including 426 children, were killed. The White House said it assessed with high confidence that the Syrian government was the perpetrator.
Human Rights Watch, the U.S.-based group, said the rockets and launchers used "strongly suggests that these are weapon systems known and documented to be only in the possession of, and used by, Syrian government armed forces."
Before the attack, President Obama had warned Syria against using chemical weapons.
"A red line for us is we start seeing a whole bunch of chemical weapons moving around or being utilized. That would change my calculus. That would change my equation," the president said.
In the days after the attack, Obama considered airstrikes against Syria, but ultimately decided against it.
His administration has been providing limited, covert training for so-called moderate rebels and the president is now seeking $500 million to step up the assistance. However, Obama has so far refrained from direct U.S. military involvement in a war that's now in it's fourth year and features multiple competing factions.
Bitter Disappointment Among Opposition
Meanwhile, many in the opposition have been bitterly disappointed by the U.S. response to the chemical attack.
"From the beginning of the revolution (in 2011) we heard that chemical weapons were a red line," Deek says. "But they were used. We discovered on the 21st of August 2013 that chemicals are not a red line."
The Syrian government denied responsibility for the attack and blamed the rebels.
However, the government did finally acknowledge its chemical weapons stockpile and agreed to turn all of it over. The United States said this week that the entire declared arsenal, 1,300 tons of chemical agents, had been destroyed. Much of the destruction took place aboard the U.S. military ship Cape Ray in the eastern Mediterranean.
Meanwhile, in Eastern Ghouta, life has only become more difficult for the survivors.
Prior to the attack, the army imposed many restrictions. For example, residents were barred from taking in cameras. But afterward, a full siege was imposed on movement in or out of the area. And many staples, such as bread, flour and medicine were not allowed in, Deek says.
The United Nations ordered a probe that found "the government employs siege warfare, instrumentalizing basic human needs for water, food, shelter and medical care as part of its military strategy."
'Surrender Or Starvation'
The report, issued in March, said many besieged civilians in areas including Eastern Ghouta must choose between "surrender and starvation." The U.N. has managed to enter the area only a handful of times with limited supplies.
One local activist and filmmaker, who is in Eastern Ghouta and asked that his name not be used, said via Skype that residents had some hope before the chemical weapons attack. But not afterward.
There are 1.3 million people in Eastern Ghouta, he says, and they feel "all alone. They don't care anymore how the outside world looks at them because they see no hope."
Residents are focused on day-to-day existence, relying on locally grown food and power produced by solar, animal manure and burning plastic.
Without electricity, few have access to news of anything beyond their area. The activist says that few are even aware of the rise of the Islamic State in the north and east of Syria and in Iraq.
The activist says that in the wake of the chemical attack, people began to accept more radical trends among the rebels.
"They see no one is coming to help them but those people, as bad as they are," he says. "This chemical attack is not an anniversary for us. It's one [link] in a very long chain of big disasters that are still going on until now."
Alison Meuse reported from her base in Beirut. You can follow her @AliTahmizian.
The human toll of the Ebola epidemic in West Africa is becoming clearer by the day. The virus has killed at least 1,350 people, making this the largest outbreak of the disease ever.
There's no Ebola cure, and only a few experimental treatments are in the works.
One called ZMapp, which contains antibodies against the Ebola virus, was used to treat two Americans who fell ill, a Spanish priest and three health care workers in Liberia, despite the fact that the medicine hadn't been safety tested for humans.
While the World Health Organization has said it's ethical to use unapproved treatments and vaccine in this unprecedented Ebola outbreak, there aren't many options. And supplies of ZMapp "are now exhausted," WHO said Thursday.
What would it take to make Ebola drugs a clinical reality? Financial incentives might help.
Even now, Ebola isn't the most appealing business proposition for drugmakers. While devastating to the people infected, Ebola hasn't, thankfully, been a widespread illness since it was first identified in 1976. Before the current outbreak, fewer than 3,000 people had reportedly died from the disease.
In the U.S., drugs to treat rare diseases have become lucrative, thanks to tax incentives, special regulatory protection and a willingness by insurers and governments to pay for life-saving treatments.
But Ebola, like many other diseases that are mainly a threat in less-developed countries, have been largely neglected by drugmakers.
