Sanctions against Iran, which were first imposed in 1979, became much more severe when they were intensified in 2010. The sanctions have affected not only Iranians, but also the Afghan migrants living in Iran. Coinciding with the Islamic Revolution in Iran, the Soviet Union invaded Afghanistan in 1979. Subsequently, Afghans started to flee their country, with many moving to Iran, a trend that has continued. A common language, religion, and geographic location made Iran the first host country for Afghans.Footnote ¹ Iran is a host country for around 7 million Afghans;Footnote ² 750,000 of them are refugees, 627,000 are visa holders, and the rest are undocumented.Footnote ³ This study regards them all as migrants, while also considering the different implications of each group’s visa status. In this chapter, I look at how the sanctions imposed on Iran impact the human security of the Afghan migrants residing in Iran.

Economic sanctions are punitive tools that are imposed by states, international organizations, the UN, or a combination of these entities to change the policies and behavior of government in a target country (among other reasons). When a state’s economy is harmed by intensified sanctions, its government faces a significant challenge in ensuring the human security of its citizens and residents. To manage this condition, the government, in providing resources and public services, often prioritizes the needs of certain citizens.

Migrants, in the view of the state, are likely to have a lower priority, which might increase their vulnerability when the state is experiencing comprehensive international multilateral sanctions. However, despite numerous studies on the impact of sanctions on society as a whole, minorities, including migrants, receive little attention. There are three noteworthy studies that do consider the effects on vulnerable groups including migrants in some fashion. An article by Peksen investigated ethnic discrimination in target countries in relation to economic sanctions and found that sanctions typically prompt governments to pursue policies of ethnic discrimination.Footnote ⁴ Kourula addressed the legal issues pertaining to the impact of sanctions on the international protection of refugees in Yugoslavia and recommended closer contact between the UN High Commissioner for Refugees (UNHCR) and the UNSC in the interests of prompting international peace and security.Footnote ⁵ There is a working paper by the World Bank that involved a quantitative study, concerning the macroeconomic consequences of Iran’s nuclear dispute and its impact on Afghan refugees in Iran.Footnote ⁶ The study’s findings reveal that the economic shock of the sanctions led to an escalation in the refugees’ outflows, and disproportionately reduces their consumption expenditures as well as the assistance provided by the host community. However, that study primarily focused on the macroeconomic aspect of Afghans’ condition.

In contrast, the study presented in this chapter explores both the theoretical and practical aspects of the impact of sanctions on two main components of Afghans’ human security: economic security (specifically employment) and access to healthcare. This empirical study is based on primary data collected through fifty-three semi-structured interviews conducted with twenty-eight Afghans, in addition to twenty-five experts (four academics, three social workers, one health-center worker, fifteen NGOs, an international NGO (INGO), and an international organization) between 2015 and 2018 in Tehran and Melbourne. The research utilized NVivo software to analyze the content of the interviews. The Afghan participants of this study are from various socioeconomic classes. Moreover, they represent variation in immigration status and gender.

Economic Security: Employment

To explore people’s economic security, this study focused on their employment and on their conditions resulting from unemployment. When Afghans began moving to Iran in 1979, there were no limitations on the job sectors open to them. However, government policies changed toward Afghans during the intensification of sanctions. In conjunction with government mismanagement, the adverse impacts of multilateral comprehensive sanctions have significantly contributed to the deterioration of the country’s economic condition that led Iran to experience 11.8 percent reduction in GDP, 40 percent inflation, and 200 percent currency depreciation in 2012, the year that sanctions against Iran were severely tightened, with the economic crisis continuing thereafter.Footnote ⁷ This economic condition severely affected the job market. Many firms faced bankruptcy and were forced to close their businesses. Consequently, the country experienced increases in unemployment, at the same time that living costs also increased.

