VIENNA/PARIS: Iran is responding to last week’s UN nuclear watchdog board resolution against it by expanding its uranium-enrichment capacity at two underground sites, but the escalation is not as big as many had feared, diplomats said on Wednesday.
Iran bristles at such resolutions by the International Atomic Energy Agency’s 35-nation Board of Governors, and it reacted to the previous one 18 months earlier by enriching to up to 60 percent purity, close to weapons grade, at a second site and announcing a large expansion of its enrichment program.
This time it plans to install more cascades, or clusters, of centrifuges, the machines that enrich uranium, at both its underground enrichment sites, five diplomats said. IAEA inspectors observing Iran’s progress plan to issue a report to member states on Thursday, three of the diplomats said.
“It’s not as much as I would expect,” one Vienna-based diplomat said, referring to the scale of Iran’s escalation.
“Why? I don’t know. Maybe they’re waiting for the new government,” they said, referring to the death in a helicopter crash last month of Iranian President Ebrahim Raisi and Foreign Minister Hossein Amirabdollahian, and the presidential election due to be held on June 28.
The IAEA Board passed a resolution a week ago calling on Iran to step up cooperation with the IAEA and reverse its recent barring of inspectors despite earlier US concerns Tehran would respond with atomic escalation. Only Russia and China opposed.
Diplomats did not go into specifics on the number or type of centrifuges being added or what level they would enrich to, though one diplomat said they would not be used to quickly expand Iran’s production of uranium enriched to up to 60 percent, close to the 90 percent of weapons grade.
The diplomats said they would wait to see what the IAEA said Iran had actually done but they were aware of Iran’s plans.
The move is “at the lower end of expectations and something we’re pretty sure they were going to do anyway,” one diplomat said, meaning it would have happened even without the resolution.
Iran did not fully follow through on its November 2022 announcement after the previous resolution. While it installed all the centrifuges it said it would at its underground enrichment plant at Natanz, 12 cascades of one advanced model, the IR-2m, are not yet in operation.
Iran is only enriching to up to 60 percent at an above-ground pilot plant at Natanz and its Fordow site, which is dug into a mountain. In November 2022 it started enriching to up to 60 percent at Fordow but it has yet to install all the additional cascades it said it would.

LONDON: More than a decade of civil war, economic sanctions, regional tensions, and a devastating earthquake have left Syria’s healthcare system in tatters and, according to a top World Health Organization official, forgotten by the international community.

Hanan Balkhy, WHO’s regional director for the Eastern Mediterranean, said last week that almost half of Syria’s health workers had fled the war-torn country. She called for innovative approaches to halt the exodus of Syrian medical staff abroad.

In an interview with the AFP news agency, she said that young doctors needed to be offered better prospects than practicing “fourth-century” medicine amid dire conditions, “where you cauterize people and send them on their merry way.”

The International Rescue Committee highlighted in a 2021 report that about 70 percent of the medical workforce had fled the country, leaving one doctor for every 10,000 people.

Balkhy told AFP that in addition to earning extremely low wages, if any at all, Syria’s medical staff faced a severe shortage of resources and equipment, including operating rooms, sterilization units, and medications.

However, according Dr. Zaher Sahloul, a Syrian-American critical care specialist and president of the medical NGO MedGlobal, every young Syrian physician he knows either plans to or dreams of leaving Syria and pursuing opportunities in other countries, “especially Germany, other European nations, or the US.”

“The flight is across the board and not related to war or conflict,” he told Arab News.

According to data released by the German Medical Association earlier this year, 6,120 Syrian doctors work in Germany without holding a German passport. These doctors account for 10 percent of the EU country’s foreign medical staff.

Balkhy said many young doctors in Syria are learning the German language on the side “so that they can be ready to jump,” which she believes is a significant concern for the region and its population.

But she also believes that finding creative solutions may encourage Syrian doctors to stay or return to their country — a choice she says many would make “willingly” with access to adequate support.

Sahloul says the main reasons behind the exodus of medical workers “are the economic collapse, hyperinflation, corruption, the collapse of the healthcare system due to long years of war, the regime’s policies of destroying what is left and pushing away anyone who wants to leave, and the lack of a viable political solution.”

