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281. Universal Health Coverage for Better Social Protection: The Case of Iraq

Author:
Sami Nader
Publication Date:
08-2024
Content Type:
Special Report
Institution:
Arab Reform Initiative (ARI)
Abstract:
Decades of violence, conflict, and humanitarian crises, combined with international sanctions and continuous neglect of the health sector, have seriously harmed Iraq’s healthcare system. As a result, many skilled physicians and other medical practitioners have left the country, causing a shortage of medical staff. Furthermore, Iraqis harbor a great degree of mistrust for the government and the public healthcare system, particularly following the outbreak of the COVID-19 pandemic, which exposed and aggravated the multitude of vulnerabilities in public healthcare infrastructure and delivery. Once a prosperous and advanced healthcare system, Iraq has been steadily bleeding out talent, with medical staff and other healthcare practitioners emigrating to find better working conditions abroad; in the same vein, a large number of Iraqis travel to regional neighbors for medical care, including to Lebanon, Iran, Jordan, and Türkiye. Ideally, the state would provide social safety and healthcare as fundamental rights for everyone to guarantee fair access and complete coverage. Yet, Iraq’s healthcare system remains in a state of acute crisis and is characterized by disorganization and poor planning, shortages of staff and resources, fragmentation and insufficient coverage, and pervasive corruption, which instead erode the quality, affordability, and accessibility of basic as well as specialist healthcare services for a majority of Iraqis. The lack of long-term, sustainable health policies is widening inequality between Iraqis; large-scale private healthcare systems, acting as substitutes for the public health system, are spreading at a steady rate throughout the country, creating a “two-tier” healthcare system—in other words, one for those who can afford private healthcare services, and the other for those who cannot. Hence, the current landscape is enabling and widening the gap in health disparities for Iraqis. This paper relies on documentation, reports, and studies, in addition to previous recent experience on the ground in terms of public finance management programs as well as regional finance and public policy. It will map the history of Iraq’s healthcare crisis and the impact of the sanctions on health coverage, as well as the strain imposed by the COVID-19 pandemic on service delivery. The paper will then build a case for a collaborative health insurance scheme as an intermediary response to leverage the strengths of Iraq’s public and private sectors, and most pertinently, to alleviate the immediate healthcare needs of the country’s population. Finally, the paper will articulate policy recommendations towards that end, and for the overall Iraqi healthcare system.
Topic:
Health, Public Policy, Health Insurance, and Social Protection
Political Geography:
Iraq and Middle East

282. Urban Communities as Alternative to Slums: A Case Study of Egypt's Asmarat

Author:
Ibrahim Ezzeddine
Publication Date:
07-2024
Content Type:
Special Report
Institution:
Arab Reform Initiative (ARI)
Abstract:
Egypt is one of the most prominent countries that are facing serious housing and informal settlements issues. The state has, at different times, developed many policies and development programs to deal with these issues. During the last decade, Egypt has witnessed a new development in addressing the issue of informal settlements: the establishment of new urban communities as alternative areas for rehousing those living in slums. This paper analyzes the Asmarat area as the most prominent governmental project in this regard, asking the following questions: To what extent do resettlement areas meet the basic needs of the population? Does the Asmarat project achieve economic, social, and cultural sustainability as a suitable housing project? The paper reviewed the Asmarat general plan in terms of the density of residential units, the road network, the distribution of commercial activities, green areas, and open spaces. The paper presents the geographical location of the study area, which is the Mokattam neighborhood in Cairo Governorate, and it reviews the general plan and the footprint for the area to be built; the three phases of the project; and the financial cost, which exceeded 3.35 billion Egyptian pounds (about US$69.8 million), according to what was announced on official websites. The paper uses the framework of economic, social and cultural rights as an indicator to assess the area. The first indicator assesses the methods of legal security of tenure. All legal safeguards that protect residents from forced eviction should be in place. The second indicator measures access to natural resources, safe drinking water, energy for cooking, heating and lighting, sanitation, waste disposal, drainage, and access to emergency services. The third indicator assesses the adequacy and affordability of housing costs in relation to personal income and the cost of daily living for individuals and families. The fourth indicator assesses the suitability of housing for family size in terms of space and protection from cold, humidity, heat, and the spread of infections. The fifth indicator assesses access to adequate housing for all those affected by the removal of their homes, and the need for alternative housing. The sixth indicator assesses the suitability of the housing location in terms of the availability of employment opportunities, access to basic and health services, access to health care and education services, and access to social services. The seventh indicator assesses the expression of the housing’s cultural and social identity, and the adaptation of the exterior and interior design and landscaping to this end.
Topic:
Urban, Informal Settlement, and Housing
Political Geography:
Middle East, North Africa, and Egypt

