In Syria, facing cholera and corruption

In Syria, the world adapts to Bashar al-Assad’s survival.

a child pours water into a bucket
Some 650 million people, or one in 10 of the world's population, have no access to safe water, putting them at risk of infectious diseases and premature death [Khalil Ashawi/Reuters]

When a war is forgotten, the problems do not go away. In Syria, a cholera outbreak could threaten the whole region, just as the World Health Organization is investigating complaints of corruption from within its ranks. Meanwhile, the ways in which the world has adapted to the Syrian government’s survival are coming into the spotlight, as Syria’s neighbours are starting to return leader Bashar al-Assad to the fold.

In this episode: 

  • Zeina Khodr (@ZeinakhodrAljaz), Al Jazeera English correspondent
  • Maria Cheng (@mylcheng), Associated Press medical writer
  • Bassam Barabandi (@BASSAMVA), co-founder of People Demand Change

Connect with us:

@AJEPodcasts on Twitter, Instagram, and Facebook

Full episode transcript:

This transcript was created using AI. It’s been reviewed by humans, but it might contain errors. Please let us know if you have any corrections or questions, our email is 

Halla Mohieddeen: When a war is forgotten, the problems don’t go away – they grow. In Syria, there’s been hardly any reconstruction to crumbling infrastructure, and now a cholera outbreak is threatening the whole region. At the same time, the ways in which the world has adapted to the Syrian government’s survival are coming into the spotlight. The United Nations has been accused of corruption in Syria, this time at the World Health Organization.

Newsreel: Corruption, misuse of funds, currying favours, and paying and providing projects to regime actors themselves.

Bassam Barabandi: They are hiring the people who are killing us at the UN to deal with us.

Halla Mohieddeen: And Syria’s neighbours are starting to re-engage with leader Bashar al-Assad. So what does all of this mean for the Syrian people? I’m Halla Mohieddeen and this is The Take.



Halla Mohieddeen: We’re talking today to three people about the lay of the land in Syria. And it’s fragmented. Assad has regained much of the military control, and controls around 70% of the population. And he is starting to regain some footing diplomatically. That’s as the humanitarian situation is growing more urgent – even while the international response is under criticism. I heard first from Al Jazeera correspondent Zeina Khodr, who’s been covering Syria for years.

Halla Mohieddeen: Let’s start with the situation on the ground in Syria. The cholera outbreak is getting worse and it’s even spread next door to Lebanon. How did it start in the first place?

Zeina Khodr: Yes, it is a serious health emergency. The United Nations is warning that the outbreak, you know, could be catastrophic, threatening the lives of many, many people. It was detected in the northern city of Aleppo back in August, and it has since spread across the country. We’re talking about thousands of cases and dozens of deaths already.

Halla Mohieddeen: This is Ahmad al-Mohammad in the eastern province of Deir Ezzor.

Ahmad al-Mohammad: I’ve suffered from diarrhoea, vomiting and a lot of pain… I don’t have any strength left. I can’t walk, I have no strength. I’ve lost a lot of energy. The water’s polluted. We drink straight from the Euphrates River. There are no services at all. 

Zeina Khodr: As we know, cholera spreads where there is no clean water and two-thirds of serious water treatment plants have been damaged by the war.

Newsreel: The UN says the war has caused extensive damage to water pipes, and more than half the healthcare facilities aren’t functioning.

Zeina Khodr: It has reached across the country. All the governorates, there have been reported cases and people are afraid because this is treatable. But much of the health sector has been destroyed by war. And so, international organisations have stepped in. They’re trying to provide as much help as possible to be able to contain it. But like you said, it has already spread to Lebanon.

Halla Mohieddeen: We’ll hear more from Zeina later in the episode. But to understand the threats to public health in Syria, we reached out to journalist Maria Cheng.

Maria Cheng: I’m the medical reporter for the Associated Press based in London.

Halla Mohieddeen: The most immediate problem is that there’s a shortage of cholera vaccine. So much so that the WHO recently announced it was changing its two dose recommendation down to one. Here’s Dr. Tedros Adhanom Ghebreyesus, the WHO Director General.

Dr. Tedros Adhanom Ghebreyesus: The one dose strategy has proven effective in previous outbreaks, although evidence on how long protection lasts is limited.

Halla Mohieddeen: Years ago, one of the two vaccine suppliers announced that it was going to shut down production. But now that shutdown is playing out at the same time as a global surge in cholera fueled by extreme weather and floods. Maria explained the fallout.

Maria Cheng: It was an Indian subsidiary of Sanofi Pester. You know, there’s been a lot of speculation that they are likely shutting down because this is not a profitable space in the market for them. And certainly the global market for cholera vaccines is going to be countries that don’t have good water sanitation. These are not countries that typically have a lot of money to spend. And it’s donors like UNICEF, Red Cross, WHO, that buy the cholera vaccines for global use. So it’s not going to be a profit making operation for them.

