Dr Askkary, an oncologist, was not the only healthcare worker who was insulted. Scores of doctors, nurses and other allied health personnel were physically attacked, harassed and intimidated during these demonstrations. Mr Beston Fatah, an advanced nurse practitioner, was beaten by a group of unknown persons while he was demonstrating along with his colleagues in Slemany Teaching Hospital. Dr Zana Dzaey, an internal medicine consultant, was also physically and verbally abused after reading a statement on behalf of demonstrating doctors in Hawler Teaching Hospital in Erbil.

The authorities continued their campaign of intimidation even after doctors and health workers chose to end the demonstrations (at least for now). Organizers and leaders of the demonstrations are being punished by the health authorities. Dr Kawa Khalil (an Ophthalmologist), Dr Hiwa Khalid Qadir (an Internal Medicine specialist) and Muhammed Abdulkarim (a physiotherapist) were formally punished by Rizgary Teaching Hospital Management for their role in organizing and leading the demonstrations. Dr Rezan Hardi, an emergency medicine consultant, was fired from her job as the head of department in Slemany Emergency Hospital for choosing to boycott work and join the demonstrations by her colleagues. Dr Kazim Faroug and Dr Samir Salih, both oncologists, were also punished for their leadership in the demonstrations.

The list goes on and on and is likely to grow. Doctors, nurses and other healthcare workers decided to join teachers and other civil servants in unprecedented demonstrations demanding better working conditions in KRI. Public servants have not received their full salaries since 2014. In that year, KRI faced a triple financial, security and environmental shock. Oil prices, KRI’s main source of revenue, have gradually decreased. ISIS attacked and occupied the second largest city in Iraq, displacing millions to KRI. That very summer, an unprecedented drought caught the authorities by surprise. The combination of such crises stretched health services to the limits of breakdown.

Acting on advice from the World Bank and IMF, the Kurdistan Regional Government (KRG) introduced severe austerity measures. One such measure is known as the ‘mandatory saving scheme’. The KRG continued to pay oil companies their dues while providing only a quarter of civil servants’ salaries according to the available scheme. The authorities promised to pay public servants their full salaries once the crisis has ended. However, now that ISIS is essentially defeated and oil prices have recovered, the authorities continued with the scheme triggering outrage and anger which resulted in mass demonstrations and strikes. Beside attempting to intimidate demonstrating health workers, the authorities also tried to blame the demonstrations for problems with access to healthcare during the strikes. Several persons, reportedly encouraged by the authorities, attacked doctors’ clinics in at least one town in KRI. Facebook posts attacked doctors for their ‘greed’ and incited violence against them.

Health workers strike and demonstrations are likely to continue in KRI. The crackdown by authorities is also likely to continue and escalate particularly after assertions by Prime Minister Nechirvan Barzani that the KRG will respond with ‘knives and pistols’ against demonstrators.

The sufferings of health workers in KRI are not isolated incidents limited to a particular geography. They are a consequence of the aggressive neoliberal policies and severe austerity that our world experienced in the post 2008 financial crisis. Therefore, the current events in KRI deserve not only solidarity but also a closer analysis to learn and draw lessons from.

The limited participation from the MENA region is intriguing given a large number of researchers, policymakers and health workers from other regions present here. While there were over 200 applications to the EV4GH programme this year, only about five were from the MENA region.

There are several theories about why this might be so. Some of the organisers and the participants of the EV4GH programme feel that the limited participation from the region might be because of visa-related issues. This might be true in the case of those whose their visas were rejected (in this instance, applicable to one person). Others feel it may be cause of a lack of interest in health policy and systems research (HPSR) from the MENA region. However, I feel  that is not really the case.

There are some universities, institutions and organisations from the MENA region that are interested, working on and leading research on health policy and systems in MENA. Examples include the American University of Beirut (AUB)’s Center for Systematic Reviews on Health Policy and Systems Research (SPARK) which has recently been appointed as the General Secretariat for the Global Evidence Synthesis Initiative (GESI).  Other institutions include the Middle East Research Institute (MERI) that is one of the leading think-tanks in the MENA. MERI is dedicating a significant portion of its work to HPSR.  In addition to the examples mentioned above, there are many other researchers and academic institutions which are producing a growing body of literature on health policy and systems in the MENA region. A relatively recent article attempted to compile a list of such literature.  Last, but not least, there is a Public Health in the Arab World (PHAW) listserv that is dedicated to announcing, publicising and discussing public health related issues in the region.

So if it is not the lack of institutions, researchers and interest, what then explains that there has essentially been no participation from the MENA region in the EV4GH programme thus far?

It seems that one of the main reasons has been the lack of publicity for the EV4GH programme in MENA. None of the major institutions, think-tanks and organisations in MENA announced the call for application for the programme. The EV4GH programme was never announced on the PHAW listserv either. Meetings, webinars or seminars which target researchers and policymakers in MENA were never conducted. Those who knew about the programme and applied to attend did so through word of mouth rather through an organisation.

The lack of participation from the MENA region is a substantial opportunity cost for the region. The EV4GH provides a rich opportunity for researchers in MENA to present their work. Such exposure is crucial particularly within the context of what is going on in the region at the moment. The theme of the fourth Global Symposium on Health Systems and Policy Research is strongly connected to the issues on conflict – an issue that the area continues to grapple with. As a current EV4GH participant from MENA, I make a commitment to spreading the word on this programme among my colleagues from the region. Hopefully more researchers will represent MENA in the next edition of the Emerging Voices for Global Health.