“Everybody is out on the streets. When I say everybody, I mean workers, grocers, children, government employees — everybody. They laugh at those of us who stay at home. They say that coronavirus is for wimps, that the more precautions you take the more you are at risk. I hear this even from my family — my husband and people close to me. The situation is so bad that even local news networks keep warning people. God have mercy on us!”

These are the words of Sara, a resident of Ahvaz, the capital of Khuzestan province. “Over the last few months my husband’s family kept complaining that I do not go and visit them,” she says. “Many of our friends say they have been going out but have not been infected and that we are being played. People do not trust the news and do not take what the government says seriously.”

On the night of Wednesday, May 6, Farhang Korebandi, the president of Razi Hospital, told a television news broadcast that the situation in Ahvaz is critical [Persian video]. “It is so bad that for every two people who come to Razi Hospital one has to be hospitalized,” he said. Korebandi blamed the resurgence of the coronavirus epidemic and the climbing curve of infections in Ahvaz on people’s refusal to take preventive measures. He added that the hospital had reported high numbers of seriously ill patients, including people with diabetes, the elderly and other vulnerable people suffering from a variety of illnesses and diseases.

On May 6, Ahvaz Jondishapur University of Medical Sciences announced that in one day alone, 111 people had tested positive for coronavirus in the city of Ahvaz [Persian chart].

“We have witnessed an increase in the number of infections just in the province of Khuzestan and investigation teams have been dispatched to the province to investigate the issue,” said Dr. Ghasem Jan-Babaei, a deputy health minister, on the same day [Persian link]. “Patients in the cities of Ahvaz, Dezful and Abadan are not seriously ill,” he said, adding the claim that “despite the 20 percent increase in the number of infections in the province in the last several days, we have now arrived at a steady flow.” 

But both the city’s residents and medical workers challenged the claims. “Razi Hospital’s capacity for hospitalizing patients has been exhausted,” says a doctor who works at the hospital but asked to remain anonymous for security reasons. “My colleagues at Taleghani Hospital and Abuzar Children’s Hospital are in the same situation. ICU beds are full and the patients have to fight against death in a very bad situation while suffering pain. From the very beginning of the coronavirus outbreak, Razi Hospital was equipped to fight it,” he says. “We increased ICU rooms to five with a total capacity of 60 beds but as we speak, we do not have a single empty bed for patients with serious conditions who are brought to the hospital’s emergency room.”

Given what Farhang Korebandi said — that one out of two people who come to the emergency room will have to stay in the hospital for treatment — the situation is dire.

 

Why has there been a surge of coronavirus cases in Khuzestan?

According to Gholam Reza Shariati, the provincial governor of Khuzestan, the number of coronavirus infections in his province has risen due to people “ignoring social distancing,” the “reopening of the bazaar and businesses” and “a more robust system for detecting patients” [Persian link].

Following a decision by the Iran Business Council, which was endorsed by the National Coronavirus Combat Taskforce, barbershops and hair salons were allowed to reopen from Wednesday, May 6, provided they observed all health guidelines. The wearing of masks and gloves in offices and crowded environments was declared mandatory.

The moment that businesses reopened, people appear to have rushed out into the streets. Photographs posted online of Ahvaz’s main  streets show people out in force, and not only to carry out necessary chores.

Sara’s husband is self-employed and runs a shop, while Sara manages the house and looks after their three-year-old daughter. She says a large number of her husband's colleagues and fellow shopkeepers re-opened their businesses after restrictions were lifted in Khuzestan. “For three months we paid our expenses because my husband owns the shop, but many of his colleagues are tenants and could not pay their expenses,” Sara says. “And there have not been many sales, either. I have no idea what so many people are doing out on the streets.”

Azadeh, another Ahvaz resident who worked for one of the well-known beauty salons in the city, says she was fired from her job because when the salon re-opened she refused to work on eyelash extensions or lash enhancement tattoos. She didn’t want to get too close to clients. “The manager of the salon called and said, ‘come in,  we are open,’” she says. “I told her I would do nail work but I would not work on eyelashes or anything that has to do with the face. ‘Then go and look for another job,’ she said, ‘because the moment I arrived at the salon I had 13 appointments and I will have more before tonight. I will give the appointments to other girls and you can find another job.’”

Azadeh says that many of her clients have called her personally and told her not to be so concerned; if it was a problem for salons to re-open, they wouldn’t have been allowed to, they said. “Part of the problem in Khuzestan is the government’s negligence, but it is also the fault of our fellow citizens who do not take the matter seriously,” she told IranWire.

