Coronavirus in the Middle East: a testing time for relations between regimes and their citizens

As Covid-19 continues to spread in the Middle East, Arab governments increasingly blame the public for failing to comply with preventive measures. The roots of this problem lie in the uneasy relationship between autocratic regimes and the people they govern – a relationship that is likely to come under further strain as the economic costs of the pandemic become more apparent.

Police checking a vehicle during the lockdown in Jordan. Photo: Xinhua 

THE CORONAVIRUS pandemic is not only testing the ability of governments to manage an unusual kind of crisis – it is also testing their relationship with the people they govern. Success in confronting the virus depends on governments and citizens working together, but among the authoritarian regimes of the Middle East that is rather a novel idea.

Engaging with the public doesn't come naturally to Arab autocrats. As a general rule, the more disengaged the public are, the more comfortable the regimes feel. Their main aim is to keep themselves in power, and since active citizenship could pose a threat to their survival it is strongly discouraged. A docile public helps to keep the regime secure – or at least it did until Covid-19 arrived.

To bring the virus under control, bold and potentially unpopular action was needed from governments, and in some ways the region's autocratic rulers seemed better-placed than others to provide it. Democratic governments were often more hesitant, fretting about the restriction of people's freedom that lockdowns would entail, but Arab rulers had fewer qualms about that.

In other ways, though, autocracy placed Arab regimes at a disadvantage. While government by decree is their preferred way of operating, it is often undermined by erratic implementation. Many of their laws end up being selectively enforced or even ignored, especially if the public are not convinced of the need for them – and this was a problem that Covid-19 brought sharply into focus.

As the pandemic dragged on, Arab governments increasingly blamed failure to contain the virus on non-compliance by their citizens. Following a sudden spate of new cases in Oman, a health ministry official blamed "continued indifference" by the public, saying "most of the infections among citizens could have been easily avoided"It was a complaint echoed by frustrated officials across the region.

Flouting the rules

There were certainly many in the Middle East – probably millions – who made little or no adjustment to their lifestyle as a result of the pandemic, but the reasons for non-compliance were many, and not necessarily a matter of choice.

Everyday life in Arab countries revolves around sociability. Weddings and funerals attract huge gatherings, mosques are packed on Fridays for communal prayers, people embrace friends warmly in the street and stay in regular contact with their extended family. In that respect the precautions against Covid-19 demanded a bigger adjustment than in some other parts of the world.

Concepts like "social distancing" and "self-isolation" don't have a natural place in Arab culture and they met resistance – though not the organised kind seen in the United States. Much of it was just an instinctive reaction to what many saw as over-bearing government.

Arab countries in general are burdened with vast bureaucracies which, as far as the public are concerned, cause unnecessary obstructions and interference in everyday life. Arab citizens expend much time and effort, not to mention ingenuity, in navigating paths through this red tape...or circumventing it altogether. There are plenty of officials who will offer short cuts in exchange for a bribe. It's scarcely surprising, therefore, that when the pandemic struck and governments began imposing restrictions many viewed them in the usual light. Their first impulse, shaped by years of experience, was to look for ways of avoiding them.

In normal times individual acts of non-compliance might not matter much, but in a pandemic it takes only one person flouting the rules to cause a major problem – as was seen in April when a cross-border truck driver in Jordan returned from neighbouring Saudi Arabia. A routine test for Covid-19 at the frontier checkpoint came back negative but that didn't necessarily mean the driver was in the clear. Since it takes a few days for new infections to be detectable, he was told to self-isolate at home pending a further test – and he signed a paper agreeing to do so.

Back in his hometown, though, the driver hosted guests at an iftar banquet – the traditional evening meal during Ramadan – before a second test for Covid-19 revealed that he was positive. As a result of his social activities, at least 90 others became infected too. One was a distributor of ice cream who passed the virus to a shopkeeper – which in turn led to the closure of 38 other shops selling ice cream from the same supplier. Special measures also had to be taken at a hospital where one of the driver's infected relatives worked as a nurse.

