How Austerity and Anti-immigrant Politics Left Italy Exposed

The Corona Virus & Immigration

Dispatches From the Edge

Mar. 25, 2020

 

As the viral blitzkrieg rolls across one European border after another, it seems to have a particular enmity for Italy. The country’s death toll has passed China’s, and scenes from its hospitals look like something out of Dante’s imagination.

 

Why?

 

Italy has the fourth largest economy in the European Union, and in terms of health care, it is certainly in a better place than the US. Per capita, Italy has more hospital beds—so-called “surge capacity”—more doctors and more ventilators. Italians have a longer life expectancy than Americans, not to mention British, French, Germans, Swedes and Finns. The virus has had an especially fatal impact on northern Italy, the country’s richest region.

 

There are a number of reasons why Italy has been so hard-hit, but a major one can be placed at the feet of former Interior Minister Matteo Salvini of the xenophobic, rightwing League Party and his allies on the Italian right, including former prime minister Silvio Berlusconi.

 

Italy has the oldest population in Europe, and one of the oldest in the world. It did not get that way be accident. Right-wing parties have long targeted immigrants, even though the immigrant population—a little over 600,000—is not large by international standards. Immigrants as a “threat to European values” has been the rallying cry for the right in France, Germany, Hungry, Poland, Greece, Spain, the Netherlands and Britain as well.

 

In the last Italian election, the League and its then ally, The Five Star Movement, built their campaigns around resisting immigration. Anti-immigrant parties also did well in Spain and certainly played a major role in pulling the United Kingdom out of the EU.

 

Resistance to immigration plays a major role in “graying” the population. Italy has one of the lowest birthrates in the world, topped only by Japan. The demographic effects of this are “an apocalypse” according to former Italian Health Minister Beatrice Lorenzin. “In five years, we have lost more than 66,000 births [per year]” equal to the population of the city of Siena. “If we link this to this increasingly old and chronically ill people, we have a picture of a moribund country.”

 

According to the World Health Organization, the ideal birth-death replacement ratio in advanced countries is 2.1. Italy’s is 1.32., which means not only an older population, but also fewer working age people to pay the taxes that fund the social infrastructure, including health care.

 

As long as there is no a major health crisis, countries muddle though, but when something like the Corona virus arrives, it exposes the underlying weaknesses of the system.

 

Some 60 percent of Italians are over 40, and 23 percent are over 65. It is demographics like these that make Covid-19 so lethal. From age 10 to 39, the virus has a death rate of 0.2 percent, more deadly than influenza, but not overly so. But starting at age 40, the death rate starts to rise, reaching 8 percent for adults age 70 to 79, and then jumping to 14.8 percent over 80. The average age of Corona virus deaths in Italy is 81.

 

When the economic meltdown hit Europe in 2008, the European Union responded by instituting painful austerity measures that targeted things like health care. Over the past 10 years Italy has cut some 37 billion euros from its health system. The infrastructure that could have dealt with a health crisis like Covid-19 was hollowed out, so that when the disease hit, there simply weren’t enough troops or resources to resist it.

 

Add to that the age of Italians, and the outcome was almost foreordained.

 

The US is in a very similar position, but for somewhat different reasons. As Pulitzer Prize-winning medical writer Laurie Garrett points out, it was managed care that has derailed the ability of the American health system to respond to a crisis. “What happened with managed care is that hospitals eliminated surplus beds and surplus personnel. So, far from being ready to deal with surge capacity, we’re actually understaffed and we have massive nurse shortages across the nation. “

 

Much of that shortage can also be attributed to managed care. Nurses are overloaded with too many patients, work 10 and 12 hour shifts on a regular basis, and, while initially well paid, their compensation tends to flatten out over the long run. Burn out is a major professional risk for nursing.

 

Yet in a pandemic, nursing is the most important element in health care according to John Barry, author of the “The Great Influenza” about the 1918-19 virus that killed up to 100 million people, including 675,000 Americans. A post mortem of the pandemic found “What could help, more than doctors, were nurses. Nursing could ease the strain of a patient, keep a patient hydrated, calm, provide the best nutrition, and cool the intense fevers.” Nurses, the study showed, gave victims “the best possible chance to survive.”

 

The issues in Italy’s 2018 election were pretty straightforward: slow growth, high youth unemployment, a starving education system and a deteriorating infrastructure—Rome was literally drowning in garbage. But instead of the failed austerity strategy of the EU, the main election theme became immigration, a subject that had nothing to do with Italy’s economic crisis, troubled banking sector or burdensome national debt.

 

Berlusconi, leader of the rightwing Forza Italia Party, said “All these immigrants live off of trickery and crime.” Forza made common cause with the fascist Brothers of Italy, whose leader, Giogia Meloni, called for halting immigrants with a “naval blockade.”

