Beirut — As anti-government protesters injured during last month’s crackdown poured into an Iranian hospital, a young doctor rushed to the emergency room to treat a man in his 40s who had been shot in the head at close range.
As doctors and others tried to revive the man, a group of armed, plainclothes security agents blocked their way, pushing some back with their rifles, doctors told The Associated Press.
“They surrounded him and did not allow us to go further,” said a doctor in the northern city of Rasht.
A few minutes later, the man died. Agents put his body in a black body bag. Then, they piled it and other bodies in the back of a van and drove away.
This was not an isolated incident.
Over the course of a few days in early January, plainclothes agents surrounded hospitals in many cities treating thousands of people injured by Iranian security forces who fired into crowds to quash mass protests against the 47-year-old Islamic Republic. These agents monitored and sometimes interfered with the care of protesters, threatened staff, seized protesters, and carried away the dead in body bags. Dozens of doctors were arrested.
This story is based on AP interviews with three doctors in Iran and six Iranian medical professionals living abroad who are in contact with colleagues on the ground; reports from human rights groups; And the AP’s review of more than a dozen videos posted on social media. All of the doctors inside Iran spoke on condition of anonymity for fear of reprisals.
AP worked with Berlin-based firm Mnemonic to identify online videos, posts and other material related to violence in hospitals.
Doctors in Iran and abroad say the level of brutality and militarization of health facilities is unprecedented in a country that has suffered decades of repression of dissent and surveillance by public institutions. In at least one instance, snipers fired on approaching patients on the roof of a hospital in the northern town of Gorgan, according to a witness account provided by IIPHA, the US-based association of Iranian health professionals.
The Oslo-based Iran Center for Human Rights has documented multiple accounts from inside hospitals of security agents preventing medical care, removing patients from ventilators, harassing doctors and detaining protesters.
“It’s systematic,” said Amiri-Moghaddam, an Iranian-Norwegian neuroscientist who founded the group. “And we haven’t experienced this pattern before.”
The government blamed armed foreign-backed “terrorists” for the protests and subsequent violence.
Health Ministry spokesman Hussein Kermanpour denied reports of preventing treatment or taking protesters away from hospitals, calling them “false, but essentially impossible.” He was quoted in state media as saying that all the injured had been treated “without any discrimination or interference on political views”. The Iranian mission to the United Nations did not immediately respond to a request for comment on the doctor’s accounts.
The crackdown, which reached its peak on January 8 and 9, was the deadliest since the Islamic Republic came to power in 1979. Full numbers of casualties and other details have been slow to emerge due to internet restrictions imposed by authorities.
The Human Rights Activists News Agency has confirmed more than 7,000 deaths and says it is investigating thousands more. The government has admitted that more than 3,000 were killed, although it has downplayed or underreported casualties from earlier unrest.
After the crackdown began, doctors in Rasht worked through a hellish 66 hours, moving each day to a different facility to help the wounded — first a trauma center, then a hospital and finally a private clinic.
On January 8, doctors said, “Every 15 to 30 minutes, the entire emergency department is emptied and then filled with new patients.”
This worsened on January 9, as injuries from live ammunition became more common and security agents became more threatening.
Medics said agents brought in wounded protesters and stood guard over them while crews worked. They stormed wards armed with automatic rifles, threatening staff and filming patients and checking records.
When it’s time to discharge a patient, he said, “they’ll take anyone who’s confirmed to be a protester.”
At one point, security agents brought the dead man’s body with shackles in front of his body. They said he suffered pellet shots to the abdomen and chest and an apparent bullet wound to the head.
He recognized the man immediately. Moments ago, his family showed his photo around the hospital, asking if he was admitted.
Raha Bahareni, the group’s Iran researcher, said Amnesty International had received credible reports of shootings close to protesters and “on a higher scale” than previous crackdowns on protests. Two videos reviewed by the AP show close-range shots of protesters’ bodies and medical equipment attached to their bodies.
The doctor said that he and other staff tried to hide the injured protesters by recording false diagnoses in the hospital records. Gunshots to the stomach are recognized as abdominal pain; Broken bones are recorded as accidental falls. A patient with a gunshot wound to the genital area was identified as a urology patient.
