Yellow buses arrive, one after another, unload and load passengers and then go off again. Counters protrude from small holes in the prison’s outer wall, offering tea and snacks to visitors. A 60-gram Hibi cake, which usually sells for 17 cents, costs around 25 here. And it’s 30 cents for a Benfi chocolate cake.
This is Rajaei Shahr Prison in Karaj, near Tehran. Today is visiting day. In the cold of November, visitors buy pale-colored tea from an old man and then sit on the bare benches outside the prison, waiting for the doors to open. Some are carrying bags of medicine, hoping that they can deliver them to their loved ones inside. News of expired or fake medicine being administered in this and other prisons make it even more urgent to get these parcels in for their family members and loved ones.
In mid-November, the number of inmates needing to go to Evin Prison’s clinic rose considerably. An inmate on Ward 7 at the prison told IranWire that several of his cellmates were complaining of painful symptoms similar to poisoning. Most of them said they had developed the symptoms after taking sedatives. An inmate at Rajaei Shahr had a similar story, and that recently several of his cellmates appeared to be suffering from poisoning after taking sedatives.
Vahid B., an inmate on Ward 1 at Rajaei Shahr Prison, says he tries not to take any pills. The widespread reports of expired and counterfeit drugs in the prison have forced him to live with his pain.
According to Vahid, inmates have two ways of getting pills. They get them from either the prison clinic or buy them from the underground network of inmates. He says that in the last few months the price of bootleg medicines has risen sharply. For example, a pack of 10 acetaminophen codeine pills — in huge demand in the prison — sells for as much as 100,000 tomans, or $24.
Vahid and other inmates are not covered by insurance. “Even before the sanctions, we suffered from lack of medical facilities,” he said. “Hygiene means nothing here and we cannot properly bathe and clean ourselves. And the nutrition is horrible. Since we get no sunshine, we are always prone to skin diseases. Before, whenever we went to the clinic we were given a pack of acetaminophen pills for every illness in the world, from cancer to corns on our feet. But even acetaminophen is nowhere to be found now. They put a couple of pills on your palm and say there is a shortage of medicine, and we have to live with it.”
Sedatives to Cure Heart Attacks
Abdolhossein is a 63-year-old retired teacher and an inmate on Ward 1 at Rajaei Shahr Prison. He was convicted of possession of illicit drugs and has eight more years of his prison sentence to serve. He suffers from heart and vascular disorders and high blood pressure. Every day, Abdolhossein takes one Losartan pill to control his blood pressure and Furosemide to control the edema caused by congestive heart syndrome. He has had numerous heart attacks, and each time he has been sent to the prison clinic, where he was examined by a general practitioner who returned him to the ward with a pack of painkillers. However, he says over the last three months he has not even been getting that. “They say that because of the sanctions we must reduce our consumption of drugs to the minimum,” he said.
Even in emergency situations, Abdolhossein is not allowed to leave the prison and receive treatment at a specialist medical center. “You cannot stop a heart attack with acetaminophen and such commonplace drugs,” he told IranWire. “They prescribe acetaminophen even for skin diseases like scabies, fungal infections and herpes.”
To get his hand on the medicine that he needs, Abdolhossein orders it through inmates who smuggle it into the prison — and, of course, they charge him several times the actual price for the service. Recently, he was sold packs of expired pills. When he objected, he was told: “in a few months you will not even be able to get this. Haven’t you heard about the sanctions and the shortages?”
Abdolhossein also tells the story of a cellmate who had recently come down with a severe type of flu. “He had a high fever,” he says. “He was perspiring and moaning continuously. We asked the doctor at the clinic to examine him. They gave him 10 aspirins. The poor guy was dying. We gave 30,0000 tomans [$8] to a prison guard to buy him 10 Ibuprofen pills.”
The gangs who buy and sell medicine are mostly under the protection of prison personnel and officials. They recently raised their prices by a hundred percent, citing sanctions as the reason. But the more serious problem is that they are now selling expired and fake drugs to inmates without making any effort to hide the fact — and again, they justify it by pointing to sanctions.
According to inmates, they have no choice but to buy the overpriced drugs smuggled in. Often the medicine is sold to them without any packaging, which probably means that it has expired or is counterfeit.
What makes the situation worse is that clinics in Iranian prisons cannot treat illnesses more serious than a cold or minor pains — prisons simply do not have the necessary medical equipment or medicine. E. Ayouzi, an inmate on Evin Prison’s Ward 2, told me the story of a cellmate who hanged himself in October. “We rushed to him to save him,” he said. “He would have survived for sure if he were outside prison. Only a few vertebrae in his neck had been damaged but he was left for too long on the floor, waiting for prison officials to get him to the hospital. A relative of his was saying that, according to examining doctors, he would have undoubtedly survived if they had taken him to the hospital sooner.”
According to Ayouzi, because of the shortage of medicine, inmates suffering from heart or respiratory diseases receive the bare minimum treatment, just enough to resuscitate them. Some prisoners insist on going to the prison clinic, but even there they do not receive proper medical attention and are returned to the ward no better off than before. He said that although prison officials deny it, a cellmate of his died because the clinic could not provide him with the adrenaline that would have saved him.
How do Sanctions Affect Safe Delivery of Food and Medicine?, November 8, 2018
The Humanitarian Cost of Sanctions on Parsian Bank, October 23, 2018
The Murderous Neglect of a Sick Political Prisoner, September 20, 2018
The Diaper Crisis in Iran: An American Conspiracy?, September 7, 2018
Journalist Alireza Rajaei: Victim of Medical Neglect in Prison, September 8, 2017
In Evin, Some Prisoners Face a Cold Winter, December 2, 2016
Political Prisoners Denied Phone Calls, Medical Care and Books, March 16, 2016
Whatever you do, don’t get sick in prison, March 2, 2016
Sponge Slippers and Dental Floss: The Delicacies of Iran’s Prisons, August 20, 2015