Trump says 'big price to pay' for Syria chemical attack

BEIRUT/WASHINGTON, April 8 (Reuters) - U.S. President Donald Trump said on Sunday there would be a "big price to pay" after medical aid groups reported dozens of people were killed by poison gas in a besieged rebel-held town in Syria.

As international officials worked to try to confirm the chemical attack which happened late on Saturday in the town of Douma, Trump took the rare step of directly criticizing Russian President Vladimir Putin in connection with the incident.

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.

"Many dead, including women and children, in mindless CHEMICAL attack in Syria. Area of atrocity is in lockdown and encircled by Syrian Army, making it completely inaccessible to outside world. President Putin, Russia and Iran are responsible for backing Animal Assad. Big price to pay," Trump wrote on Twitter.

RELATED: See images from the most recent suspected gas attack in Syria

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April 2018 Syria attack leaves dozens dead
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April 2018 Syria attack leaves dozens dead
DAMASCUS, SYRIA - APRIL 07: An affected Syrian child receives medical treatment after Assad regime forces allegedly conducted poisonous gas attack to Duma town of Eastern Ghouta in Damascus, Syria on April 07, 2018. (Photo by Halil el-Abdullah/Anadolu Agency/Getty Images)
DAMASCUS, SYRIA - APRIL 07: An affected Syrian man receives medical treatment after Assad regime forces allegedly conducted poisonous gas attack to Duma town of Eastern Ghouta in Damascus, Syria on April 07, 2018. (Photo by Halil el-Abdullah/Anadolu Agency/Getty Images)
DAMASCUS, SYRIA - APRIL 07: An affected Syrian kid waits to receive medical treatment after Assad regime forces allegedly conducted poisonous gas attack to Duma town of Eastern Ghouta in Damascus, Syria on April 07, 2018. (Photo by Halil el-Abdullah/Anadolu Agency/Getty Images)
DAMASCUS, SYRIA - APRIL 07: Affected Syrian kids wait to receive medical treatment after Assad regime forces allegedly conducted poisonous gas attack to Duma town of Eastern Ghouta in Damascus, Syria on April 07, 2018. (Photo by Halil el-Abdullah/Anadolu Agency/Getty Images)
DAMASCUS, SYRIA - APRIL 07: An affected Syrian man lies on a stretcher as he waits to get medical treatment after Assad regime forces allegedly conducted poisonous gas attack to Duma town of Eastern Ghouta in Damascus, Syria on April 07, 2018. (Photo by Halil el-Abdullah/Anadolu Agency/Getty Images)
DAMASCUS, SYRIA - APRIL 07: Affected Syrian kids wait to receive medical treatment after Assad regime forces allegedly conducted poisonous gas attack to Duma town of Eastern Ghouta in Damascus, Syria on April 07, 2018. (Photo by Fadi Abdullah/Anadolu Agency/Getty Images)
IDLIB, SYRIA - APRIL 08: A man holds a photo of a victim baby as he and other demonstrators gather to protest against Assad regime forces' allegedly conducted poisonous gas attack to Duma town of Eastern Ghouta, in Saraqib town of Idlib, Syria on April 08, 2018. (Photo by Mahmut Bekkur/Anadolu Agency/Getty Images)
DAMASCUS, SYRIA - APRIL 07: (----EDITORIAL USE ONLY MANDATORY CREDIT - 'SYRIAN CIVIL DEFENSE (WHITE HELMETS) / HANDOUT' - NO MARKETING NO ADVERTISING CAMPAIGNS - DISTRIBUTED AS A SERVICE TO CLIENTS----) Affected Syrian kids receive medical treatment after Assad regime forces allegedly conducted poisonous gas attack to Douma town of Eastern Ghouta in Damascus, Syria on April 07, 2018. At least 78 civilians dead, including women and children, according to the initial findings. (Photo by WHITE HELMETS / HANDOUT/Anadolu Agency/Getty Images)
DAMASCUS, SYRIA - APRIL 08: An affected Syrian kid receives medical treatment after Assad regime forces allegedly conducted poisonous gas attack to Duma town of Eastern Ghouta in Damascus, Syria on April 08, 2018. At least 78 civilians dead, including women and children, according to the initial findings. (Photo by Mouneb Taim/Anadolu Agency/Getty Images)
DAMASCUS, SYRIA - APRIL 08: An affected Syrian kid receives medical treatment after Assad regime forces allegedly conducted poisonous gas attack to Duma town of Eastern Ghouta in Damascus, Syria on April 08, 2018. At least 78 civilians dead, including women and children, according to the initial findings. (Photo by Mouneb Taim/Anadolu Agency/Getty Images)
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The White House declined to clarify what consequences Trump had in mind. Last year, the United States launched a cruise missile strike on a Syrian air base days after a sarin gas attack in northwestern Syria blamed on Assad.