In response, President Ahmadinejad’s administration sent an order in 2012 to limit Afghans’ work options to four categories of jobs: construction, agriculture, kilns (for manufacturing bricks), and other sectors (i.e., menial work, burning garbage, recycling chemical materials, cleaning). Further, the government prohibited Afghans from living and working in border provinces with the highest unemployment rates. There is a lack of research concerning the impacts of sanctions on the employment condition of Afghans. It has been unclear whether their circumstances parallel those of Iranians or differ substantially. The chapter addresses that question. For a better understanding of changes in unemployment facing Afghans, the interviews are presented in two sections, divided by gender. The respective experiences of men and women are further explored on the basis of socioeconomic class.

The Experience of Afghan Men

This section analyzes the work status of Afghan men living in Iran, categorized according to the three major economic classes with they identified. The economic lower class consists mostly of newly arrived Afghans who are unskilled or semi-skilled. In addition, the majority of Afghan men who are not new arrivals but lack formal education or the capacity to become skilled workers have also ranked themselves as lower class. Their employment in Iran is stable, as the government has reserved certain sectors of the economy for Afghan workers, in types of work requiring no skills or very few skills. Ms. Abedi (29) was born in Iran, where her family had settled in 1980. She stated: “My father is a seasonal worker. In the summer, he usually works in kiln factories, and in the winter, he works on cotton farms. Sometimes he works as a shoe shiner on the streets. So, he has never had the experience of being jobless.” Despite the availability of job opportunities, unskilled or low-skilled workers have no secure job; the only work they get is as a daily hire or on a short-term contract. They usually “hustle” for work at intersections or in public squares, particularly downtown. In fact, there is competition between Afghans and people from the ethnic minorities who come from villages or small cities to work in major cities, and this competition increased during the intensified sanctions.

Generally, recession in the construction sector has prompted a decrease in job offers in that sector. Those who lost their jobs in construction immediately found a new source of income, even if it was one that threatened their long-term health. Mrs. Toranj (52) was born in Afghanistan and came to Iran illegally with her family in 2001; she is an undocumented migrant. She described her husband’s experience: “He used to labor as a construction worker, but there has been no job for him there for the past four years. So, he now digs through garbage for recycling and rents one of our rooms out to addicts to use their drugs.”

Iranian employers often prefer Afghan workers because of their attitude and willingness to serve as “cheap labor.” Ms. Sahami (25) was born in Iran after her family settled in the country in 1991. She is an electronics engineer and holds refugee status. She stated: “Afghans who hang around in public squares are never out of work; Iranians prefer Afghans [as workers].” Thus, sanctions, and the government’s policy responses to them, have worsened the conditions of work for those who are unskilled or have few skills. But my research suggests that the overall rate of employment for this demographic group remained unchanged. Most Afghan male participants from the “working class” who participated in this study had not experienced bouts of unemployment. This finding is consistent with the study by Wickramasekara et al. that surveyed the occupants of 1,505 Afghan households in ten selected cities.Footnote ⁸ Their findings indicated that Afghans with a lower level of literacy enjoyed a lower level of unemployment.

By contrast, Afghan men among the first wave of migrants to Iran, with a personal history of more years spent in the country, tend to be skilled workers, master builders, or businessmen. The majority of Afghan children born into the second or third generation in Iran are well educated. Together, the majority of these Afghans are in the middle or upper class. The middle-class experience differs starkly from that of the working class. Ms. Qandehari (26) was born in Iran and is a refugee. According to her: “My brother-in-law, who used to be a master builder, was jobless for around six months. Finally, he found a job in another city and moved there, while my sister and her children continued to live in Kashan.”

The situation was similar in other parts of the labor market. Mr. Qanbari (30) was born in Iran; his family having moved there in 1983. The whole family has refugee status. Mr. Qanbari, who works for electronic appliance retail and repair shops said: “I had never experienced unemployment before the sanctions came in, but I was out of work for seven months last year. And since the New Year (March) until now (September), I have spent four months unemployed.”

