Middle East: How Refugees, Shantytowns and Sanctions Imperil Global Public Health

Syria’s announcement of its first COVID-19 case highlights the public health threat posed by war zones that produce millions of refugees and displaced persons.

Because they live in sub-human and sub-standard health and hygienic conditions, the enforcement of international law governing wars and respect for human and minority rights is now critical.

Seriously trying to wish it away?

Indiscriminate in targeting its victims, the latest coronavirus (COVID-19) casts a very different light on the need to enforce international law governing wars as well as human and minority rights.

It exposes the needs of tens of millions of refugees and displaced persons in destitute camps in Turkey, Lebanon, Syria, Jordan and Bangladesh as well as shantytowns across Asia, Africa and Latin America.

It also puts issues of basic rights, poverty, homelessness and equitable income distribution in a different perspective.

Refugees, displaced persons and embattled minorities have been for the longest time viewed as humanitarian or political problems that needed to be contained and kept beyond one’s borders. Now, they constitute a global public health hazard.

Sanctions: Dangerous for everyone’s health

In Iran, one of the world’s hardest hit countries, and the Gaza Strip (which reported its first infections in recent days), the hazard is enhanced not only by corruption and mismanagement.

Punitive and crippling sanctions and blockades designed to impose the will of one country on another also play a major role.

This applies even more so as they often have little measurable effect beyond economic degradation and make often weak health systems even more feeble.

It’s a hazard that raises the threat level not only in the current pandemic that has already wreaked havoc on lives, economies and social life, but also in future ones.

From Susan Sontag to Yuval Noah Harari

“The storm will pass, humankind will survive, most of us will still be alive — but we will inhabit a different world,” predicted historian Yuval Noah Harari.

“Pandemics are a part of biologic history . . . They reshape . . . economics, they reshape . . . sociology,” added Mike Leavitt, a former Republican U.S. Secretary of Health and Human Services and Governor of Utah.

Some four decades ago, the writer and activist Susan Sontag noted that “illness as a metaphor for political disorder is one of the oldest notions of political philosophy.”

By implication Messrs. Harari and Leavitt and Ms. Sontag suggest that pandemics create opportunities to rethink political, economic and social relations. That may be what is needed but the odds are against it.

Striking a balance between privacy and surveillance

However, that different world will mostly be shaped by elements of reactive measures taken by governments across the globe who failed to initially take the coronavirus seriously on day one—Singapore, South Korea, and Taiwan being notable exceptions.

Leaving aside the fundamental issues of striking a balance between privacy and surveillance, those reactive actions and procedures are likely to amount to band-aids rather than lessons learned.

What they will not lead to is a fundamental rethinking of issues that pose a major threat to millions of lives far beyond the boundaries of refugee camps and shantytowns.
And they are unlikely to result in the societal cohesion needed to confront the inevitable next crisis.

Iran’s plight

Comparative literature PhD candidate Donna Honarpisheh reflected from self-isolation during a family visit to Shiraz:

Sanctions are the number one cause of Iran’s limited access to medicine and other basic resources. These pressures are severely compounded during this global health crisis and are felt acutely in the day-to-day lives of Iranian citizens . . . Just as outbound travel has been suspended, the import of aid coming into Iran is limited, if at all, furthering the sense that even when dealing with a concern that affects the whole world, Iranians are largely on their own.

As a result, Iran’s isolation and Gaza’s blockade by Israel and Egypt for the past 13 years are likely to be reflected in longer-term Iranian and Palestinian political wrath and other hostile attitudes towards the outside world.

A global concern

The fact that a contagious health hazard in one country potentially threatens public health worldwide, makes ensuring the universal existence of robust national healthcare systems a global rather than a national concern.

Prioritizing politics rather than common sense self-preservation that fails to strike a balance between humanity, global public health and national security is likely to harden positions rather than create opportunities for conflict resolution.

The United Arab Emirates, Kuwait, and Qatar – the only countries to have come to Iran’s aid – were among the few in the international community to recognize that how the world handles the crisis has consequences that go far beyond healthcare.

That is true even if the UAE and Kuwait acted to ensure that they would not be targets in any future US-Iranian confrontation.

Whereas Qatar honored its relations with Iran since Tehran provides crucial logistical support, enabling Doha to withstand the almost three-year-old UAE-Saudi-led economic and diplomatic boycott of the Gulf state.

A trust deficit

Adding to the woes of Iran, like other countries with governments that are not transparent or at best economical with the truth, is the fact that the regime’s trust deficit complicates responses.

It impedes getting public compliance with extraordinary measures and raises the specter of protests at a time of quarantines and social distancing.

Egyptian authorities arrested four prominent women in recent days for protesting in demand of the release of prisoners as a healthcare measure.

Hundreds of Egyptians reportedly attempted to storm public laboratories to obtain a coronavirus test.

The locked down Philippines capital of Manila is awash with rumors of food shortages and fears of rioting and looting.

Only a matter of time

It’s at best a matter of time before the human carnage hits camps for refugees and displaced persons across the Middle East and in Asia and Africa.

Likewise it will affect countries like Venezuela that have failing health systems as a result of mismanagement and corruption – all failures which are compounded by sanctions.

According to Jan Egeland, Secretary General of the Norwegian Refugee Council:

Millions of conflict-affected people are living in cramped refugee and displacement sites with desperately poor hygiene and sanitation facilities. There will . . . be carnage when the virus reaches parts of Syria, Yemen, and Venezuela where hospitals have been demolished and health systems have collapsed.

Yemen already knows the consequences. It suffered in 2017 a dramatic surge of cholera, a disease that had been virtually eradicated from the planet.

The question is not only what happens when disease and death on a large scale or food shortages and/or famine hits the world’s most vulnerable holed up in inhuman conditions with nothing more to lose.

A tall order

Tackling that challenge is a tall order in a world dominated by nationalist leaders whose primary concern is not ensuring robust structures capable of fighting indiscriminate global threats.

Instead, they seek short-term political gain, self-aggrandizement, the settling of political scores and narrow visions of ethnic or religious supremacy.

Their approach only adds to already mounting threats of increased political instability and violence as well as migration in magnitudes that could dwarf the world’s current problem of coping with large-scale dislocation.