Iranian Cure for the Delta’s Blues

Baptist Town, with its tumbledown clapboard shacks on the wrong side of the tracks in Greenwood, Miss., seems an unlikely spot for any kind of revolution, especially one inspired by the Islamic Republic of Iran.

But soon, that Mississippi neighborhood and others like it in the Deep South may see some startling changes.

While political leaders in the United States and Iran are practicing boisterous brinkmanship over nuclear proliferation, a small group of health care professionals from both countries are quietly working together to practice a new type of medicine, beginning in Mississippi, a state that has been mired at the bottom of nearly every health index for decades. Their primary focus is the storied Mississippi Delta. The flat, hot, rural landscape that gave birth to the blues—the quintessential American art form that put suffering to song—now suffers a host of health woes, with some of the highest rates of diabetes, obesity, hypertension and infant mortality in the nation.

Despite hundreds of millions of dollars spent over the last decade to improve residents’ health there, the disparities between the Delta and the rest of the state have only widened.

“I’ve been in and out of the Delta for 40 years and nothing much has changed,” says Aaron Shirley, a 77-year-old pediatrician who pioneered public health care in the Delta. “I was wringing my hands and crying about it one day when he said, ‘Why don’t you come to my country and learn how to do it?’ And so I did.”

“He” is Mohammad Shahbazi, M.D., chair of the Department of Behavioral and Environmental Health at Jackson State University, who was born in southern Iran.

Despite its reputation in America as an international pariah with an infamous human rights record—part of former President George W. Bush’s “axis of evil”—Iran has won kudos from the World Health Organization for its innovative primary health care system. That system has eliminated health disparities between rural and urban populations over the last 30 years, reducing infant mortality in rural areas by tenfold.

Last year, as the United States was gearing up for its political slugfest over health care reform, Shahbazi­—with the tacit approval of the National Institutes of Health and Iran’s ministry of health—organized a tour of the Iranian health system for Shirley and James Miller, a health care consultant from Oxford, Miss. They met with the doctors and public health officials who built the Iranian system, visited rural “health houses” and hospitals, and returned home convinced that the Iranian model could be just the cure for what ails the perpetually ailing Delta, and perhaps even the nation.

“The health house system in Iran is like the German VW Beetle,” says Miller, of the Oxford International Development Group. “It’s simple and it works. It was developed by a country that wasn’t too popular at the time, but it solved a basic transportation problem.”

Yes, he says, Iran is a rogue nation. But “if the Iranians came up with a cure for cancer, would we not use it just because we dislike their leaders? This has nothing to do with politics,” Miller says.

In Iran’s health care system, remote village health houses are the first line of defense, staffed by villagers known as behvarzes. The behvarzes are trained to provide basic health services for villages of up to 1,500 people. Male behvarzes take care of sanitation, water testing and environmental projects. The women concentrate on child and maternal health, family planning, vaccinations and tracking each family’s births, deaths and medical histories.

Iran, a country roughly twice the size of Texas, now has more than 17,000 health houses and more than 30,000 behvarzes who cover more than 90 percent of the rural population—about a quarter of the country’s 72 million people. Recently Iran began creating health posts in city neighborhoods to perform the same functions for its growing urban population.