Coronavirus is surging in some of the most populous nations in the Middle East and North Africa, with reported cases hitting record highs in recent weeks.
In Egypt, the social media account for the doctors’ union resembles an obituary page – more than 100 health workers have died from the virus. In Iraq, frustration is mounting over the flailing health sector as cases skyrocket.
In Iran, considered the regional epicenter of the pandemic, Covid-19 deaths have soared again after the initial surge several months ago subsided. And Saudi Arabia, one of the Arab world’s richest countries, is not far behind its regional arch-rival in terms of total cases, despite having a population less than half its size.
Elsewhere in the region, some countries have seen the numbers stabilize, whereas conflict areas – Yemen, Syria and Libya – continue to grapple with limited testing capabilities.
Experts say floundering health care systems, information suppression, delayed government responses and premature reopenings contributed to the region’s deepening crisis.
“Most countries (in the Middle East) with the exception of Iran, did well in the beginning. In May, countries across the region scaled back their lockdown measures,” Dr. Rick Brennan, the World Health Organization’s regional emergency director, told CNN on Wednesday.
“Due to economic or social pressures, the easing of restrictions coincided with Ramadan causing an increase in mobility. The worry now lies with the reopening of international travel more than local transmission.”
In Iraq, the pandemic has exposed gaps in a medical infrastructure decimated by decades of sanctions, war and corruption.
A doctor and coronavirus patient simultaneously, Iraqi anesthesiology specialist Dr. Alaa Hussein al-Talaqani says health authorities need urgently to ramp up their responses. Talaqani says he tested positive on June 19.
“I am very afraid about the possibility of transmission of the virus to my family and to other people … because I am sure that it is difficult to control the viral outbreak in Iraq due to lack of simplest protective measures, due to the government default,” he told CNN.
“It is the responsibility of the Ministry of health and the Babylon Health Directorate to do what they could but they cannot do everything due to political corruption,” he said. Iraq has repeatedly said it is trying to crack down on corruption.
At Iraq’s largest cemetery in Najaf, graveyard workers say they’re receiving up to 80 bodies a day.
Neighboring Iran crossed the 245,000-case mark last week after its highest official daily death toll since the start of the virus outbreak. Iran was the first country in the region to witness an outbreak, but the spread began to slow in May. The resurgence of the virus in recent weeks comes two months after the country began to loosen its lockdown.
Out of over 264,500 cases, more than 13,400 people have died, according to WHO figures. That’s a 5% mortality rate, one of the highest in the world.
In early July, Iranian President Hassan Rouhani urged the public to come forward with their symptoms, calling it a “religious duty.”
“Unfortunately, we see that some consider being infected with the virus bad and hide it. If someone knows that they have been infected with coronavirus, they have a religious and human duty to inform others about it,” Rouhani said in a statement published on the official Iranian presidency website.
Saudi Arabia has seen a big spike in cases since June, despite launching some of the earliest and most aggressive measures to stop the spread.
It has reported over 240,000 cases and more than 2,300 fatalities – a much lower death rate than Iran. According to Brennan, ramped up testing in the kingdom contributed to its rise in reported cases.
The oil exporting giant is also the destination of Islam’s most important pilgrimage, the Hajj, forcing the kingdom to curb religious rituals. It canceled what is known as the “smaller pilgrimage” – Umrah – early in the outbreak.
It is hosting Hajj this year with limited numbers: It normally hosts 2 million pilgrims, but this year only 1,000, exclusively domestic, Muslims will attend.
Egypt’s confirmed cases almost doubled in June: from 32,612 cases in the first week to 63,923 cases by the end of the month, according to WHO, though since the start of July In July, the daily rise in cases appears to have dropped.
Almost every day, the Egyptian Medical Syndicate publishes photos of dead health care workers with the words, “May God have mercy on their soul” in Arabic. Health care workers describe the situation as desperate, and complain of a shortage of protective equipment.
At least 117 frontline workers have died from the virus and more than 400 have tested positive since the outbreak began in Egypt in mid-February, according to the doctors’ group. But Amnesty International says the number could be much higher.
“This number does not include doctors who died with Covid-19 symptoms, such as pneumonia, who did not undertake the PCR tests,” Amnesty reported last month. “It also excludes the death toll of nurses, dentists, pharmacists, technicians, delivery workers, cleaning staff and other essential workers who are also on the front line and have risked their health and well-being to ensure that people are able to access health care and other essential services.”
The fear of detention is exacerbating an already difficult situation for workers on the front lines in Egypt. Those who complain about the government’s response or the medical infrastructure can be held on charges of “spreading false news” or even “terrorism,” the Amnesty report said.
“Health care workers in Egypt have been arrested, criminalized and prosecuted simply for daring to express their personal safety concerns and, in some cases, have been denied access to adequate health care,” Philip Luther, Amnesty International’s Research and Advocacy Director for the Middle East and North Africa, said in a statement.
The Egyptian government has not responded to CNN’s request for comment about these claims.
In some countries, coronavirus is complicated by conflict. Yemen, Syria and Libya all effectively have multiple governments, all of whom are cash-strapped. In Yemen, the effects of Covid-19 hav brought the healthcare system to the brink of collapse. In Syria and Libya, the hodgepodge of political forces has created logistical challenges for the supply of PPE, test-kits and ventilators.
Syria’s rebel-held Idlib, battered by years of war, also saw its first recorded cases of the virus in the past several weeks.
“Aid workers have feared the appearance of coronavirus in northwest Syria for months,” said Kieren Barnes, Mercy Corps Country Director for Syria, said in a statement last week. “The millions who live in this region are often residing in close quarters, may not have enough clean water for drinking and handwashing, and frequently lack the necessary resources to protect themselves.”
In crisis-ridden Lebanon, Covid-19 cases are on the rise months after a relatively successful government-imposed lockdown. Prominent health professionals warn of hospitals’ limited capabilities to field large numbers of infectious cases as the health sector grapples with major cash shortages and power cuts.
CNN’s Arwa Damon contributed to this report