Health care in Iran

Keeping you safe

SummaryPolitical BackgroundCrime & KidnappingHealth CareCultural Considarations

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Health insurance is a must have. Iranian citizens are covered by a national health insurance system, but this does not cover foreigners. Health insurance should include full cover for medical transportation, medical evacuation and repatriation.

Iran is a complex country which has poor relations with the West. Travelers will need to be aware of some key issues, but should be able to manage risks. Note that some areas are more risk prone, particularly borders to the east and west.

The political system is mostly undemocratic and complicated, and consists of several competing layers. Conflicts between political interests have led to violent demonstrations and clashes between interest groups, particularly during elections. Avoid any and all demonstration and rallies and avoid taking a stance on politics. The police can act with arbitrary power use.

The theocratic government system sometimes enforces strict cultural norms, including on foreigners. This is also done by vigilante groups of religious zealots who are given a wide space to act by the state. Try and conform to the local culture. It is also important to avoid government and military areas, and to abstain from taking photos or bringing high tech electronics into the country. Westerners have been detained on suspicion of espionage for infringing on such sensitivities.

Terrorism is a concern but not overly so. There have been attacks in recent years, but the risk to travelers should be low – medium.

Crime rates are low overall and common sense should suffice. However, the eastern Sistan-Baluchistan region is home to smugglers and other groups of organized criminals and crime is a more serious concern here. The borders with Afghanistan and Iraq should be avoided.

In the longer run there is a risk that Iran may get involved in a regional or even a more global conflict. Teheran’s nuclear weapons program is now subjected to inspections by IAEA and this issue, which looked quite serious just a few years ago, is now less acute, unless the new US Trump administration decides to scrap the deal. More serious in the short run is Iran’s support for the Assad regime in Syria and growing regional competition with Saudi Arabia and the smaller Gulf states.

Political background

Iran’s political system defies normal categorization. It has to tiers or levels, one is a more classical republican system with an executive president and a legislative parliament, both elected by plebiscite, while the other, stronger level is the religious Guardians Council headed by the Supreme Leader, which relies on the Revolutionary Guard.

In real terms the Council vets and approves candidates before they can run for office, and the ultimate power in Iran rests with the clerics still. However, they are not omnipotent and must balance their acts and decisions to reflect a growing discontent, particularly in the main cities, among the large young population and students. This discontent has erupted into street violence before.

At the heart of the conflict between reform and conservatism lies the issue of the future of Iran’s 1979 religious revolution and the consequences it has brought in terms of international isolation and economic hardship. It will not be an easy balancing act, but one which Iran must perform.

Behind the scenes business elites have a strong hand in the formulation of politics as well, further complicating the picture.

In 2013 the moderate conservative Rouhani won the presidency, replacing the rather vitriolic and anti-Western Ahmadinejad. Rouhani’s victory is part of Iran’s new policy of engaging, to some extent, with the West and reflects the need to balance out the more radical conservatives.

Travelers should be mindful of Iran’s position vis-à-vis the West. Do not take a stance on political issues and do not express anti-Iranian sentiments.

Even so the rapprochement witnessed in later years means Iran is now opening up to Western business. The process will likely have fits and starts at best, but even so improvements in relations are likely to be reflected in the experience travelers and expats will have.

Crime & kidnapping

Crime rates in Iran are low in most of the country save the Sistan-Baluchistan province, the Afghan border and the Iraqi border areas. Common sense should suffice, but do note that a foreigner may stand out from the crowd and be a target for crimes of opportunity. Street crime, including bag-snatching and pick-pocketing does occur but serious crime is rarer.

Even so foreigners should try to travel in a group, especially women, and should limit circulation (this is prudent in any case as police may view with suspicion foreigners who wander about).

Note again the complex political system and the cultural sensitivities of parts of the population. You may encounter self-appointed religious vigilantes who seek to enforce strict conservative values by force, including the prevention of alcohol consumption and making sure males and females do not engage in “immoral behavior”. The state largely turns a blind eye to such vigilantism and victims may little recourse.