Unable to comply

Although some – like the Jordanian driver – wilfully ignored safety precautions, many others were in no position to observe them, even with something as basic as keeping hands clean. In Sudan, mobile washing stations had to be set up for Khartoum's street dwellers, while in Libya the UN took on the task of providing thousands of bars of soap for displaced people living in camps.

There were economic pressures too: many had to choose between risking disease and loss of livelihood. In Kuwait, for example, hundreds of Nepalese taxi drivers found themselves compelled to keep working in order to survive. Businesses, meanwhile, faced temporary closure if any of their workforce were found to have the disease. In some countries they were supposed to report any suspected cases among employees, but if someone developed a cough it was very tempting to pretend not to have noticed and hope for the best.

Even if employers tried to make the workplace safe, they had little control over what happened during meal breaks or on the journey to work. Hundreds of women at strawberry-packing centres in Morocco were diagnosed with the virus. Many lived in surrounding villages and travelled to work in minibuses that were supposed to operate at only 50% seating capacity during the epidemic. According to a local development organisation, though, their drivers were in the habit of removing all the seats – thus cramming in as many as 40 standing passengers. This wasn't a simple case of drivers being greedy: if they left any of the women behind, they would be depriving them of income.

Social distancing is easier for the better-off – for those who have their own car and a home with rooms to spare – but in the teeming alleys of Cairo it's not a realistic proposition. The same applies in the wealthy Gulf states where millions of migrant workers live in cramped accommodation with shared washing facilities, sometimes with as many as 20 sleeping in a single room. These are conditions that Arab governments have allowed to develop over the years. They have benefited from cheap labour but now everyone is paying the price.

Social

Preventive measures

In the initial stages of the pandemic Arab governments sought to keep the virus at bay through border closures and other travel restrictions, but once it had taken root within the local community other measures became necessary. These mostly followed established principles for disease control and were broadly in line with World Health Organisation guidelines, though some countries were hampered by a lack of resources. Several were already in turmoil when the pandemic began and had other issues competing for attention. Algeria and Sudan were in the throes of a political transition, Lebanon was on the brink of economic collapse while armed conflicts in Yemen, Syria and Libya meant large parts of their territory were outside the recognised government's control.

The initial strategy of most Arab governments was to try to eradicate the virus from their territory, and robust action taken while the number of cases was still small offered the best chance of success. Confirmed infections in Jordan had barely reached double figures when King Abdullah activated the National Defence Law originally intended for times of war, which gave the prime minister extraordinary powers. As it came into force the military sealed off the capital, Amman, and isolated each of the country's 12 governorates. That was accompanied by a three-day round-the-clock curfew enforced by thousands of troops, during which anyone who stepped outside their home risked up to a year in jail.

Other Arab countries – Kuwait, Saudi Arabia and Tunisia – imposed night curfews around the same time but Jordan's action was the most extreme and at first the results were somewhat chaotic. Hundreds were arrested for violating the curfew. Plans for door-to-door deliveries of food didn't materialise and the government had to allow some shops to briefly reopen. Nevertheless, Jordan's initial curfew helped contain the virus at a critical moment and, perhaps more importantly, sent a strong signal to the public about the seriousness of the situation. Despite some subsequent problems, Jordan's daily count of new cases has still not risen beyond double figures.

Technology to the rescue?

The abrupt closure of borders in the early stages of the pandemic left tens of thousands of Arabs stranded outside their home country clamouring to be repatriated, and the Gulf states (among others) organised special flights to bring them back. All returnees were tested on arrival and those found to be positive were taken into quarantine for treatment or monitoring. That left thousands of others who had tested negative but might be in the undetectable incubation stage of the virus, and therefore needed to isolate. This raised the question of whether they could be trusted to isolate themselves properly at home.

The Gulf regimes like to be seen as embracing modernity and three of them turned to technology for help in ensuring compliance. In Bahrain and Kuwait people who had been ordered to isolate were made to wear "smart" wristbands which, working in conjunction with a phone app, would keep them under electronic surveillance.

