Syria

Why is it embargoed? Syria has been on the state sponsorship of terrorism list since Washington began keeping track of such things in 1979, as Washington says it harbors enemies like Hezbollah and Hamas. But it wasn't until the last decade that trade relations were severed, with the passage of The Syria Accountability and Lebanese Sovereignty Restoration Act. Passed in 2003 and signed by then-President George W. Bush, the bill sought to punish Syria for its occupation of Lebanon. The U.S. government also accused Syrian President Bashar Al-Assad's regime of destabilizing Iraq, and the country of illicitly trading in billions of dollars in oil outside of the UN's oil-for-food swap.

But there are signs of a thaw in U.S.-Syria relations. Syria pulled its troops out of Lebanon in 2005, following the assassination of Lebanese Prime Minister Rafik Hariri - which some claim Damascus had a hand in, though Damascus has always denied it - and President Barack Obama basically resumed diplomatic ties last year.

Market size: Syria has very little domestic production of medical equipment and is reliant on imports, especially high-tech advanced imaging equipment, for its 460-plus hospitals and 1,600-plus public health centers. Of its $1.3 billion dollars spent on health care (in 2005), around $30-$50 million was spent on medical equipment imports, according to a report prepared by the Danish Embassy in Damascus last year. Not surprisingly, about one-third of its hospital equipment is imported from Europe, with Germany being a favored supplier. And the market is growing fast, the report noted, up to 50 percent per year, as the country tries to accommodate its rapidly expanding health sector under the government's ambitious, 20-year health care makeover plan.

Most in demand for import are imaging equipment and diagnostic tools, such as X-rays, ultrasound, MRI, CT scanners and ECG devices, the report said. Customs can be steep, though, and duties can range from 20 to 50 percent.

Export rules:

All medical equipment shipped to Syria, from CT scanners to Band-Aids, needs to get a license, technically called an individual validated license, issued on a case-by-case basis from the Department of Commerce's Bureau of Industry and Security. This also applies to anything re-exported - that is, shipped to a third country but destined to end up in Syria, and also anything made abroad but with at least 10 percent U.S. parts (although there is some disagreement among experts, which we can't go into here, as to whether this means 10 percent U.S. parts period, or 10 percent "controlled" parts) .

According to our sources, the bureau routinely licenses equipment to export to Syria, when it's destined to go to appropriate recipients, such as civilian hospitals and practitioners. The average turnaround time for the license is around 30 days.

While licensing equipment for civilian use doesn't tend to present a problem, one item can raise red flags: bone densitometers.

Usually, it's not a problem to ship them to, say, Damascus General Hospital, but these devices have a surprising "dual use." That is, they can be used to check if scientists working on nuclear weapons or nuclear reactors are getting their bones eaten away by radiation.

Of course, these rules only apply to new equipment. While the U.S. export controls are silent on used equipment, Syria's own domestic laws aren't. Currently, Syria forbids the import of all used medical equipment (See our earlier feature).

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