What a new Lancet Commission tells us about obesity, inequality and the choices that will shape health this century.

A newly published Lancet Commission puts a striking number on the opportunity to tackle obesity: 23.1 billion years of healthy life globally by 2100.

This figure is important because it describes the difference between plausible futures, alternate possible realities… Across the remainder of this century, decisions about prevention, treatment and access to care could profoundly change the amount of illness, disability and premature death associated with obesity.

The Commission on 21st century global threats to health assessed 17 interconnected threats, ranging from obesity, hypertension, smoking, childhood malnutrition and poor mental health to climate change, antimicrobial resistance, conflict and malicious uses of artificial intelligence.

Bringing such different problems into a common framework makes us need to think more broadly about what constitutes a threat to human survival, and about the quality of the lives people will lead. For each threat, the researchers compared plausible best and worst scenarios up to 2100. The gap represents potentially avoidable health loss, expressed in disability-adjusted life-years, or DALYs — One DALY represents one year of healthy life lost through illness, disability or premature death.

The largest estimated modifiable burdens were as follows:

• Obesity: 23.1 billion DALYs.
• Low educational attainment: 16.1 billion.
• Income inequality: 13.8 billion.
• Malicious AI use: 10.4 billion.

The prominence of education and inequality is striking. As clinicians, we focus on the person in front of us: their symptoms, diagnosis, treatment and follow-up, but this report should prompt us to ask what happens around that consultation… Does someone have the resources to act on the advice they receive? Can they obtain treatment consistently? Do their working conditions and surroundings support their health?

For me, the findings strengthen the case for keeping these questions central to clinical practice and health policy. Education, income and access to care belong in the same conversation as medicines and health technologies.

Obesity is especially important as new medicines, including GLP-1-based therapies, offer considerable promise. Turning their clinical benefits into improvements in population health requires affordable treatment, dependable access and services able to provide continuing support.

I’d liketo see access and continuity treated as central measures of success. Who receives treatment? Who struggles to obtain it? Can those who benefit continue their care? Scientific progress should be accompanied by a serious plan for reaching people whose resources are limited. Prevention remains essential: healthier food environments, opportunities for physical activity and support that people can realistically use. WHO’s guidance on GLP-1 therapies places treatment within a broader approach and warns that unequal access could widen existing health disparities.

The inclusion of malicious AI use also deserves sustained attention, as its estimated modifiable burden ranked fourth, but the uncertainty is substantial. As the Commission’s launch materials explain, estimates for threats with limited historical data, including malicious AI use, draw partly on structured expert judgement and forecasting. Nevertheless I don’t feel that the potential health consequences of malicious AI use are receiving the sustained concern and thought they warrant. The possibility of facilitating biological weapons or attacks on critical infrastructure merits serious engagement from the health community.

My view is that scrutiny should be proportionate to both the evidence and the potential consequences. Independent evaluation, accountable governance and regulation that can adapt as evidence changes deserve investment now. Uncertainty should encourage us to examine assumptions, improve monitoring and test safeguards.

There’s also a responsibility to communicate these findings carefully. Public discussion should distinguish established harms from uncertain future risks, and remain clear about what the models can support.

The word I keep returning to is “modifiable”, which places responsibility on the decisions we can influence: whether prevention receives sustained funding, whether effective treatments are accessible, whether educational opportunity expands, and whether emerging technologies are governed with public health in mind.

For clinicians, researchers and policymakers, I think this is the report’s most useful challenge. We should ask how our work can help move those plausible futures towards better health, and whose needs might otherwise be overlooked. The value of looking ahead to 2100 will depend on the decisions it helps us make today.

Read the Lancet Commission

Rethinking threats to human survival was originally published in The Yak on Medium, where people are continuing the conversation by highlighting and responding to this story.

I’ve vibe-coded an experimental game where a tiny nanobot surfs along the retina, dodges drusen, jumps macular holes and collects treatment-inspired speed boosts.

You can also rewind time when you crash. I suspect that feature would find a rather enthusiastic audience in real life.

The game is called OCT Surfer, and it’s playable in a browser, including on mobile. Its landscape takes inspiration from the luminous layers of optical coherence tomography scans. Medical anatomy supplies the scenery; the physics and treatment effects are playfully fictional.

It’s just a bit of fun but then one reads the news, and feels rather less carefree about the technology that helped build it.

Last week, Anthropic researcher Jacob Coxon resigned over concerns about AI safety. Around the same time, UK Prime Minister Andy Burnham acknowledged AI’s national-security risks while also recognising its potential to help keep us safer. ITV reported both developments.

Over the weekend, Dario Amodei called for slower AI development, with Elon Musk and Sam Altman backing him. The Guardian covered their responses.

What are the people developing the most advanced Frontier models seeing that those of us outside their companies cannot? How much of the picture reaches the public, and how much arrives through carefully managed announcements? Amodei’s own explanation points to accelerating capabilities and publicly discussed safety incidents. His proposals include giving independent evaluators sustained access inside AI companies.

That seems a useful direction, nut public support for caution is only the beginning. We still need to know what will change, who will verify it, and what happens when commercial pressures pull the other way, and these questions do deserve answers that people outside the industry can understand.

There are also quieter concerns, much closer to home. Emails, text messages, documents and LinkedIn posts increasingly seem to carry a familiar flavour. ChatGPT, Claude, Gemini, Copilot: different tools, but recognisable rhythms, structures and turns of phrase. Some of that assistance is valuable as finding the right words can be difficult, and help with expression can make communication easier. Still, I wonder what happens when asking for the words becomes our first instinct.

Writing involves deciding what we mean. The awkward sentence, the unfinished paragraph and the moment spent searching for a better explanation can all be part of that thinking. If we routinely hand over those moments, what opportunities to practise are we giving up?

MIT’s “Your Brain on ChatGPT” project caught my attention for this reason. In an essay-writing study involving 54 participants, researchers compared people using an LLM, a search engine or neither. They used EEG to measure brain activity and reported weaker neural connectivity, poorer immediate recall of their writing and a lower sense of ownership among the LLM-assisted group.

The findings are preliminary. The sample was small, the task was specific, and the study cannot establish permanent cognitive decline or tell us what happens across every kind of AI use. Lower measured connectivity also needs careful interpretation, it’s not a simple measure of intelligence. But the research raises a worthwhile question: how do we use these tools in ways that leave us more capable over time?

For me, mindful use begins with small choices. Trying a first draft before requesting a rewrite. Asking a model to challenge an argument. Checking an important claim against its source. Taking the time to understand why a piece of generated code works. There will be occasions when speed matters most, and others when the effort is worth preserving. We should be able to make that choice consciously, and consider what years of these habits might mean for our judgement, creativity and independence.

Anyway, enjoy OCT Surfer.

If your first attempt ends badly, at least this particular experiment has a rewind button.

OCT Surfer, AI and the luxury of a rewind button was originally published in The Yak on Medium, where people are continuing the conversation by highlighting and responding to this story.

Today, Wednesday 26th August 2026, is Shahrivargan: an ancient Iranian and Zoroastrian festival dedicated not merely to power, but to the moral purpose of power.

Like several festivals in the Iranian calendar, Shahrivargan occurs when the name of the day and the name of the month coincide. The same ancient pattern gives us festivals such as Tirgan, Amordadegan and Sepandarmazgan.

The Meaning of Shahrivar

Yet Shahrivargan is not just a date, but a meditation on strength, justice, responsibility and the kind of authority that deserves to endure. The name Shahrivar derives from the Avestan Xšaθra Vairya, commonly translated as “Desirable Dominion”, “Ideal Rule” or “Power Worth Choosing”.