Bahrain's system was designed to alert the authorities if the wearer of the wristband moved more than 15 metres from the relevant phone. The health ministry could also carry out spot checks by demanding selfies showing both face and wristband. Removing the wristband or tampering with it could result in a minimum jail sentence of three months and/or a fine of 10,000 dinars ($26,000).

The Kuwaiti app could also demand selfies and send out random messages, triggering an alert if no reply was received within five minutes. According to some user reviews, though, it didn't work particularly well.

The apps developed by Kuwait and Bahrain were criticised by Amnesty International which accused both countries of running "roughshod over people's privacy". While acknowledging that technology could be useful for tracking contacts, it said the apps were "essentially broadcasting the locations of users to a government database in real time", and this was "unlikely to be necessary and proportionate in the context of a public health response". The apps were certainly intrusive, but non-compliance was a real problem and the loss of privacy was offset to some extent by users not having to be locked away for two weeks in an isolation centre.

An example of the

In the United Arab Emirates, meanwhile, Dubai developed a much wider system of electronic surveillance but for a different purpose: monitoring compliance with its lockdown. This was technologically a lot simpler – it didn't need an app or a wristband, but it made everyday living very complicated.

Under Dubai's lockdown rules people were forbidden to leave their homes except for buying food and medicines or visiting a doctor. To do that, though, they needed permission from the police and the process began by registering their mobile phone on a police website along with their identity card details, their address and their car registration number. The next step was to apply online for the permit itself. Applicants had to say where they intended to go, at what time, and at what time they expected to return home. The application process had to be repeated for every trip outdoors.

Having all this data supplied in advance made it much easier for the police to check if people on the streets had a permit and whether they were complying with its terms. In a further effort to track illicit movement, Dubai's speed cameras were adjusted to photograph all vehicles using the roads – even if they were not speeding.

The resulting levels of surveillance were far in excess of what can be achieved by more conventional policing methods. In the current circumstances their purpose could be defended as benign – protecting the public from a potentially deadly illness – but that was no guarantee against its future use in different situations.

On a more positive note, the pandemic greatly accelerated two technological developments that were already under way and are likely to prove beneficial in the longer term: the shifts towards e-government and cashless transactions.

Reduced staffing of government offices – as a precaution against infection – led to many government services going online, especially in the Gulf states. Besides being more convenient, e-government simplifies people's dealings with the bureaucracy and, very importantly, reduces the opportunities for petty corruption by obstructive officials.

Various Arab governments have also been seeking to move towards a cashless society as a way of reducing fraud and corruption. “Digitalisation is the best weapon to fight corruption,” Tunisia's then-prime minister asserted in a speech last year. Covid-19 helped this along because of fears that the virus could be passed around on banknotes. Various countries issued rules requiring certain types of payment to be made electronically. In Saudi Arabia, cafes, restaurants and even taxi drivers were forbidden from accepting cash.

Hiding the virus

The statistics of infections and deaths issued by governments gave a general indication of whether the trend was up or down and how fast the virus was spreading, but it soon became clear that they did not reveal the full picture: there were often large numbers of unrecorded cases.

Some governments were accused of massaging the statistics to make them look better than they were, but the main issue was usually the availability of testing: countries with a low testing capacity tended to find fewer cases than those with a higher capacity. Levels of testing were not the only problem, though. There were also people with Covid-19 symptoms who for various reasons preferred not to make themselves known to the authorities.

The first Saudi cases were all people who had secretly – and illegally – visited Iran. Saudi Arabia doesn't allow its citizens to travel to Iran, though it has a large Shia minority who like to do so for religious reasons. They get around the ban by travelling via Bahrain or Kuwait and the Iranians, obligingly, don't stamp their passports when they arrive or leave – so there is no record of the trip. When it became clear that Iran was the main source of the infections, the Saudi authorities declared an amnesty for illicit travellers in the hope of encouraging them to come forward.

