In 1918 the “Spanish Flu” swept over the world killing 50 million people and one of the worst hit countries was Iran. One has to wonder why Iran again? Are there any commonalities we can surface as to why Iran has been twice in 100 years?

Reading an excellent article by Amir Afkhami written in 2003 entitled, “The Iranian Experience with the 1918 Influenza Pandemic,”  ( Bulletin of the History of Medicine  , Summer 2003, gave me some good information to go on.

In depicting the environment of 1918 in Iran and comparing it to today’s surfaced some important facets.

Iran in  1918 was a ravaged nation , invaded and partially occupied by the Russians and British, with a fractured society. People were at their low ebb . Today the Iranians are certainly independent but still wracked by civil disturbances, still recovering from a horrendous war with Iraq, and under economic sanctions. The psychological state of the Iranian people is not buoyant to say the least. The psychological state of the populace has a great deal to do with their physical health.

Iranian protest in Jan 2020

The  Iranian government  in 1918 was the lingering remnants of the corrupt Qajars, feeble and ineffective. They did not control their own country. Today they have a strong but economically weak government more interested in expansionism than the welfare of their people. The dual government of the civil authorities and the controlling symbiosis of the pulpit and the sword has the people divided and in tension.

In 1918, the Iranian people were close to a famine stage, especially in the rural areas. Their resistance to disease was very low. Today there is no famine in Iran but because of the stupid priorities of the Iranian regime, downgrading of  quality of life   issues to military and expansionist designs, bringing on sanctions, most Iranian people can barely pay their rent, and buy good food for nutrition.  Moreover a study indicates the Iranians suffer from a deficiency of vitamin D. This seems strange in that  sunshine, of which Iran has a surfeit, provides it. However the dress of women covered in black from head to foot, as well as a traditional avoidance of darkening the skin color, accounts for it in women.  Men in  a Muslim society  likewise avoid wearing scanty clothing. People believe that men who wear shorts are considered homosexual. Most always wear long sleeves.

Traditional beliefs and gender issues always complicate the medical field in the conservative Islamic countries ,and Iran,  especially under the Mullahs have engendered retrogression. In 1918, the  Iranians believed that an evil  wind, known as the “nakbushi” carried the disease. Even Iranian doctors believed that to be true. Today traditional beliefs still inhibit up to date treatment of illness.  Winds still play an important part in Islamic-Persian belief systems. Cutting through the cultural barriers has only been partially accomplished. Many, in 1918, just gave up hope, crawling to the nearest mosque to die. Today there is little confidence in the ruling authorities to provide the required care and home remedies are used. Some clerics were initially telling g their flocks that a good Muslim would not contract the disease.

In 1918, some of the first to die were government officials, creating another void in authority to combat the disease. Ironically it seems that many higher officials in the  current clerical Iranian regime were the first ones affected.

The health care system in 1918 was, at best rudimentary, and today, despite glowing reports  from the World Health Organization (WHO) , and other organizations with a vested interest in conveying an optimistic view of the Iranian health system, the Iranian health care today is broken, especially in convalescent care. A good part of the problem is the low esteem accorded nurses in the Islamic tradition. Iran only has half the required nurses and the care given patients has been surveyed as abysmal. Patients complain of being treated with “no dignity,” confined in unhygienic conditions, no privacy,  no communication with doctors, who are much too few, especially in the rural areas.  The medical staff expects family members to stay with the patients and provide most of the care.

Iran  provides funding for medical education in return for the graduated doctors to serve a certain period of time in rural areas, but, in fact, few do for any length of time.

Finally as written in my last post  middle easterners are a people who do not like distance from one another, especially family members and trying to impose social distances is very difficult even for an authoritarian regime like that of Iran.