A Conversation With the WHO Representative in Syria
In April of this year, Dr. Akjemal Magtymova reached out to me with an offer to explain in detail, from her perspective, the World Health Organization’s role in Syria — particularly in the context of the COVID-19 pandemic.
Dr. Magtymova is an OB/GYN by training, but has worked in international healthcare administration — largely for the United Nations (UN) and the associated World Health Organization (WHO) body — in some form since the late 1990s. She was previously the WHO representative for Oman, but has served as WHO representative to Syria since April 2020.
In this capacity, she works out of the WHO offices on Al-Jalaa Street in the Abu Rummaneh district of Damascus, an upscale area which hosts most embassies and foreign missions in the city. Visiting diplomats can grab a drink or a bite to eat at any one of the many bars, restaurants, and cafés dotting the neighborhood — like Karma café, or Gemini steakhouse. Those feeling especially adventurous can even try out the local “escape room,” where small teams are locked in a room and must solve a series of puzzles before time expires in order to escape.
It is this backdrop — not the charred piles of rubble just kilometers away, or the countless prisoners languishing shoulder-to-shoulder in any of the detention centers from the big three intelligence services scattered across the city — upon which foreign diplomats in Damascus engage. Yet naturally, this thin veneer of modern society must be tightly controlled so as not to expose the grand illusion hidden neatly away just around the corner.
Indeed, any foreign group working in the city must necessarily do so under the strict watch of mukhabarat, intelligence agents from the Assad regime’s omnipresent security state. In Damascus, they say, the walls have ears — at least those spots on the walls unscathed by blood and bullet holes.
A good example of this dynamic can be found in the Syrian Arab Red Crescent (SARC), a WHO partner organization and the local branch of the International Federation for Red Cross & Red Crescent Societies (IFRC). The SARC was credibly accused of collaborating in the Assad regime’s 2012 siege of Homs, in which the journalist Marie Colvin was targeted and assassinated, by providing evacuation channels which in fact delivered residents under siege directly into regime detention. The journalist Paul Conroy, who worked alongside Colvin up until her assassination, has often recounted how he was given an opportunity to evacuate Homs on a SARC ambulance during the siege, but refused after being warned that doing so would result in his kidnapping.
In recent years, residents of Rukban camp on the far eastern expanse of the Syrian desert have told me the same thing, explaining that intelligence officers regularly ride along on these convoys and often push for camp residents to “return” to regime-held Syria — which is widely taken to mean being sent into regime detention and subjected to torture or death. A US-based humanitarian group working on several programs in Rukban camp would later confirm to me that it has tracked numerous Rukban camp residents who were offered a chance to “return” to regime-held Syria in a SARC convoy, only to be transferred into regime detention, where they face torture and potential execution.
Dr. Magtymova would go on to tell me that in 2020, approximately 19,000 residents of Rukban camp were “returned” to regime-held areas. She would not acknowledge allegations of kidnapping by intelligence officers, which has been ongoing long before the 2020 COVID-19 outbreak, but described some of these residents as being held in “quarantine facilities” in regime-controlled territory.
Across all levels of the UN interagency, a certain degree of collaboration with regime institutions occurs, but it is often among humanitarian aid organizations where this abuse is most visible. The WHO is not obligated, for example, to appoint Assad’s health minister to its Executive Board of advisors, as it did yesterday— but if it seeks to operate in any capacity in Damascus, it must necessarily collaborate with the regime’s institutionalized method of hijacking and weaponizing humanitarian aid in Syria.
In preparing to speak with Dr. Magtymova, this institutional collaboration with the processes of aid abuse was my primary focus. After a back-and-forth with two of her assistants to set up the meeting, which was done via voice call on Microsoft Teams, I prepared a slew of questions and studied various background reports into WHO operations in Syria to gauge the situation. In short measure, I opened with a series of interrogative questions about the nature of WHO operations in Syria.
This perhaps caught her off guard, as she rather quickly sought to clarify the intent and purpose of our discussion: although she had been the one who initially reached out to me, I explained that for the purposes of publication, our “interview” would not be published in full, and that she could go off the record at any time — but that I might use some principal takeaways from our conversation in a later piece.