 

The main voice of the xenophobic campaign, however, was Salvini and the League. Immigrants, he said, bring “chaos, anger, drug dealing, thefts, rape and violence,” and pose a threat to the “white race.”

 

The Five Star Movement leader Luigi Di Mario joined the immigrant bashing, if not with quite the vitriol of Berlusconi, Salvini and Meloni. The center-left Democratic Party ducked the issue, leaving the field to the right.

 

The outcome was predictable: the Democratic Party was routed and the Five Star Movement and League swept into power. Salvini took the post of Interior Minister and actually instituted a naval blockade, a violation of International Law and the 1982 Law of the Sea.

 

Eventually the League and Five Star had a falling out, and Salvini was ousted from his post, but the damage was done. The desperately needed repairs to infrastructure and investments in health care were shelved. When Covid-19 stuck, Italy was unprepared.

 

Much the same can be said for the rest of Europe, where more than a decade of austerity policies have weakened health care systems all over the continent.

 

Nor is Italy is facing a demographic catastrophe alone. The EU-wide replacement ratio is a tepid 1.58, with only France and Ireland approaching—but not reaching—2.1.

 

If Germany does not increase the number of migrants it takes, the population will decline from 81 million to 67 million by 2060, reducing the workforce to 54 percent of the population, not enough to keep up with current levels of social spending. The Berlin Institute for Population and Development estimates that Germany will need 500,000 immigrants a year for the next 35 years to keep pensions and social services at current levels.

 

Spain—which saw the rightwing anti-immigration party do well in the last election—is bleeding population, particularly in small towns, some 1500 of which have been abandoned. Spain has weathered a decade and a half of austerity, which damaged the country’s health care infrastructure. After Italy, Spain is the European country hardest hit by Covid-19.

 

As populations age, immigrants become a necessity. Not only is new blood needed to fill in the work needs of economies, broadening the tax base that pays for infrastructure, but, too, old people need caretaking, as the Japanese have found out. After centuries of xenophobic policies that made immigration to Japan almost impossible, the Japanese have been forced to accept large numbers of migrants to staff senior facilities.

 

The United States will face a similar crisis if the Trump administration is successful in chocking off immigration. While the US replacement ratio is higher than the EU’s, it still falls under 2.1, and that will have serious demographic consequences in the long run.

 

It may be that for-profit health care simply can’t cope with a pandemic because it finds maintaining adequate surge capacity in hospital beds, ventilators and staff reduces stockholders’ dividends. And public health care systems in Europe—which have better outcomes than the American system’s—only work if they are well funded.

 

To the biblical four horsemen—war, famine, wild beasts and plague—we can add two more: profits and austerity.

 

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Turkey’s Failed Gamble in Syria

Syria-A Turkish Dilemma

Dispatches From The Edge

March 6, 2020

 

Turkish President Recep Tayyip Erdogan’s latest gamble in Syria’s civil war appears to have come up snake eyes. Instead of halting the Damascus government’s siege of the last rebel held province, Idlib, Turkey has backed off, and Ankara’s Syrian adventure is fueling growing domestic resistance to the powerful autocrat.

 

The crisis began on Feb. 25, when anti-government rebels, openly backed by Turkish troops, artillery, and armor, attacked the Syrian Army at the strategic town of Saraqeb, the junction of Highways 4 and 5 linking Aleppo to Damascus and the Mediterranean. The same day Russian warplanes in Southern Idlib were fired upon by MANPADS (man portable air-defense systems), anti-aircraft weapons from Turkish military outposts. The Russian air base at Khmeimim was also attacked by MANPADS and armed Turkish drones.

 

What happened next is still murky. According to Ankara, a column of Turkish troops on its way to bring supplies to Turkish observer outposts in Idlib were attacked by Syrian war planes and artillery, killing some 34 soldiers and wounding more than 70. Some sources report much higher causalities.

 

But according to Al Monitor, a generally reliable on-line publication, the column was a mechanized infantry battalion of some 400 soldiers, and it wasn’t Syrian warplanes that did the damage, but Russian Su-34s packing KAB-1500Ls, bunker busting laser guided bombs with 2400 lb warheads. Syrian Su-22 fighters were involved, but apparently only to spook the soldiers into taking cover in several large buildings. Then the Su-34s moved in and brought the buildings down on the Turks.

 

The Russians deny their planes were involved, and the Turks blamed it all on Damascus, but when it comes to Syria, the old saying that truth is the first casualty of war is pretty much a truism.

 

Erdogan initially blustered and threatened to launch an invasion of Idlib—which, in any case, was already underway—but after initially remaining silent, Rear Adm. Oleg Zhuravlev said that Russia “cannot guarantee the safety of flights for Turkish aircraft over Syria.”

 

The Turkish President is a hardhead, but he is not stupid. Troops, armor and artillery without air cover would be sitting ducks. So the Turks pulled back, the Syrians moved in, and now Russian military police are occupying Saraqeb. Russia has also deployed two cruise missile armed frigates off the Syrian coast.

