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Diagnosing Syria's Health Care Problems; Trying to Break the Global Gridlock; Syria: The Politics of Peace; Imagine a World

Aired November 26, 2013 - 14:00:00   ET


CHRISTIANE AMANPOUR, CNN HOST: Good evening, everyone, and welcome to the program. I'm Christiane Amanpour.

It seems that all roads lead to Geneva these days, the venue first for Iran's interim nuclear deal signed with major world powers and next the setting for a peace conference aimed at trying to end Syria's brutal and bloody civil war, a war that has largely fallen off our screens and front pages recently, especially after President Bashar al-Assad agreed to give up his chemical weapons, the price of staving off Western military intervention.


AMANPOUR (voice-over): But the war isn't over. It rages fiercely on with hundreds of thousands of dead and wounded, sick and starving.


AMANPOUR (voice-over): Look at that. These children escaped death by a hair's breadth. And more than 11.5 thousand children have been killed, the majority by explosives. That is a stunning new statistic in the mountain of horrifying milestones that has defined this war.


AMANPOUR: Severe malnutrition is making many susceptible to the onslaught of disease, such as polio. It has been eradicated in most of the world, but now it is back in Syria. And beyond the borders, 2 million refugees have escaped this war, fast becoming one of the worst refugee crises the U.N. has ever had to deal with.

On the battlefield, a punishing war of attrition that's become a proxy fight now between Sunni powers like Saudi Arabia and the Shiite heavyweight, Iran. And with no side near victory, the U.N. Special Envoy Lakhdar Brahimi has now announced that peace talks are to be held in Geneva early next year.

But there are still more questions than answers, even about that conference.


LAKHDAR BRAHIMI, U.N. SPECIAL ENVOY TO SYRIA: We have agreed on a day for the conference, 22nd of January, here in Geneva. We are still discussing the complete list of participants and we will be meeting again on the 20th of December for another trilateral (ph).


AMANPOUR: A lot of dates, a location, but so far, no participants. And if the two sides do actually finally sit down at the table, it'll be the first time since the war began.

Later, I'll talk politics of peace with Assad's big backer, Russia. But first the desperate plight of the people who are caught up in this grinding war. Our Fred Pleitgen is in Syria, witnessing a frantic new struggle against disease, the mass vaccination program on all sides of the front lines to try to control this deadly outbreak of polio.


FREDERIK PLEITGEN, CNN CORRESPONDENT (voice-over): The vaccine is bitter. Little Inouwa (ph) cringes as he swallows. But it's key to combating a polio outbreak in Syria.

"We heard of the outbreak and that the government is giving vaccinations," Inouwa's (ph) father says. "And so I went to get my son vaccinated as fast as possible."

At Damascus schools, children sing before getting the polio vaccine. The World Health Organization announced on Tuesday that the disease has spread to the Syrian capital, this after more than a dozen cases were found in northeastern Syria last month.

PLEITGEN: This is part of a massive vaccination campaign in the wake of the polio outbreak. It doesn't just involve the Syrian government, but also the World Health Organization and UNICEF as well. The doctors say they're not only trying to reach children in the government controlled areas, but are also going into dangerous zones controlled by the opposition.

PLEITGEN (voice-over): The outbreak is the first here in almost 15 years and the WHO warns that the virus is spreading as people flee their homes trying to get out of harm's way. As the fighting intensifies, opposition areas especially have seen the collapse of a health care system.

Government forces have laid siege to many rebel-controlled towns and activists say food and medicine are not reaching those who need them most. It's impossible to independently verify horrifying images of malnourished children, like these posted on social media. But an opposition leader contacted by CNN says the situation in the besieged areas around Damascus is getting worse by the day.

"Medical supplies are the most needed," he says, "because a person can manage hunger but cannot bear illness or see his child suffering from a wound from shelling. We are forced to support the free army to break this siege."

The government, for its part, blames rebel fighters for the shortages. The top Syrian health care official told me many hospitals and other medical centers throughout the country have been destroyed by the fighting.

AHMAD AL ABOUD, DIRECTOR OF PRIMARY HEALTH CARE: We (INAUDIBLE) to repair these centers or hospitals or to put like building, any building, to doing as centers, to provide the care of -- to the children (INAUDIBLE).

PLEITGEN (voice-over): While both sides point the finger at each other, it's clear who's suffering the most, Syria's children, threatened by war and now also by disease.


AMANPOUR: And Fred is joining me now live from Damascus.

Fred, it's just too heartbreaking to watch those pictures and listen to those children crying. The people who you're talking to, do they have any hope that there's any movement towards ending this war?

Who's saying what about the upcoming peace conference that's scheduled?

