The Destruction Of Iran’s Medical Infrastructure – OpEd


Medicine is a field of knowledge whose aim is to preserve and enhance health, treat diseases, and rehabilitate the injured. Medical students must study for seven years to become a general practitioner. The specialized course takes at least four years. Then there is the subspecialty program. Nursing, on the other hand, takes about five years or nine semesters of study. Iran’s youths spend years studying in the hope that one day they will be able to earn a living, meet the high expenses (around 10 billion rials), and dedicate their lives to the treatment of their fellow citizens.

The severity of dictatorship in Iran has reached a point that doctors and nurses are committing suicide or are migrating to other countries where they might have better living conditions. The dire economic situation, discrimination at work, low income, long working hours, lack of job security, surveillance by Basij forces, intimidation by the Revolutionary Guards, and security surveillance are some of the problems faced by the healthcare workforce in Iran.

Certificate of Good Standing, prerequisite to professional qualifications

Iranian doctors and nurses are seeking to obtain a “Certificate of Good Standing” to cross the border and establish their careers and lives there. With this certificate, they aim to demonstrate their professional qualifications in another country.

According to Mohammad Sharifi Moghaddam, the Secretary-General of the Nurses House, “Based on the request for ‘Good Standing’ certificates, at least 2,500 to 3,000 nurses migrate from the country annually.”

Last year, the Nursing Deputy of the Ministry of Health announced a shortage of 100,000 nursing staff in the country. If the capacity to attract at least 20,000 nurses annually exists, it would take five years to address that shortage.

The shortage of nurses is a serious problem. The standard nurse-to-bed ratio in some countries is four or five nurses per bed.

On January 27, a nursing authority told Gostaresh news website, “The nurse-to-bed ratio is 1.5 nurses per bed, and in some provinces, this ratio even falls below one nurse per bed.”

However, those who have remained in Iran are grappling with “delayed payment of nursing service fees”, which has no proportional relationship to the volume of their work and overtime hours. They are forced to find second jobs, like many other professions, to partially cover their living expenses. The shortage of doctors is also critical.

On December 2, Didban news website wrote, “The doctor-to-population ratio in Iran is 11.8 per 10,000 population, while this figure ranges from 30 to 50 in advanced countries. Iran ranks twentieth and lower among 25 countries in the region, below countries like Saudi Arabia, Tajikistan, Kyrgyzstan, and Turkey.”

200% increase in migration requests of physicians

On February 6, the state-run Etemad newspaper quoted a source in the Medical Council as saying, “In the first half of this year compared to 2018, the number of physician requests for obtaining the CGS professional certificate has increased by about 200%. In 2021, more than 4,000 physicians received the professional certificate, in 2022 more than 6,000 physicians, and in the first half of this year, more than 3,000 physicians have obtained the professional certificate. It is predicted that by the end of this year, the total number of issued certificates will reach 10,000.”

If we were to consider the requests of other specialized physicians such as pharmacists, dentists, and paramedics, the report would span several pages.

Some universities have turned parking lots into classrooms

It may be unbelievable that the higher education system in training doctors, nurses, and medical staff has reached such a disgraceful state.

On February 6, Tasnim news agency, affiliated with the terrorist IRGC Quds Force, quoted the Deputy Minister of Health as saying, “We do not have the capacity to increase medical capacity by 20% because the necessary infrastructure has not been provided, to the extent that some universities have turned parking lots into classrooms.”

He said that for every 100 medical students, there should be 24 professors. There are 75,000 medical students and 22,000 faculty members. Therefore, there is also relative shortages in the number of professors. For every medical student, there should be 5.6 instructional beds, but there are less than 1.5 beds per student, which undermines the quality of education. Other areas have similar statistics.

The boom in healthcare workforce migration services

These days, companies and agencies providing migration services to doctors and nurses are extremely busy. Many companies offer migration services to doctors and nurses.

On February 5, the state-run Donya-ye Eqtesad newspaper

wrote, “An employee of a company providing migration services to Iranian doctors and nurses states that in the past two years, the increase in demand for migration has become so profitable for intermediary companies that they have been encouraged to add additional services such as free consultation and better placement to their list of responsibilities.”

Suicides of medical residents 

However, for those who do not want or cannot migrate, what fate do they have under the corrupt rule of the mullahs? A heartbreaking letter from the Iranian Society of Psychiatrists reveals the high suicide rates among residents, indicating that the healthcare workforce is also among the suffering individuals affected by the current regime.

On January 9, the state-run Ham-Mihan newspaper wrote, “The prevalence of suicide among young doctors and medical interns is about ten times higher than that in the general population of the country. The continuation of this trend paves the way for the collapse of the country’s healthcare system.”

On February 8, the head of the Association of General Practitioners warned, “While the state of the healthcare system has not been good for a long time, these days it is in crisis and its condition has worsened significantly.”

The all-encompassing crisis of drug shortages

In this suffocating crisis, merely addressing the shortage of medication does not alleviate the pain anymore.

A member of the Health Commission of the Parliament warned about the transformation of the drug shortage into a ‘‘crisis.’’

On July 1, ILNA news agency quoted him as saying, “The number of scarce drugs in Iran has exceeded 200 types.”

If a solution is not sought, this issue may turn into a social, political, economic, health, and medical crisis, the health official said.

The Social Security Organization’s debt of 90 trillion rials to hospitals and the government’s debt to this organization, which is tens of times higher, is just a glimpse of this crisis. This is happening while some factions are taking advantage of this issue in their own interests.

On January 27, ISNA news agency quoted speaker of Majils (Parliament) Mohammad Baqer Qalibaf as saying, “I emphasized in an official letter to the President that we have allocated an exchange rate of 42,000 rials for healthcare as well. Why should medicine become 107% more expensive?”

Insufficient access to medical services 

On April 12, 2022, Mehr News Agency in referring to the Article 90 Commission of Majlis (Parliament), regarding the problem of healthcare system, wrote, “Shortage of specialist doctors, a decline in the quality of medical services, an increase in medical errors due to high work pressure and lack of replacement personnel, long waiting queues for receiving services, and the uneven distribution of doctors throughout the country as consequences of the shortage of doctors.”

Doctors, nurses, and medical staff are the guarantors of people’s health in any country, are being treated woefully.

With a nation bearing heavy expenses in their training to ensure the foundation of the country’s social, cultural, and economic health, the current regime in Iran not only fails to enhance this immense national capital but intensifies its destruction from its very foundation. To put an end to this corrupt system, the only remaining solution is nothing but overthrowing the regime at all costs to salvage the nation from this ongoing destruction.

Mahmoud Hakamian

Mahmoud Hakamian writes for The People’s Mojahedin Organization of Iran (PMOI), also known as Mujahedin-e-Khalgh (MEK)

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