Dr. Marie-Paule Kieny, WHO's assistant director-general, said last week that the lack of an approved Ebola drug is a "market failure" because the disease typically strikes "poor people in poor countries where there is no market."
Most Ebola drug research has been financed by the U.S. government, she said, with Canada also pitching in.
For Ebola, there may need to be more financial help to get research started and a reward for success. "As an investor, your expectation is that in the future very few people will have this disease and very few will be in rich countries," says Duke health economist David Ridley. "Should you pay money up front for clinical trials, or should you dangle a sufficiently big prize? It's both."
Ridley is one of the architects of an idea to encourage the development of drugs for neglected tropical diseases that has become U.S. law. Companies that get Food and Drug Administration approval for a drug to treat one of 16 neglected diseases disease get a voucher that moves any drug of their choice to the head of the line for agency review. The fast-track voucher can be sold to another drugmaker that's willing to pay for a shortcut.
Earlier this year, Knight Therapeutics, a Canadian firm, won a voucher when FDA approved its leishmaniasis drug, just the sort of medicine WHO's Kieny wants to see more of. Knight is now trying to cash in its leishmaniasis prize by selling the priority voucher to the highest bidder.
Funding by the Defense Department and National Institutes of Health has provide a push for Ebola research, Ridley says. "An extra pull, like the voucher, would be a great move," he says.
Ebola isn't on the list of neglected tropical diseases that automatically qualify for an FDA voucher. But Ridley says that would be easy to fix. The secretary of Health and Human Services can amend the voucher regulation to cover "any other infectious disease for which there is no significant market in developed nations and that disproportionately affects poor and marginalized populations."
That sounds like Ebola, doesn't it?
It was a photo that took the Ebola outbreak raging in West Africa and made it very personal.
A little boy named Saah Exco, 10 years old, lies in a crumpled heap. He had been found naked on a beach in West Point, an impoverished Monrovia neighborhood. Saah had been a patient at the Ebola holding center there, for suspected Ebola cases.
And then there he was, naked on the beach. Drifting in and out of consciousness.
People in the neighborhood knew him. But they were afraid to touch him. Many folks in West Point — and throughout West Africa — don't think Ebola is real. Yet they were afraid. What if Ebola really is real and what if the boy had the virus? It's what NPR photographer Dave Gilkey, who took the photo of the boy that ran on our website, calls "an evil Catch 22."
The boy was given a shirt and pants. But no one wanted to hold him, to take him into a home. Efforts were made to get him to a clinic but the clinic said no: The facility was not equipped to handle suspected Ebola patients.
Eventually a neighbor took Saah to John F. Kennedy Memorial Hospital in Monrovia, which cares for Ebola patients.
There was a brief glimmer of hope yesterday — word came that the boy was improving.
Then today, his fate became clear. Getty photographer John Moore, who had also taken pictures of Saah, spoke to the boy's aunt. She was checking into a Doctors Without Borders hospital in Monrovia with her five children — all of them, including her, suspected Ebola cases. The aunt said that Saah died yesterday at JFK hospital. She said the boy's mother had previously died of Ebola as well.
In a country where some believe that the virus isn't real, Saah Exco is now one of more than 500 victims, sealed in a tiny body bag.
Don't expect Secretary of State John Kerry to accept the ALS "Ice Bucket Challenge" anytime soon: Lawyers at the State Department have banned high-profile U.S. diplomats from participating in the fundraising phenomenon that has swept social media in recent weeks.
In an unclassified cable issued earlier this week, the department lauded the unique effort to raise money and awareness for amyotrophic lateral sclerosis, also known as Lou Gehrig's disease, but said it violates internal policy.
"There are firmly established rules preventing the use of public office, such as our Ambassadors, for private gain, no matter how worthy the cause. Thus, high-ranking State Department officials are unfortunately unable to participate in the ice bucket challenge," the cable sent to all U.S. diplomatic missions reads. "We sincerely wish the ALS Association continued success in its ice bucket campaign, and in its fight against Lou Gehrig's disease."
The cable notes that choosing worthy charities is a difficult personal decision that is made "even more difficult when high-ranking State Department personnel with high-profile positions are asked to participate in charitable fund-raising, and concerns about preference and favoritism always arise."
