Südwind: Written Statement on the Health situation in the Islamic Republic of Iran
In the past 3 decades, the Islamic Republic of Iran (IRI) has failed to achieve sustainable development. The excessive growth of population, poverty and unemployment due to improper policies and planning and bad governance has had its effects on the health situation of population. The combination of drug addictions, street children and homelessness, prostitution and growth of criminality, coupled with the lack of health services for the most vulnerable part of society and in those prisons has created a vicious circle that needs urgent attention. Destructive consequences of the population growth The population of Iran in the past 3 decades has increased drastically from 33.7 M in 1977 to 70 M in 2007 this include 2.47 times growth in active population versus the 4.29 times of the inactive population. The population growth at high rate is one of the main obstacles against social and economic development. It has created extensive social and economic problems including but not limited to shortage of housing, educational services, health care services and job opportunities. Cultural and religious beliefs were one of the key reasons of population growth. However, encouraging policies of the IRI based on bigoted ideas, especially in the first decade after the revolution and more recently play a much more important role. The population growth plus lack of proper investment on health care infrastructures are the main reasons for the lack of proper access to health care system by a large proportion of the society and which has deteriorated the general health of the population. Comprehensive policies to curb population growth in the country based on the latest scientific advancements in this field plus investment in health care system are paramount. In addition, various other policies which indirectly curb the population growth such as increasing the marriage age and creating job and educational opportunities for women should be considered as well. Drug Addition; A Serious Social and Health Crisis The studies of “the Office of Social Research” in Tehran reveal some shocking facts about addiction in Iran. Some of the most shocking ones are as follow: The number of addicted people is estimated 1.8 Million equal to 3.25% of population, 65% of which are under the age of 35. Consumption of opium has decreased while consumption of synthetic and more dangerous drugs such as Amphetamine has increased drastically. Although in recent years the hyperinflation has crippled the economy of the country; the price of drugs has decreased. The drop in the price of Heroin which is one of the most dangerous drugs has been significant. Around half of the prisoners in the country are those who are sentenced directly or indirectly to drug related charges. Currently drug business is one of the most profitable criminal businesses in Iran which is supported by at least fractions of high ranked authorities in the institutions of power. Political suppression, lack of healthy entertainment activities, social and economical gap between the poor and the rich, wide spread corruption in the legal system and law enforcement forces, lack of public, educational, social, and legal policies to fundamentally address this social disaster, has intensified the phenomenon. According to some experts, the addicted people are not considered patients or individuals who need help and support, they are considered as criminals who deserve serious punishments. Such approach does not help to uproot the addiction problem, nor tackles the reasons to the catastrophic dimensions of the problem. Currently, addiction can be considered one of the roots of many other social ills such as health problems burglary, murder, family violence, social violence, divorce, and child abuse. From a health point of view it shall be pointed out that using contaminated syringe is one of the sources of transmission viral diseases such as Hepatitis and HIV. We strongly believe that prevention is the least expensive way to address the health issues. This well known medical principle is very important when dealing with addiction which is not specifically a medical issue and can be considered as a health problem highly related to unhealthy social conditions. We believe that improving social security, economic security, legal protection, respect for human rights, political freedoms, creating job opportunities, proper rehabilitation programs, fighting with hopelessness are the possible and practical means that will prevent or at least lessen the catastrophic impacts of addiction problem in Iran. Public Mental Health It is estimated that 20% of Iranian population are suffering from depression and other mental disorders at different levels due to harsh social conditions. This estimate is based on the reports published by the Ministry of Health and other reports by psychologists, psychiatrics, and social workers. Some facts about other social issues directly or indirectly related to mental disorder or harsh social and economical conditions are listed below: 1. Increasing suicidal rate by 17% just in one year. 2. Reporting 10 daily suicide in the country 3. Increasing divorce rate by 9% in the first quarter of this year comparing the same period in the last year. Environmental Degradation and Its Impacts on Public Health In the year 2011 the rank of Iran between 132 countries regarding the environmental protection was 114, this rank by itself explains the bitter facts of environmental issues in Iran. Some of the main reasons for environmental degradation in Iran are as follow: 1. Rapid population growth, maximizing profit of economical activities regardless of their environmental impacts, 2. Deforestation for various reasons such as building roads and other commercial purposes. 3. Discharging untreated sewage and industrial wastewater to rivers, lakes, and other water resources is one the main reasons of water pollution. 4. Degrading of wetlands and swamps for various reasons such as discharging untreated sewage and industrial wastewater and economic activities such as building road. Lately building a road in Minakaleh wetland divided this wetland to 2 sections, after a while the western part of wetland dried up. 5. The high number of cars with non standard engine maintenance or cars without any emission control devices, supplying low grade gasoline and diesel fuel, and emission of toxic material from industries are the main reasons of very high level of air pollution. 6. Air pollution in many of the large cities of Iran is at an alarming and dangerous level. It is one of the main reasons of heart, lung, and other related diseases in Iran. We demand protection of environment by enforcing comprehensive environmental regulations to cover different areas of economic and human activities. This is an urgent demand and any delay to enforce such a regulation can cause more damage to public health. IRI Prisons the Source of Propagation Diseases and Deadly Below are some facts about current situation of IRI prisons: In 1979, when the population of Iran was 36 M, the number of prisoners was estimated at about 10,000. In 2011 the population of the country was 72 M while the number of prisoners jumped to 250,000. These figures indicates that in the past 32 years, the number of prisoners has increase 25 times which is a clear indicator of tragic social conditions. At one of the open sessions of the Iranian parliament in answer to questions about the general condition and existence of infectious and other diseases in prisons, the head of “Prisons Organization” clearly confessed that: “The situation in prisons is not satisfactory. They are overcrowded and prevention of diseases is not possible.” According to oral reports by many political prisoners, drug trafficking, prostitution, selling and buying contaminated syringes are part of daily life in prisons and all of these are supported by prisons authorities and are one of the reasons for the rapid transmission of viral diseases such as Hepatitis and HIV. Lack of proper living space in prisons is another reason for the transmission of diseases and other health hazards in prisons. This is a sad and heart-breaking image of daily life in the Iranian prisons which is inevitable” The other dark side of the prisons in Iran is systematic mental and physical torture especially on the political prisoners. They are under constant mental and physical torture. During peaceful people’s demonstration after the disputed presidential election in June 2009, huge number of people was arrested within few days. To house such population the Iranian government set up some temporary detention centers. One of the most notorious ones which captured the international attention was Kahrizak prison in south of Tehran. The building used as prison was a storage building without any facilities to house hundreds of prisoners. The level of brutality and inhuman torture and death in this prison set a new shameful record for IRI. The only physician in that centre, Dr. Ramin Poor Andarjani who knew details of the conditions was mysteriously found dead in November 2009. Herewith and in the light of the facts mentioned in this report, we demand substantial and immediate measures to be taken by the IRI to improve the situation of heath, food, and other life conditions in all prisons in Iran.