Halla Mohieddeen: Another problem is trust in the World Health Organization itself. Maria led an AP investigation focusing on Syria that just published some of the most detailed evidence to date of the agency’s alleged corruption.

Maria Cheng: Based on more than a hundred confidential emails, documents, recordings, other materials from WHO staffers in Syria, who over the past year have expressed grave concerns to WHO about potential misconduct of the director of the Syria office, including misappropriation of funds, abuse of conduct, and things like buying inappropriate gifts for Syrian government officials. They were concerned because this is an office obviously, that serves a population that is in dire need of humanitarian aid. And the office has a budget of about $150m.

This handout picture released by the Syrian Presidency, shows Syia's President Bashar al-Assad (R) receiving Hamas chief of Arab relations, Khalil al-Hayya (C) and the leader of Palestinian militant group Islamic Jihad, Ziad al-Nakhala (L) in the capital Damascus, on October 19, 2022.
This handout picture released by the Syrian Presidency, shows Syia’s President Bashar al-Assad (R) receiving Hamas chief of Arab relations, Khalil al-Hayya (C) and the leader of Palestinian militant group Islamic Jihad, Ziad al-Nakhala (L) in the capital Damascus, on October 19, 2022. [Photo by Syrian Presidency Facebook page/AFP]


Halla Mohieddeen: WHO is part of the United Nations, and it’s funded largely by donor countries. In Syria, the WHO representative is a doctor named Akjemal Magtymova. Here she is speaking in a promotional video in March.

Akjemal Magtymova: The huge proportion of WHO’s work is supply of humanitarian health supplies, equipment, regions. And this is especially true in humanitarian emergencies. 

Maria Cheng: She’s been at the WHO for a long time. She’s originally from Turkmenistan. She’s a gynaecologist by training. And she’s held several WHO roles.

Halla Mohieddeen: Magtymova joined WHO Syria in May 2020.

Maria Cheng: So at a very critical time during COVID 19.

Halla Mohieddeen: The first allegation against her that caught Maria’s attention was back in 2021.

Maria Cheng: People started telling me about this party that was held at Four Seasons in Damascus. First of all, it kind of raised my attention because this was April, 2021 and if you think back, it’s a time when many countries had very strict COVID restrictions in place, no social gatherings, you know, always be masks and things like that.

Halla Mohieddeen: So this $11,000 party at a luxury hotel, paid for by WHO, was news to Maria. She heard from her sources that the party was ostensibly for health workers.

Maria Cheng: But I was told that it focused really on this award that she herself had been given.

Halla Mohieddeen: The hotel itself is another problem – because of its owner’s relationship to the Assad government.

Maria Cheng: Most of the UN staff stays there because it is one of the only safe places to stay. The UN says Syria obviously being a conflict area. But the ownership of that hotel has come into question because it is a corporation that’s allied withPresident Bashar al-Assad. So the US and the EU and other countries have levelled sanctions against this group that owns the hotel. And there were concerns about it, not only because of that, but because of the cost. Obviously Syria is a place where more than 90% of the population lives in poverty.

Halla Mohieddeen: What Maria heard was that Dr. Magtymova was spending a lot of WHO money on hotel accommodation: a suite.

Maria Cheng: Which was more than four times what other staff were staying in. So whether or not that’s justifiable that’s up to the UN and donor countries to decide. But it is something that was raised repeatedly by staff that this was potentially a misuse of funds.

Syria's President Bashar al-Assad meets with Hamas politburo member Khalil al-Hayya in Damascus, Syria, in this handout released by SANA on October 19, 2022.
Syria’s President Bashar al-Assad meets with Hamas politburo member Khalil al-Hayya in Damascus, Syria, in this handout released by SANA on October 19, 2022. [SANA/Handout via Reuters]


Halla Mohieddeen: Maria’s investigation also found concerns from staffers not only that Dr. Magtymova may personally be benefiting, but also that the Syrian government was benefiting from WHO resources as well.

Maria Cheng: There were concerns that WHO was allied a bit too closely with the Syrian government. WHO’s been continually criticised for this. I mean, it’s difficult for any agency to operate in a conflict ridden area.

Halla Mohieddeen: Often international agencies have to work more closely with authoritarian governments than might be preferable in order to get access to people in harm’s way. And in Syria, it’s been a big problem. UN officials have accused the Syrian government of using aid as a weapon of war. But the problems can also be internal.

Maria Cheng: The concerns we heard from staffers were that she pressured WHO staff to hire the relatives of high ranking Syrian officials. There were complaints from several people that she met secretly with the Russian government, including the military, and that those meetings were kept off her official agenda for reasons that we don’t know. And that they had pressure to sign contracts for fuel, for example with people allied with the Syrian government or who are highly placed in the Syrian government.

