zohreh ganjparvar

Limited studies have reported epidemiologic data on the impact of Iran-Iraq war. This study examines the war casualties for both combatants and civilians on Iranians at national level.

Databases of Veterans and Martyrs Affair Foundation (VMAF), Janbazan Medical and Engineering Research Center (JMERC) and Ministry of Health were used to collect the data. The prevalence of injuries for both civilians and combatants was presented. Casualties were studied based on conventional and unconventional weapons attacks (1980–2018), separately.

The Iran-Iraq war led to 183 623 lost lives, 554 990 injured and 40 240 captured. The mean length of captivity was 45.7 months (1 month-19 years) and 2.7% (n = 575) died in captivity. There were 1 439 180 war related injuries recorded in databanks, mostly affecting men (98.4%). About 1 439 180 injuries were recorded, most of them related to conventional weapons (938 928 [65.24%]). Remaining artillery and mortar fragmentation in the body (39.5%, n = 371 236), psychological disorders (15.9%, n = 228 944), and exposure to chemical weapons (11%, n = 158 817) were the most prevalent war-related injuries.

Human casualties of the Iran-Iraq war on the Iranian side and the health care system are huge even after more than three decades.

The long term presence of various ankle-foot injuries reduces the individuals’ ability to perform daily activities, increases the dependence on others and will eventually lead to a reduction of life satisfaction. This study aimed to evaluate the life satisfaction of war veterans with ankle-foot neuromusculoskeletal disorders.
The veterans with ankle-foot injuries from 6 provinces, participated in this descriptive study. Medical examinations were conducted by specialists .Trained interviewers gathered demographic and life satisfaction data. Life satisfaction was assessed using the SWLS (Satisfaction with Life Scale) form. Scores ranged from 5 to 35 and the classification was as follow: very dissatisfied (5-9), dissatisfied (10-14), slightly dissatisfied (15-19), moderately satisfied (20-24), satisfied (25-29) and very satisfied (30-35). Statistical analysis was performed using SPSS 23 software.
The mean age of 577 veterans at the time of study was 52.4±8.2 years. The nervous lesion at lower limbs included sciatic 24.5% (N=141), femoral 5.3% (N=31), peroneal 28.2% (N=162), tibial 21.8% (N=126). There was 50.2% (N=290) ankle dorsiflexion. Life satisfaction’s mean score was 17.6 ± 7.1. Data showed that 17.3% (N=100) were satisfied or very satisfied and 60.0% (N=346) were dissatisfied. Moderately satisfaction level was reported in 22.7% (N=131). Significant relationships were observed between life satisfaction and disability rate (P0.05).
The majority of veterans with ankle-foot neuromusculoskeletal disorders were dissatisfied with life. The disability rate, education level and employment status were associated with life satisfaction.

During trips the imposed costs are aggravated due to time and financial limits, not being familiar with treatment centers that are covered by the insurances and charges for accommodation. Insurance, especially supplementary treatment services insurance can be an appropriate solution to decrease these costs. These kinds of insurances cover a range of services including outpatient services to hospitalization and even sometimes unlimited services. The purpose of this study was to evaluate the satisfaction of war survivors and their families under the cover of supplementary insurance from medical care during trips. This study was cross -sectional descriptive. The size of studied population was 77 people from war survivors and their families who were assessed by a provided questionnaire in 2015. The including criteria was war survivors and their families under the cover of Veterans and Martyrs Affair Foundation (VMAF) and supplementary insurance war survivors. The prepared questionnaire included two sections; the first section was included the personal indications and the second section included satisfaction evaluations. The prevalence of using medical care during trips in war survivors and their families was 2.72% and using medical care with supplemental insurance in trips was 1.5%. The obtained results from the questionnaires revealed that the highest satisfaction on medical care services and its distance belongs to the veterans' families with the mean of 4.57and 4.27, respectively. In the subject of taking back the costs, martyrs’ families were the least satisfied with the mean of 2.17. A significant relationship was found between sex and distance of the medical care services in trips (p=0.046).  Men had more satisfaction compared to women. Finally it can be mentioned that there was not a significant relationship between client group and distance of medical care services during trips (p=0.067). According to the results, affording the costs and paying them back by the insurance company needs modifications.