PLEITGEN: Yes, good evening, Christiane. There's very little hope at this point in time really on both sides. On the opposition's side as well as those people who are on the government side. First of all, there's not many people who actually believe that this Geneva conference is going to happen actually on January 22nd. There's even fewer people who believe that if, in fact, it would happen, that it could yield anything, at least in the first couple of meetings.

The big questions people obviously have is if the Assad side, if the government side takes part in this conference, what sort of concessions are they actually willing to make now that they believe that they're in the driver's seat?

And then, of course, there's the other big question that many people on the government side ask, and that is which opposition is actually going to show up? Is it going to be the Syrian National Coalition, which other groups are going to show up and do they actually have any sort of leverage on the battlefield?

Certainly talking to opposition people on the battlefield, is does not seem as though the SNC has very much to offer at this point in time. But one of the things I have to say, from being here several times this year, Christiane, is I've never seen such little hope among these people. You came here a couple of months ago; people would say we believe this might be over in a few months. We believe that there's something that could happen.

There are no people that I've seen who would say that right now. There's only people who say we know this is going to take a long time and the one thing everybody wants is for the fighting to finally stop. They don't know how that could happen. But that certainly is the real wish that people have here right now, but there is really very, very little hope.

AMANPOUR: Fred, thank you for that really, really necessary update on the plight of the people there. And it's often forgotten. So thank you for bringing us that report.

And as we've talked about, the resurgence of polio, just being one symptom of Syria's devastated health care system, my next guest is Dr. Zaher Sahloul, and he knows all too well the situation. He's president of the Syrian American Medical Society; he regularly travels into his homeland to assess and assist the injured and the dying.

And he's also a former classmate of Bashar al-Assad. They were at medical school in Damascus together. Bashar was an ophthalmologist before becoming Syria's president.

Dr. Sahloul, thank you very much for joining me from Chicago, where you are right now.

Let me first ask you about polio. We all thought it had been eradicated.

What is the real impact, the effect, the severity in Syria right now?

DR. ZAHER SAHLOUL, PRESIDENT, SYRIAN AMERICAN MEDICAL SOCIETY: What we are seeing right now in Syria is the tip of the iceberg. When we have 46 cases of polio, that means there's at least 5,000 children who are infected with the virus, carrying the virus and spreading it. And they're not diagnosed.

Not every child who is infected with the virus will have paralysis. So what we're seeing really are small minorities of the children who have the virus of polio.

And as we all know, polio is not treatable; it's very infectious and it does not abide by boundaries and by borders.

AMANPOUR: Will this vaccination program now control it? Or are we going to see more, this iceberg that you're talking about.

Are the lower parts of the iceberg going to manifest itself?

SAHLOUL: That's what everyone is expecting. Unfortunately, the World Health Organization and the UNICEF do not have presence in large territories of Syria. About 50 percent of the Syrian territories do not have access. NGOs do not have access to them. So I'm really doubtful that we have an effective vaccination campaign in areas like Aleppo, Idlib, Deir ez-Zor, where you have a majority of the cases of polio.

These areas are only accessible by Turkey or by Jordan.

AMANPOUR: And presumably they could do some vaccinating if they so chose. But let me ask you about the malnutrition.

We saw these horrendous pictures of very, very skinny, malnourished children.

What is the extent of that problem in Syria right now?

SAHLOUL: It is a huge problem. We have, according to the United Nations, 2.9 million Syrians who are trapped, who are under siege by the government, unfortunately.

We had several cases of children who died in malnutrition in areas around Damascus. These are the same area that received chemical weapons. These are the same areas that chemical weapon inspectors are going into to inspect chemical weapons. But NGOs like ICRC and Syrian Rescue Committee are not able to access, to bring food, baby formulas and other medical supplies.

It is really shame on the war that we have children dying in malnutrition near Damascus.

AMANPOUR: And you heard the doctor on the government side of the lines talking about the threats to medical establishments, that a lot of them are being attacked and hit by the bombardment.

That is probably happening, but what about the situation in the rebel- controlled area as well?

I've heard you say that they are deliberately targeted, that the very medical services themselves are a deliberate target.

SAHLOUL: Well, definitely. This is something that we've been witnessing from day one in this crisis. And before talking about Geneva, too, I think we need to have to talk about Geneva 1 convention that happened in the 19th century where the international community agreed that hospitals and medical personnel, doctors and nurses and ambulances should not be targeted.

And what we are seeing in Syria -- and I was in Aleppo and I was in northern Latakia. And some of the hospitals I visited were bombed next week. So we have doctors being killed; we have nurses being killed. We have hospitals being destroyed. And this is a travesty.

And it looks like the international community are not really caring about what's happening to doctors, the patients, to hospitals. And this is really very painful to us physicians from United States, who are trying to provide health and assistance to our colleagues in Syria. And we know them, and some of them are dying because of the aerial bombing, because of the ballistic missiles.