This distinction matters as Shahrivar does not sanctify power merely because it exists. It represents power ordered towards truth, justice and the welfare of creation: authority that earns legitimacy through how it is exercised. In Zoroastrian thought, Xšaθra Vairya is one of the Amesha Spentas . These are the divine qualities through which the wisdom and goodness of Ahura Mazda are expressed within the world. This concept became known as Šahrewar in Middle Persian and Shahrivar in modern Persian. Its linguistic descendants include shahr (now meaning a city but historically associated with a realm or dominion).

According to the Encyclopaedia Iranica, Shahrivar represents legitimate rule. Its spiritual opposite represents oppressive government, injustice and violence. This isn’t simply a theology of kings but an ethical demand placed upon anyone who posses power: rulers, institutions, parents, employers, professionals and communities. It asks whether strength is being used to protect or to intimidate; to build or to destroy; to serve life or to dominate it.

Power Worth Choosing

One of the most striking implications of Xšaθra Vairya is contained in the word vairya: desirable or worthy of choice. Power shouldn’t be obeyed simply because it can command obedience, but it should be judged.

Is it truthful? Does it protect the vulnerable? Does it permit disagreement? Does it govern through justice rather than fear?

Does it understand authority as a responsibility rather than a possession?

The power celebrated by Shahrivargan is restrained by conscience. Its legitimacy comes not from weapons, palaces, prisons or proclamations, but from service to the people over whom it is exercised, and that is what separates separates authority from domination.

The Guardian of Metal

In later Zoroastrian tradition, Shahrivar also became the spiritual guardian of metals.

This association may appear surprising until we consider the ancient Iranian image of the sky as a vast, shining enclosure: hard, luminous and protective. Metal consequently became a symbol of both the celestial realm and the strength needed to defend the good creation.

Metal, however, is morally ambiguous as it can become a plough or a sword. It can construct a home or imprison a dissident.

It can form the surgeon’s instrument, the craftsperson’s tool, the soldier’s shield or the torturer’s chain.

Like political authority, metal acquires its moral character through the purpose for which it is used. Shahrivar therefore represents strength disciplined by wisdom. It is not the celebration of force, but the transformation of force into protection.

How Shahrivargan Was Celebrated

As with many festivals inherited from the ancient world, the historical record is incomplete. Practices changed across centuries, communities and regions.

Some accounts associate Shahrivargan with the lighting of fires, family gatherings, shared food, generosity and help for those in need. A later tradition recorded in the Encyclopaedia Iranica’s history of Iranian fire festivals refers to a fire celebration on the fourth day of Shahrivar known as Shahrivargan or Āḏar-jašn.

Contemporary Zoroastrian educational material encourages acts of charity and public service, reflection on justice, and the lighting of a flame in the home. Some communities also use the day to honour fathers, father figures and others whose strength is expressed through care rather than control. These modern observances are outlined in FEZANA’s introduction to Shahrivargan.

The flame is an especially fitting symbol as fire illuminates without concealing. It exposes what darkness might otherwise hide. In Zoroastrian tradition, it represents truth, clarity and the presence of divine wisdom — not an object of worship, but a visible reminder of what is pure and life-giving. To light a flame at Shahrivargan is therefore to make a quiet promise: that whatever power we possess will be used with honesty.

Cyrus and the Memory of the Just Ruler

Some modern communities also connect Shahrivargan with Cyrus the Great, treating him as an example of the just ruler imagined by Xšaθra Vairya.

The historical evidence doesn’t establish Shahrivargan as Cyrus’s birthday, so this association is better understood as a modern commemoration than an ancient calendrical fact. Its symbolism nevertheless makes sense, as Cyrus endures in Iranian cultural memory as an image of kingship governed by restraint, tolerance and responsibility. Whether the historical ruler consistently achieved that ideal is a question for historians. What matters to the festival is the standard against which rulers are measured.

I have previously explored this continuing legacy in International Cyrus the Great Day. A society that remembers the ideal ruler also preserves the intellectual tools with which to judge the unjust one.

Shahrivargan in 2026

In 2026, it is impossible to write about the Iranian ideal of just power as though it were a neutral curiosity from the ancient world.

Following the protests of January, Human Rights Watch reported growing evidence of mass killings across Iran. Amnesty International documented unlawful lethal force against protesters, while communications restrictions made the scale of events more difficult to establish.

The violence didn’t end when the streets grew quieter. Human Rights Watch later described a wave of arbitrary arrests, enforced disappearances and coerced confessions. The blackout was not merely technological. It was an attempt to separate Iranians from one another, prevent documentation and place violence beyond the sight of the world — a subject I have also discussed in Deliberate Darkness and Eyes on Iran.

Against this background, the ancient definition of Shahrivar becomes painfully immediate. The tradition contrasts legitimate rule with oppression, injustice and violence. It therefore refuses to treat every government as rightful merely because it has acquired the machinery of the state.

Power that fires upon the people is not ideal dominion, and power that imprisons truth is not desirable rule. Power that fears witnesses, mourners, journalists, doctors, artists and ordinary citizens has confused strength with terror. Shahrivargan offers another definition: power is just only when it protects life, permits truth and accepts responsibility.

Ancient Festivals Are Living Arguments

Iran’s festivals are often presented as beautiful survivals: colourful fragments of an ancient civilisation preserved through food, poetry, family gatherings and seasonal ritual. They are all of these things, but they are also arguments.

Norouz argues that renewal remains possible, even beneath repression and digital blackout.

Tirgan asks us to remember rain, sacrifice and our responsibility towards a wounded land.

Amordadegan defends nature, life and the dream of immortality.

Sepandarmazgan honours love, the Earth and the dignity of women.

Mehregan celebrates nature, friendship and the light of Mithra.

Yalda reminds us that darkness reaches its greatest extent immediately before the light begins to return.

Shahrivargan adds another principle to this calendar of values:

Strength is worthy only when it serves justice. Heritage doesn’t survive solely in museums, archives and monuments. It also survives in the moral ideas that communities choose to carry forward, and sometimes the most enduring inheritance is not an object, but a standard.

The Dominion Within Us

Most of us will never govern a country. Yet all of us exercise some degree of power. We possess influence over colleagues, patients, students, children, relatives, readers and strangers. We decide when to speak, when to listen, when to intervene and when to remain silent.

Shahrivargan asks us to examine this small dominion within ourselves:

Do we use our strength to enlarge the freedom of others, or to narrow it? Do we protect people with less power than ourselves? Do we mistake aggression for courage? Can we accept responsibility when we are wrong?

Ancient festivals endure because their questions endure: a flame is lit, food is shared, a person in need is helped. The powerful are reminded that power has conditions. This Shahrivargan, may every flame illuminate what oppression attempts to conceal, may strength become protection and may authority become service.

May Iran know a form of power worthy of being chosen.

Shahrivargan Pirouz.

شهریورگان پیروز

More Iranian Festival Writing

Tirgan

• Tirgan in a Year of Drought (2026)
• Happy Tirgan: The Mid-Summer Ancient Festival of Iran (2021)

Yalda

• The Longest Night and the Return of Light: Yalda (2025)
• Yalda: The Ancient Iranian Festival Celebrating Light’s Victory over Dark (2019)

Other Iranian Festivals and Commemorations

• Amordadegan: Iran’s Ancient Festival of the Natural World (2026)
• Sepandarmazgan (2025)
• Mehregan: The Light of Mithra and the Ancient Iranian Festival of Autumn (2020)
• International Cyrus the Great Day (2022)

Shahrivargan: Iran’s Ancient Festival of Just Power was originally published in The Yak on Medium, where people are continuing the conversation by highlighting and responding to this story.

