Iran’s January demonstrations have been met with lethal force, according to rights monitors and clinicians who spoke to the BBC. Accounts describe security personnel inside hospitals, monitoring of medical records and the arrest of health workers, prompting some injured protesters to avoid formal care. Verification remains difficult amid an internet shutdown and restrictions on international reporting.
In Isfahan, a protester identified as “Tara” said she and a friend were struck by birdshot after security forces on motorcycles confronted the crowd. Fearing arrest if admitted to hospital, they sheltered in a nearby home and later received clandestine treatment from a known doctor. A surgeon subsequently removed some pellets but warned that others would remain. All personal names in this report are pseudonyms used for safety.
In Tehran, a surgeon using the name “Nima” described sustained mass-casualty pressure from 8 January, operating for roughly 96 hours as patients arrived with gunshot injuries to the head, chest and limbs. He recalled treating a patient with a projectile path from chin through the mouth to the upper jaw and said others required amputations, leaving permanent disabilities.
Multiple healthcare workers told the BBC that security forces were stationed in hospitals and that patient records were routinely checked to identify protesters. Some clinicians said they tried to avoid explicitly recording gunshot wounds to reduce risks to patients, raising concerns about clinical documentation and confidentiality.
Eye trauma features heavily in the caseload. The head of Tehran’s Farabi Eye Hospital, Dr Qasem Fakhrai, told the semi‑official Isna agency that as of 10 January the hospital had treated 700 patients with severe eye injuries requiring emergency surgery and referred almost 200 others. Witnesses reported patients arriving from several cities and being moved via staff lifts to operating theatres; one surgeon reportedly waived fees in at least one case.
Iranian authorities present a sharply different narrative. Officials have said more than 3,100 people were killed during the unrest, describing most as security personnel or bystanders attacked by “rioters”. Health ministry spokesman Hossein Shokri, quoted by the semi‑official Tasnim agency, said around 13,000 operations had been performed and asserted that confidence in hospital impartiality led roughly 3,000 people who had been self‑treating over six days to seek care.
The US‑based Human Rights Activists News Agency (HRANA) reported 6,301 confirmed deaths, including 5,925 protesters, 112 children, 50 bystanders and 214 people affiliated with the government. HRANA also cited at least 11,000 serious injuries and said it was investigating a further 17,091 reported deaths. These figures cannot be independently verified under current restrictions.
Resource strain is evident in patient testimonies. A witness identified as “Sina” described a Tehran facility functioning under battlefield conditions, with insufficient supplies and relatives asked to bring blankets from home. Families using health insurance were required to provide national ID numbers, heightening fears of follow‑up raids.
Human rights organisations say medics and volunteer responders who treated injured protesters have themselves been targeted. Norway‑based Iran Human Rights reported the arrest of at least five doctors and a volunteer first responder. Sources close to Qazvin surgeon Dr Alireza Golchini said he was beaten during arrest and accused of “moharebeh” (enmity against God), an offence that can carry the death penalty under Iranian law.
The accounts raise significant concerns under international human rights law. The right to health includes access to timely care without discrimination, and medical ethics emphasise confidentiality. Routine security screening of medical records and a policing presence in clinical areas risk deterring urgent care, undermining trust and compromising accurate medical documentation.
For health leaders and policymakers, the operational implications are immediate. Delayed presentation for gunshot and eye injuries increases infection, disability and long‑term rehabilitation needs; covert home treatment shifts risk to unregulated settings; and staff intimidation complicates governance, data quality and incident reporting. Surge capacity, ophthalmic services and trauma supply chains appear under particular pressure.
The information environment remains constrained. The internet shutdown and reporting restrictions mean casualty figures from HRANA and claims from state‑linked outlets such as Tasnim and Isna are not directly reconcilable. Further assessment will depend on official releases, hospital statements and continued rights monitoring as new data emerges.