Iraq’s Fragile State in the Time of Covid-19

This article is part of the series on “COVID-19 in the Middle East and Asia: Impacts and Responses”. Read more ...

The term “fragile states” refers to those countries that are particularly susceptible to internal and external shocks. Fragile states face multiplying risks and diminished coping capacities such that when a shock does strike a highly fragile state, it is more likely to cascade across multiple sectors. The COVID-19 pandemic — unprecedented in its scale, complexity, and impact —  is aggravating inequality, poverty and insecurity in fragile states and threatening to stall progress toward the UN’s Sustainable Development Goals (SDGs). 

Iraq ranks high in a number of economic, political, societal, environmental and security fragility metrics.[1] Even before the onset of the COVID-19 crisis, Iraq was facing a set of acute challenges that the country was ill-prepared to manage.[2] In fact, prior to the pandemic, some analysts had gone as far as to argue that Iraq exhibited the hallmarks of a failed state, not merely a fragile one.[3] A World Bank study released in late September warned: “Iraq is on the brink of catastrophe. Almost two decades after the Iraq war began, the country remains caught in a fragility trap and faces increasing political instability and fragmentation, geopolitical risks, growing social unrest, and a deepening divide between the state and its citizens.”[4]

Iraqi authorities have taken a series of preventative and remedial measures to deal with the pandemic and its second order effects. However, since early June, the number of positive COVID cases has soared, while job losses and rising prices have caused the national poverty rate to climb. Three overlapping segments of the Iraqi population — the forcibly displaced, women, and children — have been hit especially hard by the public health and socioeconomic impacts of COVID-19.

The Fragile State of Iraq

The term “fragile states,” which entered the development discourse in the 1990s, is usually associated with the state’s lack of will or capacity to perform its core functions. Of the numerous definitions of “state fragility” proposed by the development and research communities over the years, there is some consensus around the version offered by the OECD, which defines fragility in terms of risk and resilience — as “the combination of exposure to risk and insufficient coping capacities of the state, system and/or communities to manage, absorb or mitigate those risks.”[5]

Reflecting the broad agreement across the literature that fragility is multi-dimensional, several cross-country indices have been developed which attempt to measure fragility.[6] The most widely known of these analytic tools is the Fragile States Index (FSI) produced by the Fund for Peace, which assesses a state’s vulnerability to conflict or collapse.[7] Since the defeat of Daesh  (Islamic State / ISIL / IS) in 2017, Iraq’s FSI score has improved, with the most significant progress evident in the security domain.[8] Nevertheless, Iraq has a high level of risk exposure and limited state capacity[9] and continues to rank among the FSI’s most fragile states (i.e., currently 17th of 178).[10]  

Iraq faces severe fiscal pressures stemming from the collapse of oil prices, a fragmented political elite, and widespread popular discontent. A protracted government formation process concluded in June — months after the COVID-19 outbreak — when Parliament voted to approve the final seven members of Prime Minister Mustafa al-Kadhimi’s Cabinet members. Compounding Iraq’s vulnerability is the country’s unique exposure to the virus through cross-border interaction with Kurds in the north and Shia pilgrims in the south from Iran, the pandemic’s regional epicenter.[11] The UNDP Fragility Analysis issued in August 2020 described the most likely scenario for Iraq over the next 18 months in bleak terms: “Existing vulnerabilities will be significantly exacerbated by the COVID-19 pandemic and its impacts in different sectors; this will weaken but not completely destabilize Iraqi society and the Government.”[12]

Stark evidence of the extent of Iraq’s fragility can be found in the feeble condition of the country’s healthcare system in the face of the COVID-19 pandemic. The Iraq Ministry of Health (MoH) once presided over arguably the most advanced national medical system in the Middle East.[13] Even during the Iran-Iraq War (1980-88), the Iraqi government continued to invest in low-cost primary care, as a means of maintaining social order.[14] However, the 1991 Gulf War, UN sanctions,[15] the 2003 US-led invasion and occupation,[16] and the war against Daesh (Islamic State / IS/ ISIL) have combined to decimate the country’s healthcare system,[17] which also suffers from chronic underfunding[18] and lack of public trust.[19]