With inflation increasing, people had to watch their budgeting, and this led to a decrease in the range of foods they consumed, which in turn had an impact on small businesses. Ms. Sahami (25) recalled the fate of her father’s grocery store: “Due to the worsening economy, my father was forced to close the shop. He has been jobless for a year now, because he is old and is unable to find employment.”

Afghan participants from the upper class had different experiences depending on what job sector they were in. Many of the participants had their own businesses, particularly in textiles and the construction sector. Ms. Azami (25) was born in Iran and lives there as a refugee; her father first came to the country for business in 1977, and she is studying for a master’s degree at Tehran University. She reported:

The financial and shipping sanctions significantly affected the county’s import and exports. The manufacture of bags, shoes, and textiles amounts to one of the most promising sectors for Afghans living in Iran. Ms. Simaei’s (28) father arrived in the country back in 1982. They have refugee status. She mentioned: “We lived in Yasuj [western Iran] for twenty-seven years. My father had a dress factory; we lived well. But due to high inflation [during the increased sanctions], our sales plummeted. And then, due to government policy, we were resettled. My father could not continue his business or find any new job. He is still living off our savings.”

With a broadening of the sanctions to cover banking transactions, the government was unable to transfer its export revenues, particularly the revenue accruing to the state from oil. A large share of the revenues was “frozen” in foreign countries. On the other hand, due to currency depreciation, difficulties in importing raw materials and high inflation, Iranian goods, particularly in the clothing and shoe industries, rapidly became more expensive. Purchasing power declined sharply by 28.6 percent in 2012, followed by a further decline of 35.1 percent in 2013.Footnote ⁹ Consequently, demand for clothing and related goods dropped off.

In these circumstances, China has remained Iran’s main trading partner. When the financial sanctions made it impossible for Iran to transfer funds through the banking system, the government started to barter oil with China to import Chinese products, which were far cheaper than their Iranian counterparts. Soon, the combination of a depreciating currency, high inflation, and the influx of cheap Chinese goods affected Iran’s textile industry. Therefore, many manufacturers and retailers faced with a loss of customers, were driven to “shut up shop” or even declare bankruptcy.

At the same time, due to shipping and financial sanctions affecting oil exportation, government revenues went into a sharp decline. To manage economic conditions, the government abandoned most public-works projects. The country experienced approximately 7.5 percent economic decline, marking the worst economic downturn after the Iran–Iraq War ended in 1988.Footnote ¹⁰ This economic decline sent Tehran housing prices skyrocketing, and the demand for houses decreased. Along with that, private investment decreased as well. This created problems for Afghan master builders in particular. Mrs. Nazari (42) was born in Afghanistan and came to Iran in 1998. She lives as an undocumented Afghan together with her husband and children. She described:

Documented Afghans are eligible to become registered master builders. People with that qualification are permitted to work on contracts with Iranian citizens or the government. In the study, Ms. Qandehari spoke about her father: “He has been a registered master builder for nine years, in charge of many governmental projects, such as the Kashan University development plan. He had never been out of work before, but three months ago the plan management announced that it had run out of funds. So he is without any project now.”

The crisis in the construction sector hit Afghan master builders very hard, and all the projects open to them just vanished. Some of them were forced to take lower-level positions in addition to the indignity of being displaced. Yet some better-off Afghan families escaped the scourge of unemployment. For example, Mrs. Hadisi’s (31) family came to Iran in 1976 and she was born there. She has a bachelor’s degree in chemistry, and is now a medical science student. She mentioned her husband, who runs a computer shop: “He never encountered any change in the amount of customers that were coming his way. In fact, his job continued entirely unchanged.” The specter of unemployment also bypassed some Afghan men participants in this study who were from the upper class with jobs in sectors other than construction or garment manufacturing. But generally the findings of this study agree with Farzanegan et al., who focused on the impact of oil sanctions on microeconomic and household welfare of those living in Iran, and concluded that although both urban and rural households across various income levels affected by the oil sanctions and experiencing decline in their welfare, the middle- and upper-middle class households tend to experience greater losses compared to their less affluent counterparts.Footnote ¹¹

