According to official statistics, about 11 Iranian hospital residents died since March 2021 due to stress at work, its consequences, and the difficulties of daily life (The state-Run ISNA news agency – November 3, 2021).
By acknowledging that this tragedy continues, ISNA wrote, “For sure, we can say that this number will be increasing.” The flawed education system, low wages, and lack of insurance make it impossible for medical students in Iran to have a clear and bright future. Thus, recent suicides and deaths of hospital interns have drawn more attention in Iran’s news and media.
Several government news agencies have reported that the residents died due to COVID-19. However, other media outlets have reported that the deaths were suicides. In a letter to the regime’s Minister of Health, the Council of Iranian Medical Students reported the suicide of four medical assistants in Tehran during the 2 weeks in May 2021 (The state-run ROKNA news agency – May 4, 2021).
Exhausting work and long shifts are among the reasons that hospital interns commit suicide. Under the clerical regime’s rule, the Iranian Ministry of Health perceives its people as a cheap and expendable labor force. As a result, the flawed system leads Iran’s brightest and most elite students to treat depression only (The state-Run Sharq newspaper – September 14, 2021).
Anahita Shahrasbi
On September 9, 2021, Anahita Shahrasbi, a medical intern at Tehran’s Sina Hospital, died of cardiac arrest after experiencing intense pressure as part of her work in the COVID-19 emergency room (The public relations website of Tehran University of Medical Sciences – September 14, 2021).
The lack of adequate medical staff continues to increase workloads on medical interns; this female medical professional was the 10th person to die in less than 6 months since the beginning of 2021.
Monireh Foroughi
Monireh Foroughi, a Ph.D. student in Obstetrics and Gynecology at Tehran’s Beheshti University of Medical Sciences, was the 11th intern to die this year. There are conflicting reports about Dr. Foroughi’s death: some attribute it to the COVID-19 pandemic, others to the tragic suicide of medical interns (ISKAnews website – October 31, 2021).
In response to Dr. Foroughi’s death, Haniyeh Radkhah, an internal medicine specialist and a member of the faculty of the University of Tehran, posted on Instagram: “Suicide, cardiac arrest, immigration, and depression, this was not supposed to be the end of our story. We were supposed to be the smiling flowers, the children of Iran …. but we are not … You provided your children with a transfer abroad and a quota of medical expertise and exemption from plans and a future work. But for us … for the children of the people, what will you do? It is not acceptable that death be our end, and the earth covers our many wishes…”
Another friend of Monireh Foroughi’s wrote to Alireza Zali, the President of Beheshti University of Medical Sciences, “We were prepared to lavish her with flowers (i.e., in her wedding), but now we have to prepare ourselves to go lavish her grave with those flowers. What do you want to film with your bodyguards and cameras, standing here at her grave? Did you ever listen to her when she was alive?” (ISKAnews Website – October 31, 2021).
At least three other hospital interns were confirmed to have committed suicide before Monireh Foroughi. How painful can this be that even the title “Suicide Serials” has made headlines in state media?
Countless night shifts
Speaking about the issues facing medical personnel, Dr. Mahdiar Saeidian stated, “The minimum shift for our hospital interns and nurses should be 24 hours and sometimes up to 32 hours. But during the COVID-19 pandemic, there are no planning for the shifts. Thus, the hospital interns are forced to take longer than usual shifts. However, by law, hospital interns may not work longer than 12 shifts per month. This issue is not being observed in the country. The medical science universities change the law at their whim and do not observe it.” (The state-Run ISNA news agency – November 3, 2021).
According to a directive issued by the Ministry of Health, a hospital intern must work 24 hours a day, 12 days a month, and stay in the hospital for the remaining 18 days from early morning until 6 p.m. The salary for a single medical intern is 2.7 million Tomans ($90); for married interns, the salary is 3.2 million Tomans ($106).
Hospital interns are exploited in Iran
Hospital interns in Iran have the lowest salaries and benefits despite the massive workload on them. According to the medical code, the interns have a legal responsibility, yet they work as much or even more than a professor does. Therefore, hospital interns are considered a free labor force and are paid approximately 6,500 Tomans (21 cents) per working hour.
Due to the shortage of general physicians, the Ministry of Health assigns their duties to hospital interns, exploiting them and making them work harder. By using this tactic, the Health Ministry mitigates the problem of the lack of medical personnel. The Ministry of Health is singularly unconcerned about paying medical interns a living wage, nor does it care about their health.
In developed countries, working hours for doctors and other hospital staff are a critical topic because overwork can cause life-changing mistakes.
Medical interns in other countries are subject to labor laws and have insurance. But Iranian medical interns – even those with COVID – must pay for even a simple CT scan out of their own pockets. This is due to the Ministry of Health’s negligence and mismanagement. Given these conditions, many medical graduates migrate to neighboring countries or Europe and the United States.
A government official acknowledged that 900 young members of the university faculty of sciences and 3,000 physicians had migrated to other countries since March 2021 (The state-run Etemad newspaper – December 12, 2021).
Female interns face additional problems
In addition to work pressure, female medical interns endure all kinds of violence, simply for being women.
Hospital interns are usually middle-aged, and many are married with children. As mothers, they suffer a more complex situation and endure additional pressures in Iran’s patriarchal society. These mothers spend multiple consecutive days away from their children due to their long shifts. When they do return home after long shifts, they still need to do all the housework.
In May 2021, reports emerged about the mass resignation of first-year women medical interns from one of Tehran’s medical science hospitals. Earlier, other female interns from Iran and Shiraz Medical Science Universities had also withdrawn from their programs because their demands had been ignored.
In their resignation letters, the women wrote, “We try not to get sick, but there is nothing we can do as no one cares. Most of us have recurrent urinary tract infections. We do not have the opportunity to drink enough fluids. We do not have time to go to the bathroom, and that is how bacteria and other infections invade our bodies. We continue to work even when we have fever. We bite our lips, but we cannot take a day off.”
Female interns are warned not to get pregnant once they are hired. Those who get pregnant do not enjoy any reduction in working hours or monthly shifts, despite their physical condition. Like other medical interns, they have to endure long shifts and working hours until the last months of their pregnancies. Female medical interns are only entitled to 2 months of maternity leave.
Some of the female interns who resigned have described the hierarchy of interns as a new form of slavery and an insult to humanity.
In the Iranian medical system, the conditions for first-year medical interns are not the same as for those in their second, third, and fourth years. First-years are discriminated against. First-year interns are under a lot of pressure: they have multiple shifts and work in the hospital 21 days a month at night. Because the private sector is growing, most professors spend less time training hospital interns. Thus, most of the psychological and work pressure is placed on first-year interns.
“Extra shift,” said one of the women in the Obstetrics and Gynecology department. She continued, “We are exhausted. Our patients have become our own victims because of our insomnia and hunger. Because we have not completed our medical lessons. One victim was a newborn whose arm broke at birth.”
