Medicine is getting more and more expensive in Iran. Experts blame the trend on currency fluctuations and economic sanctions. Meanwhile, patients are the ones to suffer.
Doctor Nosrat Firusian remembers a time when he gave a patient an Iranian anesthetic. A few minutes later, the patient was still staring at him wide awake.
"He simply didn't fall asleep," Firusian recounted to DW.
Since then, the Iranian doctor living in Germany brings a big suitcase full of medicine with him every six weeks to Tehran.
Just a year ago, Firusian said, it was still possible to buy German medicine in Iran itself. But now the medication that his cancer patients need to survive has become way too expensive. He said in just eight weeks, prices have doubled, or in some cases tripled. Firusian, who is head of oncology at a hospital in western German town of Recklinghausen, knows of colleagues who face similar problems. Some have trouble getting medicine for children with leukemia.
Michael Tockuss, board member of the German-Iranian chamber of commerce, blames the problem on the EU's sanctions on Iran. The measures are intended by Brussels to force Tehran back to the negotiating table and give up its nuclear ambitions.
Drugs excluded from the sanctions
EU foreign policy chief Catherine Ashton told DW in a written statement that the system of sanctions contains all necessary measures to make sure that vital humanitarian goods are not affected.
That includes medication and food, and means such goods can be traded without any special approval. They can also be paid for through Iranian banks - something otherwise forbidden under the sanctions.
Ashton's office added that in the end, the decision to end trade with Iran lies with companies.
But many firms are hesitant to do business with Iran. Tockuss said while there are plenty of companies that want to trade with the Middle Eastern country, there are hardly any banks in Europe that still accept direct payments from there.
Tockuss remarked that's especially frustrating, "as this is not a consequence of the sanctions."
He added that smaller banks simply do not have the personnel to follow the constantly-changing details of the EU sanctions on Iran, while larger banks fear pressure from the US. The US sanctions on Iran are more rigid than the EU's.
Deutsche Bank, for one, suspended all its business with Iran about five years ago.
"We cannot conduct any payments in either direction," a spokesman confirmed to DW – even not for things excluded from the EU sanctions.
Tuckuss, who lived in Iran for seven years, said business has been conducted through third countries like Russia or Azerbaijan as a result. He consults German companies on how to go about payments with Iran.
Tuckuss said he never imagined he would one day be an expert on the Azerbaijani banking world. But the problem with transactions through third countries is that there is usually a high fee involved, making the business much less profitable.
Added to this are swings in currency values. Tockuss said the fault lies with the Iranian central bank, which long kept the country's currency - the rial - at an artificially low rate. In recent months, the rial has undergone a dramatic drop.
Drugs becoming unaffordable
Sanctions and devaluation thus drive up prices for imports including vital medication.
"They are still available in the country, but are so expensive that nobody can afford them," said Firusian.
Poor people in particular are suffering, along with pensioners and families without health insurance.
Firusian treats between 100 and 150 patients every few weeks when he's in Iran - most of them free of charge.
Iranian officials declined to give a statement to DW about the problem. A member of the Health Ministry only said that "everything is expensive in Iran, so of course drugs are, too."
Without the medicine he brings from Germany, Firusian said, he would have to resort to cheap lower-quality imports from eastern Europe or Asia. Just like the anesthetic that that didn't do the job.