The long-suffering Ahwazi people continue to endure deadly suffering from every direction, with an outbreak of Crimean-Congo Haemorrhagic Fever (CCHF) already killing at least one victim and possibly more as the highly contagious deadly disease sweeps across the region.
The first publicly identified victim, Mohammed Nasseri, a man in his twenties, died two days after his family rushed him to Sina hospital in the regional capital city of Ahwaz. When his grieving parents tried to remove his body for burial following his death, hospital officials, who had initially been unable to diagnose his symptoms, instructed them to avoid any contact with it due to the highly contagious nature of the disease, and to undergo tests themselves for infection. When the bereaved family told the hospital management that they wished to bury Mohammed’s body in the graveyard in their home village of Buhr, medical officials at first refused to allow it, insisting that they pick a more isolated location to avoid any possible contamination in a populated area. When the family pleaded with officials, pointing out that they didn’t have any land or ability to buy a burial plot in more isolated areas, the hospital officials relented and allowed the burial to go ahead on condition that the family didn’t mention this to anyone locally in order to avoid creating alarm.
As this footage shows, personnel in the special ambulance used to transfer the body for burial wore disposable protective hazmat suits, sprinkling a powder believed to be quicklime on the body, as well as in and around the grave where Mohammed was buried. After completing the burial, the medical personnel took off the hazmat suits and burnt them near the graveyard before leaving. When villagers asked Sina hospital officials for the reasons for these precautions and the cause of Mohammed’s death, the officials eventually admitted that he had died of CCHF. Many in the village and across Ahwaz are now questioning the silence of Iranian health authorities over the outbreak of such a dangerous contagious disease and why there’s been no public health awareness campaign or move to provide further information in light of the obvious risk to citizens’ lives.
Sources in Ahwaz told the Dur Untash Studies Centre (DUSC) that medical personnel at two local hospitals had admitted that the number of CCHF cases has been rising since July, with dozens quarantined in special units and multiple victims dying a few days after their arrival. The medical personnel further reportedly said that local hospitals are unequipped to deal with such outbreaks, with staff lacking specialised training, medical equipment, medicine and facilities to effectively treat such a serious disease. The medical personnel further stated that all hospital staff had been ordered to withhold information on the worsening epidemic for fear of spreading the public alarm.
In contrast, local authorities have officially presented Mohammed’s death as an isolated incident, denying the presence of any other cases of CCHF in the region, with Ebrahim Asakareh, the Deputy Governor of Karoon country, telling state media: “The individual was on a trip outside the province when he suffered acute health problems that led to him returning home, at which point he was immediately transferred to Sina hospital. This was an isolated case, and he eventually died due to the rapid progression of the disease and loss of vital signs, but the deceased patient was quarantined in accordance with healthcare principles.”
This simplistic explanation has failed to satisfy the Ahwazi people who have long experience of Iranian regime officials being ‘economical’ with the truth. It has fuelled growing public anger about the dangers of an epidemic, particularly in the regional capital where two million people live in close proximity to each other, many in conditions of chronic overcrowding with notoriously dilapidated and contaminated water facilities. There’s also considerable – and justifiable – anger among the family members of the victims, who were given no information about the disease that killed their loved ones, and received no notification about the need for all those who came into contact with the victims to be tested for the disease and quarantined if necessary to ensure that the disease doesn’t spread any further.
Many Ahwazis feel that they’ve been let down yet again by the Iranian regime’s failure to meet its responsibility to protect the lives of its Arab and other minority citizens, with calls growing for urgent action to combat the spread of the disease and minimise the death toll.
According to the World Health Organisation (WHO), the CCHF virus is initially passed to animals, such as livestock, who become infected by the bite of infected ticks, with the virus remaining in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites.
The virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases occur in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians.
Human-to-human transmission can occur from close contact with blood, secretions, organs or other bodily fluids of infected individuals. Hospital-acquired infections can also occur due to improper sterilisation of medical equipment, reuse of needles and contamination of medical supplies.
The mortality rate from CCHF is approximately 30 per cent, with death occurring in the second week of illness.
The onset of symptoms is sudden, with fever, myalgia, (muscle ache), dizziness, neck pain and stiffness, backache, headache, sore eyes and photophobia (sensitivity to light). There may be nausea, vomiting, diarrhoea, abdominal pain, and sore throat early on, followed by sharp mood swings and confusion.
The disease has been seen in Iran before, with MP Mohammad Javad Jamali blaming the smuggling of livestock across the country’s eastern borders for an outbreak in summer of 2018. Another reason for the spread of this disease in Iran, the MP noted, is the failure to quarantine livestock and domestic animals arriving in the country, along with the searing hot summer weather which provides ideal conditions for the virus to spread. Speaking during the 2018 outbreak, Jamali said that the eastern border areas had been the worst affected, with many of those who contracted CCHF mistakenly assuming that the symptoms were simply a cold or flu infection and failing to seek medical help until it was too late.
Since the beginning of the current Iranian calendar year (March 21), 12 people across Iran have been diagnosed with CCHF with two of those dying, according to Mohammad Mahdi Guya, the Director of the Ministry of Health’s Communicable Diseases Department.
Speaking to the ISNA state news agency, Guya said that cases of the disease have been reported in the cities of Iranshahr, Zabol, Kermanshah and Bandar Abbas as well as in Gilan province.
According to the health ministry, some 100 to 150 cases of CCHF are diagnosed annually in Iran, yet Ahwazis feel that these numbers are artificially deflated in order to deny the potentially deadly outbreak.
Nor is this an isolated issue. The region has long been afflicted by industrial pollution along with the diversion of the life-sustaining Karoon River, leaving Ahwazi residents with little access to potable water sufficient for even normal circumstances. The now-dried riverbeds and grossly insufficient available water, coupled with raging sandstorms and temperatures regularly exceeding 47 degrees Celsius, only exacerbates the potential for widespread catastrophic disease.
In the past ten years, Ahwaz had seen the outbreak of diseases and epidemics due to increasingly polluted air and water contamination previously unknown to the region. These new diseases pose an acute threat to the lives of Ahwazi citizens, given the absence of healthcare coverage and the lack of sophisticated medical equipment in Ahwazi hospitals. Since the devastating flooding a few months ago, many Ahwazi in rural areas and small towns were displaced, and many of their livestock died or got sick, and the regime has not provided any assistance. Instead, the regime has abandoned them in their ghost houses, surrounded by the decaying bodies of their deceased livestock, which in turn provide perfect incubators for contagious disease.
There is no safe place for Ahwazis. Those who are crowded in its cities are faced with contaminated sewage and a lack of potable water; their hospitals are ill-equipped in the best of times, and will not be able to control the spread of any contagions. Their rural countrymen have little to no access to water aside from the brackish remnants they can find in otherwise dry riverbeds; surrounded by the carcasses of their flood-killed livestock and sandstorms bearing insects and bacteria alike, they have nowhere to turn.
The Ahwazi people do not fear death. They will not sit back and wait for a preventable disease to annihilate them for the convenience of the Iranian regime, or remain silent as the regime pretends that the threat of contagious plague is imminent. Their anger at the regime for setting the stage for disease to run rampant, and for pretending that it does not exist, will only increase. And even though the regime predictably responds to legitimate protests with imprisonment, torture and murder, disease does not care for such threats, and neither will the Ahwazi people.
Rahim Hamid is an Ahwazi author, freelance journalist and human rights advocate. You can follow him on his twitter account: https://twitter.com/samireza42
The opinions expressed in this article belong to the author and do not necessarily reflect the editorial policy of the Dur Untash Studies Centre.