In Iraq, social stigma associated with the virus made people unwilling to be tested, according to Omar Dewachi, a medical anthropologist. Families feared being ostracised by friends and neighbours if one of their members was known to have been infected. For similar reasons there was resistance to recording deaths as Covid-related. "People are dying in their home without it being reported to the officials that this is a Covid-related death, or [the family] will not allow government officials to come and test," Dewachi said.

People with Covid-like symptoms were often reluctant to seek help from the Iraqi healthcare system. After decades of neglect it was in a sorry state and widely distrusted. Far from helping to contain the virus, Iraq's healthcare system contributed to its spread, according to one NGO. In order to keep the system running, medical staff were kept working when they should have been in isolation and hospitals were kept open when they should have been closed to prevent further infection.

There were also fears about people being taken into quarantine and never seen again. Dewachi explained: "There is a lot of suspicion around this issue of 'Where are you going to take our family member?'” The suspicion also has to do with the history of how healthcare quarantine cases have been dealt with over the past decades. Dewachi worked as a physician in Iraq during the 1990s and recalled that at the time people diagnosed with HIV/AIDS were sent to an isolation hospital that was guarded by the state, with armed men posted outside.

In Syria, too, the Assad regime appeared to be having difficulty persuading people with symptoms to come forward. The health ministry called on everyone to cooperate by seeking medical help if they had a fever, a cough and difficulty in breathing, and urged members of the public to report any suspected cases using a toll-free phone number. One problem in Syria was that when cases were reported security officials tended to take charge – making health workers and others reluctant to report potential new infections.

Fears about the virus escaping from quarantine centres and even burial grounds led to protests in several countries. News that quarantine facilities were being prepared at a hospital in the Yemeni city of Aden led to a sit-in by hospital workers while local residents demonstrated outside. A couple of months later, residents of Ta'izz protested outside a hospital where the city's first Covid-19 case was being treated – demanding that such cases should be transferred to "an empty area outside the city".

In Egypt those who died as a result of Covid-19 often had to be buried in secret or at night under police supervision. In April, when a 64-year-old female doctor died after being diagnosed with the disease, the first attempt to bury her was abandoned because of objections from residents in her hometown. The second attempt to bury her – this time in her husband's hometown – only succeeded after police used tear gas to disperse the protesters and arrested 23 people who were later given jail terms ranging from one to three years. A further 17 people who had escaped arrest were sentenced in their absence to ten years each.

Covid-19 burials also caused difficulties in Iraq, where some cemeteries refused to accept them. To overcome that, in the holy city of Najaf a new cemetery was established exclusively for Covid-19 victims, operated by a Shia militia with the aim of ensuring the bodies were given a religious burial. Even there, though, burials often took place at night and there was a shortage of people willing to help. One volunteer at the cemetery was quoted as saying he hadn't told his family what he was doing – for fear of being ostracised.

Yemen: Freshly-dug graves in al-Radwan cemetery, Aden, at the height of the city's epidemic

Eradication versus coexistence

So far, among the Arab countries, only Jordan and Tunisia have come close to achieving the original intention of eradicating the virus from their territory and both have recently suffered setbacks. Egypt, however, decided that this was a goal beyond its reach – mainly for economic reasons – and in May it announced a strategy of "coexistence" with the virus until a vaccine became available. In practice, that meant trying to contain the virus rather than eliminating it, thus reducing damage to the economy. Although Egypt was the only Arab country with coexistence as an explicit policy, as the pandemic continued others found themselves in a similar position despite efforts to eradicate the disease.

At first the six GCC states – Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the UAE – had some success in keeping the level of infections low, but that changed when the virus started spreading among migrant workers and since then progress has been slow. By late July Saudi Arabia had a higher number of confirmed cases than any other Arab country – more than 268,000. Qatar had the world's highest number of infections relative to its population; Bahrain had the third highest number, while Oman was ranked seventh worldwide and Kuwait eighth.

In their defence, though, they could point to very low death rates. Official figures from the GCC states, together with those from Jordan and Palestine, show that almost everyone recovered. Only about 1% of the closed cases ended in death. At the other end of the scale, several Arab countries had death rates in double figures: Sudan 11%, Syria 13%, Libya 14% and Yemen 36% (*see note).