The Afghan participants in my study who were most affected by the sanctions were members of the middle and upper classes who had been kept busy by the demands of the construction sector. Likewise, periods of unemployment became the norm for skilled workers in other sectors. Also, those who had small businesses or whose shops were forced to close also fell victim to the loss of customers due to the economic downturn. The findings show that the difference between the experience of the middle class and the upper class was that the upper class had savings and the potential to restart their business, while the middle class had no savings to sustain them during the crisis. The findings also indicate that about 30 percent of participants from this class, particularly the youth, fell to lower class status and became recipients of aid and/or resettled to third countries in order to survive.

The Experience of Afghan Women

The documented Afghan women formally have the same legal work rights as Afghan men in Iran. However, due to Afghan culture, tradition, and religious beliefs, women are often expected to stay within the home, and thus have limited access to formal paid jobs. The participants’ experiences vary in accordance with their economic class. Many women from the lower economic class have tried to find work that could be done at home, such as carpet weaving or dressmaking, while others are working for Iranian employers. For carpet weaving, in addition to supervising, the employer provides them with the pattern and material. The employer typically visits to see how the work is going and pays a wage based on the quality of the work. Ms. Abedi (29), who has a bachelor’s degree in psychology, told this interviewer: “My mother and sisters have been weaving carpets for twenty-five years. They never experienced any unemployment. This is the job that is always open to Afghans. Now some of our neighbors are undocumented and they have been living in Iran for twenty years. For all these years they have been occupied weaving carpets at home.”

Some women also work with their husbands on farms. As there is a widely held view that Afghans are hard workers with low expectations, many farmers prefer to employ Afghans rather than Iranians, as Ms. Qanbari (30) described: “Some of my relatives are seasonal workers and usually toil on the farm along with their wives. They pick roses in spring for rosewater factories.” For working-class women, there was some job instability as the economy declined. But women who lost their jobs could generally obtain other positions, although these were temporary jobs or less desirable in some other way. For example, Mrs. Toranj (52) had been hired by a cleaning company and stated: “In the last five years, my employer told me there was no work. So, I started to do some embroidery on scarves and sometimes I cut fabric for stores in summer.”

Middle-class Afghan women had different experiences. A high percentage of participants work in the textile industry. Ms. Khavari (33) was born in Iran; her father immigrated in 1973. They live in Iran as refugees, and she is a dressmaker. She noted:

Mrs. Hosseini (47) was born in Afghanistan and crossed into Iran, along with her family illegally in 1985. She used to live with her husband and four children as refugees in Iran until 2012, when they resettled in Melbourne. She explained: “I used to work as a dressmaker for the factories. In the face of economic difficulties, Afghan men entered our domain. When that happened, the number of commissions I was getting fell off, which led to unemployment. That’s when I started making dresses for my neighbors and others.”

As the decline of the building industry caused Afghan men to lose their jobs, a significant number of them transitioned into the dressmaking sector, and effectively took over jobs previously reserved for women. The middle-class women who participated in this study were affected by this trend, but on becoming unemployed they became self-employed, or could find new jobs, even though those jobs were of lesser status.

Upper-class Afghan women usually do not work. The youth of this class are mostly well educated. According to Mrs. Hadisi (31): “I was never supposed to earn money and manage the family expenses. So I followed my dream, which was to study at university.” Because upper-class Afghan families were able to rely on savings to get them through the economic situation, for the most part the employment situation of women in these families was unaffected. But the impact of sanctions on upper-class Afghan women was different than their impact on men of the same social class, who were still expected to hold employment or operate a business to support their families.