Following a brief visit to the country between May 11 and 16, WHO’s Balkhy described the healthcare situation as “catastrophic,” warning that the number of people in need is “staggering, and pockets of critical vulnerabilities persist in many parts of the country.”

In a statement published on May 18, the WHO official wrote that intensifying tensions in the region, including the Israeli operation in the Gaza Strip and the Iran-Israel shadow war, have exacerbated this catastrophic situation.

The civil war has forced more than 14 million Syrians to flee their homes and seek refuge both within the country and beyond its borders. Among them, more than 7.2 million remain internally displaced, while about 70 percent of the population needs humanitarian assistance, according to UN figures.

Balkhy said in her statement that she was “extremely alarmed” by the increasing malnutrition rates among children under 5 and nursing mothers as a result of rising poverty.

The UN warned last year that 90 percent of Syria’s population lived below the poverty line, with millions facing a reduction in food rations due to a shortfall in funding for aid agencies.

According to the WHO regional director, almost three-quarters of all deaths in Syria are caused by chronic conditions, including cancer, cardiovascular diseases, diabetes, and mental health disorders, many of which are going untreated.

She also noted the number of burn injuries in Syria has been disproportionately high, especially among children, as people, deprived of traditional means of heating and cooking, burn unsuitable materials, such as tires, plastics, and fabrics.

Fumes produced by burning these substances also result in respiratory issues.

With just 65 percent of hospitals and 62 percent of primary healthcare centers fully operational, combined with a severe shortage of essential medicines and medical equipment, access to healthcare is constrained.

Before the war erupted in 2011, Syria’s pharmaceutical industry covered about 90 percent of the national needs of medicines, according to a 2010 paper by academics from the University of Medicine and Pharmacy in Romania.

In 2013, WHO reported that the country’s local drug production plunged after the fighting caused substantial damage to pharmaceutical plants in the governorates of Aleppo and rural Damascus.

Poverty also creates significant barriers to accessing medical services and affording essential medicines, said Balkhy.

What concerned her most was “the fact that almost half of the health workforce, which forms the backbone of any health system, has left the country.”

An investigation by Arab Reporters for Investigative Journalism last year found that although the exact number of Syrian physicians who left the country remains unknown, the true extent of this exodus is larger than the NGOs and the Syrian government have reported.

“Retaining a skilled health workforce and ensuring sufficient medical supplies in Syria and across the region is a key priority,” said Balkhy.

She proposed engaging young Syrian physicians on research projects with a pathway to publishing so they can “feel that they’re doing something worthwhile,” in addition to ensuring they “at least have the equipment” to perform operations.

For Sahloul of MedGlobal, fostering a belief in a brighter future is essential to retaining both new and seasoned doctors.

“What will encourage young and old doctors to stay in Syria is believing in a better future — a new leadership that respects its human capital,” he said.

Sahloul said that international and Arab actors need to devote more attention to finding a genuine solution to the Syrian conflict — “one that ensures respect for human rights and dignity, and focuses on rebuilding.”

He added: “The current Arab normalization with the regime is flawed because it gives no hope for any meaningful change.”

Sahloul said normalization’s priorities, including refugee repatriation, curbing the manufacture of and trade in the amphetamine drug Captagon, and limiting Iran’s influence, “are not the most important priorities to the young graduates and aspiring doctors in Syria.”

Balkhy emphasized that the decline in humanitarian funding for Syria was a “central and troubling concern.” 

For instance, Al-Hol camp in Syria’s northeast — home to the wives and children of Daesh militants captured in 2019 — has grappled with many significant challenges since funding shortages forced WHO to halt medical referrals, prompting camp administrators to revoke its access.

Talks with donors in the capital Damascus during her five-day visit revealed that while they acknowledge the extent of gaps and needs, they are hampered by competing regional and global agendas.

Medecins Sans Frontieres warned on April 29 that the severe lack of funding for a vital WHO-funded medical referral system in 11 camps in northeast Syria “will lead to a marked increase in the number of preventable deaths.”

WHO said in March that it required $80 million in funding for the year 2024 to ensure the continuity, quality, and accessibility of health services and infrastructure in Syria, and to prevent a further deterioration of the already precarious situation.