Providing care to a disable relative at home exposes the caregiver to a potentially higher risk of physical and mental problems. We measured health-related quality of life (HRQOL) and its determinants among the caregivers of the Iranian survivors of the Iran-Iraq war (1980–1988) with bilateral lower-limb amputation.
Data were collected from 464 individuals comprising war-related bilateral lower-limb amputees (n=232) and their caregivers (n=232) in January 2015 in Shiraz, Iran. The 36-Item Short-Form Health Survey (SF-36) questionnaire was used to evaluate the caregivers’ QOL. Logistic regression analysis was performed to determine the most significant contributing factors.
The mean age of the caregivers and the amputees was 39.4±6.2 and 42.5±6.2 years, respectively. The mean duration of disability was 22.8±3.9 years in the amputees. Most of the caregivers were reported to be in their first marriage. The highest and lowest mean scores of the SF-36 domains in the sample population were observed for physical function (76.65±21.97) and bodily pain (53.54±24.95). QOL in the caregivers was significantly lower than that in a sample of the general Iranian female population (P The caregivers of the bilateral lower-limb amputees in the current study suffered from a poor QOL. Hospitalization and mental problems were the most significant contributing factors vis-à-vis the caregivers’ HRQOL. Health care and services should, therefore, be provided to both amputees and their caregivers.

This study aimed the evaluation of satisfaction of paraclinical services in the martyrs’ families covered by supplemental insurance. 325 members of martyrs’ families who have used paraclinical services (injections/bandages, laboratory tests, imaging services, physiotherapy and travel services) were studied. Satisfaction with the received services, distance to the receiving location of services and repayment were assessed. Reliable self-designed questionnaire (Cronbach's alpha=0.84) were approved. 31.86 percent with the average age of 60.37±17.42 years have used paraclinical services. The using of laboratory services had the highest frequency and physiotherapy the lowest, 59.1% and 5.2%, respectively. Satisfaction level of “very high” and “high” in different services varied between 70-91%. Satisfaction of the distance to the location of services ranged from 58 to 73%. Payment was reported for 36% (N=118) and44.1% (N=52)of them was applied for repayment and in 42.3% (N=22) cases the fee was received. 17-40% of them were not satisfied with the process of repayment. Lack of insurance coverage for some paraclinical services and incomplete or prolongation of repayment were the most common causes of dissatisfaction. A significant relationship (P<0.001) was observed between the satisfaction of the distance to the location of services and location (city or rural area). Satisfaction of study population from supplemental insurance in paraclinial services is relatively high. However, satisfaction of distance to the location of services and particularly repayment process are significantly low. The most important problem in receiving paraclinial services are lack of insurance coverage for service and incomplete repayment.

The purpose of this study was to evaluate the satisfaction of landmine victims less than 18 years of the types of services provided by Veterans and Martyr Affair Foundation (VMAF). The descriptive study evaluated the status of services to all landmine victims less than 18 years from Iran. Satisfaction level was measured using a self-administered questionnaire based on seven categories of services provided by VMAF. Total score ranged between 7, the least satisfactory to 35, the most satisfactory. Also, by two open questions, difficulties in using the service were investigated in more details. Finally, all data were analyzed by SPSS 22 software and independent sample t-test and ANOVA statistical tests. The mean age of 78 survivors in this study consisted of 67 (85.9%) boys and 11 (14.1%) girls was 16.1±1.9 years. The mean score of satisfaction was 14.92±5.46. Cronbach's alpha was found as 0.76, showing that the scale is reliable. The group of specialists of Janbazan Medical and Engineering Research Center (JMERC) approved the validity of the scale. Health care services had the highest (18.2%) and sports services had the least satisfaction (5.1%). More than half of the cases were dissatisfied of the low awareness with service delivery (57.7%). The most common problems in getting health care services were high cost (61.5%) and then waiting long time for visiting doctor and the uncertainty about solving their problem in hospitals (48.7%). Significant relationships were observed between satisfaction with age at the time of casualty (p=0.02), disability percentage (p=0.04), spinal cord injury (p=0.04) and province of residence (p=0.006). The satisfaction of landmine victims less than 18 years of the types of services provided by VMAF in living in border areas was at the moderate level. Although health care services had the most satisfaction level but, enumerate the various problems in receiving these services have shown significant barriers, especially in the fast and convenient access to health care services.

So far، several statistics of the number of victims suffering from chemical damage have been reported in the Iran-Iraq war. The purpose of this study was to investigate the epidemiological situation of the Iranian chemical victims on the basis of information contained in the Martyr Foundation and Veterans Affairs. In this descriptive study، data of the chemically injured veterans proved by Medical Commission of Martyr Foundation and Veterans Affairs، extracted and analyzed. By the end of 1392، 564،108 veterans were registered in Martyr Foundation and Veterans Affairs، including 79 335 patients (1/14%) with proved chemical exposure. Their mean age at the time of the study was 50/1 ± 8/15 and 98/2 percent of them are men. late complications and illnesses resulting from exposure to chemical agents specially sulfur mustard result in increasing number of chemical injuries in recent studies، and it is expected a larger number of military or civilian personnel who have been exposed to chemical agents is identified later.

