On March 13, 2020 Syria’s Minister of Health Nizar Yazigi, stated in an interview with an official news channel that the country had not yet recorded any coronavirus infections from the worldwide pandemic and went on to announce that the Syrian Arab Army had already defeated many “germs” throughout the country.[1]

Health workers wear face masks inside a hospital to prevent the spread of COVID-19, in Damascus, Syria, with the face of President Bashar al-Asad in the background. March 19, 2020. Omar Sanadiki/Reuters

The statement of the health minister seems cryptic until seen in the context of a long-running narrative by supporters of President Bashar al-Asad’s regime that uses metaphors of disease and infectious germs to denounce political opposition forces. From the beginning of the Syrian revolution in 2011 and throughout the subsequent war, the regime has portrayed the country as diseased and in need of healing and protection against pathogens.[2] A few months before the March 2011 protests, Asad compared the situation in the region that led to the Arab uprisings with disease-bearing contaminated water: “[I]f you have stagnant water, you will have pollution and microbes. […] So, what you have been seeing in this region is a kind of disease. That is how we see it.”[3]

The regime’s narrative of infection, disease and germs is symbolic and constituent of its internal logic. Using the metaphor of illness, the state justifies killing dissenters (labeled terrorists) by portraying them as germs that must be eradicated in order to ensure the survival of the country as embodied in the Syrian regime. All the while, the suffering of civilians is rendered invisible.

Using the metaphor of illness, the state justifies killing dissenters (labeled terrorists) by portraying them as germs that must be eradicated in order to ensure the survival of the country as embodied in the Syrian regime.
The coronavirus pandemic has been smoothly incorporated into this narrative of fighting disease to save the nation, but now the regime’s rhetoric asserts that it has re-established stability and order and is fully equipped to handle the health emergency. Cruelly, while the medical terminology of germs was used to denounce the opposition as well as justify killing and the widespread destruction of health infrastructure before the pandemic, the tremendous health and humanitarian implications of the spread of very real COVID-19 infections are now recklessly downplayed.


The Narrative of Western Conspiracy and Asma al-Asad’s Cancer


Illness metaphors were used for political purposes in Syria long before the 2011 uprisings. In 1980, Asad’s uncle Rifaat described dissidents in the population as “nationally diseased.”[4] He suggested labor camps and “national purification” for deviant and disposable subjects, mainly referring to members of the Muslim Brotherhood. This plan, however, was not implemented, instead those with the perceived incurable illness—those who did not respond to discipline and punishment—were killed in internment camps and in the brutal massacre in Hama in 1982.[5]

In January 2011, Bashar al-Asad characterized the root cause of the uprisings in neighboring countries as economic stagnation and the unmet demands of their populations. As he explained in an interview with The Wall Street Journal, this “stagnant water” developed microbes that eventually evolved into a disease that spread around the whole region. Asad further elaborated this idea in a June 2011 speech at Damascus University when he placed the uprisings within what he described as a long history of conspiracies faced by Syria.[6] Asad referred to these conspiracies as germs or microbes that multiplied uncontrollably and weakened the body politic of the Syrian nation which had to fight against the pathogens. Such germs work clandestinely and “infiltrate” the body:

I do not think there is a stage in Syria’s history where it was not the target of some sort of conspiracy, both before and after independence. … Conspiracies are like germs, after all, multiplying every moment everywhere. They cannot be eliminated, but we can strengthen the immunity of our bodies in order to protect ourselves against them. … We should not waste time discussing it [the conspiracy] or being frightened by it. Rather, we [should] identify the internal weaknesses through which this conspiracy can infiltrate the country. Then we should work on correcting these weaknesses.[7]

This medical terminology imagines the revolution as a disease, like a malignant tumor and depicts protesters as less than human beings, as dangerous microbes. Asad compares his war on Western conspiracy and terror to the immune system’s fight against germs. The narrative of disease provides justification for drastic measures, such as the killing of nonviolent protesters, to remove the contamination and allow the diseased nation to heal.

Another notable instance that exemplifies the regime’s use of disease imagery is the cancer diagnosis of First Lady Asma al-Asad. Her illness was first announced in a Twitter post on August 8, 2018. Subsequently, the war against protesters was aligned by regime supporters with Asma al-Asad’s fight against cancer. Many Twitter users directly associated her disease with the “cancer of terrorism.” One user proclaims, It is not impossible for someone who defeated the cancer of terrorism and conspiracies with will and strength to also defeat the cancer of the body.”[8] This rhetorical comparison presents the first lady’s body as representative of the integrity of the whole nation. Consequently, the announcement of the first lady’s cancer diagnosis, real or not, expands the narrative of fighting disease. Both Asma al-Asad’s personal health and Syria’s stability and security are allegedly in need of being cured and defended. For the country to recover, it must strengthen its defense system to repel the so-called terrorist threat.

