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Why Conjoined Syrian Twins Nawras and Mou’az Were Condemned to Death

Pauper’s Cemetery, Najha, Syria

One month old conjoined twins Narwas and Mou’az Al-Hashash died needlessly this month in a Damascus hospital because they were the innocent victims of what International Humanitarian Law defines as War Crimes.

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(Photo: Courtesy of Zahra Hospital, East Ghouta, Syria)

The boys are buried in an unmarked pauper’s grave near the town of Najha, approximately 30 miles south of Damascus as their story-one among countless hundreds of other needless deaths here—begins to fade as more senseless tragedies are reported..

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Unmarked grave of Nawras and Mou’az Al- Hashash in a Paupers Cemetery, Najha, Syria (Born 7/23/2016- Died 8//24/2016). Cause of death: Denial of life-saving Medical Aid (Photo: Franklin Lamb 9/13/2016)

Illegal siege warfare entrapped the twins as it did the entire civilian population of Hammouria in the rebel stronghold of East Ghouta, near Damascus. This area was hit with chemical weapons in August 2013 and a specialist from the Mayo Clinic’s Campus in Minnesota, USA has speculated that “environmental conditions” could be one reason reasons the boys were joined in the womb and that perhaps the mother of Narwas and Mou’az had been affected by inhaling particles from the chemical weapons, three years ago.

To whatever degree one might be inclined to credit the Mayo medical specialist’s interesting thesis; it’s irrelevant to the boy’s needless death because chemical weapons were not the immediate cause of the boy’s death. Other war crimes and regional proxy politics were.

Referring to the conjoined twins Nawras & Mou’az Al-Hashash, the Syrian Arab Red Crescent (SARC) issued a post-death press release: “The official authorities approved the evacuation of the babies by to be done the next day (7/24/2016); but the medical staff who were supervising the case inside Ghouta at Zahra Hospital refused to allow them out.” Zahra Hospital disputed this version of the events and denied they delayed the conjoined twins travel for emergency medical assistance which Dr. Mohamad Katoub, advocacy manager for the Syrian American Medical Society (SAMS) told the Wall Street Journal that Syria’s Foreign Ministry was responsible for the ultimately fatal delays. The ministry was “‘looking for a medical solution that matched its political interests’ and trying to secure medical treatment for the twins in a country with friendlier relations with Syria,” he said.

Whichever version of events one credits, the fact is that for 17 days Nawras and Mou’az were denied escape from besieged East Ghouta for lifesaving medical help although all the relevant political decision makers, as well as the UN Security Council were fully aware that surgery abroad was absolutely necessary to save the boys. More than one concerned medical group, including the Syrian American Medical Society (SAMS) and Physicians for Human Rights (PHR) made myriad arrangements to save the boys with surgery abroad. SARCS made an agreement with the Italian Association Terre des Hommes, which has an office in Damascus, for the babies to be admitted ot Rome’s Bambino Gesu Hospital in Rome to perform the surgery. London’s Great Osmond hospital was also prepared to do the surgery as well other medical centers contacted by SAMS, MSRCL, and others.

On 8/12/2016 when the boys were finally allowed to leave East Ghouta’s Zahra Hospital and come to Sinan Hospital in Damascus, for the next nearly two weeks they were not allowed to be moved abroad. As a foreseeable result of this denial to receive emergency medical help abroad, conjoined twins Narwas and Mou’az died needlessly on August 24th. The World Health Organization told this observer that it took days of negotiations to evacuate them to Damascus from East Ghouta and that the boys ran out of time as the political negotiations lagged. During the morning of 8/24/2016, Dr. Katoub issued a statement advising that “Nawras and Moaz passed away this early morning. The whole world couldn’t have the permission to evacuate them.”

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(Photo: Franklin Lamb 9/13/2016)

Next to the boy’s small concrete slab, the Meals for Syrian Refugee Children Lebanon (MSRCL) left the boys, their grieving family and the Syrian public a sketch of the precious ones drawn by Syrian artist Akram Abo Alfoz.( Ed. See photo below) A copy of which this observer obtained from Dr. Mohammad Katoub, a Syrian humanitarian, who along with his colleagues at the Syrian American Medical Society (SAMS) and Physicians for Human Rights (PHR) had for weeks pleaded the twin’s petition to save their lives. They had arranged for the twin’s life-saving surgery abroad but unfortunately these and others pleas were in vain.