Since COVID-19 struck Iraq, the country’s depleted force of frontline healthcare workers has been under immense pressure.[20] Hospital wards have become breeding grounds for infections,[21] placing physicians and staff at great personal risk. Healthcare practitioners have been assaulted by angry family members of patients suffering from or who have succumbed to the virus.[22] In a video address to the United Nations General Assembly on September 23, President Barham Salih appealed for assistance in dealing with the “mounting violence towards the medical community.”[23]

The Spread of Coronavirus in Iraq and the Struggle to Combat It

The first case of COVID-19 in Iraq was recorded on February 24 in the city of Najaf, linked to someone who had recently returned from Iran. Three weeks later, Iraqi authorities implemented a nationwide curfew in an effort to curb the spread of the virus.[24] The initial lockdown measures, which banned all “nonessential” traffic, public gatherings and businesses, at first appeared to yield results. On April 2, however, Reuters reported that there were many more COVID-19 cases than the Ministry of Health seemed willing or able to confirm[25] — a report for which the news agency was suspended from working in the country and fined.[26]

On March 26 by order of the Iraqi Cabinet, a ministerial-level Committee for National Health and Safety chaired by the prime minister was established to direct and coordinate national efforts to combat COVID-19. The next day, President Salih launched a national anti-pandemic initiative “for the defense of the homeland,” exhorting the public and private sectors to work together to stem the virus.[27]

Since then, Iraqi authorities, like their counterparts in other countries, have wrestled with the difficult tradeoff between restricting movement and reopening the economy. Heading into Ramadan, they relaxed enforcement of the stringent movement restrictions.[28] However, with the number of confirmed cases rising and Eid Al-Fitr approaching, they instituted an overnight nationwide curfew during the holiday (May 21-28). Nevertheless, Iraq experienced another spike in confirmed cases,[29] prompting a one-week reimposition of strict lockdown measures.[30]

This pattern repeated itself later in the summer. The Iraq Ministry of Health (MoH) imposed a comprehensive lockdown across Iraq during Eid Al-Adha (July 31-August 8).[31]  After the holiday, the Kurdistan Regional Government (KRG) lifted the restrictions preventing movements within Iraqi Kurdistan, as well as between Kurdistan and Federal Iraq;[32] and the Iraqi Higher Committee for Health and National Safety canceled the weekly three-day full curfew. These announcements of the easing of restrictions occurred just as health officials were confirming rising numbers of positive covid cases and deaths.

The World Health Organization (WHO) reported in mid-August the number of infected COVID-19 cases in Iraq “… exponentially rising to an alarming and worrying level, suggesting a major health crisis soon.”[33] An assessment by Médecins Sans Frontières (MSF) the next month made clear that the crisis had already arrived — and that it was escalating.[34] Amidst that crisis but with the pandemic wreaking havoc on the Iraqi economy, Iraqi authorities decided to reopen land border crossings for trade and permit restaurants and five-star hotels to resume business provided they adhered to public health guidelines.[35]

Translating the call for national unity of purpose and coordination of effort in battling the pandemic into effective action in a country as weakly centralized and politically fragmented as Iraq was bound to be difficult — and has proven so. The woeful state of the Kurdistan Regional Government’s (KRG) finances, low global oil prices, and expanding public sector liabilities have strained its ability address the secondary effects of the pandemic.[36] Long-running disputes over oil, revenue-sharing and other contentious issues have roiled the relationship between Erbil and Baghdad even in the midst of the pandemic.

Some notable religious institutions such as the (Sunni) Iraq Figh Council[37] and the Union of Muslim Scholars of Kurdistan have urged the failthful to adhere to the government’s anti-covid measures. So, too, have prominent religious figures such as Grand Ayatollah ‘Ali al-Sistani, who declared the fight against the virus to be a collective obligation; ruled that knowingly spreading COVID-19 could obligate the spreader to pay compensation to those affected; issued guidance recommending that the faithful follow state authorities’ public health edicts and quarantine protocols; and mobilized charitable institutions.[38] However, some leaders have discouraged compliance.[39] One such dissenting voice is the populist Shia cleric Muqtada al-Sadr, who early on exhorted followers to continue participating in religious commemorative ceremonies and making visits to the shrine in Najaf.[40]

At the onset of the pandemic, civil society organizations (CSOs) and protest movements directed their organizational structure towards awareness-raising across the country.[41] On behalf of its 196 NGO members and observers, the NGO Coordination Committee for Iraq (NCCI) declared its members ready and willing to support the government’s pandemic response.[42] However, the ability of sub-state actors to fill the pandemic response “gap” has been limited by a variety of factors, including health and security risks to staff, restrictive legal frameworks for their activities, difficulty obtaining access exemptions, and the constrained ability of international partners to support their efforts.[43]