The Russian Foreign Ministry warned against any military action on the basis of "invented and fabricated excuses," saying this could lead to severe consequences.

A joint statement by the medical relief organization Syrian American Medical Society (SAMS) and the civil defense service, which operates in rebel-held areas, said 49 people had died in the attack. Others put the toll even higher.

The United Nations Security Council is likely to meet Monday afternoon on the chemical attack at the request of the United States and eight other members, diplomats said.

 

'HORRIBLE' IMAGES

Last week Trump said he wanted to pull U.S. troops out of Syria, though his advisers have urged him to wait to ensure Islamic State militants are defeated and to prevent Assad's ally Iran from gaining a foothold there.

There are about 2,000 U.S. troops on the ground in the country working to help fight Islamic State militants.

A top Trump security aide said on Sunday the United States would not rule out launching another missile attack. "I wouldn't take anything off the table," said Tom Bossert, the White House Homeland Security and Counterterrorism Adviser, in an interview on ABC's "This Week."

"We are looking into the attack at this point," he said, adding that the photos of the incident are "horrible."

In one video shared by activists, the bodies of around a dozen children, women and men, some with foam at the mouth, were seen. "Douma city, April 7 ... there is a strong smell here," a voice can be heard saying.

RELATED: A look back at another Syria gas attack

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Syria gas attack
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Syria gas attack
ATTENTION EDITORS - VISUAL COVERAGE OF SCENES OF INJURY OR DEATH A man carries the body of a dead child, after what rescue workers described as a suspected gas attack in the town of Khan Sheikhoun in rebel-held Idlib, Syria April 4, 2017. REUTERS/Ammar Abdullah
ATTENTION EDITORS - VISUAL COVERAGE OF SCENES OF INJURY OR DEATH People stand near a dead body, after what rescue workers described as a suspected gas attack in the town of Khan Sheikhoun in rebel-held Idlib, Syria April 4, 2017. REUTERS/Ammar Abdullah
A man breathes through an oxygen mask as another one receives treatments, after what rescue workers described as a suspected gas attack in the town of Khan Sheikhoun in rebel-held Idlib, Syria April 4, 2017. REUTERS/Ammar Abdullah
A man breathes through an oxygen mask, after what rescue workers described as a suspected gas attack in the town of Khan Sheikhoun in rebel-held Idlib, Syria April 4, 2017. REUTERS/Ammar Abdullah
ATTENTION EDITORS - VISUAL COVERAGE OF SCENES OF INJURY OR DEATH Men stand near dead bodies, after what rescue workers described as a suspected gas attack in the town of Khan Sheikhoun in rebel-held Idlib, Syria April 4, 2017. REUTERS/Ammar Abdullah
EDITORS NOTE: Graphic content / A Syrian child receives treatment at a hospital in Khan Sheikhun, a rebel-held town in the northwestern Syrian Idlib province, following an attack on April 4, 2017. A suspected chemical attack killed at least 58 civilians including several children in rebel-held northwestern Syria, a monitor said, with the opposition accusing the government and demanding a UN investigation. / AFP PHOTO / Omar haj kadour (Photo credit should read OMAR HAJ KADOUR/AFP/Getty Images)
A man holds an injured baby inside a Turkish ambulance as injured Syrian people enter into Turkey from the Cilvegozu border gate in Hatay province, near the Syrian border on April 4, 2017. Turkish President Recep Tayyip Erdogan in a phone call with Russian counterpart Vladimir Putin on April 4, 2017 condemned a suspected chemical attack in northwestern Syria as an 'inhuman' strike that could endanger peace talks based in the Kazakh capital. / AFP PHOTO / DOGAN NEWS AGENCY / - / Turkey OUT (Photo credit should read -/AFP/Getty Images)
IDLIB, SYRIA - APRIL 4: A wounded kid receives medical treatment at sahra hospital after Assad Regime forces's attack with chlorine gas to Khan Shaykhun town of Idlib, Syria on April 4, 2017. (Photo by Abdulghani Arian/Anadolu Agency/Getty Images)
IDLIB, SYRIA - APRIL 4: A woman gets treatment at a hospital after Assad Regime forces attacked with suspected chlorine gas to Khan Shaykhun town of Idlib, Syria on April 4, 2017. (Photo by Bahjat Najar/Anadolu Agency/Getty Images)
IDLIB, SYRIA - APRIL 4: A child gets treatment at a hospital after Assad Regime forces attacked with suspected chlorine gas to Khan Shaykhun town of Idlib, Syria on April 4, 2017. (Photo by Bahjat Najar/Anadolu Agency/Getty Images)
ATTENTION EDITORS - VISUAL COVERAGE OF SCENES OF INJURY OR DEATH A man carries the body of a dead child, after what rescue workers described as a suspected gas attack in the town of Khan Sheikhoun in rebel-held Idlib, Syria April 4, 2017. REUTERS/Ammar Abdullah TPX IMAGES OF THE DAY
A crater is seen at the site of an airstrike, after what rescue workers described as a suspected gas attack in the town of Khan Sheikhoun in rebel-held Idlib, Syria April 4, 2017. REUTERS/Ammar Abdullah TPX IMAGES OF THE DAY
Turkish officials with chemical clothes carry a injured man on April 4, 2017 in Hatay province, near the Syrian border. Turkish President Recep Tayyip Erdogan in a phone call with Russian counterpart Vladimir Putin on April 4, 2017 condemned a suspected chemical attack in northwestern Syria as an 'inhuman' strike that could endanger peace talks based in the Kazakh capital. / AFP PHOTO / DOGAN NEWS AGENCY / - / Turkey OUT (Photo credit should read -/AFP/Getty Images)
EDITORS NOTE: Graphic content / Bodies lie in the parking area of a hospital in Khan Sheikhun, a rebel-held town in the northwestern Syrian Idlib province, following a suspected toxic gas attack on April 4, 2017. A suspected chemical attack killed at least 58 civilians including several children in rebel-held northwestern Syria, a monitor said, with the opposition accusing the government and demanding a UN investigation. / AFP PHOTO / Omar haj kadour (Photo credit should read OMAR HAJ KADOUR/AFP/Getty Images)
IDLIB, SYRIA - APRIL 4: A child gets treatment at a hospital after Assad Regime forces attacked with suspected chlorine gas to Khan Shaykhun town of Idlib, Syria on April 4, 2017. (Photo by Bahjat Najar/Anadolu Agency/Getty Images)
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Reuters could not independently verify the reports.