There remain conflicting reports about why it took almost three weeks for the boys to be evacuated. Dr. Bakr Abu Ebrahem, who delivered the twins, told The Wall Street Journal “If these were two boys born in Damascus, they could have been taken out within 48 hours to another country. “But only because they were born in the Ghouta, they have delayed.”
The continuing siege of East Ghouta, was perhaps the major, but not the only factor that blocked the conjoined twins from receiving emergency life-saving separation surgery. Narwas and Mou’az were in Damascus at Sinan hospital for nearly two weeks as their medical condition deteriorated and local and international humanitarian appeals for them to be allowed life-saving surgery abroad remained “under consideration.”
The twins were the indirect victims of crimes of collective punishment, the baring of humanitarian access to civilians, the starvation of civilians, the use against civilians of unconventional improvised weapons and weapons systems, including but not limited to, poisonous gas, indiscriminate weapons including barrel, cluster and incendiary bombs, landmines and snipers, as well as the deliberate targeting of Hospitals and Clinics, Schools, Mosques, Churches and Synagogues, Public Markets and other Public Gatherings. All of which are outlawed by binding Treaty and Customary International Law (CIL).

During the morning of 8/19/2016 this observer met briefly with the Dr. of Narwas and Mou’az and the no doubt competent staff at Sinan Hospital. I agreed not to publish her name. She was obviously stressed. Her colleague said that the Dr. was upset because Sinan hospital could not perform the lifesaving operation and because of the long delays with arrangements for sending them abroad for medical help not available in Syria. As I stood outside the boy’s intensive care five heavily armed troops arrived with a plain clothes security official. We had an amicable discussion and the gentleman told me to help the babies get surgery abroad I must first contact X who was in charge the babies file and all cases involving foreign NGO’s. The office of X was contacted more than once but the was no reply to emails or phone calls.

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Above: Sinan Hospital, a private medical facility in Damascus was in a sense Narwas and Mou’az’ prison as well as their hospital the last weeks of their lives because the boys were prevented from leaving to receive lifesaving medical treatment abroad (photo: Franklin Lamb 8/19/2016)

Narwas and Mou’az were blocked from leaving their “hospital prison” to travel to any number of hospitals abroad that were ready, able, and waiting to receive them with confidence that the boys could be saved. As critical days passed, the boys were kept on the second floor of the Sinan Hospital. Their bodies weakened and they began to gasp and struggle to live.

According to Ahmed Tarkji, President of SAMS, “The tragic death of these two brave souls could have easily been prevented, this is unacceptable!” Politics condemned the twins to an avoidable death.

This oberver will never forget seeing Mou’az holding the arm of his brother and smiling at him! This observer has no doubt that Sinan hospital has a fine, competent staff and that SARCS, the ICRC, UNOCHA and sundry NGO’s also did heroically try to save “our boys”. For in one sense Nawras and Mou’az Al-Hashash were “Every boys.”

The regrettable fact remains that it was known that the boys would die if they continued to be “incarcerated in their hospital prison” as one Physician explained, “without being granted humanitarian release for life saving surgery abroad.”

MSRCL was able to arrange for two plants which this observer was honored to plant and water, on either side of their grave, one for each twin and also to place some traditional Eid al Adha branches which according to one Koranic Hadith, Prophet Mohammad (PBUH) frequently placed on the grave of his personal loved ones.

However, these gestures are effectively only “feel good.” And none of the efforts by many saved Nawras and Mou’az.

I personally failed the boys. Surely there was more this observer could have done, while a guest in Syria, to help save them.

Near the end of my last visit and sitting with the twins at their gravesite and telling them about Gulliver’s Travels, it began to get dark. A gentleman approached and warned me that the area was not safe at night and that I should leave quickly. So after singing softly to the boys, “Twinkle Twinkle Little Star” which I like to think is their favorite song, I stood up to leave having no doubt that their protective aura would keep me safe en route back to Damascus.

In this observers criminal law classes a long time ago and far away from Sinan Hospital, we learned at Boston University School of Law that Negligent Homicide is a criminal charge brought against those who, through their negligence, allow others to die.
But given the context of the war in Syria and all the efforts by various local and regional parties to achieve military and/or political advantage from the precious conjoined twins case, this observer’s investigation leads him to conclude otherwise. That with respect to the twins deaths, a more compelling argument might be proffered to a yet to be created international court, that Nawras and Mou’az Al-Hashash were victims of War Crimes.

Finger pointing will likely continue over who should be held accountable for the deaths of the conjoined innocents Narwas and Mou’az Al-Hashash as well as the countless thousands of other civilian victims of this war.

Let history judge and enforce accountability. But what is indisputable is that for the past five years the World has failed the people of Syria.

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Franklin Lamb volunteers with the Lebanon, France, and USA based Meals for Syrian Refugee Children Lebanon (MSRCL) which seeks to provide hot nutritional meals to Syrian and other refugee children in Lebanon. http://mealsforsyrianrefugeechildrenlebanon.com. He is reachable c/o fplamb@gmail.com.

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