At the request of authorities, MSF has terminated its medical care activities in the city of Zahedan, capital of the province of Sistan-Baluchistan, in southeastern Iran.
Zahedan, capital of the province of Sistan-Baluchistan, is an Iranian city located approximately 70 kilometers (20-30 as the crow flies) from the border with Pakistan and Afghanistan. Since 2001, Médecins Sans Frontières (MSF) has been providing free medical care to Afghan refugees and Iranians lacking the resources to pay at clinics located in the city's poorest neighborhoods (Shirabad, Karimabad and Besat).
For the last several years, Iranian authorities have been returning Afghan refugees in the region (about 75 000) to their country. In addition, in 2007, Sistan-Baluchistan was placed off-limits to foreigners for reasons of "internal security." MSF has continued its activities there since 2008, thanks to the presence of its local staff and has been the only international organization still "tolerated."
"We received ultimatums a number of times from Iranian authorities instructing us to leave the area," says Karine Gillain, head of mission in Tehran. "We would negotiate each time and always managed to delay closure for several months, but last week we had no choice and had to end our activities."
MSF's doctors, nurses and midwives held an average of more than 5,000 free medical consultations per month in the two clinics that remained open until now, including one dedicated to maternal and child care. Most of the patients were women and children from poor families.
"We hope that the Ministry of Health facilities will care for the patients who came to our clinics, just as we have been sending them the most urgent cases up to now," says Gillain. "However, we fear that the poorest patients will not be able to pay for treatment or will be afraid to seek care."