The coronavirus pandemic is highlighting glaring inequalities and the lack of resources for vulnerable communities worldwide. Joe Stork, in a prescient analysis from 1989, explains how health care is always mediated through politics and power. With vivid examples from across the Middle East, this article from the MERIP archives is indispensable to understanding the current crises in public health.
While people around the world are under lockdown, Palestinian workers in Israel continue to labor in the now accelerated construction sector. While Israel’s project of control and expansion exploits their labor, Palestinians are put at greater risk without proper testing, accommodations or healthcare.
Lebanon’s highly privatized system of health care is presenting challenges to implementing a public health approach to the COVID-19 pandemic. With the country already suffering from multiple political and economic crises, containment of the coronavirus has been more effective than expected. But serious obstacles to the public’s health and well being remain.
Pharmacists in Turkey, like the author’s parents, are working overtime to serve their communities and to adapt quickly to shifting government orders during the COVID-19 pandemic. While steps are being taken to mitigate the impact of the virus on the most vulnerable, various forms of inequality entrenched across the country mean that certain groups suffer much more than others.
Voices from the Middle East: Doctors, COVID-19 Patients and Dilemmas of Treatment under Sanctions in Iran
Caring for COVID-19 patients without the proper equipment and medicine is difficult anywhere. In Iran it is especially devastating to know that lives are being lost due to US sanctions. Two pediatricians at provincial hospitals in Iran describe their experiences.
Gaza’s health system has been severely weakened by 13 years of Israeli land, sea and air blockade. With 2 million residents and not enough hospital beds, protective equipment and other essentials, the arrival of COVID-19 could spell disaster. Danya Qato gets the details of Gaza’s dire situation and the response of health care workers to the pandemic in this interview with Salam Khashan, a doctor in Khan Yunis.
US sanctions against Iran, along with Iranian government policies, have created insurmountable obstacles for domestic drug manufacturers who are struggling to provide people with the health care they need, especially now as COVID-19 ravages Iran. An Iranian pharmaceutical company employee explains why procuring supplies has become so difficult.
As Iraq now confronts the arrival of COVID-19, its war-damaged medical infrastructure and degraded environment will make it harder to combat the virus. In 2019, Omar Dewachi explained how these same conditions transformed innocuous bacteria into dangerous drug-resistant strains.
Iranians have repurposed, reconfigured and transliterated the psychiatric concepts of depression and trauma as depreshen and toroma. In this wide-ranging interview, Orkideh Behrouzan speaks with Sheila Carapico about the politics of Iranian mental health care policy, public discussion of the effects of 40 years of revolution and war and the ways in which a younger generation is forming identities through depreshen-talk. Behrouzan is a physician, medical anthropologist, scholar of science and technology and the author of Prozak Diaries: Psychiatry and Generational Memory in Iran. She teaches in the anthropology department at SOAS, University of London.
Negative stories about the Middle East dominated Western news headlines in 2015. It’s easy for Americans, especially those who listen to Republican presidential candidate Donald Trump and his supporters, to get the impression that the region is just one miserable homogeneous place of violence, terror, religious fanaticism and authoritarianism.
There is a name whispered in opposition circles in Syria — an insurance policy against what after three years of conflict seems inevitable. If you are injured very badly, there are two imperatives: Get to the Jordanian border. Then, get to Umm ‘Abdallah.
“She’s the one,” says Muhammad ‘Ali Shamboun, a limping young man from Dar‘a now living in Amman. He motions to the unimposing woman, about ten feet away, whose succor he has been awaiting for two years. “If she says, ‘Do this operation,’ it’s done.”
There are few obvious reasons to visit Basatin, a poor district off the Ring Road at the southern edge of Cairo. Getting there requires a driver willing to bob and weave through a succession of potholed lanes barely wide enough to accommodate pedestrians and the tiny shops that spill into the street. The problems of Basatin are the problems of Egypt: grinding poverty, overcrowding and the slow deterioration of state services. The neighborhood has learned to fend for itself, and non-residents are regarded with suspicion. I stick out more than most. One man watches me curiously for a while, and wanders over to ask if I am Syrian.
Jamal is not yet a teenager. His school closed in 2011, soon after the Syrian revolution turned into an armed conflict, and his father found him a factory job. One day in 2012 as he returned from work there was a battle going on in the main street near his home. Jamal immediately started carrying wounded children smaller than he is to shelter in a mosque. Then Syrian army reinforcements arrived, clearing the streets with gunfire and hitting Jamal in the spine. The youngsters who took him to the hospital advised him to say that “terrorists” had caused his injury. But Jamal did not want to lie — he told the doctors that a soldier had fired the bullet. The doctors told him to shut up and say it was the terrorists. But they treated him anyway.
It was February 1987, at the front lines near Khorramshahr, in the south of Iran along the Iraqi border. We had been engaged in heavy battles for over a week. Our troops had penetrated fortified Iraqi positions, and the Iraqis were making us pay: Artillery and mortar shells rained down on us with a vengeance, as did bombs from Iraqi planes.
Five-year-old Layan cupped her hands over her ears and screwed her eyes shut when she tried to describe the effect of a sonic boom. She said the sound scares her, even though her father, Muntasir Bahja, 32, a translator, has told her “a small lie to calm her”—that the boom is nothing more than a big balloon released by a plane and then popped.
Throughout the 1990s, social conditions in Iraq have deteriorated to levels last experienced three and four decades ago. This decline is associated with a dramatic reduction of the gross national product from around $3,500 to under $700 per capita, but changes in the GNP do not tell the entire story.  While Iraq's social indicators, including child mortality, today are certainly not the lowest in the world, the extent and rate of decline there is unprecedented in the modern world.
The men guarding the ruins of the remote Kharanj oil pumping station near Iraq’s border with Saudi Arabia don’t wander around much. Parts of this facility, destroyed by American air raids during the 1991 Gulf war, remain “hot” — radioactive. The guards confine themselves to one small building, avoiding wreckage contaminated by US bullets made of depleted uranium (DU).
Driving into the former battlefield, one passes Iraq’s rich Rumeila oil fields and the demilitarized zone with Kuwait, which is littered with rusting tanks and vehicles. Many are hot.
The publication of the Boston Women’s Health Book Collective’s famous and controversial book Our Bodies, Ourselves (1976) created wide repercussions and charted a way for women all over the world to gain personal control, through the possession of objective and necessary information, over their own bodies, health status and lives.
A group of interested Egyptian women started to meet in May 1985, with the idea of finding ways to spread the message of the book to Egyptian and Arab women. They agreed to form a collective to produce a similar book in Arabic.
Amira is explaining to some village women how to use herbal medicines that grow in their neighborhood. “I learned the skill from my grandmother when I used to help her harvest the wild plants,” she says. Amira describes the plants, carefully differentiating those for colds: babounij (chamomile), khatmiye (athea), na’na (peppermint), zatar (thyme); those for abdominal colics: yansoun (anise), krawya (caraway), shemra (fennel); and those for diuresis, shoushet dura (corn stigma), bakdounes (parsley), and bu‘atheran (millofia). She is also very precise with her instructions.
Over the past two decades, public health workers have successfully developed primary health care: basic preventive and curative services that address critical health problems and are available close to people’s homes. Primary health care includes immunizations; maternal care; education for health, hygiene and nutrition; family planning; availability of essential drugs; and first aid. The difficulty now is in making primary health care widely available and of good quality. In most countries high technology hospitals in the capital cities, and exotic, expensive drugs still dominate the expenditures for health care.