Iran: Patients Suffering From Rising Medical Costs, 45% Of Diabetics Can’t Afford Treatment – Interview

I recently had the opportunity to conduct an interview with a medical doctor in Iran, whose name is being published anonymously to avoid any possible repercussions in the country of origin. The concepts and information provided, as well as the high level of interpretation of Iranian sociopolitical reality, are breathtaking as Iran is one of the least known countries on the world stage. In continuation is the full interview. 

Question 1: From the time when you graduated and in the present, what are some of the changes in the Iranian society that you have experienced?

Response:  I am Dr. A.M., a doctor from the city of Mashhad (Eastern Iran). I have twenty years of experience in occupational therapy in this city and other cities in Khorasan province.

I am in favor and support the Mojahedin Khalq organization and represent a generation of Iranians and doctors inside Iran who had no role in the 1979 revolution, but we have been greatly affected by the revolution and the war. We experienced several stages during the 40 years of the Mullah’s ruling in Iran:

1 – The first generation after the victory of the revolution who opposed the Islamic government were subjected to oppression, which was almost the most horrible period of this government. The massacre and torture of dissidents on the one hand and the killing of Iranian youth on the battlefield that Ruhollah Khomeini and his supporters extended it for their establishment on the other hand. This period is when my generation, the generation of the seventies, witnessed the rule of terror within society and also towards our families.

2 – The second decade of the revolution with the end of the war and the establishment of so called moderate Islamic forces such as Rafsanjani- which were affiliated to technocrats, the government system became focused on security and the suppression of social protests that took place during Hashemi Rafsanjani’s term. With the coming to power of Mohammad Khatami after the suppression of student protests in 2008, the presence of IRGC repressive forces in all social spheres took place. 

3 – In the third decade of the Islamic Republic of Iran, we also had a security atmosphere and widespread social repression by the regime’s security systems. 

4 – During the last 10 year, the change of social forces took place to the detriment of the government, and the movements of December 2017 and November 2019 were able to unite the social forces against the government, and the repressive structure of the regime was terrified of this solidarity of social forces against the ruling elite. 

In the meantime, the activities of the Mojahedin Khalq Organization and its supporters inside Iran, of which I am also a supporter of this organization, always existed during these years; They are present inside Iran as an alternative and the main opposition to the ruling regime. 

Question 2: With the new president coming to power, what do you expect to change in the public health sector and what are some of the issues that are pressing very hard the Iranian families today?

Response: The 13th government (Ebrahim Raisi) has so far done nothing to improve the functioning of the health care system, except for the nationwide vaccination against the COVID-19, which was delayed for several months due to political rivalries. It is not work of a government, of course, but a long-term plans, but what comes out of the evidence is that due to the bankruptcy of the government economy in Iran, (inflation in the health sector is higher than in other sectors of the Iranian economy) many patients, such as diabetics and heart patients are not able to follow their treatment. According to the latest report of the Ministry of Health, forty-five percent of diabetic patients have stopped their treatment due to the high cost of their medicines.

The economic situation of Iranian households is in dire condition and according to Hamid Hosseini, a member of the Iranian Chamber of Commerce, only four million Iranians out of eighty-seven million Iranians are above the poverty line, which means that only three forth (3/4) of Iran’s population has the ability to live a normal life. Most of these four million are affiliated to the officials of the government or security forces.

Question 3. How is the state of medical technology in Iran? Medical infrastructure in Iran? 

Response: Iran is an importer of medical technologies from the West, China and Russia. Of the 194 pharmaceutical companies in Iran, ninety-five percent are importers of raw materials for medicine, so in global sanctions, food and medicine were always exempt from any sanctions. They can import advanced medical equipment from the United States to Iran if they want. The medical structure of Iran is completely dependent on the developed world and we do not produce any technology in this field.  Medical infrastructure includes treatment infrastructure and specialists in the field of treatment.

What is included in the medical infrastructure, including the buildings and medical equipment inside of them, except for the buildings, the rest of the equipment infrastructure is the import of Western, Chinese and Russian technologies, but regarding the manpower for working with this equipment, it can be said that they can handle it and there is no dependency in this regards. 

Question 4. How is the participation of women in the medical field in Iranian universities?

Response: In fact, the female labor force in Iran in the two fields of education and health is almost equal to international standards. The female  participation  in the field of health care is twenty-five percent. Out of 150 thousand Iranian nurses, more than fifty percent of them are female. It is estimated that less than ten percent of the faculty members are women. In the field of medical education, the number of male and female medical students is equal.  

Question 5. What are some of the challenges in medical infrastructure and burdens for medical doctors?

Response: What we call the public health system of Iran is in fact the achievement of sixty years since the formation of the health system. During these sixty years, the overall structure of Iran’s health care is up to the standards of the World Health Organization, but what has prevented this structure from providing adequate services to Iranians is the change in the strategy of this structure by Hashemi Rafsanjani’s government during his 8 years tenure. According to the laws of the Rafsanjani government, Iran turned the medical and health needs of Iranian citizens into health goods, and many of the basic health rights of Iranian citizens became marketable goods. It used government funding to cover the cost of treatment for citizens. The business approach to the health system over three decades has caused economic inflation in this area to pose a serious threat to public health, according to the Ministry of Health. Forty-five percent of diabetic patients have discontinued their treatment due to rising drug prices, and on the other hand, the commercialization of the health sector has made the society poorer, and treatment has become a luxury. Creating chronic diseases and disability for most of the lower social deciles.

Question 6. Please add any other topics that you deem appropriate.

Response: Currently, in the medical field due to the incompetence of the government and political disputes a large number of health workers have left the system and sought jobs outside the health system. On the other hand, the dire economic situation of doctors and nurses working in this field has also led to the widespread migration of Iranian doctors and nurses in recent years. The deputy director of the medical system announced the annual departure of 3,000 doctors and thousands of nurses. This extensive migration of doctors and other health professionals will soon lead to a shortage of these personnel in the health sector, and Iranian citizens will be deprived of the medical services they need.