The border areas to the east and west are partly lawless and infested with smugglers and sometimes even militants. These areas are best avoided unless on pressing business, in which case a special security evaluation should be obtained prior to travel.

Kidnappings have occurred in the past in Sistan-Baluchistan. Other than that risks should be small.

Health care

Health insurance is a must have for foreigners who otherwise have no cover.

Healthcare facilities in major cities are of a reasonable quality, but outside these the quality drops. Iran has long been subjected to sanction and supplies of some types of medication may be limited. Health care is overall not too expensive in Iran.

If you need an ambulance dial 115. Doctor and some health care workers will speak English.

Health insurance is available for citizens as Iran operates a public health care system for its own citizens, all of whom are covered at least in principle through their workplace. This system provides basic health care to citizens, albeit at a quality which is lower than you would expect in the West. Iranians who want better health care obtain access to the private sector through private health insurance.

Health insurance is a must as under the present system foreigners, travelers and expats receive no cover under the public system and must pay for treatment out of pocket. While this may change if Iran’s international relations normalize we are not there as yet.

Health insurance is also important as even Iran’s private sector may be unable to handle complex cases, and medical repatriation or evacuation may become necessary. It is imperative that travelers and employers obtain sufficient and comprehensive health insurance before travel.

If you need prescription medicine it may be prudent to bring your own supply as medical supplies are not always available. If you do bring drugs make sure to bring proper documentation to avoid trouble with the authorities.

Cultural Considerations

Briefly on culture
To people at home within a given culture, there will be a set of norms and values which governs everyday life, often in an almost subconscious manner. Think of how people tend to interact back home: How are relations between age-groups, genders, colleagues, religious groups, employers and employees, citizens and state etc. usually defined? Then consider that these relationships and the norms and even rules which govern then are very familiar to you – indeed you will probably consider them almost natural. This is the effect of culture upon people living within a group.

But the world is a diverse place, and cultures are very different around the globe. To complicate matters further cultures are anything but static; indeed, by their very nature they are always in flux. A country will often be home to different cultures as well, although it may sometimes be possible to identify a preponderant culture within a country.

Cultural differences and travel security
When you travel to a country or an area with a significantly different culture from your own this may affect your safety. This effect may take several different shapes.

The most basic effect is that of simply being different, of sticking out, familiar to any tourist in the world: The local population has little trouble identifying you as a traveler, tourist or expat. This raises your profile and increases your vulnerability, especially to street crime and scams, which may be serious in high-risk countries. While probably difficult to avoid, this basic fact should always be borne in mind. You will be more exposed and have less instinctive understanding of your surroundings that would the case back home.

Examples of specifics: Locals laws and customs
There may be more specific effects as well. Local laws will reflect the local culture, and this can have a very direct effect, e.g. bans on specific products, behavior or rules affecting interaction between people. Classic examples include a ban on consumption of alcohol or drugs, limits on driving, bans on homosexuality or laws governing interaction between unmarried couples. Clearly local laws must be obeyed as they apply to all.

Health care and health insurance may also be affected. This is most often the case when it comes to how much practical support relatives are expected to supply at a hospital or clinic (e.g. food and basic care), or how much access family members can have to a hospitalized dependent.

But specific effects may also be subtle. As a foreigner, it is easy to break local customs unwarily, which may cause offense or resentment. This can be embarrassing of course; however, to transgress deeply held convictions e.g. of a political or religious nature may trigger hostility. Travelers and expats should always refrain from any political debates with locals, and should at least make themselves familiar with local customs and religious beliefs.

When it comes to religion specifically sensitivity may be high. If confronted with locals, it is best to express agreement with their stated convictions in a discussion. Most often it is not a problem to belong to a different major faith or denomination, but it may be. It is almost always a bad idea to confess to atheism if confronted by zealots.

Always remember that, even though you may disagree vehemently with elements of the local culture, you are the visitor. Do not try to convince locals of “the errors of their ways” and never, ever proselyte.