283. Lebanon’s Solar Rollout: In What Ways Has It Been an Unjust Energy Transition?

Author:
Yusra Bitar
Publication Date:
06-2024
Content Type:
Special Report
Institution:
Arab Reform Initiative (ARI)
Abstract:
Lebanon’s national electricity supply has nearly collapsed, with the country’s residents experiencing constant power cuts over the past three decades and total blackouts since 2020.1 This has led residents across the country to find their “coping strategies” - which have become somewhat normalized - to deal with the national shortages, including purchasing or subscribing to diesel generators.2 More recently, these coping strategies have started to include solar energy installations, which have been deemed revolutionary for Lebanon,3 although in reality, the story is much more complex. As the climate crisis worsens and global institutions start to advocate and fund just transitions,4 it is imperative to reflect on what this means to prevent the repetition of collective injustices. This paper briefly outlines the solar energy landscape in Lebanon and asks some questions about the country’s solar rollout, including who benefits from it and how, as well as how this process repeats past energy injustices. It then presents some case studies of initiatives that have addressed some community energy needs while offering lessons for future energy planning. The paper concludes with recommendations to policymakers, civil society organizations, and the private sector as they transition to solar energy.
Topic:
Environment, Solar Power, and Energy Transition
Political Geography:
Middle East and Lebanon

284. The Muhammasheen Mobilization Among Yemen’s Most Marginalized Community

Author:
Aisha Al-Warraq
Publication Date:
04-2024
Content Type:
Special Report
Institution:
Arab Reform Initiative (ARI)
Abstract:
The historical disenfranchisement Yemen’s Muhammasheen face would still be invisible today, to the rest of the country and wider the world, if not for the community’s own mobilization efforts in the past four decades. Muhammasheen, meaning “the marginalized”, is a contemporary term for a people whom the rest of Yemeni society had for generations untold referred to with names such as Al-Akhdam, “the servants” or Al-Abeed, “the slaves”. Despite centuries of recorded history in Yemen, this ethnic minority’s dark skin has traditionally been denigrated by the rest of society as not belonging to the country, causing them to face caste-like ostracization, stigmatization, and denial of basic human dignity. Muhammasheen communities are often found in shanty towns at the periphery of Yemen’s urban centers and in isolated rural areas. This exclusion from mainstream society, dispersion around the country, and the blurry definitions that define the group have made assessing their numbers difficult, with estimates ranging anywhere between 500,000 and 3.5 million.1 In the 1990s, Muhammasheen who sought to better their community’s situation began to be increasingly vocal and active in drawing attention to their plight and asserting their right to be regarded as full members of society. The powers that be have, by turns, attempted to oppress and coopt these initiatives, as well as exploit the Muhammasheen’s vulnerable status, which has only been exacerbated by Yemen’s ongoing civil war. The belligerent parties on all sides, for instance, have sought out Muhammasheen youth in their impoverished communities and lured them to fight on the frontlines with the promise of a paycheque. At the national level, Muhammasheen advocacy is today as fragmented as the country itself. However, the drive within the group to better the community at large continues to gain momentum, as evidenced by the ever-growing number of local initiatives around the country, even as the goal of full citizenhood remains a distant prospect. The following paper examines the history and development of Muhammasheen-led activism in Yemen, and this marginalized community’s struggle for self-empowerment.
Topic:
Marginalization, Racism, Activism, and Muhammasheen
Political Geography:
Middle East and Yemen

