Here in the United States, the average American is aghast at finding the United States on opposing sides to Russia in a massive conflict, while the Pentagon continues to underestimate Soviet nostalgia and lust for Ukraine – having assessed Putin as unlikely to embark on a full-scale invasion of Ukraine and instead more likely to seek ‘salami tactics’, cutting small slices of Ukraine away over a five-year plan. In fact, Putin has been playing the long, long game.

Battle-hardened warriors and humanitarian workers familiar with Russia from its presence in Syria are in no doubt Putin is invading with the intention of taking the entire Ukraine. The United States – and an incredibly ineffectual and battle-shy Nato – continually underestimates Putin as a leader and also underestimates the risks of the long-standing provocation of Russia.

Putin is not cowed by hollow sanctions being imposed at the final hour (instead of immediately after the annexation of Crimea in 2014). Putin has silenced Russian opposition for the last four years, and he has long sought to insulate the Russian monetary system independent of international transfer for the last three years – a system far more independent of the global economy than the Western monetary system.

Putin has been diversifying his engagement and alliances overseas, often where the United States has left a vacuum. Putin is closely allied with China and India for both gas supplies and trade ties, and has expanded political ties with China which itself has expanded and deepened its engagement with Pakistan (and likely Afghanistan) as part of its Belt and Road Initiative. It has also matured its natural gas exploration and development on the Arabian Sea through Gwadar in Pakistan. India joined the United Arab Emirates in abstaining from voting to condemn Russia’s actions at the UN Security Council this week.

The Middle East is a place where Russia has been deeply entrenched and heavily invested, digging in ever more as the United States pursued disengagement. I have spent much time living there, practising medicine, and travelling to teach and assess the aftermath of war as a human rights defender including in the wake of the Iraq War, the genocide ISIS waged on the Yazidis, the bitter war waged by the Taliban on Pakistan, and most recently – immediately before the pandemic – the war Nato ally Turkey waged on the Syrian Kurds, displacing the Kurdish people from Rojave after the United States effectively green-lit the operation.

Russia has been waging insurgency warfare alongside Hezbollah in Syria and supporting Assad’s military for almost the entirety of the Syrian Civil War, now 11 years old. Along the way, the Russians also fought ISIS and deepened their partnership with Iran. This, against a background of being defeated by insurgency warfare in Afghanistan by the US Pakistan trained Mujahideen during a ten-year occupation of Afghanistan forty years ago, which has never been forgotten by Russia’s current leadership.

Neither the Ukrainians nor Nato allies – other than Turkey – have had anything approaching the same exposure to successfully achieving military objectives in an insurgency warfare setting. Molotov Cocktails and Babushka battalions will not do the trick. Russia has not only the upper hand militarily but the grit to stick out conflicts when the West ups and leaves.

Syrians describe Putin’s personality as one who ‘will stick the bayonet into you until he meets bone. As long as he meets no resistance he will keep pushing, deeper and deeper into tissue until he finally meets resistance’.

We are going to see a lot more devastation in Ukraine than we could ever be prepared for.

For those who have been following the Middle East closely, we anticipated a conflict drawing in the world’s preeminent powers long ago. The Syrian Civil war rapidly pulled in world powers – Russia and the United States – as proxies. Much like the Spanish civil war, which saw all participants in direct conflict a decade later in what would become the second world war, we today see Russia and the United States dangerously close to open conflict.

The shock and dismay in the United States and Europe at the conflict is deeply surprising to me and I can’t help thinking, to a degree, perhaps orchestrated. The actions of Russia are highly predictable given America’s refusal to confirm Ukraine would remain neutral of Nato, which is an absolute deal breaker for Russia’s national security. Since the fall of the USSR, there has been universal understanding that expansion of Nato was a foolish provocation of Russia and would never be undertaken.

In the Middle East, seasoned in two decades of unrelenting war post 9/11, we have seen much scepticism. It seems the West is allowed to invade without sanction, but not Russia. It seems acceptable for the West to topple seated governments, but not Russia. Pakistanis are observing the United States’ newly embraced ally India has been curiously silent on the Ukraine war much to President Biden’s chagrin.