Halla Mohieddeen: The allegations were serious enough that Maria says WHO has undertaken one of its largest internal investigations in years. We asked WHO about these allegations and a spokesman told us they take them extremely seriously, but could not comment further on the details because their internal investigation is still ongoing.

Halla Mohieddeen: For Syrians, however, all of this corruption at the WHO doesn’t look like anything new.

Bassam Barabandi: My name is Bassam Barabandi, I’m a former Syrian diplomat. I’m living now in Washington, DC.

Halla Mohieddeen: You heard him at the start of the episode, talking about the UN.

Bassam Barabandi: As a diplomat, I worked something like 20 years with the Syrian government. I work in the UN, then the embassy to China, then to DC.

Halla Mohieddeen: And Bassam’s opinion, based on his years of observation, is that the UN system allowed this to happen.

Bassam Barabandi: There’s no transparency. They always think that if there’s a corrupt system, we have to work with the corruption in order to achieve our mission.

Halla Mohieddeen: One way this plays out, he says, is through the Syrian government’s control of access to the country. They control the visas.

Bassam Barabandi: The regime don’t issue visa for the people to come to Syria if they don’t fit its own narrative. If you get someone with history of transparency and blah, blah, blah, there’s no way to get the visa. And the UN high level in New York, we always tell them. They always need some scandals to say, wow, that’s sad. But everybody knows this situation.

Halla Mohieddeen: But Bassam does still think this new investigation has broken ground because of the information from inside WHO.

Bassam Barabandi: The biggest difference is that it has more legal evidence from inside to say we are corrupted.

Halla Mohieddeen: For Maria, the reporter who led the AP investigation, the question now is if WHO will be held to account or risk facing further loss of trust.

Maria Cheng: WHO is a critically important public health institution. We depend on this agency to lead the response to global health crises. And there have been repeated instances of serious allegations of misconduct in various offices. And it’s unclear whether or not they have prompted real change at WHO. As we noted in the Syria story, Dr. Magtymova remains in place. She is officially still a SIR representative. She is still being paid a director level salary. So there are serious concerns about how accountable WHO is.

Halla Mohieddeen: One effect of health crises like cholera is that they draw the international community in further with the Syrian government. From industrial-scale torture and detention to starvation as a weapon of war, the Syrian government’s abuses are well-known. But the WHO isn’t the only one facing criticism. That’s after the break.

Patients receive treatment at a recently-opened medical center for Cholera cases in the Syrian town of Darkush, on the outskirts of the rebel-held northwestern province of Idlib, on October 22, 2022.
Patients receive treatment at a recently-opened medical center for Cholera cases in the Syrian town of Darkush, on the outskirts of the rebel-held northwestern province of Idlib, on October 22, 2022. [Aaref Watad/AFP]


Halla Mohieddeen: More and more, dealing directly with the Syrian government is on the rise, as Syria’s neighbours face a future with Assad in it. To hear more about how Syria’s foreign relations are changing, we need a quick recap of what they’ve been.The Syrian government is backed in large part by Iran and Russia, while Arab countries have been split. And Al Jazeera’s Zeina Khodr says to understand Syria’s future, you need to understand which countries have a say in its fate.

Zeina Khodr: This is a country where there’s more than one foreign army. What you’re talking about the Iranians, the Russians, the Americans, the Turks, and they’re going to have to decide the end game. And right now it’s not a priority. The balance of power is going to have to change one way or another for something to move.

Halla Mohieddeen: At the same time, there has been some movement diplomatically. Can you tell me about the Palestinian Group, Hamas?

Newsreel: Hamas delegation is visiting Syria today for the first time in 10 years.

Halla Mohieddeen: They made an official visit to Damascus last week. And before 2012, Hamas had made its main political base there – so that’s quite a big deal isn’t it?

Zeina Khodr: Well Assad, the Syrian president, he’s been gradually restoring relations with some Arab countries as of late. There’s like this growing sense, if you like, that the regime has prevailed and the latest reconciliation is with them.

Halla Mohieddeen: Just so I’m clear, so why is Hamas doing a u-turn? What’s prompted Hamas’ change of position?

Zeina Khodr: I mean, Iran played a big role here. Iran being the closest ally to the Syrian president. Of course, there’s also Russia. Iran and its local ally here in Lebanon, Hezbollah as well. They played a role. You know, in their view, Hamas should belong in the quote unquote, or what they call the axis of resistance against Israel. So this was a move by Iran, if you like to show you know that their camp is strong and more players are joining their camp.

Halla Mohieddeen: As for the Arab countries, the one at the forefront of bringing Assad back into the fold is the United Arab Emirates. The UAE is part of a regional cold war with Iran, so engaging with Assad is a great way for them to try to counter Iran’s influence.

