"Syria would prefer that, if and when AIDS does become a problem, a Western country gets the blame."
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In a basically reasonable account, the Ministry of Health thus manages to lay the blame for AIDS on the convenient scapegoats of America and the gay community. Every pamphlet printed, every policy implemented, and every advertisement published has carefully calculated goals. Even the location and condition of the AIDS Prevention Center in Damascus serves the government’s purpose: By not maintaining the building and its grounds, by not advertising its location or its hours, the Ministry of Health gives the impression that it feels no concern about the possible emergence of AIDS in Syria.
What are the government’s goals regarding the possible spread of AIDS? First, it continually protects Syria to the best of its ability through a regimen of mandatory testing for many categories of people. Second, since it cannot afford to divert resources from the budget, which is already strained by military needs, the government keeps HIV testing as economical as possible. It uses a communal testing system that, in the government’s view, does not overly increase risk. Third, it would prefer that, if and when AIDS does become a problem, a Western country such as the United States gets the blame. Syria maintains a pragmatic attitude toward achieving these goals.
Syria has had success in preventing the internal spread of AIDS, but it has also been quite lucky: the country lacks several important risk factors for the disease. Prostitution exists (I’ve been propositioned), but it is not a large industry; injection drug use is unmentionable, even among most young and disenchanted elements of society. The Health Ministry mainly worries about foreigners like myself entering the country and spreading the virus.
My time in Syria left me feeling very uncomfortable with the government’s attitude toward public health. Health policy on AIDS – and on other issues like clean air and water – seems entirely subservient to the primary political aim of those in power: maintaining the domestic legitimacy and stability of the regime. In an abstract way, I have a certain appreciation for the government’s clarity of vision, for the way it picks narrow public health goals and uses its limited resources efficiently and even innovatively to accomplish them. But I am troubled by the goals themselves, which often have little to do with public health, and also by many of the government’s methods, which raise serious ethical concerns about privacy and human rights.
Syria’s ulterior motives for its health policies diminish the pride and morale of people working in the country’s public health field. They also suggest a troubling scenario for how the country would react to an AIDS outbreak. Its health system is structured to keep the virus out using any available means, not to provide infected citizens with treatment and support. Syria could easily respond with rapid and severe measures that take no concern for civil liberties or for a patient’s quality of life. Where health policy is so closely connected to political control, the international community should be concerned that, in a crisis, human rights may be the first thing to go.
Nahaliel Kanfer is a junior in Jonathan Edwards College.