Despite Asad’s metaphorical rhetoric of the need to strengthen the country’s immunity in order to maintain its health, since the beginning of the protests in 2011 his regime has explicitly targeted doctors, nurses and hospitals.
Despite Asad’s metaphorical rhetoric of the need to strengthen the country’s immunity in order to maintain its health, since the beginning of the protests in 2011 his regime has explicitly targeted doctors, nurses and hospitals, as countless eyewitnesses report.[9] Derek Gregory argues that the regime’s targeted warfare against health personnel has a strategic logic, including to silence witnesses to atrocity, increase casualties through bombing of the human and material infrastructure that support the sick and to destroy morale.[10] Amnesty International also describes the Russian and Syrian destruction of hospitals in rebel-held territory as a strategy of war, killing hundreds of health workers and civilians, displacing thousands of people and violating international humanitarian law. The United Nations estimates that about 70 percent of health workers have fled the country as of March 2020.

The Asad regime has also attacked water and electricity infrastructure, which leads to polluted water that dramatically worsens the already dire health situation. These atrocities are part of a biopolitical warfare that is even reviving long-eradicated diseases such as polio (the regime then tried to conceal the outbreak) and complicates the treatment of infections due to increasing antibiotic resistance and limited availability of medicine. In addition to the bombing of health infrastructure or sarin gas attacks, which attract international attention, centuries-old biological warfare also has less visible components. By withholding medicine or chlorine to purify water, the regime aggravates diseases and targets whole populations it wants to control.


Arrival of the Coronavirus Pandemic


At present, the Syrian regime portrays the war as won and aims to return to what it considers normality. Similarly, Asma al-Asad declared her own victory when on August 3, 2019 the Syrian presidency’s Twitter account announced that, almost exactly one year after her diagnosis was made public, the first lady had defeated her cancer. At the same time that the regime brought the hashtag #ALifeJourney to an end, it also symbolically announced the end of the war and the contestation to its rule. The implication was that nothing—not even a highly infectious pandemic—could harm the country or the body of the nation. The regime started, and was able to control, the narrative of germs and infection in relation to the political uprising. But the advent of the coronavirus pandemic quickly made clear that an actual health emergency would cause another humanitarian disaster when it hit war-ravaged Syria with its barely existing health infrastructure, largely destroyed by the regime itself.

The regime started, and was able to control, the narrative of germs and infection in relation to the political uprising. But the advent of the coronavirus pandemic quickly made clear that an actual health emergency would cause another humanitarian disaster.

On March 22, 2020 the government finally acknowledged the first coronavirus case inside Syria. Opposition media accuse the government of covering up thousands of cases.[11] Resorting to an old rhetorical trick, the education minister said on March 14 that it would be impossible for the government to hide cases, even if it wanted to. Yet, more than a week before confirming the first coronavirus case, the government had already taken measures similar to those of many other countries, such as suspending many flights and public transportation between provinces, closing schools, imposing a curfew and cancelling public events. Following early calls to release prisoners who languish in overcrowded jails with insufficient sanitation and nutrition, the regime reluctantly extended an amnesty and freed a limited number of detainees arrested for petty crimes. Political prisoners, however, have not been released. Human rights activists fear that the respiratory disease could spread fast among prisoners due to poor living conditions. The same holds true for refugee camps in northwest and northeast Syria, which are potential hotspots as the health conditions there are also dire.

While the number of infected people worldwide has surpassed one million, the total official number of coronavirus infections in Syria on April 14 amounted to only 29, including two deaths and five recoveries. As of December 2, the total number of infections in government-held areas has gone up to 7,973 (422 deaths and 3,624 recoveries).[12] Additionally, the daily infection rate in Syria is currently zero. All national numbers are compared with the global numbers of COVID-19 infection rates, deaths and recoveries on the website of the General Organization of Radio and TV (part of the Ministry of Information). Examining the numbers on this website reveals the (mis)use of statistics: By comparing the unrealistically low numbers in Syria with the worldwide data of COVID-19, the impact of the virus in Syria appears insignificant. Yet, the real number of infections is likely much higher but unknown due to severe shortages of testing.