Every year on 23 August, Avicenna Day takes place: the Persian physician, philosopher and polymath whom Europe came to know as Avicenna (c. 980–1037).

Nearly a millennium after his death, Avicenna still belongs to several worlds at once. He was born near Bukhara in Central Asia, matured within the Persian intellectual culture of the Samanid realm, wrote most of his scholarly works in both Persian and Arabic, travelled through lands that are now Iran, and died in Hamadan. His ideas then crossed another frontier: translation carried them into European universities, where they helped educate generations of physicians for over five centuries.

His story is therefore not only about an extraordinary individual. It is also about how knowledge travels , between languages, societies and centuries.

The physician who organised a world of knowledge

Avicenna’s best-known medical work, The Canon of Medicine, was a vast, carefully structured medical encyclopaedia in five books. It brought together inherited Greek and Hellenistic medicine, the achievements of physicians working in the Middle East and Central Asia, and Avicenna’s own clinical reasoning and observations.

Its architecture was part of its achievement: The five books moved from general medical principles to simple medicines, diseases of particular organs, conditions affecting the body more broadly, and compound remedies. Avicenna did not merely collect information: he classified it, tested relationships between ideas and made an enormous body of knowledge teachable.

Gerard of Cremona translated the Canon into Latin in Toledo during the second half of the twelfth century. From the thirteenth and fourteenth centuries onward, the work became deeply embedded in European medical education. It was studied at universities including Montpellier and Paris, while parts of it remained in use at some European institutions into the seventeenth century , and, in a few places, even later.

This is why Avicenna is so often pictured alongside Hippocrates and Galen. In the European medical tradition, he was not a marginal intermediary between antiquity and modernity. He became an authority in his own right: the princeps medicorum, or the “prince of physicians.”

Six ideas that still feel strikingly familiar

It’s easy to turn a great historical figure into a catalogue of “firsts.” That can obscure more than it reveals. Avicenna did not practise modern medicine, and we should not retrofit twenty-first-century science onto an eleventh-century text. Many ideas in the Canon belonged firmly to the medicine of its time and were eventually superseded of course. Yet some of his clinical habits and observations remain remarkably recognisable:

• Isolation and contagion. Avicenna described phthisis, what we now associate with tuberculosis, as contagious and recommended separating patients with overt disease to limit transmission. He did not invent the later Venetian forty-day system from which the word quarantine derives, but his advice represents an important early statement of respiratory isolation.
• Testing medicines. In Book Two of the Canon, he set out seven conditions for assessing a medicine through experimentation. Among them were the need to study a drug free from confounding alterations, to distinguish direct from accidental effects, and to look for results that occurred consistently or in most cases. These were not modern randomised trials, but they show an unusually disciplined concern with how therapeutic claims should be judged.
• Neurological observation. His clinical writing included careful descriptions of facial paralysis, facial spasm and severe forms of neuralgic pain. This was evidence of medicine grounded in close attention to signs and symptoms.
• Diabetes. Avicenna recorded the excessive thirst, urination and abnormal appetite associated with diabetes, as well as serious complications including gangrene.
• Cancer surgery. He discussed the progression of cancer and argued that, when surgery was possible, diseased tissue should be removed early and completely. His account also reflects an awareness that cancer could extend into surrounding tissues.
• Prevention. Avicenna linked health to movement, diet, sleep, environment and psychological balance. The details belonged to his era, but the larger idea, that medicine must preserve health as well as treat disease has never left us.

A “Book of Healing” that was not a medical book

The Canon alone would have secured Avicenna’s place in history, but medicine was only part of his intellectual project.

His other monumental work, The Book of Healing was not primarily about healing the body. It was a philosophical and scientific encyclopaedia concerned with logic, natural philosophy, mathematics and metaphysics: a work intended, in a sense, to heal the intellect of ignorance.

Avicenna’s philosophical system shaped debate across the Islamic world for centuries. Through Latin translation it also exerted a powerful influence on medieval European thinkers. Medicine and philosophy were not separate careers for him; they were connected attempts to understand human beings, nature, causation and knowledge.

Standing at the beginning: Afshana

Almost a decade ago, I had the privilege of visiting Afshana, the village near Bukhara in present-day Uzbekistan where Avicenna was born.

Standing there was unforgettable. Great historical figures can become so monumental that we lose sight of their beginnings. Yet the journey of one of history’s most influential minds began in this small Central Asian village.

From Afshana, Avicenna’s life carried him westward through the Persian world. His writings travelled farther still: copied by hand, translated, commented upon and eventually printed, they moved from Central Asia and Iran into the intellectual life of Europe.

That geographical sweep matters as history is too often told within modern national borders, but Avicenna’s life reminds us that ideas have always crossed them.

From Afshana to Vienna

Avicenna’s international legacy is given physical form at the Vienna International Centre, home to the United Nations Office at Vienna. The Persian Scholars Pavilion, donated by Iran and inaugurated in 2009 , places him alongside three other giants of Persian science and thought: al-Biruni, Rhazes and Omar Khayyam.

There is something fitting about finding these four scholars together at an international institution. Their works emerged from a connected intellectual world, moved across languages and disciplines, and became part of humanity’s shared inheritance.

Medicine’s enduring responsibilities

At a lecture by England’s Chief Medical Officer at Liverpool’s Tung Auditorium last year, one slide distilled medicine into two enduring elements: the diagnosis and cure of disease, and the prevention of ill health. It paired a scene from a copy of Avicenna’s Canon with Luke Fildes’s nineteenth-century painting The Doctor.

The juxtaposition captured why Avicenna still matters. The content of medicine changes; it must change. Old explanations are tested, corrected and replaced. But the profession’s central obligations, to understand illness, care for the sick and prevent avoidable suffering, remain recognisable across the centuries.

Avicenna’s legacy is not that every conclusion in the Canon survived. No scientific legacy should be measured that way. It lies in the scale of his synthesis, the discipline of his reasoning, the seriousness with which he treated observation, and his conviction that medicine should concern itself with health as well as disease.

On Avicenna Day, we remember a Persian physician born in a village near Bukhara whose books crossed continents and whose influence endured for centuries. But we also remember something larger: knowledge has no single homeland. It is preserved, expanded and passed on and, at its best, placed in the service of human life.

Further reading

• Stanford Encyclopedia of Philosophy: Ibn Sina
• Encyclopaedia Iranica: Avicenna’s influence in the West
• National Library of Medicine: a Latin edition of the Canon
• Respiratory isolation for tuberculosis: a historical perspective
• Avicenna’s rules for assessing medicines
• Avicenna’s writing on facial paralysis and spasm
• Diabetes in medieval Persian medicine
• Avicenna’s concepts concerning cancer
• United Nations Vienna art guide

Avicenna’s Thousand-Year Journey was originally published in The Yak on Medium, where people are continuing the conversation by highlighting and responding to this story.

Each summer, on the seventh day of Amordad (the fifth month of the Iranian calendar) Iranians celebrate Amordadegan, an ancient festival dedicated to immortality, plants and the sustaining power of the natural world. The date follows an old Zoroastrian system in which every day and every month carried a sacred name, when the two names coincided, the day became a festival.

A name meaning “without death”

The name Amordad developed from the Avestan Amərətāt, meaning “not dying”, “deathlessness” or “immortality”. Its Middle Persian form was Amurdād, while Amordad is commonly used today. The initial “a” is significant as without it, mordad would be associated with death rather than its negation. The widespread modern month-name “Mordad” therefore obscures the festival’s original meaning.

