On a recent visit to Libya, I met a family living in an improvised shelter in a displaced persons camp east of Tripoli. One of the tens of thousands Libyan families uprooted by war, the family of seven was living in a room barely 20 paces long and half as wide. A clothesline, a pile of mattresses, a hot plate and the stench of body odor filled the room. Outside, they faced a shortage of potable water and abusive taunts from locals.
The spread of the novel coronavirus will have a devastating effect on the Middle East’s communities of refugees and migrants. The pandemic may also bring into focus the legitimacy and governance deficit of increasingly troubled Middle Eastern regimes.
A swift public health and economic response could strengthen authoritarian rule by these regimes, but not indefinitely. A critical lesson of the 2011 Arab uprisings and the protests that erupted last year is that without more inclusive governance, less corruption and greater economic equity, technocratic and coercive tools are only stopgap measures. The demands for citizen buy-in are likely to grow in the Middle East in the pandemic’s aftermath.
The pandemic’s most immediate and ruinous impact will be felt in the region’s active civil wars: Libya, Yemen and Syria.
Libya’s medical infrastructure under Col. Muammar el-Qaddafi was already pretty weak. In the nine years since Colonel Qaddafi’s fall, it has been gutted by corruption, neglect and several rounds of civil war.
The latest phase began in April 2019 when Khalifa Hifter, the warlord and the military ruler of eastern Libya, attacked Tripoli, the capital, to topple the country’s internationally backed Government of National Accord, led by Prime Minister Fayez al-Sarraj. The fighting that followed saw scores of attacks on health facilities and emergency personnel by Mr. Hifter’s forces. The violence in Libya has worsened since the outbreak of the pandemic as the warring sides and their foreign backers exploit diplomats’ distraction.
The opposing political authorities in this divided land have taken some modest steps, like a curfew and a ban on large gatherings. But the response has been hampered by mounting economic woes caused by low oil prices, Mr. Hifter’s blockade of oil ports and the desire by elites on both sides to keep paying their fighters.
Political authorities depend on armed groups, who could use the public health crisis to further consolidate their power; already, Mr. Hifter’s militia has threatened outspoken doctors in eastern Libya. Militia bosses will likely intercept outside medical aid and channel that materiel to their fighters or hoard supplies for sale on Libya’s black market. A viral outbreak in one town or community might trigger increased stigmatization and violence.
Thousands of irregular migrants, mostly from Africa, who were trying to reach Europe, are uniquely vulnerable. Housed in militia-run detention centers, the migrants endure torments like torture, rape and forced labor. A lethal virus will make the suffering unspeakable.
Yet Libya pales in comparison with Yemen, the world’s biggest man-made humanitarian disaster. The war in Yemen has already exposed the symbiotic nature of war and disease. Its cholera outbreaks, the worst in modern history, were almost entirely the result of attacks on hospitals, water and sanitation facilities by the Saudi-led coalition.
The fighting also spawned a horrifying famine, leaving most people in the country dependent on foreign food and fuel imports. Though Yemen has not reported any cases of the coronavirus, that is because of a lack of testing and an unwillingness among the factions to report the contagion. A widening coronavirus epidemic in Yemen will force many into an existential choice between infection or starvation.
Efforts to implement a cease-fire agreed to by the warring parties and their foreign backers in Yemen have stumbled, and escalating clashes are occurring. As is the case of Libya, outside meddlers seem more focused on stoking a proxy war than on the welfare of citizens.
The ravages of war on the health sector, which include shortages of medicine and medical personnel fleeing the country, have left the country dangerously exposed. If unchecked, the pandemic’s spread across Yemen, amplified by the country’s densely packed population, will worsen Yemen’s isolation and disintegration, and devolve more power to insurgents and militias.
But it is in Syria that the impact of a coronavirus outbreak could be truly apocalyptic, especially for the country’s millions of displaced people. Airstrikes by the Assad regime and its Russian backers have obliterated health facilities in opposition areas. In the last rebel-held province, Idlib, there are 153 ventilators for a population of three million. A recurring water shortage and Syria’s urban population density — greater than that of New York City — only adds to the peril. Over a hundred thousand could die in Idlib alone.
Citizens across the country shouldn’t depend on their leaders: The warring factions have long used public health interventions as political currency and as weapons of war. Thousands of political prisoners jailed by the Assad regime are acutely at risk.
The Syrian economy is in a free fall, and the Syrian lira is depreciating at a catastrophic rate. Before the outbreak, protests erupted in regime-held areas over economic conditions and access to medical care. This is likely to worsen.
The virus will also challenge the capacities of seemingly stable governments. The wealthy Gulf monarchies could weather the storm, but the ride may be bumpy. On top of fiscal constraints imposed by low oil and gas prices, their attempts at diversification to the non-oil sector — to tourism, trade and logistics — have been pummeled by the global economic retreat.
The Gulf monarchies will be less likely to channel aid to poorer regimes that have depended on their largess — Egypt, Jordan and Morocco — and that had faced protests even before the outbreak. As protesters move off the streets in response to public health measures, the coronavirus crisis may give these governments a temporary reprieve. But the demonstrators are regrouping and preparing for another round of unrest, which worsening conditions could make even more widespread.
In Tunisia, the Arab world’s only democracy, the stakes are even higher: How the Tunisian government, grappling with widespread unemployment, high-costs of living and public outrage at corruption, handles the outbreak’s economic fallout could prove a pivotal test of Arab democracy.
Across the region, with the attrition of services by the state, informal governance involving civil society, kin groups, or militias could fill the gap. It is a process that has been underway for decades in Lebanon, but it is spreading to the region’s multiple conflict areas, to borderlands and to some cities.
What makes this shock to the Middle East different and more severe is that the usual fire-brigades — a bailout by the Gulf states, international organizations or great powers — may not arrive as they have before. International institutions may still play a role, but their finite resources are consumed by the pandemic’s global scale. Europe has been terribly wounded by the virus. Infections and deaths in the United States are rising fast, and the Trump administration has turned inward.
The Arab world’s leaders are on their own, and if the past is any guide, that is not ground for widespread hope. Seismic changes can have small beginnings, especially in a region hobbled by economic stagnation, political sclerosis, proxy wars and an unfounded confidence in the endurance of the status quo.
As the old Arabic proverb goes, “Even a mosquito can make the lion’s eye bleed.”