AMANPOUR: We do have some pictures, your own pictures, of the hospital in Latakia that you were dealing with, that you say has now been attacked.

But I want to ask you as we're looking at these pictures, to tell me about what you know Bashar al-Assad.

It does seem incredible that the two of you were classmates at medical school in Damascus all those years ago.

SAHLOUL: Well, I mean, there's always side, the different side for, I would say, the dictators. I always wonder what would be the classmates of Hitler or Karadech (ph) or Milosevic have in mind about the other dictators.

But you know, when he was in medical school, he was a humble person. He was accessible. I had a couple of meetings with him after he became a president and he didn't talk a lot. I mean, he was very humble and he mentioned one time that he preferred to be a physician.

It's interesting to say that -- I mean, I heard some of his speeches and interviews. And he always uses medical terminology to describe what's happening. So his first speech, for example, when he talked about the demonstrations in Syria, he said that we have germs in Syria that we need to get rid of.

In one of the interviews, he mentioned that if you are a surgeon and you have blood on your hands, that doesn't mean that you are a criminal. In another interview, he said -- he was asked whether he would be as brutal (ph) as his father. And he said, "If you have a gangrenous leg in your body and you cut it, that means that you are trying to save the body. You're not a criminal or brutal."

So he tends to use medical terminology but of course.

AMANPOUR: All right, Dr. Sahloul. I appreciate it. I appreciate you joining me to tell us about what is going on medically in terms of the health of the people of Syria right now.

And in another natural disaster zone, half a world away, another mass vaccination effort is underway in Tacloban, the region of the Philippines that's been hardest hit by Typhoon Haiyan. Some 30,000 children there need to be immunized against polio and measles.

With more than 5,000 people killed by the storm and uncounted numbers left homeless in crowded, unclean conditions, young children there, too, are particularly vulnerable to disease and infection.

And after a break, we'll return to Syria's civil war and the prospects for peace as one of Assad's main backers, can Russia now be an honest broker at the negotiating table? Courting the Kremlin, when we come back.




AMANPOUR: Welcome back to the program.

Now to the politics of trying to get peace in Syria. The so-called Geneva 2 conference called for January is aimed at getting both the Assad regime and the opposition to agree to a transitional government as a first step.

But right now the two sides are as far apart as ever and crucially it's not even clear who, if anyone, will attend from the much fractured opposition.

Russia is a key backer of the Assad government. It was Moscow that engineered the deal to get him to give up his stash of chemical weapons. And it's Russia that continues to play a prominent diplomatic role in the region.

So I asked Vitaly Churkin, Russia's ambassador to the United Nations, whether it can engineer a successful peace conference as well.


AMANPOUR: Welcome to the program, Ambassador. Thanks for joining me.


AMANPOUR: So here we have again the attempt to get a peace process on the way for Syria. But we don't even know who's actually going.

Is that a little alarming? Even the special envoy couldn't say who's actually going from all the parties involved.

CHURKIN: Well, this is precisely the problem. And this is the reason why it has not been possible to convene the conference until this point.

And only yesterday the secretary-general was able to announce January 22 as the date for the convening of the conference.

But still, work needs to be done about the opposition, because there is no unity among the opposition. And various opposition groups do not recognize the right of the national coalition, which is usually referred to as the logical representative of the Syrian opposition, as their representative.

And of course for the conference to be successful, not only the opposition groups need to be constructively engaged, but also there must be acceptance among them that they are well represented.


CHURKIN: So some work still needs to be done. And we are participating in this work, because even though the United States said that they are going -- they were going to bring the opposition to the table, we're also in the process of talking with various opposition groups in order to make sure that they do come to Geneva, they do come as united as possible and they talk constructively on the basis of the Geneva communique of 2012.

AMANPOUR: Well, if you had to bet right now, this peace conference is scheduled for about two months away, do you think it'll happen?

And do you think it'll be meaningful?

I mean, uniting the opposition has been attempted for the last 2.5 years.

Do you think there will be a meaningful conference?

CHURKIN: I -- you know, my gut feeling is that it is going to happen this time unless there is a major provocation. And what is disturbing is that we here again return to this conversation of changing things on the ground before the conference takes place.

So the danger now is an effort by the opposition to reverse the military situation and to have some military gains and then things can go badly. And in the absence of unity among the opposition, then the convening of the conference may be at risk.

AMANPOUR: All right. You talk about the military track and the opposition; well, obviously also President Assad has very powerful friends, including you and Iran. And there is a lot of military activity on his side as well.

Is President Assad expected to be part of a post-conference reality?

Or does the peace proposal envision him leaving power somehow after a peace deal?

CHURKIN: Well, of course, there is nothing about him leaving power in the Geneva communique. But -- which is going to be the basis of the negotiations.