285. Operation Al-Aqsa Flood in Lebanon’s Palestinian Camps: Emotion and Reason, Solidarity and Militancy

Author:
Marie Kortam
Publication Date:
01-2024
Content Type:
Special Report
Institution:
Arab Reform Initiative (ARI)
Abstract:
In September and early October of 2023, I was in Lebanon on a working visit to the Ain al-Hilweh Palestinian refugee camp after the outbreak of bloody battles between the Fatah movement and the “Muslim Youth.”1 The clashes in Ain al-Hilweh began on 30 July 2023, following the assassination of Abu Ashraf al-Armushi, Fatah’s security chief for southern Lebanon. The Palestinian National Security Forces, affiliated with the Palestinian Authority, are responsible for protecting and managing the security of Palestinian refugee camps in Lebanon, and communicating with the Lebanese army to solve any incidents that occur. The clashes continued intermittently until late September, and stopped completely as Operation Al-Aqsa Flood began, with rogue elements on both sides promising to resume their conflict after the Gaza War. This was not the first time that Ain al-Hilweh camp has witnessed an armed conflict between Fatah and the "Muslim youth." This battle was one round in a series of escalations between Fatah and various Islamist militant groups which began with the establishment of Osbat al-Ansar in 1990, then with more extremist groups that splintered from al-Ansar after it concluded a peace agreement with Fatah in 2002. In reality, this battle was a conflict between Fatah and Hamas over control of the camp, as part of their fundamental struggle over Palestinian legitimacy. One hypothesis suggests that the recent clashes in Ain al-Hilweh resulted from an attempt by a party with no stakes in reconciliation between Fatah and Hamas to scuttle the dialogue conference in Egypt held on 30 July 2023. Fatah members, residents, and activists in the camp claim that Hamas is fighting “with another’s sword” against Fatah, that is, using unrecognized Islamic groups in the camp such as the Maqdisi group led by Fadi Al-Saleh, a close affiliate of Hamas who works with Turkish non-governmental organizations and supports the "Muslim Youth" groupings. Historically, the camps in Lebanon were under the control of the Palestine Liberation Organization (PLO), and still are. However, since Mahmoud Abbas took over the administration of the Palestinian Authority, the Fatah movement, the PLO, and all Palestinian national institutions have marginalized refugees and failed to prioritize their cause. As a consequence, Palestinian refugees became increasingly discontent with Abbas’ positions, even those within the ranks of the Fatah movement, albeit this discord was not always made public. As for Hamas, it lost its base in the Yarmouk camp in Syria after the rift between it and the Syrian regime with the outbreak of the Syrian revolution, which made it search for another base among the refugees. Ain al-Hilweh camp was one of its areas of interest, as the largest Palestinian refugee camp in Lebanon where Islamist movements such as the Osbat al-Ansar and the Mujahid Movement were present, making the camp fertile ground for Islamist activity. Hence, it became logical for Hamas to compete with Fatah over governance of the Lebanese camps, the most important of which is Ain al-Hilweh as the capital of the Palestinian diaspora. This article presents a preliminary analysis of the perception of Palestinian refugees in Lebanon towards Operation Al-Aqsa Flood and the forms of solidarity with Gaza, both as socio-political solidarity and as militant engagement at a moment of intense competition between Fatah and Hamas. The article also raises the issue of the mobilization of Palestinian refugees in Lebanon and Hamas's attempts to establish influence in the camps in the aftermath of Operation Al-Aqsa Flood. The article is based on official and informal meetings, observations during field visits to the camps in early October and November 2023, and a review of news coverage.
Topic:
Refugees, Solidarity, Hamas, Armed Conflict, and Al-Aqsa Flood
Political Geography:
Middle East, Palestine, Gaza, and Lebanon

286. Nomads of the Void: Unpacking the Enigmatic Lives and Survival of Syrian Dom Refugee Women in North Lebanon

Author:
Jasmin Lilian Diab and Asli Saban
Publication Date:
12-2024
Content Type:
Journal Article
Journal:
Journal on Migration and Human Security
Institution:
Center for Migration Studies of New York
Abstract:
This article investigates the challenges faced by the Syrian Dom community in Lebanon, with a particular focus on the gender-specific adversities encountered by women. Historically nomadic, the Dom have largely settled in the MENA region, though recent conflicts in Syria have displaced many to Lebanon, where they live in precarious conditions alongside other refugees. Through a mixed-methods approach, this research delves into the multiple layers of discrimination experienced by Dom women, exacerbated by their ethnic background, gender, and legal status. Such factors combine to place Dom women in highly vulnerable positions, perpetuating their marginalization and complicating their integration into Lebanese society. By focusing on vulnerabilities, forced labor, sexualization, protection, and intimate-partner and familial dynamics, this paper offers insights into how systemic inequalities intersect with identity formation in a less-explored displacement context within Lebanon. The study concludes with recommendations for targeted interventions aimed at empowering these women, improving their access to necessary services, and facilitating their social inclusion.
Topic:
Minorities, Women, Refugees, Syrian War, Marginalization, Nomad, and Dom People
Political Geography:
Middle East, Lebanon, and Syria