In Zoroastrian thought, Ameretat or Amordad is one of the Amesha Spentas -these are the divine attributes or beneficent immortals associated with Ahura Mazda and the good creation. Amordad represents immortality and is the guardian of plants. She is closely paired with Haurvatat (later Khordad) who represents wholeness or health and protects water. Their relationship reflects an obvious truth of life: water sustains plants, and plants sustain human beings and animals.

Immortality in this tradition was therefore not simply an abstract promise of an afterlife. It could be encountered in the renewal of vegetation, the return of growth after apparent death, the nourishment supplied by crops and the continuity of life from one generation to the next.

This means Amordadegan belongs to a broader family of Iranian “name-day” celebrations, alongside festivals such as Tirgan, Mehregan, Abanegan and Azargan. These observances transformed the calendar into something more than a method of counting time but rather the year became a cycle through which different elements of creation, moral qualities and divine powers were remembered and honoured.

Plants as part of the sacred creation

Amordadegan reveals something profound about the ancient Iranian relationship with nature and that plants weren’t regarded merely as property or raw materials, but belonged to the good creation and possessed spiritual as well as practical significance.

In a Zoroastrian creation narrative preserved in Middle Persian literature, the destructive spirit withers the original plant. Amordad gathers and crushes it, mixing its essence with water that is then carried across the earth as rain. From this, innumerable plants emerge. Amordad is consequently described as presiding over the plants from which every living creature eats and survives.

The story expresses an interconnected view of existence and highlights that water, plants, animals and humanity do not stand in isolation. Damage to one part of creation threatens the others — protecting what sustains life becomes a religious and moral responsibility. An even broader interpretation of Saadi Shirazi’s famous 13th century poem Bani Adam.

This should not be simplified into a claim that ancient Iranians practised modern environmentalism. Their worldview emerged from a very different religious and historical context. Nevertheless, it clearly rejected the idea that humanity possessed an unlimited right to contaminate or destroy the natural world — respect for water, soil, fire, vegetation and useful animals formed part of the defence of the good creation against pollution, disorder and decay.

Immortality, nourishment and renewal

Amordad was also associated with the mythical White Haoma, described as the foremost of plants. In Zoroastrian eschatology, this plant would be used at the final renovation of the world to prepare a life-giving substance through which the blessed would become immortal in body and soul. The plant therefore connected everyday nourishment with the ultimate defeat of death. This helps explain why food, plants and gratitude were inseparable from the festival’s spiritual meaning. Eating was not simply consumption, but involved receiving the gifts of water and vegetation.

Later Zoroastrian texts even associated respectful silence and blessings at meals with honouring Khordad and Amordad.

The precise ceremonies of ancient Amordadegan are not fully documented — General Zoroastrian festival practice included worship, ritual cleanliness, communal meals, hospitality, music and an emphasis on joyfulness. Modern accounts commonly describe people visiting gardens and green spaces, tending plants, planting trees and giving thanks for vegetation.

A festival of life after the January massacres

Amordadegan has acquired a painful contemporary resonance following the January 2026 uprising and its violent suppression. Amnesty International reported that Iranian security forces unlawfully killed thousands of protesters and bystanders, particularly during 8–9 January.

Human Rights Watch described evidence of coordinated mass killings across numerous provinces, including the use of firearms against protesters and bystanders and gunshot injuries to heads and torsos. Families seeking truth and justice have subsequently faced arrests, intimidation and attempts to silence public mourning.

Against this background, remembering Amordadegan is not merely an exercise in historical nostalgia. A festival whose name means “without death” stands in direct moral contrast to a system that answers demands for dignity and freedom with bullets, prisons and executions.

Its message is that life must be protected; that human beings belong within, rather than above, the living world; and that renewal remains possible even after devastation. Preserving such traditions is therefore a form of cultural resistance. It reconnects Iran with a civilisation older than the Islamic Republic and affirms that the country’s identity cannot be reduced to its present rulers.

Amordadegan reminds us that Iran belongs to life, nature, freedom and its people, not to those who cultivate fear and death.

The Four Ancient Festivals of the Seasons

To read about the other festivals and how our ancestors marked the passing of time, explore my previous articles:

• Norouz — The festival of Spring, and rebirth
• Yalda — The festival of Winter, and victory of Light over Dark
• Mehregan — The festival of Autumn: nature, love, and friendship
• Tirgan — The Summer festival of rain, remembrance, and resistance

Explore More

Iran’s heritage is vast, beautiful, and enduring. Learn more about the incredible history of our country here with 52 Sites of Iranian Culture and World Heritage

Learn about the trailblazing Iranian Women through history here

Learn about Sepandarmazgan, Valentine’s Day in Iran, here

Amordadegan: Iran’s Ancient Festival of the Natural World was originally published in The Yak on Medium, where people are continuing the conversation by highlighting and responding to this story.

This weekend marks Tirgan, the ancient midsummer Iranian festival of rain, water, poetry and renewal.

In gentler years, I have written about Tirgan as one of the four great ancient Iranian festivals of the seasons: Norouz for spring and rebirth, Tirgan for summer and rain, Mehregan for autumn and friendship, and Yalda for winter and the victory of light over darkness.

Unfortunately, in 2026, it feels impossible to write about Tirgan only as a celebration… In the heavy shadow of 2026, the mid-summer sun feels different as we approach this weekend’s festival carrying the profound grief of the January Iran Massacre — the largest two-day mass slaughter since the Second World War and a period of mass killing, executions, internet blackouts, disappearances, grieving families, silenced streets, and a world that too often looks away. Yet, looking back at the ancient roots of Tirgan, we find that our ancestors understood exactly what it meant to fight against suffocating despair…

Mythology as Metaphor: Tishtrya and Apaosha

Tirgan is fundamentally a celebration of survival against drought, rooted in the ancient battle between the sky archangel Tishtrya (the bringer of rain) and the demon of drought, Apaosha. Tishtrya is the bringer of rain, the herald of thunder and lightning, the hope that the land has not been abandoned . By contrast, Apaosha represents physical thirst, withered crops, and famine. Apaosha is the manifestation of sterility, barrenness, suffocation, the cracked earth, the cloudless sky, the field where nothing grows. But in 2026, Apaosha has taken a different form. The demon we face is the crushing oppression and the tragedy of January.

Apaosha is present wherever a mother is denied the body of her child, wherever a prisoner is taken to the gallows after a sham trial. Wherever the internet is cut so that screams cannot travel. Wherever a regime mistakes silence for victory. Wherever the world decides that Iranian lives are somehow more distant, less urgent, less countable.

But Tirgan reminds us that drought is not the natural order of things, it is a force to be resisted. The story doesn’t end with Apaosha — it waits for Tishtrya. In the mythology, Tishtrya is initially battered and on the verge of defeat by the black demon Apaosha. It is only by calling out to Ahura Mazda, the Supreme Creator, and through the collective will of the people, that Tishtrya finds the strength to strike back and emerge victorious, pouring rain over the land. Today, as we mourn those we lost, we are in the midst of that very battle. We are fighting our own Apaosha so that justice and life might pour over the land once more….

Arash the Archer: The Ultimate Sacrifice

No figure symbolizes Tirgan more than Arash the Archer. Legend says that in a time of desperate land disputes between ancient Iran and Turan, accompanied by a devastating drought, Arash was chosen to define the borders and bring peace.