During his March 13 interview, the health minister claimed that there would be enough medical facilities and specialized personnel to handle a potential outbreak of the pandemic. Upon questioning, he insisted that a handful of companies would produce face masks to distribute among the population, with a surplus to be exported abroad. The condition of the Syrian health care sector was portrayed by the health minister as exceeding even the dreams of Europe and the rest of the world. But according to the Syria Justice and Accountability Centre (SJAC), the pandemic is not under control and the government is facing a severe public health crisis. Residents reported to SJAC that an outbreak in Damascus has overwhelmed health workers, overcrowded the hospitals and led to an atmosphere of fear due to extensive surveillance by intelligence officers within hospitals.[13] Some people claim they would prefer to die at home of hunger or disease—and resort to seeking medical advice through social media—rather than go to a hospital because they cannot afford to pay for an expensive test or fear the poor conditions.[14] After initially loosening the restrictions, the government recently reintroduced measures of social distancing and banned gatherings during prayers—including Eid al-Adha—funerals and weddings. Curfews have not been reimposed, however, and the distancing measures are barely enforced. Syria is not prepared to handle the enormous demand for isolation rooms and appropriate medical equipment, including face masks, ventilators and disinfectants when even health personnel are not adequately provided with masks for their own protection.


Illness Metaphor Distorts Pandemic Reality


The political use of the imagery of disease to disparage enemies is not unique to the Syrian regime. Metaphors of illness have been employed for centuries and in various contexts, such as Nazi Germany, the Rwandan and Armenian genocides, the Israeli-Palestinian conflict and others. For example, German fascists employed the metaphors of parasites, syphilis, tuberculosis and cancer to denounce European Jews and suggested as a radical treatment of the “Jewish problem” to surgically cut it out.[15] In her seminal work Illness as Metaphor, Susan Sontag shows how the concept of disease is never innocent and how the metaphor of illness has been used to describe social or civil disorder by projecting a sense of evil onto cancer or other epidemic diseases. She also highlights how the language of warfare and disease are strongly intertwined, with words such as invasive, defense, infiltrate or kill commonly employed in both contexts.

Even faced with an unexpected pandemic, it is striking how effortlessly and consistently the coronavirus rhetoric of the Asad regime was integrated into an existing state narrative of war-induced “disease” and Western conspiracy spreading “germs.” Creating an environment of fear and misinformation, in this case by denying and downplaying the extent of COVID-19 infections and policing hospital workers, is a simple but efficient strategy to suppress dissent against the government. The cruel irony behind the health minister’s announcement that the Syrian Arab Army has fought many “germs” in Syria and will be the country’s rescuer from the pandemic is exemplified by the word he used, tahara, which has a double meaning of cleanse or purify in both military and health contexts. While the word does not directly translate into “defeat,” it can be used to refer to a city that is cleansed of enemies in wartime as well as to refer to someone cured of an illness. But it can also imply ethnic cleansing, which is derived from the same root.

Warfare and the treatment of illnesses (imagined or real) are intertwined in the official rhetoric and reflected in the regime’s actions. The Syrian regime that sent its army to fight against so-called germs within its borders is the same one that bombed the nation’s hospitals and crucial health infrastructure, leading to an increase in the suffering of the civilian population and a devastating lack of preparation for a real health emergency.


[Noura Chalati is a doctoral candidate at Freie Universität in Berlin and a research fellow at Leibniz-Zentrum Moderner Orient.]





[1] Al-Modon online, “The Syrian Health Minister on Corona: “The Army Cleansed the Country from Germs,” March 13, 2020. [Arabic]

[2] This article builds on ideas that were first developed in my master’s dissertation submitted in August 2019 at the University of Edinburgh (unpublished).

[3]Interview with Syrian President Bashar Al-Assad,” Wall Street Journal, January 31, 2011.

[4] Salwa Ismail, The Rule of Violence: Subjectivity, Memory and Government in Syria (Cambridge: Cambridge University Press, 2018) p. 34.

[5] Ibid.

[6] Al-Bab, “Speech by President Bashar Al-Assad at Damascus University, 20 June 2011.”

[7] Ibid.

[8]  Ali Mourad, @ALIM43, Twitter post on August 8, 2018. Translation by the author.

[9] Derek Gregory, “’Your Turn, Doctor’,” Geographical Imaginations blog, November 30, 2016.

[10] Derek Gregory, “The Death of the Clinic,” Geographical Imaginations blog, December 11, 2016.

[11] Borzou Daragahi, “Coronavirus: Syria Confirms First Case Amid Accusations Regime Covering up ‘Thousands’ of Infections,” The Independent, March 23, 2020.

[12] Ortas online, “Latest Statistics,” General Organization of Radio and TV Syria. [Arabic]

[13] SJAC, “‘Like a Horror Movie’: Major COVID-19 Outbreak in Damascus and Failed Response,” August 13, 2020.

[14] Virginia Pietromarchi, “In COVID-hit Syria, People ‘Prefer to Die than Come to Hospital’,” Al-Jazeera, October 5, 2020.

[15] Andreas Musolff, Metaphor, Nation and the Holocaust: The Concept of the Body Politic (Routledge: Routledge Critical Studies in Discourse 3, New York, NY, 2010).


How to cite this article:

Noura Chalati "Illness as Metaphor and Reality in Syria," Middle East Report 297 (Winter 2020).

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