Employers have rewarded the sacrifice of Iranian nurses with sackings, unpaid salaries for shifts already worked, and revolving 89-day contracts – one day short of any job-security and rights.

On Saturday 9^th May, protests by nurses in Gilan province, in the north of Iran, took place – drawing attention to the high death toll exacted from amongst their colleagues in the course of the struggle to prevent hundreds of civilians from falling to coronavirus, amidst an absolutely shambolic response from the governing regime.  Despite the heroic endeavours of the members of this profession, in an area of Iran particularly badly hit by the outbreak, the health authorities now deem the nurses to be surplus to requirements and have ended the agency contracts on which they were engaged thus leaving them facing unemployment.  Many of them had left jobs at privately-run clinics and medical centres to relieve the huge pressure on the health service in Gilan province, at grave risk to themselves and their families, in the reasonable expectation that the government – mindful of the shortages of nurses there – would then move to secure their engagement thereafter, affording them a precious degree of stability in their working lives.

All of this is taking place while the world observes 12 May as International Nurses Day.

Mohammad Hosseinpour, one of the nurse activists working in Gilan, stated, “Many of the nurses whose death notices were published during the coronavirus outbreak, as well as those currently protesting, had been issued an 89-day temporary contract.  Many of them then contracted the virus and transmitted it on to their relatives.  They worked on an equal footing with other nurses and took their own lives in their hands, yet they did not stand to gain the slightest benefit.

“On Saturday, a protest was held in Gilan by nurses, a large number of whom had come to work at Gilan University of Medical Sciences to bolster the ranks of their fellow nurses.  Many of them have even left their previous positions, having heeded the regime’s desperate call for more nurses, in the expectation that this would facilitate their employment under the Ministry of Health with the according benefits and job security.  Some of our colleagues came from other clinics; for example, one had been working in Ardabil [a neighbouring province] and had come here in the hope that she would be able to get a more secure job in response to the needs identified during the critical situation in Gilan.  After our protests, it was decided to form a 10-member committee of nurses to follow up on this issue at the Gilan University of Medical Sciences.”

“How long must this exploitation of nurses go on for?!  If the government is to pay nurses, it must do so directly and to the nurse, not the intermediaries [HR pool/sector agencies].  How long are the intermediaries between the Gilan University of Medical Sciences and the manpower [nurses] going to be allowed to cause all kinds of problems, such as delays in payment of wages and low incomes?  My co-workers have not been paid for exactly 51 days today.  We have had a 50% increase in wages for nurses since the beginning of this year, but the nurses engaged from the intermediary company operating under the auspices of the “Nurses’ Home” [the Iranian nurses’ professional trade association] have not been entitled to this increase.”

Mohammad Sharifi Moghaddam, head of “Nurses’ Home”, stated, “The 30,000 nurses engaged and deployed by the Ministry of Health are covered by the country’s labour code.  The Ministry of Health’s policy over the past seven to eight years has been based on two approaches; one is to increase supply – which is to increase the number of nursing graduates – and the other is to eliminate the job security of nurses.  All of this is an effort by the Ministry of Health to make nursing labour cheaper.”

According to reports from the Iranian Labour News Agency (ILNA); at the beginning of the coronavirus crisis in Iran, the state hospitals overseen by the Ministry of Health were severely affected by the lack of sufficient manpower, and so the Ministry issued an official call for nurses nationally.  A large number of nurses were hired in different cities, especially in the “red zone” areas, but under 89-day duration contracts.  Indeed, the Ministry of Health is continuing to recruit a large number of personnel needed to combat the coronavirus crisis under this type of arrangement and will probably say goodbye to them by the end of the quarter.  This form of volume limited duration work set-up is concluded in accordance with the provisions of the country’s labour code – though, in practice, many of the according benefits and entitlements are not extended to workers engaged under these arrangements.

100s of nurses made redundant while COVID-19 takes off

Since the second half of April this year, there have also been reports of extensive lay-offs of nurses and staff at the Atieh Private Hospital in Tehran, one of the largest private medical facilities in the Middle East region.  According to this news, half of the 1,200-strong medical staff workforce at Atieh Hospital have been deemed surplus to requirements and sent home.

This mass shedding of the workforce by private hospitals – which are considered to be amongst the most powerful economic enterprises in the country – is all the more surprising at a time when hospitals throughout Iran are facing unprecedented levels of demand amidst the pandemic, and when nurses and other medical staff are urgently needed with those already engaged under the most intense pressure.

The rampant privatisation of healthcare for profit has been overseen in Iran in recent years – especially during the tenure of president Hassan Rouhani’s government – and this has had major consequences, including; corruption, the prioritising of profit over patient care and treatment, a drastic reduction in the number of nurses, and the depriving of the underprivileged (a mass swathe of Iran’s population) from anything remotely resembling adequate healthcare provision.

Last year, the aforementioned Mr Sharifi Moghaddam called for an increase in the budget allocated to the nursing sector, citing the critical situation facing this particular workforce as well as the failure to allocate a budget line for the implementation of the Nursing Services Tariff Law in 2019, which caused real concern and frustration amongst the nursing profession.

Meanwhile, reliable reports are emerging of a resurge in coronavirus infections and deaths following the lifting of the haphazard restrictions belatedly brought in by the regime after Iran became one of the worst-hit countries and the main epicentre of the outbreak in the Middle East region.  According to the regime’s own media reports, the southern province of Khuzestan has been in complete lockdown since Thursday 7 May, with 9 towns and cities having been designated as virus “red zones”.  The hospitals in Ahvaz, the provincial capital, reported that they have run out in terms of ICU capacity and are facing a catastrophic situation.  This is compounded by the massive shortage in human and technical resources in the medical sector.

Once more, there is a belief and expectation that – as was the case in March – medical personnel will be drafted in to come to the rescue.  In that month alone, more than 100 medical personnel – including doctors, nurses and other health professionals – contracted COVID-19 in the course of their duties and died in agony.  They showed selfless dedication without raising the issue of their unpaid wages or woefully poor conditions of service.  The question remains as to how long the nurses’ sense of duty and professionalism can diffuse their righteous anger and disgust at being continually neglected, taken for granted and treated as a dispensable commodity.

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