Iran faces possible health-care crisis

The Washington Times :
Tehran Iran is facing a possible crisis in its health-care system as a result of economic sanctions and alleged government mismanagement of diminishing state funds, according to officials here.
The lack of money is already being felt in hospitals throughout Iran, where medical staffs have been told that they are working in war-time conditions and should prescribe drugs sparingly or in many cases, not all in an effort to save resources.
It means our hands are tied, said Nasrin, a doctor at a government-run hospital in the central city of Shiraz. We’ve been given a list of over 120 drugs that we are not to prescribe, because we simply don’t have them.
Nasrin said that drugs to treat heart problems, diabetes and cancer are particularly scarce. Like others interviewed for this story, she gave only her first name because of the sensitivity of the issue.
While there is an ample supply of over-the-counter drugs and pharmacy shelves are still well-stocked, patients suffering from more serious conditions are increasingly unable to get treatment for their illnesses.
The scarcity derives from a complicated set of circumstances that includes both a heavy dose of Western sanctions, which are aimed at forcing Irans leaders to halt their uranium-enrichment program, as well as what critics here say are missteps by the government.
While some of the anger over the shortages has been directed at the United States and other global powers, there has also been an internal backlash.
Hosseinali Shahriari, the head of parliament’s health committee, said this month that the government is playing with our people’s health and is not assigning the approved finances.
Shahriari noted that the cost of chemotherapy has quadrupled in just the past year, and is now approximately $67, 000 out of reach for all but the wealthiest Iranians.
Practically speaking, he said, we have to tell a majority of such patients to go and die…
But Iranians have grown accustomed to receiving highly subsidized medical treatment from the government, and they hold authorities responsible for rising prices or unavailable medicines.
At the start of each year, Iran’s annual budget is submitted by the president’s office to the parliament, which amends and ultimately approves cash allotments to be paid by the central bank to various state ministries.
With oil exports down and Iran’s ability to conduct international financial deals severely hamstrung, the bulk of those funds have not been delivered by the central bank this year. As a result, the health ministry has received only a fraction of its budget, and care has suffered.
Under normal times, the funds are distributed to state-run hospitals and companies with licenses to import medical equipment, supplies and pharmaceuticals.
Rasoul Khezri, a member of parliament’s health committee, said that according to the health ministry’s standards, we should always have a surplus of medicine for the next six month.
But our reports indicate the medicines in reserve are only sufficient for the next two months.
Iran’s minister of health, Marzieh Vahid Dastjerdi, explained in a recent nationally televised interview that authorities have begun to import supplies of vital medicines by commercial flight because they cannot wait for the usual cargo-ship deliveries. Of the $2.5 billion called for in Iran’s annual budget to import medicine and medical supplies, she said, only $600 million had been delivered by Iran’s central bank this year.
The problem has been compounded by a collapse in the value of Iran’s currency, the rial, meaning that the cost of medicine and other imported supplies has risen dramatically.
The chiefs of Iran’s medical schools recently wrote a letter to the government in which they complained of a 350 percent increase in the price of medical equipment, delays to essential medical projects and overdue payments to insurance companies.
Ordinary citizens, too, have expressed frustration with their government. Zohreh, a 60-year-old housewife, said the price for her daughter’s epilepsy drug has doubled in the past three months. When I ask why they have raised the price, they say we have a shortage of the medicine, she said.
The government must help poor people like us. Mojtaba, who has a thriving private family practice in central Tehran, said: This isn’t a situation that can persist for more than a couple of months.
The human cost and the potential national expense of caring for too many sick people can’t be ignored. Some industrious Iranians near the border with Turkey are advertising their ability to deliver hard-to-find medicines.
They simply cross the border, purchase the medication and use couriers to make deliveries throughout Iran. Meanwhile, some doctors are advising their patients to fly to neighboring countries to purchase the drugs they need.
But for the millions of Iranians who cannot afford such arrangements, it has been hard to adjust to a world of diminished health resources.
One of the tenets of the Islamic republic since its inception in 1979 has been universal health care. Any working Iranian is entitled by law to insurance coverage from their employer…
I can reduce our family’s intake of certain foods and utilities, even basic things like chicken and rice, and still survive, said Massoud, a 28-year-old office worker. But when someone in my family or I gets sick or needs surgery, it’s not something I can just ignore.

