[Marxism] In Syria, Health Workers Risk Becoming ‘Enemies of the State’

Louis Proyect lnp3 at panix.com
Wed Dec 4 09:14:48 MST 2019

NY Times, Dec. 4, 2019
In Syria, Health Workers Risk Becoming ‘Enemies of the State’
By Rick Gladstone and Malachy Browne

The nearly 9-year-old conflict in Syria has been punctuated by repeated 
violations of what is considered acceptable in war, including the 
military’s use of chemical weapons, torture of prisoners and recurrent 
bombings of hospitals in rebel-held areas. Less attention has been paid 
to another outcome: the government’s criminalization of medical care.

On Wednesday, Physicians for Human Rights, a group that has documented 
the collapse of Syria’s health care system, released a study asserting 
that over the course of the war, President Bashar al-Assad has 
successfully made medical assistance to his enemies a crime.

Whether it is disinfecting a fighter’s wound or even supplying 
painkillers to clinics in an insurgent-held neighborhood, such acts are 
punishable under a counterterrorism law enacted by Mr. Assad’s 
government just over a year after the conflict began in March of 2011. A 
special court has tried tens of thousands under the law, including many 
medical workers.

“This report illustrates how the Syrian government has effectively 
criminalized the provision of nondiscriminatory care to all, regardless 
of political affiliation,” Physicians for Human Rights said in the 
study. Health workers who provide care in line with their legal and 
ethical obligations, it said, are branded as “enemies of the state” in 

The study is based on extensive interviews with 21 formerly detained 
Syrian health care workers who have fled the country, including seven 
physicians, four pharmacists, three medical volunteers, one paramedic 
and one psychiatrist. All said they had endured torture and 
interrogations while imprisoned and did not want to be identified by 
name, fearing retribution against their families or against themselves 
if they ever returned.

A majority of them were arrested, the study said, “because of their 
status as care providers, and their real or perceived involvement in the 
provision of health services to opposition members and sympathizers.”

The New York Times interviewed three of them who said they had been 
detained and interrogated for months. They described cells so cramped 
that inmates took turns to rest. Two of them — a pharmacist and a 
surgeon — said they had been arrested at their workplaces.

Most of the former detainees described a similar process of extracting 
confessions that could be prosecuted under the counterterrorism law, the 
Physicians for Human Rights study said. “Most had judicial review of 
their cases by either military field courts, military courts, or 
counterterrorism court, where due process protections are suspended in 
practice,” it said.

There was no immediate comment by the Syrian authorities to the study. 
Mr. Assad’s government has repeatedly defended the counterterrorism law 
as a necessity for what he contends is his success in retaking and 
stabilizing most of the country, where by some estimates a half-million 
people have been killed and roughly half the prewar population of 22 
million have fled their homes.

Ibrahim al-Kasem, a Syrian lawyer who used to represent detainees, said 
that trials in military courts are held in secret, and detainees can be 
tried in the counterterrorism court without their lawyers. In such 
settings, he said, “the judges have the ability to do anything.”

Mr. al-Kasem is now the executive director of the Caesar-File Group, 
established after a Syrian military police photographer code-named 
“Caesar” released 55,000 images in 2014 believed to show evidence of the 
systematic torture and death of thousands of detainees.

Rights activists and legal scholars say the counterterrorism law itself 
is exceedingly vague on what constitutes terrorism so that even peaceful 
acts could be prosecuted. They say the law also violates a precept of 
the Geneva Conventions that obliges doctors and other health care 
professionals to treat the wounded and sick, regardless which side they 
may support.

“The law is problematic,” said Mai El-Sadany, legal and judicial 
director at the Tahrir Institute for Middle East Policy, a 
Washington-based research group. “The reality is that under this law, 
anyone could be a terrorist.”

When and if the Syria war ends, she said, keeping such a law on the 
books would present an enormous challenge to rebuilding the country. 
“How can people begin to return to a state where they suffer the risk of 
prosecution?” she said.

Mr. Assad’s government was a pioneer in the targeting of health care 
workers as a battlefield strategy, and has been ignoring criticism of 
the policy for years. The United Nations Commission of Inquiry, a panel 
of investigators that has been collecting evidence of human rights 
violations in Syria, said back in 2013 that government forces had been 
systematically denying treatment to the sick and wounded in areas 
controlled by the opposition.

“The denial of medical care as a weapon of war is a distinct and 
chilling reality of the war in Syria,” the panel said.

Michiel Hofman, the senior humanitarian specialist at Doctors Without 
Borders, a medical charity that operates in insurgent-held areas of 
northern Syria, traced the targeting of health care workers to the 
prelude to the war, when peaceful protesters wounded by Mr. Assad’s 
security forces sought treatment at hospitals.

“The authorities said, yes you can treat people but you have to report 
the patients to the police. Patients didn’t want to be reported to the 
police, so health care workers created clinics in homes and underground 
hospitals,” Mr. Hofman said. “The Syrian authorities regarded these 
hospitals as illegal, right from the start, and a vicious cycle was 
created early in the conflict.”

Asked about the prospects for rebuilding Syria’s health care system, Mr. 
Hofman was pessimistic.

“The reason for the persecution of medical workers has not been 
removed,” he said. “Attacks on health care have become the new normal.”

The vast majority of detainees interviewed by Physicians for Human 
Rights said they would not go back to Syria under the current 
conditions, said Rayan Koteiche, one of the study’s authors. “The 
continuing threat and persecution of professions including medical 
professionals is a huge barrier to returning,” he said. “To freely 
practice in accordance with their code of ethics — they don’t see that 
as possible.”

Carlotta Gall, Jack Ewing and Karam Shoumali contributed reporting.

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