Pakistan’s Prime Minister, Imran Khan, was in Moscow on February 24 when Russia rolled into Ukraine. His advisers had weighed the pros and cons of being in Moscow at that time but, recognising their energy-deficient status and their need to expand their diplomatic spheres, the Pakistani premier went ahead minus the press conferences, photo ops, and public engagements. On the agenda was Afghanistan and its aftermath, which impacts Pakistan and China and Central Asia. Also an agenda item, Pakistan seeks Russia to build a liquid natural gas installation in Gwadar Port on the Arabian Sea – already fully developed by China.

Underlining the success of the visit, Pakistan’s leader will join Putin when they are both hosted in China in March. This is the new geopolitical alliance and, even as India cozies up to the United States to counterbalance Pakistan’s deep relationship with China, they may today be reconsidering that alliance particularly as its major arms supplier is Russia. India is seen as a rising democracy that has recently enjoyed deepening engagement with the United States, although Prime Minister Narendra Modi’s illiberal and explicit Hindu Nationalism has given the United States pause. India is armed from Russia and France while India’s modernisation of its military has been delayed as India engages in a tense standoff against China across the Himalayas.

When Afghanistan collapsed and the United States left in such an ignominious and appalling manner, India lost significant investments there to the tune of USD 3 billion, which it had been cultivating as a counter to Pakistan – hoping to entrench Pakistan in a pincer-like vice between Hindu Nationalist India and a pro-India Afghanistan. Pakistan relished with significant schadenfreude to see the exit of the United States in Afghanistan and was doubly thrilled when this exit took with it India’s geopolitical efforts to influence Afghanistan. For Pakistan, the United States debacle in Afghanistan was truly a win-win.

That collapse underlined just how Central Asia is becoming of critical importance. Afghanistan, Uzbekistan, Kazakhstan, Tajikistan, Turkmenistan, Kyrgyzstan, and many oil-rich states and former Soviet vassals encircling Russia, remain loyal to Russia and are aware they may also be on the list for annexation or subjugation by an imperial Russia. Afghan refugees fleeing the Taliban remain in Mazar-i-Sharif still awaiting humanitarian entry into Uzbekistan or Tajikistan where border control has been extremely tight in keeping with Russia’s wishes. This war means the future for those once fleeing the Taliban is even more bleak.

China also pursues influence here and has been as deeply invested here as in Africa. Pakistan is long functioning as a Chinese Satellite state already favourably armed by China in terms of aircraft fighter jets, submarines, frigates to even up the balance of power with India. In addition to this, China has long been building hard infrastructure inside Pakistan including the Gwadar Port authority on the Arabian Sea, which is part of the USD 62 billion Chinese-Pakistan Economic Corridor. Drawing closer to Russia can only benefit Pakistan which has been cast into the cold by the United States despite being a staunch partner in both the Afghanistan war to bring down the Soviet Union and the ‘Global War on Terror’. Finding and executing Osama Bin Laden in Pakistan’s West Point brought United States-Pakistan relations to their lowest point. Unsurprising, President Biden’s appeal to Pakistan to drop the visit to Moscow on the eve of the Ukrainian invasion fell on deaf ears. Pakistan is looking for staunch allies, not fair-weather friends ruled by election cycles.

Russia’s influence in Syria has essentially been uncontested by the West in Syria, almost from the outset, having crossed the infamous red line of using chemical weapons on its people, President Obama undercut then-Secretary of State John Kerry who had announced airstrikes against Syria with France. That was a green light to Assad, Russia, and Iran that the United States was not engaging.

As a result, Russia has partnered unhindered and exerts influence over Iran and even overrides Iran in Syria as needed. Russia has had little to lose and everything to gain and the United States has confirmed repeatedly it has been in retreat, not only from the Middle East, but essentially all international intervention.