He climbed to the highest peak of Mount Damavand, poured his entire life force into his bow, and fired an arrow that flew for two days. Where it landed, peace was declared, and the rains finally came. But the effort cost Arash his life.

This year, the story of Arash is no longer just a myth — but a painful, living reality. And there isn’t one Arash, countless Iranians have been Arashes, standing on peaks, pouring their lives into a demand for freedom, and making the ultimate sacrifice for their country.

These were young people who gave their whole bodies to one impossible gesture of courage. Women who stood unveiled before the machinery of violence. Students who shouted into streets they knew were being watched. Workers, doctors, artists, lawyers, teachers, athletes, children… They gave everything so that the arrow could fly. Some arrows were names. Some were videos sent before the internet died. Some were last messages to family. Some were blood on the pavement. Some were songs.
Some were simply the refusal to kneel. Though they are gone, the arrow of their courage is still in flight, carrying the promise of a peaceful, renewed Iran.

Traditions of Resilience: Water and Rainbows

Traditionally, Tirgan is celebrated with Ab Pashi — the joyous splashing of water. While the youthful laughter in the village streams might be muted this summer, water remains a symbol of purification. It is used it to wash away the despair, and to water the seeds of hope planted by those who fell.

For the young (and the young at heart) there is also the custom of Tir-o Bad, the tying of seven-colored rainbow bands on the wrists. These are worn for ten days and then released into a stream with a wish. It’s a small ritual, but a profound one… In ordinary times, perhaps that wish is for health, love, rain, prosperity, family, or the fulfilment of a personal dream.

This year, the wish is heavier — For the names not to be forgotten.
For the disappeared to be found. For prisoners to be spared execution.
For grieving parents to be allowed to mourn. For those who fired on the people to face justice. For the world to stop looking away. For Iran to breathe again. And perhaps most of all, for memory to survive amidst the drought of forgetting.

Healing Through Food

Even in sorrow, we gather. Families will still prepare the traditional foods of Tirgan, sharing them as an act of quiet defiance, a way of saying that culture and our bonds cannot be broken by violence.

Stirring pots of Shol-e-Zard (a sweet saffron rice pudding flavored with rosewater and decorated with cinnamon and pistachios) reminds us of the sweetness and endurance of our heritage.

Likewise, sharing bowls of Ash Reshteh. a dense, nourishing soup made of beans, herbs, and Persian noodles topped with kashk (a fermented whey preserve). sustains us. It is a communal dish, meant to be made and eaten together, reinforcing the community ties that carry us through the hardest seasons.

Against the Darkness

Iranian mythology has always understood darkness and has never pretended that evil is abstract. In the Shahnameh (the epic Book of Kings, and inspiration for the Godfather film series), Zahhak is not merely a tyrant; he is a ruler fed by the brains of the young. He survives through fear, propaganda, ritualised violence and the sacrifice of a generation. His power depends on people believing he is permanent, however he is not.

Iranian culture has always understood that mourning and joy are not opposites. They are intertwined. We recite Hafez in grief and in celebration. We place flowers beside graves and on festival tables. We light candles for the dead and for the future. We gather not because suffering has ended, but because isolation is how darkness wins.

The blacksmith Kaveh raises his leather apron as a banner. Fereydoun rises. Zahhak is bound beneath Damavand. Again and again, Iranian mythology gives us this pattern thatdarkness appears overwhelming, but it is never the final condition of the world.

Ahriman rages, but dawn returns.
Zahhak devours, but the people rise.
Apaosha withholds the rain, but Tishtrya fights.
Arash dies, but the arrow flies.

This is why the ancient festivals matter. They are not nostalgia or museum pieces, and they are not just decorative remnants of a pre-Islamic past. These are a language of survival and they remind us that Iran is older than its tyrants, older than the prisons, older than the gallows… Older than the slogans of men who fear music, women, colour, poetry, water, laughter and memory.

A wish for Tirgan

Tirgan is not an escape from politics. In a year like this, it is a form of defiance — To celebrate water under a regime of drought is defiance.
To remember Arash under a regime of erasure is defiance.
To speak the names of the dead under a regime of denial is defiance.
To tie a rainbow thread around the wrist and make a wish for freedom is defiance.

As we observe Tirgan this weekend, we honor the bright star Tishtrya, and we honor the modern-day Arashes who laid down their lives in January. The darkness of 2026 has been deep, but the mythology of Iran tells us that the rain always follows the drought, and light always pierces the dark.

The arrow has been shot. The rains will come.

Happy Tirgan.

The Four Ancient Festivals of the Seasons

To read about the other festivals and how our ancestors marked the passing of time, explore my previous articles:

• Norouz — The festival of Spring, and rebirth
• Yalda — The festival of Winter, and victory of Light over Dark
• Mehregan — The festival of Autumn: nature, love, and friendship

Explore More

Iran’s heritage is vast, beautiful, and enduring. Learn more about the incredible history of our country here with 52 Sites of Iranian Culture and World Heritage

Learn about the trailblazing Iranian Women through history here

Learn about Sepandarmazgan, Valentine’s Day in Iran, here

Tirgan in a Year of Drought was originally published in The Yak on Medium, where people are continuing the conversation by highlighting and responding to this story.

There are some moments in medicine when a disease doesn’t simply add another diagnosis to the textbook, but rather changes the way we think about boundaries. These include the boundaties boundary between eye disease and systemic diseases, the boundaries between animal health and human health, and the boundaries between occupational exposure and clinical ophthalmology. This recent paper in Nature Microbiology may be one of these moments.

Researchers have described an emerging human eye condition called persistent ocular hypertensive viral anterior uveitis, or POH-VAU, associated with covert mortality nodavirus (CMNV), a virus previously recognised in aquatic animals such as shrimp and fish. The study, published on 26 March 2026, reported CMNV infection in ocular tissues and seroconversion in 70 patients with POH-VAU, and linked risk to frequent unprotected aquatic animal exposure and raw aquatic animal consumption.

This is a newly described form of viral anterior uveitis (inflammation in the front part of the eye) associated with very high intraocular pressure. In other words, it behaves like a mix of viral uveitis and secondary glaucoma. That matters because inflammation can damage the eye, but pressure can damage the optic nerve. Together, they can threaten vision.

Why this story matters

Most people think of seafood safety in terms of the gut: food poisoning, parasites, hepatitis A, norovirus, shellfish toxins. Eye inflammation is probably not the first thing that comes to mind.

But this study suggests that a virus circulating in aquatic animals may be associated with a specific pattern of human ocular disease. The strongest reported exposure signals were frequent unprotected processing of aquatic animals and consumption of raw aquatic animals, together accounting for 71.4% of the investigated cases in the Nature study.

This does not mean that everyone should stop eating seafood. It does not mean cooked seafood is suddenly unsafe. But it does mean we should take seriously the occupational and domestic handling of raw aquatic animals, particularly where exposure is repeated, hands are injured, or eye-touching occurs after handling raw seafood.

From an ophthalmology perspective, this is exactly the kind of condition that can be missed if we only think in silos. A patient presents with recurrent anterior uveitis, keratic precipitates, iris changes and high pressure. We test for the usual suspects: herpes simplex, varicella zoster, cytomegalovirus. But what happens when those tests are negative… the pressure keeps rising, and the exposure history points not to another person, but to a fish market, aquaculture pond, seafood counter, kitchen or raw seafood preparation environment?

What is CMNV?

Covert mortality nodavirus was first described in relation to shrimp disease and aquaculture loss. It is called “covert” because affected shrimp may die out of sight, sinking to the bottom of ponds. WOAH’s technical disease card for CMNV still lists its zoonotic importance as “none”, while also noting that infection can affect production in fish species and that closely related nodaviruses may survive freezing but be inactivated by heat treatment.