But our answer to your question is that the Syrians must decide that themselves. They know that there is a Geneva communique; they know that. They need to talk about political transition. They know that they need to put together a transitional body by mutual agreement, including agreeing on the personalities.

What is going to happen after that remains to be seen after they have had a chance to get into the negotiations with the support, hopefully, of key members of the international community. Russian support is going to be there, both for the government and for constructive participation of the opposition.

AMANPOUR: Given the fact that in Geneva the world powers just signed an interim nuclear deal with Iran, is Iran invited to this Geneva 2 conference on Syria?

And is that presence accepted by the United States and the other parties?

CHURKIN: This is -- this is -- this is one of important issues because we believe that Iran should be invited. Kofi Annan, when he was special envoy with the secretary-general believed that Iran should be invited.

Now both Ban Ki-moon and Lakhdar Brahimi, secretary-general of the United Nations and special representative of the secretary-general for Syria, believe that Iran should be invited.

But the United States is against. We think it makes no sense because now the nuclear deal has been made; and we are -- United States engaged Iran both multilaterally and bilaterally. And then, you know, whether Iran is in the room or not, in -- of the conference, it's going to be a player in Syria.

So it's better to have it in the room; it's better to have its support, the deals which we hope will be reached, in Geneva rather than alienate Iran once again. That mistake has been made a number of times before; let's not repeat it in the context of the Geneva 2 conference.

AMANPOUR: Let me ask you then on the -- specifically the nuclear issue, as you can see, this deal has been signed, has created a storm of opposition in Israel, in some parts of the Arab world, in the U.S. Congress.

What can you say about your confidence that this deal will be kept to, that Iran won't break out, that there is sufficient verification?

Do you feel that?

CHURKIN: Yes, we do. You know, it's because it's not a rhetorical deal. It's something which is setting in train (ph) very important steps from Iran and the international community and cooperation with Iran.

The nuclear program of Iran, the enrichment program will essentially be not stopped but sort of not developed any further and, in some cases, turned back. What I'm referring to is the intention of Iran to dilute some of the uranium which was enriched to 20 percent.

New verification measures are being put in place. A joint commission is going to be -- is established between the six and Iran involving IAEA and its inspectors.

So this is -- I mean, the paper has been released. It's a pretty detailed and very serious deal which I believe is a great achievement, both for the six and for Iran and it's particularly important that we are finally talking in practical things and there is a real opportunity here to get rid of this specter of Iranian nuclear weapon.

And if this is -- if it were to happen -- and we believe that there is a very good chance of that -- then this threat to Israel, which has been hanging over their heads for such a long time, will be taken care of.

So I think that the Israelis and other doubters should give everybody an opportunity, those who are involved in the actual negotiations, to move ahead on this deal. And that might turn around the entire situation in the bigger region. It will have a positive impact on Syria; will hopefully have a positive impact on the Israeli-Palestinian track and the entire situation of the Middle East.

So we're really at a crucial point now. And we are very pleased and encouraged that we are beginning to turn away from the logic of confrontation on the use of military force to dialogue and involvement. This is something which Russia has been advocating for a long time.

AMANPOUR: Ambassador Churkin, thank you very much indeed for joining me.

CHURKIN: Thank you, Christiane.


AMANPOUR: Now for more than 2.5 years, Syria's civil war has also produced a brutal war on the truth. The Committee to Protect Journalists says that 28 newspeople were killed in Syria; at least 18 are considered missing, all in the past year alone, making Syria the most dangerous country on Earth for the press.

After a break, peace in Syria was also on the agenda when Pope Francis welcomed Russian President Vladimir Putin to the Vatican this week.

But wait until you hear what Pope Francis has to say to his own Roman Catholic flock. The very latest -- and it is extraordinary -- when we come back.




AMANPOUR: And finally tonight, Pope Francis continues to astound, making a personal appeal to Russia's President Vladimir Putin, urging him to help broker a peace in Syria.

Now imagine a world where the pope has taken on an even harder challenge, preaching to the choir. Pope Francis has issued his first official papal document, the Evangelii Gaudium, or the Joy of the Gospel.

And he pulled no punches in addressing the faithful with a robust call for major reform, quote, "I prefer a church which is bruised, hurting and dirty because it has been out on the streets rather than a church which is unhealthy from being confined and from clinging to its own security."

It seemed to be a shot across the bow at customs and conventions that have alienated millions of Catholics and a call to arms for a church seeking a revival. Already by his near-ascension to the throne of St. Peter, priests in Italy report a significant rise in church attendance and Francesco is now Italy's most popular baby name.

Tomorrow we'll dive deeper into the nuts and bolts of the Gospel According to Pope Francis.

And that's it for our program tonight. Remember you can always contact us as our website,, and follow me on Twitter and Facebook. Thanks for watching and goodbye from London.