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- Healthcare exclusion
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This is an extract from our latest Activity Report, looking back on our work in the previous year.
2013
Rates of drug addiction in Iran remain high, yet many addicts have difficulty accessing the medical and psychological care they need.
The Iranian authorities have recognised that drug addiction and HIV infection are a growing public health concern, and have taken significant steps to initiate harm reduction and HIV/AIDS prevention among injected-drug users.
However, the broad medical needs of high-risk groups remain acute, especially in Tehran, where drug users, sex workers and street children are stigmatised and are therefore unable to access the general health system.
In Darvazeh Ghar, one of the poorest neighbourhoods in Tehran, Médecins Sans Frontières (MSF) continued to run a health centre dedicated to women and children under five who are excluded from healthcare, including undocumented refugees.
Together with Iranian authorities and local organisations, MSF offered free, basic healthcare, including medical consultations for women and children, gynaecological care, family planning and postnatal care. A mental health programme started in September, with treatment and support provided by a psychiatrist and a psychologist.
Iran’s Bureau for Aliens and Foreign Immigrants’ Affairs estimates that the country hosts 850,000 refugees, most of them Afghans. While registered refugees are granted private health insurance, those who are undocumented have limited access to healthcare.
At the end of 2013, MSF had 30 staff in Iran. MSF has worked in the country since 1996.
Known as Persia prior to 1935, Iran was one of the greatest empires of the ancient world. Iran became an Islamic republic in 1979, when the monarchy was overthrown, and clerics assumed political control.
Although the prevalence of infectious diseases is relatively low in Iran (less than one per cent for HIV), it is much higher in vulnerable groups. MSF provides free healthcare to excluded and marginalised groups in south Tehran, including drug users, sex workers, street children and the Ghorbati ethnic minority.
The team operates a referral system and runs mobile clinics in partnership with Society for Recovery Support, a local organisation which specialises in support for addicts and provides psychosocial assistance, harm reduction and shelter.
MSF runs a clinic offering a comprehensive package of medical services designed for high-risk patients who suffer from stigma and/or require further assistance with following their treatment. Services include counselling, psycho-social aid, medical and mental health consultations, ante- and postnatal care, family planning and treatment for sexually transmitted infections.
A quarter of the patients MSF sees in Tehran, Iran's capital, are children under five years old.
MSF is currently running a project located in south of Tehran (one of the most vulnerable areas named as Harandi area), dedicated to vulnerable women and children under 15. MSF provides medical and psychological care, as well as social support to most at risk population for infectious diseases as sexually transmitted infections (STI), Hepatitis C (HCV) and HIV-AIDS positive cases and tuberculosis.
More than 60% of the 160,000 HIV patients in the country are drug users, and an estimated 50% to 75% of injectable-drug users have hepatitis C.
Special attention is given to drug users, sex workers, ex-drug users, direct family members of drug addicted people, (Afghan) labour children and local nomadic communities. MSF is providing health training through group consultation for drug users (with support of mental health team -including psychologist, social workers and peer workers).