ایران با یک بحران بهداشت احتمالی مواجه می‌شود
تهران- به قلم جيسون رضائيان-بنا‌به گفته مقامات، در این‌جا، ایران در نظام بهداشت خود با یک بحران احتمالی مواجه است که نتیجه تحریمهای اقتصادی و آن‌چه گفته شده؛ سوءمدیریت دولت در کاهش هزینه‌های دولت بوده است.
فقدان پول، پیشاپیش در بیمارستانهای سراسر ایران، احساس می‌شود، جایی که کارکنان آن گفته‌اند آنها در شرایط جنگی کار می‌کنند و باید داروها را در بسیاری از موارد با جیره‌بندی مصرف کنند تا بتوانند امکاناتی را ذخیره کنند.
نسرین یک پزشک که در بیمارستان دولتی شیراز کار می‌کند گفت دست ما بسته است و لیستی از 120نوع دارو به ما داده شده که تجویز نکنیم چون دیگر تأمین نمی‌شود. نسرین گفت داروهای درمان مسائل قلبی، دیابت و سرطان به‌ویژه کمیاب هستند...
کمیابی داروها ناشی از یک مجموعه پیچیده از شرایط از جمله دوز سنگینی از تحریمهای غربی می‌باشد که هدف آنها وادار کردن رهبران ایران است تا برنامه غنی‌سازی اورانیوم خود را متوقف کنند…
درحالی‌که برخی از خشم و نارضایتی از این کمبودها رو به آمریکا و سایر قدرتهای جهانی سمت و سو داده شده اما پیامدهای منفی داخلی هم داشته است...
وزارت بهداشت ایران، تنها بخشی از بودجه خود را دریافت کرده است… رسول خضری یک عضو مجلس از کمیته بهداشت گفت گزارشات حاکیست ذخیره دارویی ما تنها تا دو ماه آینده کفاف می‌دهد .
مرضیه وحید دستجردی وزیر بهداشت ایران گفته است مقامات محموله‌های دارو را به جای با کشتی با پروازهای تجاری وارد می‌کنند زیرا نمی‌توانند منتظر شوند… وی افزود از بودجه ۲.۵میلیارد دلاری بهداشت تنها 600میلیون دلار از طرف بانک مرکزی تحویل داده شده است.
قیمت داروها به‌دلیل افت ارزش ریال به‌طور چشمگیری بالا رفته‌اند... رؤسای دانکشده های پزشکی اخیراً طی نامه‌یی به دولت شکایت کردند که قیمت تجهیزات پزشکی تا 350درصد افزایش یافته است...
شهروندان ایران نیز سرخوردگی خود را از دست دولت بیان کرده‌اند. زهره یک خانه‌دار 60ساله گفت قیمت داروی صرع [اپیلپسی] دوبرابر شده است و مقامات می‌گویند دلیلش کمبود دارو می‌باشد...
یکی از قوانین جمهوری اسلامی از زمان انقلاب 1979 بهداشت جهانی بوده است و هر کارمند ایرانی بنا‌به قانون مشمول بیمه پوشش درمانی از طرف اداره مربوطه می‌باشد.
مسعود یک کارمند 28ساله می‌گوید من می‌توانم مصرف خانواده در مواد غذایی و سایر کالاهای خانگی را کم کنم و حتی موارد پایه‌یی مانند مرغ و برنج را محدود کنم و باز هم زنده بمانم اما وقتی کسی در خانواده‌ام بیمار است یا نیاز به جراحی دارد این چیزی نیست که آن را نادیده بگیرم.  (واشنگتن پست 2/9/1391)


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