That contrast is striking, as until very recently, CMNV was primarily an aquaculture and animal-health problem. If the Nature findings are now confirmed and expanded, it may also become part of the ophthalmic and public-health conversation. CMNV appears to have a broad aquatic host range. The Nature paper describes it as prevalent in farmed and wild aquatic animals worldwide, and the article includes a figure on CMNV prevalence in farmed and wild aquatic animals globally. This matters because aquaculture is no longer a niche industry. Global fisheries and aquaculture production reached 223.2 million tonnes in 2022, according to the FAO, comprising 185.4 million tonnes of aquatic animals and 37.8 million tonnes of algae. As aquaculture expands, the number of people handling raw aquatic animals (in ponds, markets, processing facilities, restaurants and homes) also grows.

What does POH-VAU look like clinically?

POH-VAU stands for persistent ocular hypertensive viral anterior uveitis.

Breaking that down:

Persistent — it can recur or become prolonged.
Ocular hypertensive — the eye pressure is raised.
Viral — the suspected driver is viral infection.
Anterior uveitis — inflammation is mainly at the front of the eye.

For patients, this may translate into:

• red eye
• eye pain or discomfort
• blurred vision
• light sensitivity
• halos around lights
• raised eye pressure
• recurrent inflammation
• glaucoma-like optic nerve risk if pressure remains uncontrolled

Who might be at risk?

The current signal is not “anyone who eats fish” but rather around exposure intensity.

The Nature paper found that CMNV exposure frequency, number of severe exposures and exposure severity were associated with increased POH-VAU risk. It also reported that frequent unprotected processing of aquatic animals and raw aquatic animal consumption were commonly reported exposure events.

The groups to think about include:

• people working in aquaculture
• fishmongers and seafood market workers
• seafood processors
• restaurant staff handling raw seafood
• people frequently preparing raw fish, shrimp, crab, molluscs or cephalopods at home
• people who eat raw or undercooked aquatic products
• close contacts of high-exposure individuals, although this remains an area needing more evidence

The Nature article also describes a subgroup of patients without direct aquatic animal exposure but with close contact with family members who had severe or frequent CMNV-risk exposure, which raises the possibility of indirect transmission routes requiring further study. That last point should be handled carefully as although it’s not a reason for alarm, it is a reason for surveillance, better exposure histories and more research.

Should the public be worried?

I would frame this as: watch, don’t panic.

There are several reasons for caution. Firstly, the currently described human cases come from a defined clinical study population, not a global outbreak. The study is important, but we do not yet know the true global incidence, whether similar cases are being missed elsewhere, or how often exposure leads to disease.

Secondly, the main practical risk appears linked to repeated or severe exposure to raw aquatic animals, especially unprotected handling. That makes this particularly relevant to occupational health and food-preparation hygiene.

Thirdly, cooking remains a key distinction. WOAH notes that there are no reports on CMNV stability specifically, but that a closely related nodavirus can survive freezing at -20°C and be inactivated by heat treatment at 50°C for 5 minutes. That does not allow us to give a precise household cooking rule for CMNV in humans, but it does support the general message: freezing is not the same as cooking, and thorough cooking is likely to be safer than raw consumption.

What should people do?

The practical advice is simple and sensible.

• Wear gloves when frequently handling raw aquatic animals.
• Avoid touching your eyes while preparing raw seafood.
• Wash hands thoroughly after handling raw seafood.
• Cover cuts or abrasions before food preparation.
• Clean surfaces and utensils properly.
• Cook seafood thoroughly.
• Seek urgent eye care for a painful red eye with blurred vision, light sensitivity or halos.

For clinicians, I would add one more point: ask about exposure. In recurrent hypertensive anterior uveitis, especially if standard viral testing is negative or the clinical course is atypical, it may be worth asking:

• Do you handle raw fish, shrimp, crab, squid or shellfish?
• Is this at work or at home?
• Do you ever handle seafood with bare hands?
• Do you eat raw or undercooked aquatic products?
• Have you had cuts or abrasions while handling seafood?
• Does anyone in your household work with raw aquatic animals?

TL;DR

A new seafood-linked eye disease has been described. It is called POH-VAU, and it is associated with CMNV, an aquatic animal virus.

For the public: this is not a reason to fear seafood. It is a reason to handle raw seafood safely, cook seafood properly and seek urgent assessment for a painful red eye.

For clinicians: this is a reminder that exposure history matters. Not all viral uveitis begins with herpes. Some stories may begin in the seafood market, aquaculture pond or kitchen.

For public health: this is a signal worth watching. The seafood supply chain is global. Eye inflammation may be local. The connection between the two may be more important than we previously realised.

POH-VAU: The New Seafood-Linked Eye Disease was originally published in The Yak on Medium, where people are continuing the conversation by highlighting and responding to this story.

There are some traditions so old, so deeply woven into the soul of a people, that even history’s cruelties cannot extinguish them. Norouz, celebrated throughout Iran and Central Asia, is one of those traditions.

The ancient festival of the Spring Equinox (20th March this year) returns with green shoots pushing through cold earth, with the scent of hyacinths and herbs, with polished mirrors catching the light, with candles, coloured eggs, apples, garlic, sumac, and the soft gathering of loved ones around the haft-seen. Norouz arrives with poetry on the lips and memory in the heart and it asks us to begin again.

And yet this year, for the people of Iran, Norouz does not arrive lightly. The blossoms of the sabzeh (lentil sprouts) unfold under an unusually heavy sky. It comes amid grief, repression, exhaustion, and uncertainty. It comes to a nation whose people have endured years of violence and humiliation at the hands of a regime that has treated dignity as a threat and freedom as a crime. It comes now in the shadow of war, with ordinary people once again trapped between fear, instability, and forces far beyond their control. It comes to homes carrying sorrow, to families carrying absence, to hearts carrying both anger and ache. And still, Norouz comes.

The Meaning of Norouz

Norouz literally translates to “New Day.” Originating in the Achaemenid era and rooted in ancient Zoroastrian traditions, it represents the primordial victory of light over darkness and spring over winter.

I have written before about Norouz as an ancient festival of renewal, rebirth, and reconciliation. About its beauty and its symbolism (the way the haft-seen table becomes a language of hope, each object carrying meaning: new life, health, patience, abundance, love, wisdom, light after darkness). I have written about the joy of it too: the rituals of spring cleaning, the tenderness of family visits, the exchange of sweets and laughter, the old instinct to enter the new year with an open home and an open heart.

And we can’t forget food (because Norouz is not only seen, it is tasted). It lives in the table as much as in the poem. In herbs and rice, in fresh fruit, in pastries and nuts, in tea poured for guests, in the fragrance of kitchens preparing dishes that carry memory from one generation to the next. These are not small details they are the texture of continuity, and they are how culture survives.

This year, all of these meanings feel heavier, more urgent, and more precious. This is because in times of suffering, hope is no longer a soft sentiment, but rather becomes an act of defiance.

No Norouz table is complete without the Haft-Seen: the seven symbolic items starting with the letter ‘S’, such as Seer (garlic for health), Seeb (apple for vitality), and Samanu (sweet pudding for abundance). To lay a haft-seen table in a year like this is not to deny reality. It is not to look away from pain. It is to insist that pain will not be allowed to define the whole story. It is to say that the people of Iran are more than the regime that brutalises them, more than the headlines that flatten their lives, more than the wars that entrap them. It is to say that beneath oppression there remains an older, deeper Iran: an Iran of poetry, hospitality, memory, beauty, ceremony, kindness, and endurance.

