On smuggling routes to Turkey, families unintentionally overdosing children

AMMAN: Dozens of young children in rebel-held northern Idlib province are suffering from overdoses as their families give them opioids and other drugs to keep them quiet along the dangerous smuggling route into Turkey, medical sources told Syria Direct.

The drugs include anything from drinkable sleeping aids to opioids and narcotics meant for adults, a local doctor, a pharmacist and an Idlib-based people smuggler told Syria Direct. In some cases, the drugs are administered via injections.

Use of the drugs is reportedly widespread along Idlib’s border region with Turkey, home to a network of people smugglers working to guide displaced Syrian families across the border.  

Turkish snipers line the border area just across from northwestern Idlib province. If caught smuggling themselves into Turkish territory, Syrian refugees can face arrest or live gunfire, a Human Rights Watch report found last year.

Families with young children who try to cross into Turkey from Idlib face a difficult choice: bring along their wide-awake children who may cry or scream—and risk being shot—or give their children “sleeping medicine” provided by smugglers to keep them quiet along the way.

Dozens of families have unintentionally overdosed their children while trying to make the dangerous crossing into Turkey in the past several weeks alone, sources in Idlib told Syria Direct this month. Instead of completing their journey, these families must turn back and seek emergency medical treatment back home in Syria.

Displaced children in Idlib province from October 31. Photo courtesy of Idlib Media Center. 

In one Idlib town, Darkoush, less than three kilometers southeast of the Turkish border, hospital director Dr. Ahmad al-Ghandour said said his staff treats five to seven children with drug overdoses per week ever since a “wave” of displaced Syrians began arriving in there in recent months.

Thousands of internally displaced Syrians streamed in rebel-held Idlib after fleeing intense airstrikes and ground battles in the country’s east. Many of them then tried to reach Turkey via smuggling routes, and inadvertently overdosed their children with drugs meant to keep them quiet.

“Most of these patients aren’t even what you’d call ‘children’ yet,” the doctor said. “They’re two years old, or younger.”

Al-Ghandour said he recently treated drug overdoses in two infants and their three young cousins in Darkoush earlier this month. The children and their family were en route to Turkey after fleeing Syria’s eastern Deir e-Zor province.

The five children arrived to al-Ghandour’s hospital two weeks ago on a Friday, showing signs of overdoses from an unknown drug. It was sunrise, and al-Ghandour hadn’t yet shown up for work.

By the time al-Ghandour arrived later that morning, the two infants had already died and their father was inconsolable, “in a state of shock,” al-Ghandour recalled. He “couldn’t comprehend what was happening.”

The night before, to avoid drawing the attention of Turkish snipers, the father gave his children, nieces and nephews a “liquid [sleeping] medicine” he reportedly bought at a nearby pharmacy to keep them quiet, al-Ghandour told Syria Direct.

But whatever was in the medicine proved too high a dosage for the children. On the way into Turkey, all five became weak and disoriented: signs of an apparent overdose.

“God only knows what that medicine was,” said al-Ghandour. “It could have been a pill, liquid, an injection or a mixture of those things.” The family rushed back towards the hospital in Darkoush, but did not arrive in time to save all of the children.

The younger of the two dead children was just three months old, al-Ghandour told Syria Direct, a baby girl. Their father could not be reached for comment. His three nieces and nephews all survived.

Black market sedatives

Potentially addictive drugs such the opiate painkiller Tramadol can be dangerous to young children—the US Food and Drug Administration recently released a statement warning that Tramadol increases the risk of “difficult breathing and death” in children younger than 12.

But Tramadol, as well the anxiety medication Alprazolam, and Diazepam—better known as Valium, a drug often used to treat anxiety—are widely used within people smuggling networks in Darkoush, Ahmad Khalilo, a pharmacist in Darkoush told Syria Direct.

The result is a black market of sorts, catered around keeping babies and other young members of trafficked families silent on the road to Turkey, he said.

“This kind of medicine, I don’t sell it at all in my pharmacy,” Khalilo said, though he says customers have asked. “I always advise families to be be aware, so that they can avoid these drugs or at least give an appropriate dosage for their children’s ages,” he said.

Khalilo said most pharmacies in the area do not stock these drugs and if they do require a doctor’s prescription.

So where are parents and people smugglers sourcing supplies of opiates and anti-anxiety medications to give their children, with no apparent prescription?

“In this chaos, smugglers can get drugs easily,” said Khalilo, “especially because there are storehouses selling them without any oversight.” Some pharmacies sell drugs to smugglers “to make extra money,” he alleged.

Last week, Syria Direct reached out to one smuggler, Abu Saleem, who regularly guides families across the border into Turkey from northern Idlib and neighboring Latakia provinces. He would not say where he buys sedatives for his customers, but did admit to administering them to children.

Abu Saleem said he and his associates give both sleeping pills and injections to children in preparation for the crossing into Turkey. But while pharmacist Khalilo accused smugglers like Abu Saleem of coercing prospective families to go through with the drugs, Abu Saleem said otherwise.

“We don’t force the families to give their children pills or injections,” the smuggler said. “If they don’t want to, okay.”

But for parents of small children, the option of whether or not to give them sedatives may—in reality—not seem like much of a choice. To say no to the suggestion of a smuggler like Abu Saleem means accepting the risk that a child’s noises could get them shot or arrested by Turkish border guards.  

“Children cry during this journey,” said Abu Saleem, “especially the little ones.”

“This can ruin everything.”