She agreed, though not after a conspicuous series of clicks and a sudden echo. I considered saying hello to the intelligence officer in the background, but quickly thought better of it. (Later on during the course of our nearly hour-long discussion, the same conspicuous series of clicks and sudden echo would periodically reappear — usually after I broached a sensitive subject.)
The bulk of our conversation was mostly diplomatic, consisting of a careful, highly managed explanation of WHO processes and operations in Syria — something you’d expect from a standard-fare press briefing, not to mention a phone call being listened in on by security agents. Rarely did her answers diverge from what the WHO writes in its press releases and mission notes, and she explained these processes with a certain emotional energy, upbeat but restrained, the sort befitting of a career diplomat.
Indeed, throughout the discussion Dr. Magtymova made sure to clarify repeatedly her substantial background and expertise in, as she saw it, “healthcare diplomacy.” At one point, she launched into an extensive aside about how during one of her previous assignments in another country, she successfully negotiated a tense situation with gun-wielding men over a cup of coffee by simply listening to what they had to say. Listening, from the perspective of Dr. Magtymova, is perhaps the most important element of diplomacy. It is what brings together a broad array of competing interests for the good of all involved.
From my perspective, practical outcomes seemed a more important factor than personal diplomacy. When Dr. Magtymova told me that “nothing is more important than the battle of COVID-19,” I pressed her to explain the WHO’s vaccine distribution plan for Syria. Beyond healthcare workers, she said, IDP camps in SDF-held northeast Syria would be the WHO’s priority for vaccinations moving forward. Idlib and the northwest would receive relatively little aid, which would be provided primarily via the Bab al-Hawa crossing between Syria and Turkey. (Two weeks after our conversation, a small shipment of several thousand vaccines provided via the WHO-managed COVAX program finally arrived in Idlib from the Turkish border crossing.)
When asked to explain why these inequities in vaccine distribution exist, Dr. Magtymova touted the WHO’s work in establishing a “global vaccine supply chain,” but decried the “chilling effect of sanctions” as having a significant impact on their vaccine distribution in Syria, ostensibly a result of profit-oriented supply chains perceiving certain market risks in the country. When I pressed her to provide examples of this supposed “chilling effect” sanctions have had in the country, she refused, citing operational security concerns among the WHO’s partner organizations in Syria.
Nearing the end of our discussion, I asked Dr. Magtymova about vaccine access to prisons, noting the hundreds of thousands actively being held in detention across Syria. Packing dozens of prisoners shoulder-to-shoulder in a single small room is an essential aspect of detention in regime-held areas, and one which has been institutionalized across nearly every branch of the regime’s detention apparatus. Logically, such systemic overcrowding must also promote outbreaks of coronavirus.
After another conspicuous series of clicks and a sudden echo, she explained that she tries to alert the ICRC to outbreaks of COVID-19 in prisons, but said she might have to work personally with “prison agencies” in order to prevent future outbreaks.
Then, remarkably, she diverged from the subject, launching into a lengthy tirade about the perception of various prison systems across the country. While people think of Assad’s prisons as bad, she told me, other prisons — like the SDF-managed Al Hol camp — are far worse. Al Hol, as she repeatedly described it, was actually a “concentration camp,” a hotbed of extremism where “children have been brainwashed” into supporting militant groups like the Islamic State. It was camps like these, not the regime’s prisons, which Dr. Magtymova brashly suggested I focus my attention on.
I figured this was as good a time to stop as any. I politely ended our conversation, promising Dr. Magtymova that, after all, she had provided some truly fascinating insights into WHO operations in Syria.
Revised, 5/2023: A previous version of this article contained the line “for the purposes of publication, our ‘interview’ would be off the record — but […] I might use some principal takeaways from our conversation in a later piece.” (para 11). This sentence has been updated to accurately reflect the nature of the conversation, which took place on record alongside an (oft-exercised) option for on-background commentary.
