The best and worst of worlds: Tehran's public hospital wards

In the early morning, families spread rugs, plastic bags or even cardboard in order to sit on the pavement. As they gather to prepare breakfast on portable gas stoves, the smell of fresh barbari and lavash bread fills the air and tomatoes sizzle in the pan for omelettes.

Behind them is the tall, grey outline of the hospital, merging on bad days into the Tehran smog. These are fathers, wives and mothers from the provinces who have brought their loved ones here in search of a cure.

And with fresh barbari and lavash, they make it through the day. Warm bread helps keep patients, families and nurses afloat. In the dialysis centre, Mrs Fakoori is taking her turn to bring fresh bread for the entire ward. She is here with her 16-year-old daughter, Azadeh, who is almost blind in both eyes with diabetes, and Mrs Fakoori sits by her side, knitting shawls and sweaters as her daughter undergoes dialysis.

In many wards, the families of patients have an informal rota for buying the bread. Every patient looks forward to nine o’clock when it usually arrives.

But behind the smell of toasted wheat and sesame seeds, and the sweetness of the sugary tea served with the bread, are the realities of dozens of people who are seriously and sometimes terminally ill.

Qassem is a 10-year-old boy with large, curious brown eyes and a rare blood condition. He has come to the hospital with his 23-year-old brother from Qeshm Island, 1400km away in the Persian Gulf. Qassem lost both his parents before the age of three and his brother serves as his guardian. Full of energy while holding his brother’s hand, Qassem knows his test results better than the doctors and quickly corrects them if they utter a wrong digit.

Mr Nazari is 75 and comes to the hospital with his apartment caretaker. He has diabetes and two failed kidneys, but he insists he will live to 124: “110, but add 14 years for the 12 Imams, the prophet and his daughter.”

Farzaneh Khanom, the daughter of Mrs Shayeshteh, sits in a corner and complains to Miss Elahi, the youngest nurse, about her mother’s constant nagging.

In the past six months, the number of patients at the hospital has doubled, and in some departments tripled, as the government’s new health scheme – the president called it “Rouhani-Care” on his Twitter feed – has been introduced.

“From all across Iran, every last person with some odd pain they never looked into, has now decided to have themselves checked,” one nurse tells me half with laughter, half with annoyance.

Under Tarh-e Salaamat (health plan), up to 90% of patients’ medical bills at public hospitals are paid for, more than ever before. It also covers additional costs outside the standard public health insurance that government employees have long been eligible for. It makes extra provision for remote areas and for people suffering from rare diseases.The first phase was rolled out in April 2014 and the second in September.

To benefit from Tarh-e Salaamat, patients must be hospitalised - that is, they must be on a hospital bed. The plan does not yet cover sarepayi, out-patient treatment (where they do not stay overnight), although the health ministry has announced that this too will be included in consecutive phases.

Continue Reading: http://www.theguardian.com/world/iran-blog/2015/jan/28/-sp-iran-rouhani-healthcare-budget-hospital-wards