A Syrian boy runs past rubble in eastern Al Ghouta province, outside Damascus
Hashem Osseiran, Alessandria Masi and Kim Bode

BEIRUT – Russia's proposal for a partial truce in the Eastern Ghouta suburbs of Damascus is not a "humanitarian pause," but a "humanitarian posture," says Dr. Annie Sparrow, a critical-care pediatrician and public health professional.

In Syria Deeply's latest Deeply Talks, Sparrow and Mohamed Katoub, advocacy manager for the Syrian American Medical Society (SAMS), spoke with our editors about the deteriorating humanitarian situation in the besieged Damascus suburbs. (Listen to the full audio here)

Last week, Moscow called for daily, five-hour cessations of hostilities to allow for aid deliveries and medical evacuations. However, it usually takes a convoy between eight to 10 hours to deliver aid to the rebel-held enclave, both doctors said.

This first convoy of aid arrived Monday in the area, which is now suffering from persistent attacks against healthcare in addition to severe shortages in medical supplies and life-saving medicine. Even for the convoys that do arrive in Eastern Ghouta, they would only play a "limited" and "cosmetic" role in alleviating the suffering of nearly five years of living under siege and fierce government shelling that has killed nearly 600 people since February 18, said Katoub.

Katoub said that more than 29 attacks against healthcare staff and services have been reported since the start of the government's latest escalation. More than 10 ambulances have been destroyed and at least six health facilities have been put out of service because of the shelling.

These attacks have reduced the capacity of health staff to respond to medical needs by more than 40 percent, Katoub said, adding that doctors are adjusting to deteriorating conditions by reusing medical supplies that are meant for one-time use and prioritizing life-saving operations over less-fatal cases.

Meanwhile, Sparrow noted that only 107 doctors remained in Eastern Ghouta, where they have to provide care for 400,000 people; 80% of whom are estimated to be living in underground shelters and basements. "To put that in perspective, under normal circumstances, one doctor may look after 100 patients. That is a ratio we consider to be appropriate and normal," she said. "And these are patients that are suffering from the normal range of diseases, not including this incredible burden produced by war trauma, bombs, chemicals weapons and chronic disease.

The U.N. has condemned the recent escalation and has called on Moscow and Damascus to respect the United Nations Security Council resolution passed on Saturday demanding a 30-day nationwide cease-fire.

However, the U.N. is not taking the "needed actions to save lives," even though it has ground access to Eastern Ghouta, Katoub said.

"The U.N. are partners in this war crime," he said, noting that statements would not be enough to save civilians stuck in the opposition holdout.

Sparrow said that, through its inaction, the U.N. has "weaponized aid."

"The U.N. has adopted this posture where they are in Damascus, there are hundreds of international staff, it's a multibillion-dollar operation, and they insist that some of this will trickle down to people in need. But it is very clearly not," Sparrow said. "One could even argue that they are complicit in the war crimes by adopting this posture and refusing to stop working with the very same government that is committing these crimes."

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Merkel's Legacy: The Rise And Stall Of The German Economy

How have 16 years of Chancellor Angela Merkel changed Germany? The Chancellor accompanied the country's rise to near economic superpower status — and then progress stalled. On technology and beyond, Germany needs real reforms under Merkel's successor.

Chancellor Angela Merkel looks at the presentation of the current 2 Euro commemorative coin ''Brandenburg''

Daniel Eckert

BERLIN — Germans are doing better than ever. By many standards, the economy broke records during the reign of outgoing Chancellor Angela Merkel: private households' financial assets have climbed to a peak; the number of jobs recorded a historic high before the pandemic hit at the beginning of 2020; the GDP — the sum of all goods and services produced in a period — also reached an all-time high.

And still, while the economic balance sheet of Merkel's 16 years is outstanding if taken at face value, on closer inspection one thing catches the eye: against the backdrop of globalization, Europe's largest economy no longer has the clout it had at the beginning of the century. Germany has fallen behind in key sectors that will shape the future of the world, and even the competitiveness of its manufacturing industries shows unmistakable signs of fatigue.

