By SARAH EL DEEB
BEIRUT (AP) — As wounded anti-government protesters poured into an Iranian hospital during last month’s crackdown, a young doctor hurried to the emergency room to help treat a man in his 40s who had been shot in the head at close range.
When the doctor and others tried to resuscitate the man, a group of armed, plainclothes security agents blocked their way, pushing some back with their rifles, the doctor told The Associated Press.
“They surrounded him and didn’t allow us to move further,” the doctor in the northern city of Rasht said.
Minutes later, the man was dead. The agents put his body in a black body bag. Later, they piled it and other bodies into the back of a van and drove away.
This wasn’t an isolated incident.
Over the course of a few days in early January, plainclothes agents swarmed hospitals in multiple cities treating the thousands wounded by Iranian security forces who fired on crowds to quash massive protests against the 47-year-old Islamic Republic. These agents monitored and sometimes obstructed care to protesters, intimidated staff, seized protesters and took 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 AP’s verification of more than a dozen videos posted on social media. All of the doctors inside Iran spoke on condition of anonymity for fear of retaliation.
The AP worked with Mnemonic, a Berlin-based organization, to identify online videos, posts and other material relating to violence in hospitals.
The doctors in Iran and abroad said the level of brutality and militarization of health facilities was unprecedented in a country that for decades has experienced crackdowns on dissent and surveillance of public institutions. In at least one instance, snipers on the roof of a hospital in the northern town of Gorgan shot at approaching patients, according to a witness’ account provided by IIPHA, a U.S.-based association of Iranian health care professionals.
The Iran Human Rights Center, based in Oslo, has documented multiple accounts from inside hospitals of security agents preventing medical care, removing patients from ventilators, harassing doctors and detaining protesters.
“It is systematic,” said Amiry-Moghaddam, an Iranian-Norwegian neuroscientist who founded the group. “And we have not experienced this pattern before.”
The government has blamed the protests and ensuing violence on armed foreign-backed “terrorists.”
Health Ministry spokesman Hossein Kermanpour denied reports of treatment being prevented or protesters being taken from hospitals, calling them “untrue, but also fundamentally impossible.” He was quoted in state media as saying all injured were treated “without any discrimination or interference over political opinions.” The Iranian mission at the United Nations did not immediately reply to a request for comment on the doctors’ accounts.
Doctors tried to protect the wounded
The crackdown, which reached its height on Jan. 8 and 9, was the deadliest since the Islamic Republic took power in 1979. A complete toll of casualties and other details have been slow to emerge because of internet restrictions imposed by authorities.
The Human Rights Activists News Agency says it confirmed more than 7,000 deaths and that it is investigating thousands more. The government has acknowledged more than 3,000 killed, though it has undercounted or not reported fatalities from past unrest.
Once the crackdown began, the doctor in Rasht said he worked through 66 hours of hell, moving each day to a different facility to help with the wounded — first a trauma center, then a hospital and finally a private clinic.
On Jan. 8, “every 15 to 30 minutes, the entire emergency ward would be emptied and then refilled with new patients,” the doctor said.
It got worse on Jan. 9, as wounds from live ammunition became more common and security agents became more menacing.
Agents brought in wounded protesters and stood watch over them as staff worked, the doctor said. They burst into wards, armed with automatic rifles, threatening staff and filming patients and checking documents.
When it came time to discharge a patient, he said, “they would take anyone who was confirmed to be a protester.”
At one point, security agents brought in the body of a dead man with his hands shackled in front of his body. He had pellet shots to his abdomen and chest and a clear bullet wound to the head, he said.
He recognized the man immediately. Only moments earlier, his family had been showing his photo around the hospital, asking if he had been admitted.
Amnesty International has received credible reports that targeted, close-range shootings of protesters took place, and “at a far greater scale” than in past crackdowns on protests, said the group’s Iran researcher Raha Bahereini. Two videos verified by AP show the bodies of protesters with close-range shots and medical equipment connected to their bodies.