Wide variations in death rates have been seen in other parts of the world too, for reasons which have not yet been fully explained. Availability and quality of medical care is undoubtedly a factor in some countries, but death rates can also be distorted if levels of testing are low and large numbers of non-fatal cases go undetected.

Judging the regimes

How the Arab public will view their governments' handling of the pandemic remains to be seen but the likelihood is that it will be judged more according to people's expectations than actual performance. Lack of effective action by the authorities in Yemen, Libya, Sudan and Iraq, for example, surprised no one and for their inhabitants Covid-19 was just one concern among many. In some parts of the region, though, expectations are higher and the regimes may be judged accordingly.

These raised expectations can be traced back to the Arab Spring uprisings of a decade ago, which toppled four entrenched regimes and caused the remaining ones to reflect on their survival prospects. The mass revolt signalled that the legitimacy of their rule – typically based on heredity, religion or nationalism – was wearing thin and they needed to pay more attention to how they were perceived by the public. While that hasn't made them more accountable or less repressive towards critics, there has been a conscious effort, especially in the Gulf, to highlight the more benevolent aspects of autocratic rule: in return for political quiescence the government aims to provide the public with a sense of wellbeing and contentment.

The UAE appointed Ohood bint Khalfan Roumi as the world's first Minister for Happiness

In 2016 the UAE became the first country in the world to appoint a Minister for Happiness. This was followed by the creation of a "National Happiness and Positivity Programme" and a "Happiness Index" aimed at making the UAE one of "the top five happiest countries" by 2021. In a similar vein, Saudi Arabia established a national Quality of Life" programme to "enhance the participation of citizens and residents in cultural, entertainment and sport activities" (though not in politics).

Having created these expectations, the question now is whether they can sustain their promises of happiness – not only while the pandemic lasts but also through a difficult aftermath when unpopular measures will probably be needed. The general expectation is that it will take some years to recover from the economic downturn and almost everyone is likely to be worse off as a result. Globalisation also makes the problem more intractable because no country is totally in control of its own economic destiny.

Reassurance is dangerous

The economic adjustment in the wake of the pandemic is clearly going to be painful and will make more demands on the Arab public. To avoid trouble the regimes will, at the very least, need to ensure that the public understand what is being done, and why. But the difficulties the regimes have experienced securing compliance in relation to the virus so far are not an encouraging sign.

Faced with a crisis, the first instinct of authoritarian regimes is to deny that anything is amiss. When that fails, their second line of defence is to insist everything is under control. And when that fails too, they blame sinister external forces.

The Covid-19 crisis was a bit different, though. Since it was clearly a global problem there was no point in Arab countries pretending to be unaffected or blaming their enemies, and while their natural inclination was to reassure the public and assert that they were in control, there were dangers in doing so. In order to secure compliance they needed to convince people that strong preventive measures were necessary – and the way to do that was not by reassurance but by spreading alarm.

This was the nub of their compliance problem: widespread unwillingness to comply was a sign that the public were not alarmed enough. Governments were often far too eager to focus on positive messages, such as the numbers of people who had recovered from the virus or the authorities' efforts to create a safe environment by disinfecting streets and buses.

Experience from elsewhere, plus evidence from behavioural psychologists, has shown that the public respond best in an emergency when they are convinced of the seriousness of the situation but in the absence of trust between the public and regimes, the regimes placed their reliance on enforcement rather than persuasion – and it didn't work.

In steering a course through the aftermath of the pandemic, Arab regimes will again be seeking forbearance from the public, perhaps even more so than during the pandemic itself. To succeed, they will have to be honest with the public and show a degree of transparency that they haven't shown so far.

 

*Note: Death rates are based on figures from Worldometer on 9 August 2020 and calculated as a percentage of closed cases. The number of closed cases is obtained by deducting “active cases” from total confirmed cases.

● This article was first published by Culturico