فهرست نشریات علمی دسترسی آزاد ایران

The recent twelve-day armed conflict in Iran -despite the tireless efforts of health personnel nationwide and the relatively short duration of the crisis- once again exposed critical vulnerabilities within the national health system when it is confronted with large-scale emergencies. Previous experiences during floods, earthquakes, and particularly the COVID-19 pandemic have already illustrated that significant weaknesses persist within our health infrastructure when facing major crises.[1] As health threats continue to expand, diversify, and increasingly transcend national borders, a comprehensive reassessment of health system preparedness is become an urgent priority. During this brief yet intense crisis, the country’s digital infrastructure experienced severe disruption. The substantial reduction -and eventual complete loss- of internet bandwidth compromised access to emergency medical information services, digital health platforms, electronic prescription systems, and even certain international operational networks. Evidence from other conflict settings -such as the Tigray crisis in Ethiopia-demonstrates similar patterns of digital health system failure, including the destruction of patient records and the collapse of health information management systems. These studies emphasize that merely restoring outdated digital structures is inadequate; instead, a fundamental transformation toward more resilient and adaptive digital infrastructures has become necessary.[2] Broader research further indicates that achieving digital resilience in health systems requires more than technical backup. It demands shock-absorbing capacity, adaptive capability, and the ability to implement deeper structural changes that enable systems to withstand cyber threats and infrastructural breakdowns.[3] Equally concerning was the partial breakdown of internal communication among health personnel during the conflict. Messaging applications -routinely relied upon under normal circumstances- became inaccessible, halting real-time coordination among healthcare teams using social media platforms. In contrast, secure emergency communication frameworks such as the European Union’s Critical Communication System (EUCCS) illustrate how crisis-affected health sectors elsewhere maintain operational communication even under extreme conditions.[4] Health providers -from students to senior clinicians-continued their duties with remarkable dedication. However, the psychological, physical, and financial pressures placed upon them, especially in the absence of structured emergency support systems, underscore the urgent need to strengthen health workforce resilience. According to frameworks developed by the World Health Organization and the Organization for Economic Co-operation and Development (OECD), enhancing workforce resilience requires strategic planning, systematic crisis-readiness training, and sustained investment in professional security and personal well-being.[5,6] Based on these observations, several strategic priorities require immediate attention: ·        Strengthening pre-crisis coordination mechanisms through unified emergency preparedness planning among universities, academic departments, healthcare centers, and executive health leadership. ·        Establishing health policy think tanks within universities that maintain continuous, operational engagement with regional and national crisis management committees. ·        Redesigning data security protocols and server access systems to ensure operational continuity during cyberattacks and to protect digital health infrastructures from disruption or infrastructural damage. ·        Preparing the health system to maintain essential services during power outages, communication failures, water shortages, and large-scale displacement -including equipping healthcare facilities with essential infrastructure and deploying mobile health and public health units. ·        Developing strategic reserves of medical and protective resources, particularly for hazard-specific risks (e.g., nuclear or chemical threats), and especially for facilities located near high-risk zones. ·        Establishing official, professionally trained rapid response teams supported by institutional investment in physical preparedness, psychological resilience, and financial protection. Reliance on volunteerism alone -though valuable- is neither sufficient nor sustainable. ·        Revising medical and health sciences curricula -including general medicine, specialty training, and allied health programs- to incorporate practical, competency-based training in disaster response, trauma care (e.g., ATLS), and crisis simulation exercises.[7] Iran’s experience is not unique. Globally, national crises increasingly outpace the response capacity of health systems. Post-COVID analyses by the OECD emphasize that health system resilience must be recognized as a central pillar of national security -alongside military preparedness and civil defense- and requires rigorous analysis, targeted investment, and sustained political commitment.[5] Although this crisis was deeply distressing, it presents a critical opportunity for structural reform, strategic integration of health security into national resilience policies, and renewed consideration of the future architecture of a crisis-ready health system. Post-crisis evaluations should be institutionalized as standard practice, with their findings directly informing policy development and operational planning.