In 2004, a year before Merkel was first elected Chancellor, the British magazine The Economist branded Germany the "sick man of Europe." Ironically, the previous government, a coalition of center-left and green parties, had already laid the foundations for recovery with some reforms. Facing the threat of high unemployment, unions had held back on wage demands.

"Up until the Covid-19 crisis, Germany had achieved strong economic growth with both high and low unemployment," says Michael Holstein, chief economist at DZ Bank. However, it never made important decisions for its future.

Another economist, Jens Südekum of Heinrich Heine University in Düsseldorf, offers a different perspective: "Angela Merkel profited greatly from the preparatory work of her predecessor. This is particularly true regarding the extreme wage restraint practiced in Germany in the early 2000s."

Above all, Germany was helped in the first half of the Merkel era by global economic upheaval. Between the turn of the millennium and the 2011-2012 debt crisis, emerging countries, led by China, experienced unprecedented growth. With many German companies specializing in manufacturing industrial machines and systems, the rise of rapidly industrializing countries was a boon for the country's economy.

Germany dismissed Google as an over-hyped tech company.

Digital competitiveness, on the other hand, was not a big problem in 2005 when Merkel became chancellor. Google went public the year before, but was dismissed as an over-hyped tech company in Germany. Apple's iPhone was not due to hit the market until 2007, then quickly achieved cult status and ushered in a new phase of the global economy.

Germany struggled with the digital economy, partly because of the slow expansion of internet infrastructure in the country. Regulation, lengthy start-up processes and in some cases high taxation contributed to how the former economic wonderland became marginalized in some of the most innovative sectors of the 21st century.

Volkswagen's press plant in Zwickau, Germany — Photo: Jan Woitas/dpa/ZUMA

"When it comes to digitization today, Germany has a lot of catching up to do with the relevant infrastructure, such as the expansion of fiber optics, but also with digital administration," says Stefan Kooths, Director of the Economic and Growth Research Center at the Kiel Institute for the World Economy (IfW Kiel).

For a long time now, the country has made no adjustments to its pension system to ward off the imminent demographic problems caused by an increasingly aging population. "The social security system is not future-proof," says Kooths. The most recent changes have come at the expense of future generations and taxpayers, the economist says.

Low euro exchange rates favored German exports

Nevertheless, things seemed to go well for the German economy at the start of the Merkel era. In part, this can be explained by the economic downturn caused by the euro debt crisis of 2011-2012. Unlike in the previous decade, the low euro exchange rate favored German exports and made money flow into German coffers. And since then-European Central Bank president Mario Draghi's decision to save the euro "whatever it takes" in 2012, this money has become cheaper and cheaper.

In the long run, these factors inflated the prices of real estate and other sectors but failed to contribute to the future viability of the country. "With the financial crisis and the national debt crisis that followed, economic policy got into crisis mode, and it never emerged from it again," says DZ chief economist Holstein. Policy, he explains, was geared towards countering crises and maintaining the status quo. "The goal of remaining competitive fell to the background, as did issues concerning the future."

In the traditional field of manufacturing, the situation deteriorated significantly. The Institut der Deutschen Wirtschaft (IW), which regularly measures and compares the competitiveness of industries in different countries, recently concluded that German companies have lost many of the advantages they had gained. The high level of productivity, which used to be one of the country's strengths, faltered in the years before the pandemic.

Kooths, of IfW Kiel, points out that private investment in the German economy has declined in recent years, while the "government quota" in the economy, which describes the amount of government expenditure against the GDP, grew significantly during Merkel's tenure, from 43.5% in 2005 to 46.5% in 2019. Kooths concludes that: "Overall, the state's influence on economic activity has increased significantly."

Another very crucial aspect of competitiveness, at least from the point of view of skilled workers and companies, has been neglected by German politics for years: taxes and social contributions. The country has among the highest taxes on income in Europe, and corporate taxes are also hardly as high as in Germany anywhere in the industrialized world. "In the long run, high tax rates always come at the expense of economic dynamism and can even prevent new companies from being set up," warns Kooths.

Startups can renew an economy and lay the foundation for future prosperity. Between the year 2000 and the Covid-19 crisis, fewer and fewer new companies were created every year. Economists from left to right are unanimous: Angela Merkel is leaving behind a country with considerable need for reform.

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