287. Missiles and Misfits: Reimagining Home and Security for Queer Internally Displaced Persons From South Lebanon

Author:
Jasmin Lilian Diab
Publication Date:
12-2024
Content Type:
Journal Article
Journal:
Journal on Migration and Human Security
Institution:
Center for Migration Studies of New York
Abstract:
This paper sheds light on the often-overlooked intersectionality of armed conflict, displacement, and sexual and gender identity, with a focus on the experiences of LGBTIQ+ internally displaced persons (IDPs) from South Lebanon amidst the ongoing armed conflict between Israel and Hezbollah. Employing a qualitative research approach, the study conducted 18 in-depth interviews with members of the displaced LGBTIQ+ community to capture the nuances of their lived experiences. Through thematic and narrative analysis, the research aims to uncover the multifaceted challenges faced by LGBTIQ+ individuals who have been internally displaced due to the protracted conflict. The findings highlight the intricate interplay between the external conflict dynamics and the internal struggles of sexual and gender minorities navigating displacement. Themes such as resilience, identity negotiation, discrimination, and community building emerge from the narratives, providing a rich and textured understanding of the intricate fabric of their lives. The paper not only contributes to the growing body of literature on conflict-induced displacement but also foregrounds the unique challenges and coping mechanisms employed by LGBTIQ+ individuals in the face of adversity. By amplifying the voices of those often silenced, this research seeks to inform policies and interventions that are more inclusive and responsive to the specific needs of internally displaced LGBTIQ+ populations in conflict settings, fostering a deeper understanding of the complexities inherent in their journeys of survival, resilience, and identity reconstruction.
Topic:
Security, LGBT+, Hezbollah, Internal Displacement, and Armed Conflict
Political Geography:
Middle East, Israel, Lebanon, and South Lebanon

288. Deal or No Deal: The Road to a Cease-fire in Gaza and on the Lebanon-Israel Border

Author:
Gerald Feierstein and Randa Slim
Publication Date:
03-2024
Content Type:
Video
Institution:
Middle East Institute (MEI)
Abstract:
The Middle East Institute hosted an on-the-record briefing on current Israel-Hamas cease-fire negotiations and likely outcomes in the coming days and weeks.
Topic:
Negotiation, Hamas, Ceasefire, and Armed Conflict
Political Geography:
Middle East, Israel, Palestine, and Gaza

289. Risks and challenges to oil and gas markets in the current Middle East conflict

Author:
Colby Connelly, Emily Stromquist, Karen Young, Yesar Al-Maleki, and Nikolay Kozhanov
Publication Date:
03-2024
Content Type:
Video
Institution:
Middle East Institute (MEI)
Abstract:
The Middle East Institute’s (MEI) Program on Economics and Energy cordially invites you to a panel discussion of the war-time threats to energy transit along the Red Sea corridor and to regional production facilities, within the context of broader supply-and-demand dynamics. Since Hamas’ Oct. 7 terrorist attack on Israel and subsequent war in Gaza, hydrocarbon prices have held relatively stable, although attacks by Houthi militants on shipping in the Red Sea could cause long-term market shifts and geographic segmentation. Why have we seen such a low impact on oil prices to date despite profound regional instability? What explains natural gas prices staying at historic lows? Are Gulf oil facilities at risk? What is the outlook for gas production in the Eastern Mediterranean? And how is OPEC considering outside supply competition and near-term demand? To answer these and other questions, MEI has convened five top US and regional energy and geopolitical risk analysts, who include contributors to MEI’s new edited volume Energy Transitions in the Middle East. They will reflect on their assessments of oil and gas markets prior to Oct. 7 as well as share their views on the current risks and challenges for fossil fuel producers in the region.
Topic:
Economics, Markets, Oil, Energy, and Natural Gas
Political Geography:
Middle East, Yemen, Gaza, and Red Sea

290. Expert Voices: Iran’s record-low election turnout

Author:
Alex Vatanka
Publication Date:
03-2024
Content Type:
Video
Institution:
Middle East Institute (MEI)
Abstract:
MEI's Iran Program Director Alex Vatanka discusses his main takeaways from Iran's recent elections and their record-low voter turnout.
Topic:
Elections, Domestic Politics, and Voting Behavior
Political Geography:
Iran and Middle East