Objective (s): Independency in life activities has an important role in individuals with disability to bring them back to normal life. The objective of this study was to determine Instrumental Activity of daily Living in survivors of the Iran-Iraq war with bilateral lower limb amputation. A cross-sectional study was performed to assess the level of Instrumental Activity of daily Living (IADL) - Lawton and Brody IADL scale questionnaire- in Iran-Iraq war related bilateral lower limb amputees (n=335). The Chi-square test was employed as statistical methods. Data were analyzed using SPSS software. The average age of the patients was 42. 05 (SD=6. 33). The majority of the cases %97. 6 (n=327) were male and married. The most dependency in IADL were housekeeping (91. 3%)، food preparation. And the least was ability to use telephone (4. 2 %). Age، level of education، employment status، co morbidity، phantom pain and its severity and duration was significantly (P≤0. 05) associated with Instrumental Activity of daily Living scale. This study showed that war related bilateral lower limb amputees were dependent in some IADL scales، especially housekeeping and food preparation. Rehabilitation programs might help the amputees to be more independent in their normal life activity.

Physical and general health limitations may affect quality of life among children survivors of land mine and explosive remnants of war (ERW). This study aimed to assess the quality of life among children survivors of land mines and ERW injuries in Iran in 2010.

A total of 69 adolescent survivors of land mine and ERW injuries at the time of study were enrolled. In this cross-sectional study, adolescents were called in from border provinces that included the most land mines and ERW contaminated areas in the country, i.e. Kurdistan, Kermanshah, Khuzestan, Ilam and West Azerbaijan. Component scores were determined from responses to questions about physical and mental health on SF36.The validity of the Iranian version of questionnaire was 0.65-0.9. The questionnaire consisted of 36 questions measuring eight domains of health-related quality of life including physical functioning, physical role, bodily pain, general health, vitality, social functioning, and emotional and mental health role.

The mean age of participants was 16.68±1.18 years and the mean time since the injury was 7.85±3.1 years. Eighty-eight percent of the cases were boys. More than two third (69.6%) (n=48) of the victims were living in two provinces of Kurdistan and Kermanshah. About one-third (36.2%) (n=25) were studying at high school level. The children survivors had the highest score in physical functioning (50.5 ± 23.1) and the lowest in emotional role (8.69 ± 21.1). Overall, children survivors were suffering greatly in all different aspects of quality of life than the age-matched controls in all SF-36 eight domains (p≤0.01).

Children survivors of landmine and ERW injuries (at an age range of 14-19 years) due to Iraq-imposed war greatly suffered from a lower quality of life due to a combination of physical and mental factors affecting them.

during Iran-Iraq war about 40000 veterans and civilians were captured by Iraqis government. The purpose of this survey was to evaluate the most important health problems and issues in the prisoners of war after about 20 years of returning. This qualitative study was based on focus-group discussion in Iranian prisoners of war after returning. 10 prisoners of war who were physician, dentist or psychologist invited to participate in seven meetings to understand the types and consequences of the prisoner’s reentry health problems. Then the problems were categorized and 20 problems were listed. In order to prioritize the problems each returned prisoner handicapped the problems from 1-10. The highest scores considered as the most important problems. The mean age of the cases was 45.5 with the age range of 41-57 years. Duration of capturing was between 30-100 months. The most important health problems in order of importance were PTSD, dental diseases, depression, anxiety and musculoskeletal problems respectively. The results the finding emphasizes the need of further surveys to find out the prevalence of health problems in Iranian prisoners of war.

during Iran-Iraq war about 40000 veterans and civilians were captured by Iraqis government. The aim of this survey was to assess employment problems and issues in the prisoners of war after about 20 years of returning.

This qualitave study was based on focus-group discussion in Iranian prisoners of war after returning. The 7 meeting was held to understand the types and consequences of the prisoner’s reentry problems. 10 prisoners of war were invited to participate in the study. The problems were listed by using brain storming. Then the problems were categorized. In order to prioritize the problems each prisoner handicapped the problems from 1-10. The highest scores considered as the most important problems.

The mean age of the cases was 47 with the age range of 41-55 years. Duration of capturing was between 48-118 months. The most common employment problems was early retirement, unemployment but receiving complete pension, lack of regulatory system about prisoner of war employment laws and less informed prisoner of war on existent employment laws, respectively.

The results this study revealed that the prisoner of war face different types employment and unemployment problems. It is important to accomplish a further study in order to assess the magnitude of this finding.

Health issues on chemical exposure and chronic, multi-symptom health problems have been a concern for nearly two decades. In this study the health related problems in Iranian chemical warfare survivors with severe ophthalmologic complications were surveyed. Data were collected from 149 survivors using a questionnaire. About half of the cases 49.7% (n=75) had other war related injuries. The average time of hospitalization during the preceeding year of study was 1.5 (SD=1.7). The most health related problems reported by the survivors in order of importance were included: 1)Co morbidity 69.7% (n=104) 2) Drug 69.1% (n=103) and 3) rehabilitation problem s 54.3% (n=81). The most common co morbity was related psychological problems, and lack of drug was considered the most important problem regarding the drug problems.