Zeina Khodr: The UAE was among the first Arab countries to restore diplomatic relations with Syria. It was a few years back, but the UAE foreign Minister visited Damascus and was greeted by the Syrian president. And then the Syrian president later travelling to the UAE.

Halla Mohieddeen: That was back in March.

Newsreel: The visit sends a signal that the Arab world is now willing to reengage with Syria’s once widely shunned president.

Zeina Khodr: The first country he visited, aside of course Russia and Iran, during the course of the war. It’s really, for the regime, it’s a battle now for credibility and legitimacy. It’s been shunned by much of the world because of its brutal crackdown. And in fact, that’s why it even lost its membership in the Arab league.

Halla Mohieddeen: Syria’s membership was suspended back in 2011. But some countries are pushing for it to be reinstated.

Zeina Khodr: The Arab League is going to hold their annual summit in a few days and it’s just such a polarised region that they don’t agree on anything. And this comes within that.

Halla Mohieddeen: Where does all the politics of this leave the people who are suffering from cholera or the refugees that neighbouring countries want to return home sooner rather than later?

Zeina Khodr: Vulnerable, alone. I mean, yeah you speak refugees. I mean,  here in Lebanon, they’re just not welcome. And the situation is similar in Turkey. The government uses them as some sort of a scapegoat for their failures here in Lebanon.

Halla Mohieddeen: Just on Wednesday, hundreds of Syrian refugees returned home from Lebanon. It was the first official repatriation since the pandemic began. And that has people worried.

Zeina Khodr: A lot of people here, Syrians, are from Homs or the Damascus countryside areas, which were the epicentre of the rebellion against the regime. So these people are not welcome back. So they’re worried and they feel that the international community has abandoned them, and that’s the way they felt for years. You know, they feel that if the international community stood by their side, they would’ve won the war a long, long time ago. So right now they’re concerned and they’re weak.

An aerial picture shows a view of a recently-opened medical center for Cholera cases in the Syrian town of Darkush, on the outskirts of the rebel-held northwestern province of Idlib, on October 22, 2022. United Nations.
An aerial picture shows a view of a recently-opened medical center for Cholera cases in the Syrian town of Darkush, on the outskirts of the rebel-held northwestern province of Idlib, on October 22, 2022. United Nations. [Aaref Watad/AFP]


Zeina Khodr: And, yeah, they’re just waiting just to see, you know, if they are going to be forced back. But it’s unlikely to happen because at the end of the day, Lebanon relies on support from the international community. It’s not just going to put, you know, tens of thousands of refugees and push them back to Syria. It’s not going to happen that way.

Halla Mohieddeen: Is Syria a safe country to return them to?

Zeina Khodr: No, it’s not. There are no security guarantees. There have been many cases and documentation of people who have returned going back to prison. I’ll just give you one example.

Halla Mohieddeen: Zeina mentioned a boat that capsized off the coast of Syria on September 23. More than 100 people died.

Zeina Khodr: There were a few survivors when that boat capsized, right? Some of them were Syrian. They never return home. Their families are asking, where are they? These are survivors from a boat that sunk off the coast of Syria. They were found, taken to hospital, and now they have disappeared.

Halla Mohieddeen: How awful. You’ve been covering all this for so long, Zeina and we always ask you this, but does it feel like a new chapter in the stalemate?

Zeina Khodr: No not yet. In other wars, there could be some sort of a peace treaty or a political settlement and people move on. I’m not sure about Syria. I’m not sure that people can actually live together again. There has been so much demographic changes on the ground. People, the movement of people from one area to another, the movement of communities, whether they are religious communities. The divide is just so deep. I just, it’s very hard to see what kind of an end game, when you have these different groups unable to even, you know, sit on the same table and never mind live side by side.

Halla Mohieddeen: And that’s The Take. This episode was produced by Alexandra Locke with Chloe K. Li, Amy Walters, Ashish Malhotra, Negin Owliaei, Ruby Zaman and me, Halla Mohieddeen. Alex Roldan is our sound designer. Aya Emileik and Adam Abou-Gad are our engagement producers. And Ney Alvarez is Al Jazeera’s head of audio.

Episode credits:

This episode was produced by Alexandra Locke with Chloe K. Li and our host, Halla Mohieddeen. Chloe K. Li and Negin Owliaei fact-checked this episode.

Our production team includes Chloe K. Li, Alexandra Locke, Ashish Malhotra, Negin Owliaei, Amy Walters, and Ruby Zaman. Our sound designer is Alex Roldan. Aya Elmileik and Adam Abou-Gad are our engagement producers. Ney Alvarez is Al Jazeera’s head of audio.

Source: Al Jazeera