Yale Bulletin and Calendar

January 30, 2004|Volume 32, Number 16















Dr. Asghar Rastegar

Yale physician who helped Iranian earthquake relief efforts describes 'fallout' of the disaster

On Dec. 26, a major earthquake measuring about 6.7 on the Richter scale struck the ancient city of Bam in the Iranian desert; almost one week earlier, an earthquake of similar scale struck southern California.

Three people died in the California quake, while 40,000 to 50,000 people were killed and thousands injured in Bam, a city of 100,000 people.

The wide disparity in the loss of lives can be attributed mostly to the poor infrastructure in Iran and the lag time of about eight hours before any effective help arrived on the scene, according Dr. Asghar Rastegar, professor of internal medicine at the School of Medicine, who spent six days on a relief effort to the Middle Eastern nation that was organized by AmeriCares.

From Dec. 30 to Jan. 6, Rastegar served as a physician volunteer and helped distribute humanitarian aid, as well as assess the health needs of the population.

"There's a major political fallout right now in Iran," says Rastegar, who is also associate chair for academic affairs. "People are very angry because they partly blame the government for this tragedy. Earthquakes have happened many times before in Iran. While it was unusual to have an earthquake in this particular desert area, it should not have come as such a surprise."

Rastegar, who is a native of Iran, contends there needs to be appropriate and enforceable building codes to decrease building collapse and the resulting injuries and loss of life. He also says there needs to be better safety precautions as well as more rapid response to provide emergency help in the aftermath of the earthquake such as field hospitals and search and rescue teams with specially trained dogs.

If Iran were an open society, there would be considerable investigative reporting into what happened, contends Rastegar, noting that the people initially did not get the care they needed. In such massive disaster, he says, the help often needs to come from the outside because the survivors are dealing with their own personal tragedies.

In the last quarter-century, there were four major and many minor earthquakes in Iran. Rastegar, who worked with AmeriCares in Iran's last major earthquake in 1990, says the government must have the ability to help people prepare for future earthquakes with earthquake drills and mobilize resources almost immediately to the site.

Before the earthquake, Bam was a well-to-do city with thriving tourism, a Korean car factory, and a date and citrus fruit trade. Many visitors came from all over the world to see the citadel and the ancient mud city.

In the ongoing relief effort, the city was divided into 12 zones with each zone assigned to an Iranian medical university. Rastegar visited an area assigned to Yazd University where two tents were dedicated to providing health care to the area. As a kidney specialist, Rastegar's expertise was very useful, as kidney shutdown is a common result of muscle injury from earthquakes. In addition to delivering medical advice, Rastegar and the team from AmeriCares also helped deliver over 80,000 pounds of medical supplies to local hospitals and health clinics.

"When I arrived in Bam, there was an eerie feeling," says Rastegar. "There wasn't any sign of public or personal mourning. The buildings at the edge of the city were intact, but 70% of the buildings in this 2,000-year-old city as well as the citadel, one of the oldest buildings in the world, are destroyed, including the two major hospitals."

Despite the destruction, many people from Bam refuse to live in tent cities, says the Yale physician; instead, they pitch tents in the damaged yards in front of what used to be their homes. Before the earthquake, they lived on their land tending their dates and citrus trees.

Rastegar says he is amazed by the international response to the tragedy. Iranian Nobel Prize winner Shirin Ebadi immediately set up a relief fund in Tehran that will primarily benefit women and children. In addition, there has been an outpouring of support from the U.S. and other countries.

The injured are going to need psychological as well as physical rehabilitation, notes Rastegar, adding that what struck him the most was that the injured never cried.

"In Iranian culture, crying is a big part of the mourning process, and there was none," he says. "I think they were stunned. There's going to be a phenomenal need for psychological care that needs to be delivered recognizing religious, language and cultural sensitivities."

Rastegar says he has not slept well since returning from the relief effort -- that his dreams are haunted by images of ravaged buildings and families ripped apart by death and injury. "Last night was the first time I didn't dream about what I saw," he comments.

Rastegar recalls meeting a girl with kidney failure who lost her family and a woman with a chest injury who thanked him profusely.

"Her gratitude for the fact that I was just there holding her hand and talking to her was incredible," says Rastegar. "Her continuous thanking is something that still stands out in my mind."

He also recalls playing soccer with a seven-year-old boy in the midst of the destruction. "To see that simple act amid all this tragedy was a very hopeful sign," says Rastegar. "It reminded me that life truly does go on."

-- By Karen Peart


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