Past, Present and Future of Iranian Naval Health and Maritime Medicine

The history of the Persian (Iranian) fleet backs to more than 3000 years ago. Navy was the most organized force in the ancient Persia. Xerxes (Khashayarsha, the fourth king of the Achaemenid Empire ruled from 486 B.C.) arranged the most famous fleet in the Persian military forces (Figure 1). According to Herodotus, the size of Xerxes’ expeditionary force was over two million men and four thousand ships (1). The vast oceans and seas in Asia and Europe witnessed bravery and proficiency of the Persian military forces in carrying out their missions for keeping security and spreading the parade of civilization (Figure 2). Therefore, it is quite expected that the health of the troops was among the main priorities for the ancient Persian army in order to maintain their power and continue their victories. Persia was on the cross road of several cultures. Then, Persian naval force played as an inductor for reciprocal cultural exchange between India and China from one side and Greek and Rome from the other side. They also played a prominent role for merging the ancient medical science from these cultures. Consequently, the medicine was enriched in Persia with the spiritual believes of Iranian people. Of prominent importance, Iranian medicine mainly focused on a “healthy life style” in every aspects of life and took spirituality and psychological dimensions of health into account in all medical interventions (2). Therefore, Simurgh and Golnar (pomegranate flowers) were considered as symbols of spiritual health which were granted from the king to soldiers as their guardians (3) (Figure 3). The danger of seas is still the same as it was and marine operations are still full of natural challenges. Nevertheless, after thousands of years, the appearance, performance, missions and nature of the modern naval forces have substantially changed by new technologies. Iranian Naval Force has dramatically evolved during the past recent decades in terms of modern indigenous made fleets, missiles, communication tools, radars, submarines and flying systems. In parallel, the medical needs and requirements of naval forces have markedly evolved in all health dimensions. In addition, the epidemiology of diseases passed three transitional periods during the last centuries that presented emerging challenges for naval forces. Accordingly, marine and submarine medicine faces several sophisticated conditions now. Obviously, the standard health including physical, mental, social and spiritual for military forces is higher than the general population to enable them for special operations in nonconventional conditions, particularly when they battle an enemy. Therefore, naval forces not only should be physically fit, but also must be mentally and spiritually prepared. Furthermore, their families must be properly supported and socially protected to ensure troops for being fully committed in their missions. In all of these fields, prevention has a priority to treatment and is more cost-effective. Primordial prevention includes defining and controlling the health risk factors, which depends on an integrated research program as well as a functional information technology and data management. To confront emerging and re-emerging epidemics, data gathering, recording, analyzing, and management, including important information about disease frequency and distribution, particularly by geographic information system and remote sensing, is a major task for military services. Then, establishing and improvement in the surveillance by modern technologies including geographic information system (GIS) and remote sensing are important priorities for marine medicine, which could be facilitated by satellite services and modern drones. In addition, health education must be considered as a critical step toward disease prevention as well as patients care, where virtual systems might play a major role. Beside individual hygiene, it is easier to control environmental factors for diseases by modern tools. Furthermore, healthy nutrition in naval forces could be planned and achieved to be a model for the civilian population.