One factor in Trump's decision to bomb Syria last year was the television images of dead children.

Trump will be joined at the White House on Monday by John Bolton, who takes over as White House national security adviser.

Trump has shaken up his core national security team in the past two weeks, replacing national security adviser H.R. McMaster and firing Rex Tillerson as secretary of state.

Bolton, a hard-charging former UN ambassador, praised Trump's missile response last year, though he has generally focused more on Iran as a bigger national security threat.

Trump was set on Monday to talk with senior military leadership at a previously scheduled meeting at the White House.

U.S. Defense Secretary Jim Mattis had warned in March during a trip to Oman that chlorine attacks would be "very unwise," saying Trump had "full political maneuver room" to respond, though he stopped short of threatening retaliation.

 

SHELTERING IN BASEMENTS

The Syrian Observatory monitoring group said it could not confirm whether chemical weapons had been used in the attack on Saturday. Observatory Director Rami Abdulrahman said 11 people had died in Douma as a result of suffocation caused by heavy bombardment.

Medical relief organization 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 U.S.-based vice president of SAMS, which operates medical facilities and supports medics in Syria, told Reuters another 35 people had been killed at a nearby apartment building, most of them women and children.

RELATED: Heartbreaking scenes from Eastern Ghouta, Syria

17 PHOTOS
Heartbreaking scenes from Eastern Ghouta, Syria
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Heartbreaking scenes from Eastern Ghouta, Syria
Six-month-old twins Safa and Marwa, who suffer from malnutrition, are seen at their home in the Hazzeh area, in the eastern Damascus suburb of Ghouta, Syria, October 25, 2017. REUTERS/Bassam Khabieh SEARCH "KHABIEH MALNUTRITION" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Two-and-a-half year old Hala al-Nufi, who suffers from a metabolic disorder which is worsening due to the siege and food shortages in the eastern Ghouta, reacts as she sits on a bed in the Saqba area, in the eastern Damascus suburb of Ghouta, Syria, October 25, 2017. REUTERS/Bassam Khabieh SEARCH "KHABIEH MALNUTRITION" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. TPX IMAGES OF THE DAY.
A Syrian shovels away debris from the higher floor of a building that was reportedly shelled by regime forces in the rebel-held Eastern Ghouta town of Kafr Batna on the outskirts of Damascus on November 20, 2017. / AFP PHOTO / ABDULMONAM EASSA (Photo credit should read ABDULMONAM EASSA/AFP/Getty Images)
ATTENTION EDITORS - VISUALS COVERAGE OF SCENES OF DEATH AND INJURY An injured student lies on a bed at a field hospital in the town of Jisreen, in the eastern Damascus suburb of Ghouta, Syria October 31, 2017. REUTERS/Bassam Khabieh TEMPLATE OUT
DAMASCUS, SYRIA - NOVEMBER 20: People inspect the debris of a building after Assad regime's warcrafts carried out airstrikes over residential areas of Kafr Batna town of the Eastern Ghouta region of Damascus in Syria on November 20, 2017. It is reported that 9 civilians, including 4 children were killed after the attack. (Photo by Anas Damashqy/Anadolu Agency/Getty Images)
ATTENTION EDITORS - VISUAL COVERAGE OF SCENES OF INJURY OR DEATH A wounded man is seen lying in Douma hospital after heavy shelling in the rebel-held besieged town of Douma, eastern Ghouta in Damascus, Syria, November 19, 2017. REUTERS/Bassam Khabieh TEMPLATE OUT
