Although the difficulties’ health personnel face, are quite similar to those of workers in other fields, the political dimensions of physicians ’crises in the region have increased remarkably. Medical doctors are kidnapped in some hotbeds of several Arab armed conflicts to provide treatment for some Militia members, in addition to their indirect involvement in military confrontations in Northeastern Syria through Turkey. Moreover, there is a gap between the medical syndicate and the political authorities regarding the actual number of COVID-19 cases, which was quite evident in Turkey.

Medical doctors in some states of the region suffer from delayed payment of their salaries as a result of the decline in oil prices as well as the decline in the financial budgets of their countries. This leads to what is known as the ‘brain drain’, in addition to their contracting diseases such as the coronavirus due to their presence on the front lines confronting the epidemic with short medical supplies. The lives of medical doctors in some countries are endangered, as they get exposed to repeated attacks by community members due to the absence of adequate security measures. 

The crises of medical doctors in the region are by no means a recent phenomenon, but their features evolve according to different regional conditions and the emergence of transnational epidemics. The Middle East reflects a variety of crises that physicians are exposed to, particularly in hotbeds of tension.

Targeted by militias 

1-    The repercussions of the on-going chaos: 

Medical doctors are among the key target groups in some hotbeds of armed conflict. For example, in December 2020, a number of media outlets reported that doctors were still being kidnapped in Tripoli, particularly Dr. Al-Siddiq bin Dallah. This may be most relevant to an armed militia leader needing covert treatment, as he cannot be transferred to public hospitals due to his being associated with some criminal activities.

This was not the only kidnapping Dr. Dallah was exposed to, since he was subjected to another attempt two weeks earlier. Other medical doctors working in the same hospital were also exposed to kidnapping at different times. Accordingly, the General Syndicate of Libyan Medical Doctors denounced the kidnapping incident and called on authorities to investigate the incident. They called for intensifying their endeavors for his release and for the arrest of the perpetrators of this crime, in order to put an end to what it described as the ‘farces’ that  the doctors face. Furthermore, recent assaults against health personnel and their affiliates negatively impact health services for Libyan citizens.

Kidnappings of doctors in Libya have drawn the attention of the WHO during the 2018-2020 period, especially since perpetrators are usually masked gunmen, who drive four-wheel drive cars, and target their victims within a short time. This indicates a rigorous process of monitoring doctors prior to the kidnapping. Perpetrators are often anonymous. Doctors are also a main target group in a number of Syrian regions within the attacks on medical facilities, partly as a result of the shortage of drug supplies resulting from the Western sanctions on the Syrian regime.

Military conflicts

2-    Indirect involvement in military clashes: 

Some reports indicate that in September 2019, Turkey transferred some doctors from major cities to Şanlıurfa and Mardin during the military operation targeting Northeastern Syria with the aim of reducing the influence of the Kurdish People's Protection Units, which is perceived by Erdogan's regime to be a key threat to Turkey. Meanwhile, doctors' vacations were suspended, so that they would participate in the treatment of injured cases on the front lines. 

Economic crises

3-    The aggravation of the internal economic situation: 

Following the spread of COVID-19, some countries in the region, such as Iran and Iraq, suffer from the emigration of health workers, who prefer to work aboard. This included medical doctors as well as nurses. During Iran's celebration of Nurse's Day on December 20, 2020, Iranian statistics indicated a 300% increase in the migration of nurses, particularly in light of the lack of job security and fear for life.

Perhaps the worsening economic situation prompted medical workers in places like Tunisia and Iraq to organize group protests. In the middle of 2020, many health workers in Sulaymaniyah, Iraq went on strike due to the delayed payment of their salaries, resulting from the severe economic crisis of reduced oil prices and the decline in the federal budget.

These precarious economic conditions lead to the emigration of doctors to better countries, and even to better conditions in some collapsed countries. Somalia, for example, has become a destination for Syrian doctors due to the availability of high paying jobs. This was stated by the head of the Syrian Doctors Syndicate, Kamal Amer, in his interview with "Sama" channel in November, 2020, which he later denied it in ‘Al-Watan’ newspaper for fear of the reaction of the official Syrian authorities.

The dilemma of transparency

4-    The gap between the medical  syndicates and the political authorities: 

This clearly applies to Turkey, following the escalation of debates in September 2020 regarding COVID-19 infections. The medical doctors syndicates considered the numbers announced in the official statements to be much less than the actual outbreak. Politicians, especially those affiliated with the ruling Justice and Development Party (AKP), see the danger of the medical syndicates to amount to the danger of COVID-19, in terms of the threats the syndicate spreads.  

COVID-19 Risks   

5-    Infection by diseases: 

Given that  medical doctors are on the front lines of combating the COVID-19 epidemic, they are the most vulnerable to getting infected by the virus, and even killed as seen in many Arab cases. This may be associated with poor health systems, improper medical care, as well as a lack of financial resources allocated to the medical sector within the general budget. The crisis is aggravated in marginalized border areas of some countries.

Community violence

6-    Exposure to repeated assaults: 

Some countries of the region have witnessed attacks on the medical staff due to the lack of effective security measures in hospitals and the failure to reduce crowding in hospital reception areas, which sometimes sets doctors in confrontation with patients, during their dealing with infected or suspected cases, as was the case in Iraq and Sudan. Therefore, on May 31, 2020, the Sudanese interim government approved a legislation imposing severe penalties for violence against medical personnel, including prison sentences. 

The Syndicate welcomed the legislation, which aims to end the repeated attacks on some doctors in a number of hospitals and checkpoints. This negatively hindered endeavors dedicated to combatting the pandemic.  Sudanese Prime Minister Abdallah Hamdok said in a tweet: "The legislation aims to protect members of the White Army from repeated attacks, to set the legal penalty for violations and to ensure the due appreciation for them". 

Interlocked crises

Thus, it is quite clear that health personnel are facing various crises in the region, due to fragile healthy systems, particularly in conflict hotspots. There are also increasing pressures on medical doctors residing in the region due to the intense emigration of large numbers of doctors in light of the increasing demand for them in Gulf countries, Eastern Europe, North America and other regions. 

Ruling parties are currently targeting physicians, who challenge the official data pertaining to the outbreak of the pandemic, which sets the credibility of the ruling parties at stake. Medical doctors’ lives are continuously at risk due to their presence in the front lines in their combat against the epidemic, which reflects both chronic crises as well as new pressing ones.