This defiance is woven into the very fabric of the festival’s traditions, particularly the food. Despite skyrocketing inflation and food scarcity, families still make immense sacrifices to prepare the traditional spreads. The aroma of Kuku Sabzi (a rich, fragrant herb frittata symbolizing rebirth) fills the air, served alongside endless platters of pastries, cookies, and dried fruits. The rituals of visiting neighbors and healing old wounds through hospitality continue. By breaking bread and sharing sweets, the people refuse to let the darkness of their political reality extinguish their humanity.

That, perhaps, is what moves me most about Norouz. It is not merely festive. It is civilisational. It belongs to a historical depth that predates this regime by centuries, indeed millennia. It carries the wisdom of a people who have known conquest, upheaval, exile, and grief before , and who have nevertheless kept turning toward spring.

The state may try to control bodies, streets, voices, and public spaces. It may try to intimidate, censor, punish, and erase. But there is something it can never fully conquer: the deep cultural memory of a people who still know how to gather around a table, recite a poem, offer sweetness to a guest, light a candle, and mark the turning of the year with hope. That is why Norouz matters so much now.

It matters because oppression tries to shrink life. It tries to reduce people to survival and drains colour from the everyday. It makes joy seem dangerous and tenderness seem frivolous. Norouz refuses that shrinking. It brings colour back. It restores ritual. It says that beauty still has a place, that memory still has a place, that joy (however fragile) still has a place. And there is something profoundly moving, too, about the way Norouz carries both sorrow and hope without contradiction. It does not ask people to forget what they have suffered. It does not demand easy optimism. It knows that winter exists. Its wisdom is deeper than that. It simply insists that winter is not the end of the story.

In this, Norouz feels especially Iranian. It holds grief and beauty together. It understands that heartbreak and longing can coexist with music, with hospitality, with poetry, with a table set carefully for others. It does not pretend away suffering and dignifies survival.

This is why poetry belongs so naturally to Norouz. Hafez, Sa’adi, Rumi, Ferdowsi, Khayyam remind us that that human beings are not sustained by bread alone, but also by metaphor, by memory, by beauty, by words that endure.

The mystic poet Hafez in particular is the patron laureate of Norouz. The 14th-century “safe-keeper” of the Persian soul, his words have never felt more agonizingly relevant than they do this year. When Iranians look at the mirror on their Haft-Seen, reflecting the flickering candlelight of a nation in peril, Hafez’s message offers a radical, enduring comfort:

“I wish I could show you when you are lonely or in darkness, the astonishing light of your own being.”

Iranians are drawing on this astonishing light. They are leaning into the poetry of their ancestors to survive the precariousness of their present.

An Act of Quiet Defiance

For decades, the ruling clerics in Iran have frowned upon Norouz. Predating Islam by over a millennium, the festival is viewed by the regime’s hardliners as an irritating pagan relic. Because of this, simply celebrating Norouz has become an act of quiet, joyful rebellion. When Iranians meticulously engage in khooneh tekouni (the traditional spring cleaning) to welcome the new year, they are attempting to wash away the gloom of economic collapse, political repression, and the terrifying drumbeats of regional war.

It is adeclaration that the soul of Iran is older than its oppressors. A reminder that identity cannot be fully policed, and a refusal to let war, repression, and grief extinguish the possibility of renewal.

And perhaps that is what the people of Iran are doing this year, as they have done so many times before: enduring. Preparing the table despite everything. Choosing life in the midst of fear and refusing to let brutality have the last word.

Unity in Diversity

Norouz belongs not to one narrow category of people, but to a vast cultural inheritance, shared and cherished across regions, communities and traditions, including minority groups who have kept its spirit alive in their own ways. That has always been one of the festival’s most moving qualities: its generosity. Norouz does not shrink identity but rather expands it, and reminds us that culture is often most powerful where it is shared, adapted, and passed lovingly from hand to hand.

The festival is not solely an Iranian affair, nor does it belong to any single ethnicity or religion. It is a public holiday in thirteen countries, uniting millions.

In a time where minority groups in Iran face extreme persecution, Norouz stands as a powerful equalizer. It is celebrated fervently by the Kurds, often taking to the mountains with music and fire, as well as by Parsis, and followers of the Baha’i faith, who endure some of the regime’s most severe systemic abuses. For these communities, Norouz is a shared heartbeat, a reminder of a collective cultural identity that predates their modern suffering and outlasts their oppressors.

Whispers in the Grass

The festival concludes after thirteen days with Sizdah Bedar, a day spent outdoors in nature. It is a time for music, dancing, and children playing in the fields. A profound tradition on this day involves young people tying knots in the blades of grass and whispering their deepest wishes before discarding the greenery into running water.

This year, the whispers tied into those blades of grass will carry a heavier burden as they are no longer simply wishes for romance or personal fortune — they are pleas for freedom, for peace for an end to the repression and bloodshed that has stolen so much from so many.

The core promise of Norouz remains unbroken: Winter, no matter how harsh, how brutal, or how long, always inevitably gives way to Spring. In a world where anger and fear seem to prosper, the Iranian people’s steadfast commitment to celebrating “the New Day” is the ultimate proof that hope (like the sabzeh growing on millions of tables) just can’t be stopped from reaching for the light.

Norouz mobarak.

Norouz returns, as it always does: carrying memory, carrying beauty, carrying longing, carrying love. It returns to a wounded people and asks them, gently but insistently, to keep faith with tomorrow.

That may be the deepest truth of this ancient festival:

Not that suffering disappears.
But that hope survives.

To the people of Iran , and to all those carrying Iran in their hearts, may this new year bring safety, freedom, dignity, and peace. And until that day comes, may the flame of hope remain lit.

The Four Ancient Festivals of the Seasons

Read about the other three ancient festivals of the seasons, centrepieces of Iranian culture which take places at the four solstices and equinoxes, here:

Yalda — The festival of Winter, and victory of Light over Dark.

Mehregan — The festival of Autumn: nature, love, and friendship

Tirgan — The summer festival of rain

52 Sites of Iranian Culture and World Heritage:

Learn more here

Sepandarmazgan — Valentine’s day in Iran

Learn more here

Norouz, Still. was originally published in The Yak on Medium, where people are continuing the conversation by highlighting and responding to this story.

As eye care professionals, we spend our entire professional lives fighting to preserve light. We train to master the delicate microscopic topography of the cornea, the retina, and the optic nerve, all with the objective of saving our patients from the encroaching dark. What happens when the state itself wields darkness as a weapon and what is our clinical and moral response when blindness is not caused by disease or tragic accident, but is deliberately inflicted as a tool of political suppression?

Over the past few weeks, I have been chatting to colleagues in Iran in audio rooms on Clubhouse and X/Twitter Spaces. These conversations, often held late into the night through encrypted channels and VPNs to avoid state surveillance (sometimes with the participants using voice-altering technology), have been harrowing. Through the static and the fear, my fellow eye physicians and surgeons have described a waking nightmare — an ongoing, systematic campaign by Iranian security forces to intentionally blind protesters.

“We are not just treating collateral damage,” a Tehran-based vitreoretinal surgeon told me “When you look at the trajectory of the pellets, the clustering around the orbital region, and the volume of ruptured globes, the clinical evidence points to only one conclusion. They are aiming for the eyes. They are shooting to blind.” An oculoplastics colleague told me that security forces were “deliberately shooting at the head and the eyes” and doing so “so they can no longer see,” adding that many patients required eye removal and were left blind. The themes in the conversations surfaced on fear, shortages and a sort of survivors’ guilt — the moral injury of treating a preventable epidemic of ocular trauma

Why the eye?