But Azadeh also pointed to a bigger problem. “There are some people who cannot afford to pay for health equipment, but there are also those who are unwilling to spend money on disinfectants, masks and gloves. For instance, it has been announced that in Khuzestan people must wear masks and gloves in public spaces. A pack of latex gloves costs 179,000 tomans [$42] here and people cannot afford it. And freezer gloves are no good. I like to make money — but I have to stay alive to spend it. In this situation, you might fall ill at any moment. The only remedy is to stay home and take precautions.”

 

Outbreak of Cholera

Over the last few days, there have been unofficial reports on social media of a cholera outbreak in Khuzestan, but they have been denied by government officials. In a live online chat with the public on the evening of Monday, May 4, Gholam Reza Shariati, the provincial governor of Khuzestan, said, “Because of its climate, Khuzestan has cholera outbreaks twice a year, in May and in September, but, as of now, we have had no cases of cholera in the province.”

On Tuesday, May 5, the governor’s office in Ahvaz issued a statement denying that city water had been infected by cholera bacteria. The statement also called for legal action to be taken against the people who had spread the rumor.

Yet only two days earlier, on Saturday, May 2, Shariati himself had warned against the danger of a cholera outbreak and had said that he had ordered cities and villages in the province to dredge open water conduits and spray them with lime to prevent the spread of the disease. 

Roshanak, an employee of an insurance company in Ahvaz, heard about the cholera outbreak from a doctor who is trusted by her company. “He knew about it and told us to take it seriously,” she says. “We now only drink water that has been boiled. Cholera has happened before in Khuzestan and now that we have coronavirus as well, the situation is bound to get worse. Of course, there are many who say this is only a rumor. After the situation was declared normal, our friends go to falafel shops in Lashkar Abad every night and they are not worried at all. But I am afraid because I have a young child.”

The doctor I spoke to at Razi Hospital confirmed that he had seen cases of cholera. “Unfortunately, we have had some cases, and the patients were hospitalized in the emergency ward,” he told IranWire. “They were mostly margin-dwellers or from bordering towns,  from Gheyzaniyeh and Hamidiyeh in particular. Either the situation in their neighborhoods is unhygienic and they have open streams or they live next to vegetable fields. But the coronavirus situation is so horrible that nobody talks about cholera. Considering that there is a cholera outbreak in Khuzestan twice a year and one them is in May, we advise people to boil drinking water even if they have purifiers at home and, as much as possible, not consume raw vegetables and fruits.”

 

Coup de Grâce: Air Pollution 

While the people of Khuzestan are struggling with the coronavirus epidemic and a possible cholera outbreak, a dust storm moving in from Iraq has made the crisis even worse. Photographs of pollution and poor air quality in Khuzestan, published by both traditional and social media, show a high level of haze, a situation that can worsen conditions for people suffering from heart and pulmonary diseases.

Mohammad Javad Ashrafi, Director General of Khuzestan’s Environmental Protection Agency, said on the afternoon of Wednesday, May 6, the level of haze in the port city of Abadan reached 6,547 micrograms per cubic meter, 43.64 times the level deemed to be safe. The corresponding numbers for several other towns on that day were as follows: 1,790 in Ahvaz, 1,646 in Hamidiyeh, 6,535 in Khorramshahr, 2,772 in Susangerd and 1,453 in Shadegan.

Hospitals in Ahvaz, Mahshahr, Dezful, Abadan and Khorramshahr are struggling with shortages of facilities, medical equipment and manpower to treat coronavirus patients. Air pollution and cholera — dangerous at the best of times — pose further deadly risks to people’s health and lives, especially as people are not being stopped from fearlessly congregating in public spaces in cities.

 

Related Coverage:

IranWire reports on the Coronavirus Outbreak in Iran

Lies, Misinformation and Makeshift Graves: a Chronology of Coronavirus in Iran

Iran Continues to Harass Journalists Reporting on COVID-19, 5 May 2020

The Economic Impact of Coronavirus on Single Iranian Women, 1 May 2020

Hit Hard by the Pandemic Recession, Many Iranian Day Laborers Turn to Scavenging, 29 April 2020

More Than 7 Percent of Iranian Covid-19 Victims are War Veterans, 28 April 2020

Will Ramadan Worsen the Spread of Coronavirus?, 24 April 2020

Iran's 4 Big Lies About its Response to Coronavirus, 24 April 2020

Iranian Online Network Still Peddling Coronavirus Disinformation, 21 April 2020

 

 

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