In the Kurdistan Region of Iraq (KRI), peshmerga patrols were dispatched to implement the curfew. However, “securitizing” the pandemic response in this manner, though perhaps necessary, has fed the suspicion that lockdowns are politically motivated efforts to curb peaceful assembly and muzzle legitimate popular grievances and demands.[44] In the south, Popular Mobilization Units (PMU), al-Hashd al-Sha’abi, joined the fight against the virus — mounting “awareness” campaigns, cleaning and disinfecting public spaces, assisting with burials, and deploying field hospitals.[45] Yet, the emergence of the PMUs as an “auxiliary relief agency” has complicated the new Iraqi government’s efforts to contain and dismantle them.

In recent weeks, the COVID-19 pandemic has shown no signs of abating. On the contrary, Iraq’s situation has progressively worsened.[46] Numerous factors have stymied efforts to curb the spread of the virus. The approach of local authorities to the enforcement of lockdown measures has varied across governorates. Cultural norms, mistrust of the state, and the prevalence of the informal economy have resulted in spotty public compliance.[47] The return of protesters to the streets in Baghdad and the flocking of thousands of Shia worshippers to the holy city of Karbala to observe Arbaeen in early October attest to the challenges that Iraqi health officials and political leaders have faced in restricting mass public gatherings.[48]

Disparate Risk Factors and Impacts

In Iraq, as elsewhere, the health-related and secondary effects of the pandemic have been distributed unevenly across the country and within the various segments of the population.

In terms of the spatial distribution of COVID viral infections, the highest rates of vulnerability are in the West and South.[49] Baghdad remains the epicenter of the pandemic with more than half of the country’s cases. [See Figure 1.]

Figure 1. Iraq Confirmed COVID-19 Cases by Governorate

Source: https://coronavirus-covid-19-iraq-atlasgis.hub.arcgis.com/

Besides the immediate health effects of COVID-19, the adverse household welfare impacts  in the form of reduced wages, increased expenditures, and service disruptions — fall heaviest on those with preexisting vulnerabilities. In the case of Iraq, three overlapping segments of the population stand out: the forcibly displaced, women, and children and adolescents.

1. The Forcibly Displaced

COVID-19 has increased the exposure of those forcibly displaced to health risks and has deepened their preexisting vulnerabilities.[50] According to the May 6 Global Cluster Report, the spread of COVID-19 in Iraq has intensified the needs of the 1.4 displaced persons (IDPs) and 4.1 million returnees who required assistance prior to the outbreak.[51] The UN High Commissioner for Refugees (UNHCR) reported in July that more than 6.7 million Iraqis — approximately 18% of the population — are in need of humanitarian assistance and protection.[52] Of the enormous number of internally displaced, 71% have taken refuge in Iraqi Kurdistan — this in addition to 300,000 refugees from neighboring countries, mainly Syria.[53] Although most of the affected population[54] lives in host communities, almost a third is spread across 40 camps where movement restrictions have cut the delivery of aid. Although COVID-19 cases in IDP camps had not been common, evidence has emerged in recent weeks of community transmission.[55]

In August 2019, the Government of Iraq consolidated and closed a number of IDP camps. The stated goal at the time was the return of all IDPs to their area of origin by the end of 2020. However, even before the pandemic, the process of “ending” displacement in Iraq had been anything but trouble-free. The restoration of damaged infrastructure and services in many liberated areas was, and is incomplete.[56] According to the UNFPA, the needs of returnees in areas of origin as well as out-of-camp IDPs are severe.[57] With Iraqi authorities continue to press IDPs to return to their areas of origin, the health and socioeconomic prospects for the forcibly displaced are uncertain, at best.