ATTENTION EDITORS - VISUAL COVERAGE OF SCENES OF INJURY OR DEATH A wounded man is seen lying in Douma hospital after heavy shelling in the rebel-held besieged town of Douma, eastern Ghouta in Damascus, Syria, November 19, 2017. REUTERS/Bassam Khabieh
A man walks on rubble after an airstrike in the rebel-held city of Douma, in the eastern Damascus suburb of Ghouta Syria November 2, 2017. REUTERS/Bassam Khabieh
Two-and-a-half year old Hala al-Nufi, who suffers from a metabolic disorder which is worsening due to the siege and food shortages in the eastern Ghouta, is held by her uncle in the Saqba area, in the eastern Damascus suburb of Ghouta, Syria, October 25, 2017. REUTERS/Bassam Khabieh SEARCH "KHABIEH MALNUTRITION" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. TPX IMAGES OF THE DAY.
Children wait to be examined from Unicef health workers in Kafra Batna in the Damascus suburb of eastern Ghouta, Syria October 30, 2017. REUTERS/Bassam Khabieh
ATTENTION EDITORS - VISUALS COVERAGE OF SCENES OF DEATH AND INJURY An injured student lies on a bed at a field hospital in the town of Jisreen, in the eastern Damascus suburb of Ghouta, Syria October 31, 2017. REUTERS/Bassam Khabieh TEMPLATE OUT
ATTENTION EDITORS - VISUAL COVERAGE OF SCENES OF INJURY OR DEATH Injured students lie on beds at a field hospital in the town of Jisreen, in the eastern Damascus suburb of Ghouta, Syria October 31, 2017. REUTERS/Bassam Khabieh
Smoke rises at a damaged site in Ain Tarma, eastern Damascus suburb of Ghouta, Syria, September 14, 2017. REUTERS/Bassam Khabieh
Children hold corncobs at Ain Tarma, eastern Damascus suburb of Ghouta, Syria July 19, 2017. REUTERS/Bassam Khabieh
A Syrian child is seen walking near International Red Cross vehicle in the rebel-held city of Douma, in the eastern Damascus suburb of Ghouta, Syria November 12, 2017. REUTERS/Bassam Khabieh
A Syrian woman walks past damaged buildings in Douma, in the eastern Damascus suburb of Ghouta, Syria November 15, 2017. REUTERS/Bassam Khabieh
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The joint statement from SAMS and the civil defense said medical centers had taken in more than 500 people suffering breathing difficulties, frothing from the mouth and smelling of chlorine.

Tawfik Chamaa, a Geneva-based Syrian doctor with the Syria-focused Union of Medical Care and Relief Organizations (UOSSM), a network of Syrian doctors, said 150 people were confirmed dead and the number was growing. "The majority were civilians, women and children trapped in underground shelters," he told Reuters.

Douma is in the eastern Ghouta region near Damascus. Assad has won back control of nearly all of eastern Ghouta from rebel groups in a Russian-backed military campaign that began in February, leaving just Douma in rebel hands.

The Ghouta offensive has been one of the deadliest in Syria's seven-year-long war, killing more than 1,600 civilians, according to the Syrian Observatory for Human Rights.

Taking Douma would seal Assad's biggest victory since 2016, and underline his unassailable position in the war that has killed hundreds of thousands of people since it mushroomed from protests against his rule in 2011.

 

(Reporting by Dahlia Nehme and Tom Perry in Beirut, Mustafa Hashem in Cairo, Roberta Rampton, John Walcott, Mark Hosenball, Michelle Price and Sarah Lynch in Washington, Michelle Nichols in New York, Suleiman al-Khalidi in Amman, Stephanie Nebehay in Geneva, Anthony Deutsch in Amstersdam, John Irish in Paris, and Polina Ivanova in Moscow; Writing by Tom Perry and Roberta Rampton; Editing by Adrian Croft and James Dalgleish)​​​​

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