The doctor said he and other staff tried to hide wounded protesters by recording false diagnoses in hospital records. Gunshots to the abdomen were identified as abdominal pain; broken bones were recorded as a falling accident. One patient who had been shot in the genitals was identified as a urology patient.
“We knew that no matter what we did for the patients, they wouldn’t be safe once they stepped out of the hospital,” he said.
The AP could not independently confirm the doctor’s account of events at the hospital in Rasht. But it conformed with AP’s other reporting.
The AP verified videos posted from four hospitals as a snapshot of the Iranian security forces’ activity. Mnemonic gathered dozens of videos, posts and other accounts it says showed forces were present in and around 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 with partners an archive of more than 2 million documents.
One video verified by AP shows security agents breaking through glass entrance doors into Imam Khomeini Hospital in the western city of Ilam. They then barged through the halls with their guns, yelling at people.
The Health Ministry told state media it was investigating the incident, saying it was committed to protecting medical centers, staff and patients.
Other videos verified by AP show a heavy presence of security forces surrounding three hospitals in Tehran, firing tear gas and chasing protesters.
Treating the wounded in hiding
Other doctors worked in clandestine centers to treat the wounded away from authorities.
On the night of Jan. 8, a 37-year-old general surgeon was out for 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 vague terms, but the fear in her voice made clear she needed his help urgently. She gave him an address.
Just before midnight, he drove to the address, a clinic for cosmetic procedures. Inside, he found the lobby transformed into a trauma ward, with more than 30 wounded men, women, children and elderly on the couches and blood-covered floor, shouting and crying,
The surgeon spent nearly four days there, treating more than 90 people, he estimates, as volunteers brought in more wounded. At first, it was just him, the ophthalmologist, a dentist and two nurses.
He used cardboard boxes and pieces of soft metal as splints for broken bones. With no anesthesia or strong painkillers, he used weaker suppository analgesics. The clinic had no blood supplies or transfusion capabilities, so he administered IV drips to rehydrate them and raise their blood pressure, a process that took hours.
At some point that night, phone lines were cut off and for 12 hours, he couldn’t call for more help. They couldn’t send patients to hospitals for fear they’d be arrested.
One woman, in her 30s, had been hit by bird shot at close range, destroying the roof of her mouth and the area around her nose and below her eyes, the surgeon recalled.
A young man in his 20s had been shot with live ammunition in his elbow, shattering it. The surgeon sutured the wounds but knew the arm would have to be amputated.
A family of four — a mother, father and their 8- and 10-year-old children — were all riddled with pellets, the surgeon said. The older boy had dozens of pellets in his face, but amazingly none hit his eyes.
On the morning of Jan. 9, the phone lines started working again, and the surgeon reached out to doctors he trusted to refer patients to them. First he had to make sure to remove all bullets and pellets from their bodies so they wouldn’t be detained at the hospital. He wrote referral letters saying the patients had been in car accidents.
The surgeon summoned three other doctors to help in the hidden clinic. When new wounded were brought in, the patients who had been stabilized applauded and flashed victory signs to them, he said.
“They started to make the atmosphere happy through their pain. … I just couldn’t believe that moment,” the surgeon said, his voice breaking. “It was so human.”
None of the wounded died at the clinic, though 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.
Doctors targeted for arrest
Since Jan. 9, at least 79 health care professionals have been detained, including a dozen medical students, according to Homa Fathi, an Iranian dentist pursuing a Ph.D. in Canada and member of IIPHA who has been monitoring Iranian government action against health professionals since 2022. Many of those detained were accused of resisting security agents’ orders or other charges connected to providing medical care to protesters, said Fathi.
Around 30 have been released, most on bail, but many of them still face charges, including one accused of “waging war against God,” a charge that carries a death penalty, Fathi said. Authorities are also keeping some doctors under surveillance at home to ensure they don’t receive or visit wounded protesters — an unprecedented level of control, she said.
The surgeon who treated protesters at the secret clinic said he was surprised security forces never stormed that location to make arrests.
But arrests have come since. Two health care workers who volunteered at the clinic were seized from their homes, the surgeon said.
“I am waiting, too.”