The United States has repeatedly retreated particularly under President Obama, but also under President Trump. It retreatd from Russia’s war on Georgia in 2008; the United States observed the heartbreaking Iranian Velvet Revolution in 2009, but failed to respond to the brave Iranians protesting; the Arab Spring turned to Arab Winter with the United States hastily congratulating the rise of the Muslim Brotherhood in Egypt, the United States has had no influence over the Syrian Civil War since almost its 2011 inception; the United States lost an ambassador in Benghazi abandoning him disgracefully to die without support as the Libyan war descended into an abyss which continues, Russia’s annexation of Crimea went undeterred by the United States in 2014. Indeed by August 2021, the United States confirmed what the world already knew: America remains deeply weakened in resolve and inability to fight insurgency wars, and in Ukraine, America shows that we are dangerously provocative without risking our own troops, at the expense of both Ukraine and Europe.

The enormous vacuums created by the vacillation and retreat of the United States and the rhetoric of Nato and the EU has long been occupied by Russia, Iran, and China.

The Arab world does what it does best – taking a pragmatic approach. The United States long ago lost its credibility in Syria – and the whole region – most recently when President Trump in 2019, despite standing so close to Crown Prince Mohammed bin Salman Al Saud after the Khashoggi assassination, failed to punish Iran for an extraordinary drone attack on Saudi Aramco (ineffectually protected by United States patriot missiles) in September 2019. Now we are on the cusp of reintroducing a very uranium-rich Iran back into the international community as the Joint Comprehensive Plan of Action (JCPOA) is finally recognised and Iran will return to trading with oil over USD 100 per barrel.

Ain’t it grand? If you are a dues-paying member of the Axis of Evil, things couldn’t be going any better.

For Israel, like the Arab world, the pragmatic and battle-hardened Jewish State long ago knew the Assad you know is better than the devil you don’t.

Israel has settled into the new geopolitics of an Assad, propped up by Russia, in return for warm water naval ports for Putin. Even so, Russia allows Israel to target Iranian assets inside Syria while Russia continues signing long-term arms deals with Iran and trade deals with Iran. Russia is here for the duration and Israel knows this. With the Abraham Accords rapidly solidifying with real trade deals and business ties, the Arab Gulf World united by both a common enemy of Shia predominance and dismay at American betrayal may come to rely on one another even more than originally imagined.

The region is shifting in its geopolitics and the highly nimble Abraham Accord nations are waiting to see where the compass will finally show due north. Hence hedging bets, Saudi Arabia has started to reengage with Iran and even Iraq, and yet again the world’s hardiest bravest most thankless fighters – the Kurdish Peshmerga – are once again without western support. They too may become pragmatic and move closer to Russia as both Turkey and Iran attempt to squeeze the Kurdish region in an ever-tightening noose in the fractured Iraq of today.

Meanwhile, Turkey may still capitalise from this conflict Turkey under Erdogan remains a Nato ally – with its second-largest standing army, and manufacturer of some of the most advanced weaponised drones in the world – yet was long scorned when seeking the true benefit of Nato membership, entry into the EU, and now has given up that aspiration.

Today, Turkey is seeking to broker reconciliation between Russia and Ukraine, and is relishing the criticism Erdogan is piling on Nato and the West for their weakness in the face of Russian aggression. Unconfirmed reports suggest Turkey is denying access to the Black Sea for the Russians, perhaps in exchange for carrots Turkey can extract from both the West and Russia. Turkey purchased S400 anti-aircraft missiles from Russia, which can shoot down Nato and United States fighter aircraft rather than purchase the patriot anti-aircraft missiles systems affronting President Trump at the time, also revealing how major powers like Turkey have long been hedging their bets by playing both sides and are not afraid to confront either Russia or the United States.

Meanwhile in America, our President weekends in Delaware. The Oval Office is empty. We are captured in our obsession with woke Neo-orthodoxy, including the demonisation of Jewish people as white supremacist colonialists, our obsession with finding domestic terrorists which might be in our militaries and perhaps even about to pounce on our school boards ‘innocently’ peddling critical race theory (including parents who object to the theory). We have critical important concerns with gender fluidity, transgender sports, and until recently, overbearing pandemic restrictions though overnight the pandemic has vanished from our televisions. Divisions between Americans have never been deeper our sense of place in the world never more obscured.

Barely six months since the most cataclysmic exit of American forces in history from Afghanistan, it is business as usual and there is both war and money to be made.