By Mahmoud Aslan

 

TEHRAN, 18 March, - (ANA) - Iranian hospitals have received roughly 15,000 war wounded since the US-Israeli military coalition launched strikes 16 days ago, according to health ministry officials and Iranian media reports cited by The International Institute for Strategic Studies (IISS).

 

The surge is overwhelming a health system already stretched thin after a security crackdown on anti-government protests that swept more than 100 cities in late December, leaving emergency departments across the country absorbing tens of thousands of gunshot and pellet injuries.

 

Now, war casualties are arriving on top of that earlier wave, pushing a medical infrastructure weakened by years of international sanctions toward its limits.

 

The conflict has also taken a toll on the healthcare sector. 11 health workers were killed during the opening days of the war, and 55 others were injured. The dead included four doctors, two nurses, and three emergency responders, along with two other health workers whose exact roles were not specified in official reports.

 

Damage has also been reported at 18 pre-hospital emergency bases and between 14 and 18 ambulances, as well as at several county health centres, comprehensive health service facilities, and rural health houses.

 

Health authorities say thousands of wounded people have been treated and discharged since the fighting began, though hundreds remain hospitalised and many have required surgery. The influx of patients has placed heavy demands on intensive care units, operating theatres, and blood supplies across the health system.

 

Deputy Health Minister Ali Jafarian said at least 31 hospitals and major clinical centres have been hit during the US-Israeli campaign, leaving 12 of them out of service.

 

Health authorities say the attacks have complicated efforts to treat a rising number of casualties, many of them civilians injured in strikes on urban areas. The World Health Organisation has verified at least 13 attacks on hospitals and other health facilities in Iran since the conflict began.

 

Interviews with surgeons, health officials and medical staff paint a picture of a health sector squeezed from multiple directions: the flood of war casualties, damage to hospitals and ambulance infrastructure from coalition strikes, chronic shortages of advanced equipment caused by years of sanctions, and an internet blackout that has crippled the digital systems hospitals depend on to coordinate patient flow and allocate scarce beds.

 

 

 

 

Abbas Ali Mousavi Mirmolk, a general surgeon at Kasra Hospital, said he witnessed a massive influx of acute injuries requiring immediate surgery or intensive care. Departments expanded daily to accommodate new patients, and the compound nature of many injuries demanded additional planning at every decision point, particularly when resources were limited.

 

"For any surgeon, what happened in Iran during these days of war was a severe test of the health system's ability to operate under unprecedented pressure," he said.

 

The system has held so far. Whether it can continue to do so is the question Iranian health officials are reluctant to answer directly.

 

Ali Reza Raeisi, Iran's deputy health minister, told Iranian media that the country's health system continued to function despite the enormous pressure, insisting that hospitals had not collapsed and that medical teams managed the flow of casualties within a compressed timeframe.

 

Hospitals in Tehran, Isfahan, Shiraz, and Mashhad took in the most critical cases requiring complex surgeries or intensive care. At the same time, facilities in smaller provinces handled less severe injuries or stabilised patients before transferring them to better-equipped centres. This triage-by-geography helped ease the burden on hospitals closest to the hardest-hit areas, officials say.

 

Raeisi attributed part of that resilience to Iran's accumulated experience managing crises, from the Covid-19 pandemic to earthquake response. He pointed to the country's extensive network of teaching and university hospitals in major cities, which allowed health authorities to draw on large numbers of resident physicians and medical students to reinforce emergency departments.

 

Rasoul Khalili, a 49-year-old general surgeon, said the weakness of Iran's hospital infrastructure was evident well before the wounded began arriving. During the war, hospitals came under tremendous strain on beds, operating rooms, and emergency departments.

 

"The existing infrastructure was never designed to handle this volume of casualties in such a short period," he told The New Arab.

 

Medical teams responded by reorganising departments, converting some facilities into temporary treatment points and continuously adjusting patient flow, Khalili said.

 

"Teaching and university hospitals were activated to relieve pressure on the main facilities," he added. "The system showed a notable capacity to adapt, but any future increase in casualties could exceed its absorptive limits."

 

 

 

 

The war exposed in sharp relief the damage that years of sanctions have done to Iran's medical supply chain.

 

International restrictions have made it difficult to import advanced medical equipment, specialised surgical supplies, and spare parts for sophisticated devices.

 

Some hospitals were forced to rely on existing stockpiles or locally manufactured alternatives, solutions that helped in the short term but may prove insufficient if the conflict drags on.

 

Mohammad Reza, a physician at Rasalat Hospital, said the impact of sanctions and the scarcity of advanced equipment was "unmistakable during the crisis."

 

The shortage of precision surgical instruments and some essential medications made treating compound injuries far more complicated.

 

"Modern surgery depends on precise tools," he said, "and any gap forces medical teams to use less effective alternatives, which increases treatment times and puts patients at greater risk."

 

Mousavi Mirmolk agreed, recounting moments when he had to either use less precise substitute equipment or reschedule certain procedures until better resources became available.

 

"These decisions are uncomfortable for any surgeon," he said, "but they are the reality of this crisis."

 

The crisis, he added, confirmed the need to develop a stable and sustainable supply chain and to guarantee access to vital equipment regardless of sanctions.

 

 

 

 

Among the less visible disruptions was the internet shutdown or restricted access that affected some areas during the war.

 

Eyewitnesses indicated that the blackout disrupted coordination systems between hospitals, which rely on digital networks to share real-time information about available beds in emergency and intensive care units.

 

Under normal conditions, Iranian hospitals use electronic systems to direct patients to facilities with appropriate capacity. The outages disabled parts of that infrastructure.

 

Some hospital administrators reverted to older methods of coordination, including direct phone calls and internal communication networks disconnected from the global internet.

 

The blackout also affected digital systems used to manage medical records and organise ambulance dispatch.

 

Abd al-Hussein Soudagar, an Iranian healthcare expert, said one of the strengths that helped the system manage the crisis was its prior experience with disasters.

 

"The capacity of teaching hospitals to draw on resident physicians and medical students allowed them to ease pressure on primary facilities and ensure care reached all the wounded," he told TNA.

 

That experience, Soudagar said, helped organise patient flow, set priorities and distribute resources more effectively.

 

"This shows that the ability to adapt is not just a matter of material resources," he said, "but of experience in planning and management under pressure, which is a decisive factor in the success of any health system during major crises."

 

The human cost of that adaptation was high. Reports describe medical staff working continuous shifts for several days due to the volume of cases arriving at emergency departments.

 

Some hospitals called in retired doctors and senior medical students to help manage the surge. The physical and psychological toll on health workers became an additional challenge layered on top of the equipment shortages and infrastructure strain.

 

Since the conflict began, Iranian authorities say at least 1,300 people have died, with thousands more injured across the country, placing extreme pressure on hospitals and emergency services already struggling to cope with the influx of casualties.   - (ANA) -

 

AB/ANA/18 March 2026  - - -