Re: What Made My Day Today? :-)

On 7/8/24 20:38, Physfitfreak wrote:

  Ok, ... :)
 After days of looking into this "Pezeshkian" guy, I have a slightly better idea about the answer to the question of who he is and especially why Iranians trusted him over Jalili.
 It is a long story, but in one sentence, the answer is being practical. Pezeshkian has a ton of action experience, because he's been in the field of public health, getting him very close to people and their medical needs and everything about their lives that affect that; while Jalili has stayed theoretical. This is what determined the outcome of the elections.
 Pezeshkian mentioned it only once in his debates, but he and his friends and relatives together built tens of "Khaneye Behdasht" (KB), literally meaning "house of health" units in rural areas of Iran, without getting paid for the work. They did that voluntarily, using the support of Health Ministry.
 If you were familiar with life in rural Iran, you'd know what these little nano-hospitals mean.
 I spent two months, one summer in mid 1960s, in a rural village to the west of Tehran in a house belonging to distant relatives of a distant relative :) And I remember those days perfectly well, and I've often thought about what I saw and pondered on, so I can now say that I am familiar with life in those conditions.
 The life there is wonderful by the way and nobody should get the idea that life is bad in there.
 But matter of health, and a thousand related matters, asks for more work. Even I, in 5th grade, understood that very well in those two months.
 These little KBs are the smallest things in the world that you can call "hospital" :-) KB only has one bed and a curtain separating it from the rest of the area, which is that same office in which the bed is placed. There are a few medical equipment there, usually out of the way, and there is a desk, and there are about 4 seats in case a whole family bring their kid or parents there.
 There are no "doctors" there. The actual medical doctors are stationed at a larger facility a distance away and in charge of several of these KBs. The one to three or so medical staff that work inside these KBs are called "BehVarz" (BV), literally meaning "health practitioner". The number of staff depends on the village's population, and most KBs are staffed with two BVs, one male, one female to check both genders accordingly. But very small villages have just one BV, usually a female.
 This is a picture of a KB freshly built:
 https://i.postimg.cc/59P4BWfb/Khaneye-Behdasht.jpg
 It is not 100% ready yet, and is missing its sign and a few infrastructure outside of it.
 And this a shot of inside of them:
 https://i.postimg.cc/G2WZQKgP/inside-KB.jpg
 That's it. What you see is what you get.
 And this is one with the BV inside doing her work:
 https://i.postimg.cc/Vkz5gB3c/BehVarz.jpg
 A BV with her nomad patient:
 https://i.postimg.cc/6q0Tx8vP/Beh-Vars-and-patient.jpg
 Now, the interesting thing is what these BVs do. You might think with so little equipment and space, and such a small number of people in those villages, there is not much for them to do... Nothing is farther than this image from the truth.
 BVs have a myriad of work, every minute of their working time. In fact, they are mainly creating and maintaining careful records. Records of everything. Because the subject of health in a rural area under KB coverage is tied to everything you can imagine in that area!
 Let me go through a few of those tasks here so you could get an idea what magnitude of work BVs are involved in. The information is from a paper. Other than treating patients, BV is constantly performing these tasks:
 - finding out and recording of census information in the area. What languages they speak, how many men, women, children, what age groups, how many pregnant, their names, who supports the families, how much education they have, their jobs, those with handicaps, those with chronic illnesses, genetic illnesses, marriage status, who moved in or moved out of the area, who died, what are their traditions, beliefs, etiquette, religion, etc
 - using the census material to modify and correct the choices of BVs working in that KB, in a way to get the most out of their efforts.
 - numbering of the houses in the entire area in a certain way.
 - in each living unit, what is the situation with:
   * water
   * electricity
   * telephone
   * drinking water
   * bathing
   * sewage
   * material used in housing
   * manner of accessing sewage
   * roads inside the village
   * access to roads outside village
   * access to public houses
   * distance to food sources
   * distance to schools
   * distance to mosques
   * quality of nutrition
   * etc
 - organizing the entire people into groups with specific medical needs
 - assessing the extent of medical services, volume of work, and types of work needed
 - determining the extent of quality health education needed in the area, and carrying out that education.
 - teaching the rural school teachers, as well as everyone who has access to groups of people in an every day manner, the fundamentals of healthy living, and having them teach such practices and knowledge to their kids and/or audiences.
 - using kids who are thus educated with fundamental health practices to take the knowledge and measures to their families and showing them how healthy living is.
 - creating good health habits in the area
 - creating trust in people for the KB goals and its BVs.
 - creating both self-care and self-reliance in the people of the area
 - creating volunteer groups from people in the area to help BVs carry out the educational tasks.
 - choosing BVs with family in the area, so in cases needed they could ask their family members to help them do a certain types of chores like finding and encouraging people who are scheduled to show up to KB for further treatment but don't show up, or show up outside of schedules previously made, etc.
 - teaching volunteer groups some basic chores of conducting and acquiring health information like weighing patients and newborns, getting their temperature, height, making electrolyte drinks, etc.
 - carrying out vaccinations both for people as well as their livestock
 - sharing all recorded information to the local health office in charge of many KBs
 - creating and maintaining medical files for each patient or pregnant woman, including the information about their previous deliveries before KB was built in the area, and determining their genetic illnesses or conditions if present to prevent cases of homozygote births, etc.
 - closely watching pregnant women and scheduling numerous visits for them, more frequently as time progresses.
 - sending pregnant women who need special treatments to the local health office that's equipped with tools and medical staff to deliver such treatments.
 - teaching women who've just given birth, health measures applied to such periods, and helping them in carrying out such measures. Especially during the first two years after birth, watching the nutrition and delivering necessary healthcare to the kid, as this period determines the future of the kid in matters of strength in character and psychological health of the person.
 - teaching and delivering help to parents of kids under 8 years old, to provide skills and experiences in their kids that will form their ability to learn throughout the rest of their lives.
 - help in creating knowledge and care for parents about raising their kids under 8 years old in a way that leads to a better ability in them to later be creative and observe the laws and thus reduce a myriad of social expenses in the country.
 etc and etc
 As you see, almost none of these tasks are carried out in an ordinary physician's office. Yet, anything that a physician does in a patient's visit is also included in what these BVs do everyday. What they can do in the way of treatment, they do, and what they cannot, they arrange for the patient to be seen and treated in the local health office with highly skilled medical staff and equipment needed.
 And the service is totally free to patients.
 These KBs are now all over the rural areas of Iran. There are even mobile versions of them also serving nomads, moving as the nomads move north and south.
 Pezeshkian has been seriously involved in creating these KBs. And personally has created many of them. In a way, this type of action began in his life during the Iran-Iraq imposed war, when no KB was even thought out yet. He was a new graduate of medical school and ended up in charge of providing medical needs to soldiers in the fields. Taking care of all the logistics involved. In many missions, he was an active combat soldier too and saw combat.
 So, by the field of study he chose, he began a life of doing things at the rock bottom level throughout the rest of his life, until he entered politics.
 So he is a quite different man from Jalili. No wonder he didn't say anything about his plans and ideas. He has to see it and face them first, before forming his way of handling those tasks :) He has to face them at the rock bottom level first. That's why he never answered those questions, and yet stayed so confident of himself that he'll do the right thing whatever it may be.
 Now 80% of my worries about him and his men is gone. The remaining 20% is about how he'll manage working with others in high offices. I hope he's had that skill built in him also.
 There's also a "BV Day" in formal calendar of Iran to celebrate and appreciate their hard work and service.
 Now after blowing a couple of hours on KBs and BVs, let's see a few more of them :)
 https://i.postimg.cc/wTGSDvzz/inside-kb-1.jpg
https://i.postimg.cc/wTLGRkwX/in-the-field.jpg
https://i.postimg.cc/L691j9Tx/in-the-field-2.jpg
https://i.postimg.cc/BnGHtTz1/inside-kb-3.jpg
https://i.postimg.cc/v8tpPyR1/in-the-field-3.jpg
     