2. Women

Pandemics exacerbate gender inequalities for women and girls, and can impact how they receive treatment and care.[58] Even before the Coronavirus pandemic struck, the status of women in Iraq was precarious. In 2019, Iraq ranked 120 of 189 countries on the UNDP Gender Inequality Index (GII).[59] Women’s participation in the labor market in Iraq was among the lowest in the world, due to multiple barriers to their entering and remaining in the labor market,[60] ranging from key laws that discriminate against them to deeply entrenched dominant social roles attributed to them.[61]

COVID-19 has undermined Iraqi women’s financial autonomy and economic livelihoods due to preexisting gender inequalities compounded by the protracted political instability in the country. An Oxfam gender analysis of three sample areas (Kirkuk, Diyala, and Sulaimaniyah) found that, in addition to financial and livelihoods challenges, Iraqi women have faced greater difficulties accessing health and support services, have assumed increased domestic and care-giving responsibilities, possess limited decision-making power to alter their circumstances, and lack information about the pandemic itself.[62] In addition, the Kvinna till Kvinna Foundation has reported an increase in all forms of gender-based violence in Iraq (GBV).[63]

3. Children and Adolescents

Children and adolescents are particularly vulnerable during infectious disease outbreaks.[64] Although this age demographic may be less susceptible to contracting the COVID-19 virus, young people are still likely to be adversely impacted due to school closures, child labor as a result of the economic downturn, family stresses, and shocks to other members of the household.

Iraq has one of the youngest populations in the world. Those under 18 years of age comprise 45% of the population.[65] COVID-19 is just the most recent threat to Iraqi young people. Before the pandemic broke out, one out of five children and adolescents were poor.[66] Unemployment rates were high among Iraqi youth. A 2019 US Department of Labor report estimated that 450,000 Iraqi children (14 and under) work by begging, selling on the street, in businesses such as garages or factories, or as domestic labor.[67] The fact that many of Iraq’s younger workers are employed under verbal agreements in temporary, seasonal or irregular jobs with no social security coverage and little savings has added to their precarity.[68]

The worldwide pandemic has severely impacted Iraqi children and adolescents. Due to COVID-19, the child poverty rate is now set to double to over 2 out of every 5, or 37.9% of all Iraqi children.[69] Frequent curfews have made distribution of food and hygiene supplies difficult. The risk of abuse, neglect, and exploitation by criminals, extremists, and human traffickers has increased.[70] The financial strain of the pandemic has also raised the risk of child labor[71] as well as of child marriage[72] — both being frequent practices and negative coping mechanisms for families living in poverty.

The pandemic has also adversely the Iraqi education sector, which was still recovering from decades of underinvestment and instability. An August 2017 report issued by UNICEF cited “remarkable improvements in education in Iraq” but at the same time identified numerous persistent weaknesses, including large dropout and repetition rates, as well as decreasing student learning outcomes due to multiple-shifting of schools and teacher shortages.[73]

COVID-19 has set back the post-conflict rehabilitation of educational facilities that had been damaged or destroyed during the three-year war against Daesh. Moreover, when in February thousands of primary and secondary schools were closed in response to the pandemic, 10 million Iraqi children (ages 6 to 17) were affected throughout the country.[74] An assessment conducted by Mercy Hands in May found that the vast majority of children in IDP camps in Salah Al Din, Anbar, Ninewa, and Baghdad had not received any type of schooling.[75]

Primary and secondary schools in Iraq are due soon to partially reopen. Higher education authorities in Iraq and Kurdistan Region have allowed a blended form of education for the 2020-2021 academic year. KRG has made available a new e-learning site containing lessons for grades 1-12 and announced the reopening of schools for grades one, two, and twelve will be attending classes while the rest will study online.[76] Yet, managing the reopening of schools is a tall order, as it will require adequate measures and resources to deal with crowded classrooms, lack of WASH facilities, school feeding and vaccination programs, and remote learning accessibility. It remains to be seen how, and how well Iraqi authorities will be able to meet the educational needs of IDP and refugee children, including those whose camp-based schools are scheduled for closure to induce families to return to their area of origin.[77]  

Conclusion

Few countries are as well endowed as Iraq in human and natural resource wealth-generating potential. Yet, there are fewer countries still which have experienced the carnage and devastation that Iraq has over the past three decades. For the latter reason and others, Iraq entered the COVID era with markedly high exposure to, and a limited capacity to address the public health and second order effects of the pandemic.

The IMF forecasts a “long ascent” from the pandemic — an uneven and partial rebound in 2021 prone to setbacks.[78] The COVID-19 crisis is exacerbating existing vulnerabilities for all social groups in every country. For fragile states such as Iraq, and especially for those most highly exposed among its population — notably, the forcibly displaced, children and adolescents, and women — the climb to recovery and resilience looks to be steep, arduous, and uncertain.