McMohan - 9:34 am on Jun 20, 2013 (gmt 0)
Here is a site that targets the entire Middle East region. It is in English and the content is significantly same as its parent site. rel="alternate" hreflang="x" targets by country/language. AFAIK there isn't a region code nor a sub-country code.
Is writing the rel="alternate" annotations for all the countries in the Middle East an option?