The Associated Press notes: "By the time the cable was sent at least one high-ranking diplomat, Ambassador to Israel Daniel Shapiro, had already participated and had challenged U.S. Ambassador to the United Nations Samantha Power to douse herself with ice water for the cause. But by then, Power and the other ambassadors got the memo."
During the nearly two years that journalist James Foley was held hostage in Syria, before he was killed by the Islamic State this week, Phil Balboni worked hard to get him released.
Balboni is the co-founder and CEO of the online international news company GlobalPost, which Foley was freelancing for at the time of his capture, in November 2012. Foley also was freelancing for GlobalPost when he was captured in Libya by dictator Moammar Gadhafi's forces, in 2011, and held for 44 days.
The video of Foley's beheading, which was posted Tuesday on YouTube, shows another U.S. journalist being held hostage, Steven Sotloff, who was freelancing for Time magazine. The militant in the video who carries out the beheading threatens that Sotloff might be next, depending on what President Obama does.
Phil Balboni talks with Fresh Air's Terry Gross about James Foley's captivity and what Balboni tried to do to secure his release.
On deciding whether to pay a ransom
It's very easy to have these theoretical policies about not paying a ransom until you're faced with the real life-and-death situation. Personally — and I know I speak for the Foleys as well — we would've paid a ransom. We were working very hard to raise the money. We had extensive conversations about this with branches of the United States government, with legal counsel. We were well schooled in the law and what was permissible for the family to do. So I had no problem with it. I can understand, giving money to these evil people is a very hard thing to do. I would judge no one who felt that it was entirely improper. But speaking for myself and for John and Diane Foley, we were prepared to do it if we could raise the money.
On communication with Foley's captors
The original demand from the captors was November of 2013. At that moment we'd never had a communication from Jim, and we'd never had an official "proof of life," as it's called. During that communication with the kidnappers, they offered us the opportunity to get proof of life, and the Foleys drafted a series of questions that only Jim could answer. They were extremely difficult — obscure family events that only Jim could know. When those proof-of-life questions came back answered correctly, perfectly, it was a hair-raising moment for all of us because we knew definitively, with certainty, that we were dealing with the people who were holding Jim.
On learning of Foley's kidnapping
I have such a clear mental picture of this. I was sitting in my home in Cambridge, Mass., it was Saturday morning following the Thanksgiving holiday, and I got an email on my Blackberry from a freelance journalist who was a friend of Jim's who was on the Turkish-Syria border saying that she feared that Jim had gone missing.
It was kind of déjà vu for me because I had the same experience when Jim was abducted by Col. [Moammar] Gadhafi's fighters in Libya during the civil war there in the spring of 2011. I immediately called one of the senior people at an international security firm that specializes in kidnap and ransom cases whom I'd worked with in Libya in 2011, and I hired him to work on the case, and from that day, literally, every single day for almost two years we have worked on Jim's case.
We've had, at one time, as many as three or four people in the field in Turkey, sometimes in Syria itself, in Lebanon and other places gathering information. We didn't know where Jim was. We didn't know who took him. We knew nothing. And it took an immensely long time to find out where he was. And, as so often is the case, it was luck that brought the first word that Jim was alive and where he was being held. And it came from a young Belgian, who had gone to pursue jihad in Syria and had been brought home by his very brave father. And he had befriended Jim and had been held in captivity with Jim in northern Syria. And that was the first we had detailed information and knew that Jim was alive and that he was being held by a jihadist group.
On how he will remember Foley
When I see Jim in my mind's eye, which I will for the rest of my life, at his final moment, showing such incredible courage, never flinching just before his executioner put the knife into his throat, that needs to be honored, and we are proud of what we do. Sure, we'd all like more resources to do it with — hopefully as we grow stronger we will — but the importance of the mission, I think, is what Jim's life is all about. He loved telling these stories, and he was drawn to conflict. It's where he really came alive.
On what other hostages, who have been released, have said about Foley
It was universal among all of the released hostages that we talked to that Jim was their favorite, the person whose spirits — no matter what punishment was inflicted on him, and he was regularly singled out for very harsh treatment; I won't go into the details, but he was regularly subject to abuse — but he always kept their spirits up. He always kept them believing that they would get out, and he tried to be a spokesperson with the captors for the other hostages and to keep their morale up. It was so wonderful to hear that and to know that Jim was strong and that he could bring that strength to others.