“No matter what we did to the patients, we knew they would not be safe after they left the hospital,” he said.
The AP could not independently confirm the doctor’s account of events at the hospital in Rasht. But this is consistent with other AP reporting.
The AP reviewed videos posted by four hospitals as a snapshot of activity by Iranian security forces. It says the memo collected dozens of videos, posts and other accounts of troops in and around the nine hospitals, in some cases firing guns and tear gas. Mnemonic has been preserving digital evidence of human rights violations in Iran since 2022, creating an archive of more than 2 million documents with partners.
A video reviewed by the AP shows security agents smashing through the glass entrance doors to Imam Khomeini Hospital in the western city of Ilam. Then they stormed through the halls with their guns and shouted at people.
The Health Ministry, which said it was committed to protecting medical centers, staff and patients, told state media it was investigating the incident.
Other videos reviewed by the AP show a heavy presence of security forces surrounding three hospitals in Tehran, firing tear gas and chasing protesters.
Other doctors worked in secret centers to treat the wounded away from the authorities.
On the night of January 8, the 37-year-old surgeon general was out to dinner in Tehran when he received a call from a professional friend he hadn’t heard from in years. The friend, an ophthalmologist, spoke in slurred words, but the fear in her voice made it clear that she urgently needed his help. She gave him the address.
Before midnight, he drove to the address of the cosmetic procedures clinic. Inside, they found more than 30 wounded men, women, children and the elderly lying on couches and blood-spattered floors as the lobby transformed into a trauma ward, screaming and crying.
The surgeon spent about four days treating more than 90 people, he estimated, as volunteers brought in more wounded. At first, it was just him, an ophthalmologist, a dentist and two nurses.
They used cardboard boxes and pieces of soft metal as splints for broken bones. With no anesthesia or strong painkillers, they used weak suppository painkillers. The clinic had no blood supply or transfusion capabilities, so they managed IV drips to rehydrate him and raise his blood pressure, a process that took hours.
At some point that night, the phone lines were cut and for 12 hours, he was unable to call for further help. They could not send patients to hospitals for fear of being arrested.
A woman in her 30s was shot by a bird, which destroyed the roof of her mouth and the area below her nose and her eyes, the surgeon recalled.
A 20-year-old youth was shot in the elbow with live ammunition and shattered it. The surgeon sutured the wounds but knew the arm would have to be amputated.
The family of four — mother, father and their 8- and 10-year-old children — were all riddled with pills, the surgeon said. There were dozens of bullets in the older boy’s face, but surprisingly none hit his eyes.
On the morning of January 9, the phone lines started working again, and the surgeon reached out to doctors he trusted to refer patients to him. First he had to ensure that all the bullets and pellets were removed from his body so that he would not be confined in the hospital. He wrote referral letters saying that patients had been in car accidents.
The surgeon called three other doctors to assist him in the secret clinic. When new casualties were brought in, the stabilized patients clapped and showed him signs of victory, he said.
“He started cheering the atmosphere through his pain. … I couldn’t believe that moment,” the surgeon said, his voice breaking. “It was very humane.”
None of the injured died at the clinic, but two dead bodies with gunshot wounds to the head were brought in, he said. The AP could not independently confirm the surgeon’s account of events at the clinic.
Since January 9, at least 79 health professionals, including a dozen medical students, have been arrested, said Homa Fathi, an Iranian dentist pursuing a Ph.D. In Canada and members of the IIPHA are monitoring the Iranian government’s action against health professionals from 2022. Most of those arrested were accused of resisting orders from security agents or other charges related to providing medical care to protesters, Fathi said.
About 30 people have been released, most on bail, but many of them still face charges, including one accused of “waging war against God,” which carries the death penalty, Fathi said. Authorities are keeping some doctors under house arrest to ensure they don’t receive or visit injured protesters — an unprecedented level of control, he said.
A surgeon who treated protesters at a secret clinic said he was surprised security forces never stormed the place to make arrests.
But then came the arrests. Two health workers volunteering at the clinic were seized from their homes, the surgeon said.
“I’m waiting too.”
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