A few more pics to give you the right idea how nano these KBs are:
https://i.postimg.cc/Pf0GD74R/kb-1.jpg
https://i.postimg.cc/xjvGGJyV/kb-2.jpg
https://i.postimg.cc/3N2HNjPR/kb-3.jpg
https://i.postimg.cc/vHcG59f0/kb-4.jpg
https://i.postimg.cc/ZY3Dy5D1/kb-5.jpg
and insides:
https://i.postimg.cc/GhXPB0rW/inside-kb1.jpg
https://i.postimg.cc/8Pc4mkyp/inside-kb2.jpg
The local medical centers that each cover several KBs are larger and are actually small hospitals which do surgeries, treat broken bones and various injuries, and have a pharmacy in them. Here are a couple of them:
https://i.postimg.cc/0j3GrD1z/local-medical-center.jpg
https://i.postimg.cc/SQzft168/local-medical-center-2.png
and a newly built:
https://i.postimg.cc/t41qhPQX/local-medical-center-3.jpg
and a mobile KB for nomads:
https://i.postimg.cc/jSHDW9pH/mobile-kb.jpg
KBs aren't just in rural areas. There are many of them in urban areas also, but their name is not Khaneye Behdasht, but Paygahe Salamat (PS), literally meaning "wellness station". A PS serves an area of about 13000 people. Any village in which the population reaches 13000, will have its KB named PS.
Some of PS are located as a unit by themselves not in junction with a regular hospital, but some are inside the area of a large hospital and their names are slightly different, but the responsibilities are still the same as other PS and KBs.
So all the time consuming crap that a medical doctor or a surgeon has to carry out which a BV is perfectly capable of doing is thus subtracted from doctor's work and relegated to BVs and doctors only spend their valuable time very efficiently, with all the information they'd ever need of the patient at hand, provided by BVs. This is the idea behind this whole system. It is a result of not having enough MDs and surgeons in the country, as they're part of the brain-drain Iran still suffers.