The eye is anatomically exposed and symbolically powerful. A destroyed eye sits on the face, and is permanently visible. It alters identity, employability, independence and social participation in a way that is immediate and legible to everyone. In an IranWire ophthalmological review, the authors describe the use of pellet-type munitions as “an indiscriminate and brutal practice that does not just injure; it maims.” There is another logic behind this too: if you take away sight, you take away witnessing.

For clinicians, these injuries are also hard to count. In environments where protesters fear arrest or reprisals, people delay or avoid hospital care. Doctors may treat quietly, incompletely document, or be pressured to disclose information. The missing denominator becomes part of the weapon: undercounting blunts outrage, and silence protects perpetrators.

A grim clinical reality

This clinical reality aligns with a barrage of recent investigative reports. A disturbing investigation published by The Guardian on January 13, 2026, revealed that hundreds of gunshot eye injuries had been documented in just one Iranian hospital alone. This is localised data which represents only a fraction of the national trauma. According to IranWire’s comprehensive tracking, which includes a detailed ophthalmological review of blinding as a weapon, over 500 severe eye injuries were reported across Tehran and other Iranian provinces in a terrifyingly short span of a couple of days.

The mechanics of this suppression are devastatingly simple and highly effective. Security forces are deploying birdshot, metallic pellets, and high-velocity paintballs at close range, bypassing the torso and aiming directly for the heads and faces of demonstrators who are unarmed. Colleagues describe receiving patients, amongst them young women and university students, attending with presentations from severe corneal lacerations and hyphaema to traumatic optic neuropathy, massive retinal detachments, and shattered globes that are entirely unsalvageable. This is alongside later complications such as infection, chronic pain syndromes, and inflammatory sequelae including sympathetic ophthalmia. Often the radiological imaging shows multiple metallic pellets embedded deeply within the orbit. The IranWire review makes a service point that will feel familiar to any UK clinician who has lived through system strain (albeit at an entirely different scale): when severe trauma clusters in time, even well-organised specialist pathways can be overwhelmed.

“In a single night, our triage looked like a war zone,” a second year resident physician shared on a Clubhouse room. “I performed four enucleations in one shift. We are removing the eyes of twenty-year-olds. This is a punitive blinding and the regime wants them to survive so they can serve as walking warnings to the rest of the population when they see them in the street. A missing eye is a permanent mark of dissent.”

Forwarded messages, restricted access, and internet shutdowns make independent verification of each event difficult. But we should listen to our colleagues and reflect their voices. What matters is that multiple sources describe a consistent injury distribution, a dense clustering of trauma to eyes and heads, which is hard to square with incidental, random harm.

Clinicians at risk

During and after the 2022 protests following the death of Mahsa Jina Amini, the medical community in Iran itself became a target. Doctors who treat these ophthalmic injuries risk arrest, torture, and the revocation of their medical licenses. In some cases, they are facing execution –(BMJ). Death certificates and medical records are routinely forged by the authorities to obscure the true cause of the injuries. Indeed, some colleagues are forced to establish clandestine, underground clinics, operating with smuggled surgical supplies and utilising makeshift slit-lamps, purely to keep young protesters out of state-run hospitals where treatment is often followed by immediate arrest.

A global pattern

While the scale and deliberate malice in Iran are currently unprecedented, the weaponisation of blindness in crowd control is tragically not an isolated, regional phenomenon. As an international ophthalmic community, we must acknowledge that the misuse of “less-lethal” crowd control weapons has caused an epidemic of visual impairment globally.

In Chile’s 2019–2020 protests, UN experts cited nearly 400 cases of eye injuries and loss of sight linked to anti-riot shotguns, calling for accountability. In Hong Kong, after a protester’s eye injury became a rallying point, demonstrators swarmed the airport chanting: “An eye for an eye!” In Gaza, ocular injuries have been compounded by the destruction of eye care centres.

The United States also documented a surge in severe ocular trauma during the 2020 Black Lives Matter protests and related demonstrations, often from less-lethal kinetic impact projectiles (including rubber bullets, foam batons and bean bag rounds). These munitions are designed to be fired at the ground to ricochet into the lower extremities, or aimed strictly at the larger muscle groups of the legs and abdomen. Instead, they were repeatedly fired at chest and head height. Protesters, photojournalists, and casual bystanders suffered ruptured globes, orbital fractures, and permanent vision loss after being struck by these KIPs. In a statement widely shared within ophthalmology, the American Academy of Ophthalmology warned: “While classified as non-lethal, they are not non-blinding.”

In the United States, the blinding was largely attributed to poor training, panic, or the reckless misuse of crowd-control protocols by militarized police forces. In Iran, the evidence strongly suggests a calculated, top-down directive to maim.

Regardless of politics or policing, the result for the patient in the examination chair is exactly the same: an irreversible plunge into darkness. The weaponisation of visual trauma is a direct assault on public health and human rights and we cannot remain confined to our clinics and operating theatres while the tools of our trade are rendered necessary by the brutality of the state. Especially whilst our colleagues are risking their lives to pull birdshot from the eyes of brave young men and women who simply asked for freedom. My colleagues in Iran are begging the international medical community not to look away and to use our platforms, our journals, and our medical societies to amplify the voices of the Iranian doctors risking everything in the dark.

Sight is a fundamental human right. It is time the global medical and ophthalmic community stands firmly against those who would steal it to keep a population blind to their own power.

What eye care professionals can do:

1) Support colleagues working under intimidation and scarcity.
My conversations on Clubhouse and X/Twitter Spaces conversations have reminded me how isolating it can feel to practise ethically in a politicised clinical environment. Peer support, discreet mentorship networks, and secure routes for sharing de-identified clinical patterns can help clinicians protect patients without increasing risk to themselves.

2) Advocate from evidence, not ideology.
Advocacy doesn’t require partisan alignment, simply fidelity to what we see: preventable blindness. When our professional bodies state plainly that certain tactics are “not non-blinding,” bedside reality is translated into public-health language that policymakers cannot, and should not, ignore.

3) Document, safely and rigorously.
Working or volunteering in such environments is already a challenge but documentation is key. Whether injuries are intentionally targeted or foreseeably caused by facial firing patterns, accurate clinical documentation supports patient care, enables epidemiology, and (where appropriately anonymised and safeguarded) contributes to accountability.

4) Prepare for “mass ocular trauma.”
Major-incident planning rarely specifies ocular injury, yet these episodes create exactly that: clusters of open globes, vitreoretinal emergencies, complex lid and orbital trauma. Under strain, rehearsed pathways, delivered at scale can help (rigid shields, avoidance of pressure on suspected open globes, prompt CT imaging of orbit/face, appropriate infection prophylaxis and tetanus cover, and rapid access to VR and oculoplastics).[NG1]

Further Reading:

https://iranwire.com/en/features/114366-blinding-as-a-weapon-an-ophthalmological-review/

https://static.prod.iranwire.com/pdfcomponent/Report_JOCl.pdf

https://www.theguardian.com/global-development/2026/jan/13/hundreds-of-gunshot-eye-injuries-found-in-one-iranian-hospital-amid-brutal-crackdown-on-protests

https://iranwire.com/en/features/147525-live-ammunition-fired-at-protesters-over-500-eye-injuries-reported-in-tehran-and-across-iran/

Deliberate Darkness was originally published in The Yak on Medium, where people are continuing the conversation by highlighting and responding to this story.