 

But for Erdogan, the home front is heating up.

 

Even before the current crisis, the Republican People’s Party (CHP) has been demanding that Erdogan brief the parliament about the situation in Idlib, but the President’s Justice and Development Party (AKP) voted down the request. The rightwing, nationalist Good Party—a CHP ally— made similar demands, which have also been sidelined.

 

All the opposition parties have called for direct negotiations with the Assad government.

 

The worry is that Turkey is drifting toward a war with Syria without any input from the Parliament. On Feb. 12, Erdogan met with AKP deputies and told them that if Turkish soldiers suffered any more casualties—at the time the death toll was 14 dead, 45 wounded—that Turkey would “hit anywhere” in Syria. To the opposition that sounded awfully like a threat to declare war.

 

Engin Altay, the CHP’s deputy chair, said “The president has to brief the parliament, Idlib is not an internal matter for the AKP.” Altay has also challenged Erdogan’s pledge to separate Turkey from the extremist rebels, like Hayat Tahrir al-Sham, an affiliate of al-Qaeda. “Is this even possible?” he asked, “There is no way to distinguish these from each other.”

 

Turkey made an agreement with Russia in 2018 to allow it to set up observation posts in Idlib if it pledged not to support extremists like Tahrir al-Sham , but Ankara has facilitated the entry of such groups into Syria from the beginning of the war, giving them free passage and supplying them with massive amounts of fertilizer for bombs. In any case, the extremists eliminated any so-called “moderate” opposition groups years ago.

 

“Turkey said it would disassociate moderate elements from radicals,” says Ahmet Kamil Erozan of the Good Party, “but it couldn’t do that.’

 

The Kurdish-based progressive People’s Democratic Party (HDP) parliamentarian Necdet Ipekyuz charged “Idlib has become a nest for all jihadists. It has turned into a trouble spot for Turkey and the world. And who is protecting these jihadists? Who is safeguarding them?

 

Erdogan has jailed many of the HDP’s members of parliament and AKP appointees have replaced the Party’s city mayors. Tens of thousands of people have been imprisoned, and tens of thousands dismissed from their jobs. The media has largely been silenced through outright repression—Turkey has jailed more journalists than any country in the world—or ownership by pro-Erdogan businessmen.

 

But body bags are beginning to come home from a war that looks to a lot of Turks like a quagmire. The war is costly at a time of serious economic trouble for the Turkish economy. Unemployment is stubbornly high, and the lira continues to fall in value. Polls show that a majority of Turks—57 percent—are more concerned with the economy than with terrorism. While Turks have rallied around the soldiers, before the recent incident more than half the population opposed any escalation of the war.

 

And Turkey seems increasingly isolated. Erdogan called an emergency session of NATO on Feb. 28, but got little more than “moral” support. NATO wants nothing to do with Syria and certainly doesn’t want a confrontation with Russia, especially because many of the alliance’s members are not comfortable with Turkey’s intervention in Syria. In any case, Turkey is not under attack. Only its soldiers, who are occupying parts of Syria in violation of international law, are vulnerable.

 

The Americans also ruled out setting up a no-fly zone over Idlib.

 

Erdogan is not only being pressed by the opposition, but from the Nationalist Movement Party (MHP) within his own ruling coalition. The MHP, or the “Gray Wolves,” have long represented Turkey’s extreme right. “The Turkish nation must walk into Damascus along with the Turkish army,” says Devlet Bahceli, leader of the MHP.

 

Erdogan has no intention of marching on Syria’s capital, even if he could pull it off. The President wants Turkey to be a regional player and occupying parts of Syria keeps Ankara on the board. But that line of reasoning is now under siege.

 

Turkey’s allies in the Syrian civil war are ineffective unless led by and supported by the Turkish army. But without air cover, the Turkish army is severely limited in what it can do, and the Russians are losing patience. Moscow would like the Syria war to end and to bring some of its military home, and Erdogan is making that difficult.

 

Moscow can be difficult as well, as Turkey may soon find out. The two countries are closely tied on energy, and, with the sanctions blocking Iranian oil and gas, Ankara is more and more dependent on Russian energy sources. Russia just built the new TurkStream gas pipeline across the Black sea and is building a nuclear power plant for Turkey. Erdogan can only go so far in alienating Russia.

 

Stymied in Syria and pressured at home, Erdogan’s choices are increasingly limited. He may try to escalate Turkish involvement in Syria, but the risks for that are high. He has unleashed the refugees on Europe, but not many are going, and Europe is brutally blocking them. He may move to call early elections before his domestic support erodes any further, but he might just lose those elections, particularly since the AKP has split into two parties. A recent poll found that 50 percent of Turks say they will not vote for Erdogan.

 

Or he could return to his successful policies of a decade ago of “no problems with the neighbors.”

 

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