To recapitulate, women from the lower socioeconomic class who participated in this study had little fear of unemployment. If they lost their job, they could immediately find another, although it was often much less desirable work. Middle-class participants found themselves unemployed more often or given inferior job responsibilities as time wore on, while upper-class women were largely unaffected, as their families had sufficient resources to weather the economic situation.

Access to Healthcare

The sanctions imposed on Iran are intended in part to cut the Iranian government’s financial resources through their impact on exports, shipping, and financial transactions. Sanctions have indeed had a severe impact on the Iranian government’s budget, and this resulted in part in a reduction of subsidies for essential public services. Government expenditures on health declined after the imposition of UN sanctions in 2006, with a 42 percent reduction in healthcare spending that year. As the UN and multilateral sanctions tightened in 2010, undermining state revenues, government spending on healthcare declined even further, with a 32 percent reduction.Footnote ¹²

As a result, during these years, private spending by individuals for healthcare increased significantly: Private health expenditure per capita increased from $459 in 2006 to $796 in 2010 (although private healthcare expenditures decreased somewhat, to around $620 in 2013, with the change in administration and prospects of success for the JCPOA agreement). Public health expenditures continued to decrease after 2013.Footnote ¹³ This increase in health costs borne by individuals was experienced with particular severity as Iran experienced a sharp depreciation in its currency during this period. The toman, the currency used in everyday transactions, declined from 1,000 toman per $1 in 2010 to around 4,000 toman per $1 in 2012.Footnote ¹⁴ This imposed significant pressure on ordinary people, who had limited access to hard currency.

The government provides free primary health services for all residents, including Afghans in Iran, while Afghans must pay for secondary health costs. However, this arrangement was affected by the economic downturn that took place with the tightening of the sanctions. Dr. Soroush is a general physician and lecturer with expertise on Afghans in Iran. He explained changes during the sanctions era: “Iran’s economy is not good, which has an impact on services. Some primary health parameters changed to secondary health services in hospitals, so they required payments for those.”

In regard to healthcare, the sanctions impacted Afghans differently than Iranians in other ways as well. Iranian people must pay insurance fees monthly to have a pension after retirement and for health insurance as well, which covers secondary health services such as hospital care. Iran’s government provides all international students studying in Iran with access to health insurance. Mrs. Hosseini’s husband and children studied at university, and she mentioned: “We had been covered by free health insurance from the university.” But other segments of Afghans were not eligible for this form of health insurance. As a result, medical expenses were one of the main costs for Afghans in Iran.

The UNHCR used to cover the medical costs for Afghan refugees who were hospitalized in governmental health centers. Ms. Muzaffari worked with the UNHCR on behalf of an NGO. She explained:

Mrs. Kaboli (40) was born in Afghanistan. Her family entered Iran in 1983 and lived as refugees there. She is a student at a seminary. Based upon her experience, she provided more detailed information about receiving health expenses from the UN:

According to participants, the UN stopped this policy in 2013–2014 and started to deal with a governmental insurance company, which provides cheaper and more universal coverage. The negotiation took around two years, from 2014 to 2016, which coincided with the intensification of sanctions. As a result, during the UNHCR negotiation with the new company, patients with chronic diseases were not covered by any insurance, although the UN paid some of their expenses to the hospital directly. Mrs. Noori (37) has kidney failure and needs dialysis three times a week. She disclosed her experience:

Furthermore, the UNHCR limited other financial supports for refugees’ healthcare. Mr. Hamidi (25) used to live as a refugee in Iran and he is a radiologist now. He described his friend’s experience: “The UNHCR used to pay Afghans’ surgery costs to the hospital, but now they only pay for emergency cases. When my friend approached the UNHCR (in Tehran), they told him, ‘Ask your doctor and the head of the hospital to certify that if you did not have surgery, then you would die. Only then we would pay your fees.’”

However, since 2015, coinciding with the JCPOA, all refugees and documented Afghans have been able to register in the Salamat Insurance plan. The plan operated after negotiation between the UNHCR, the Bureau for Aliens and Foreign Immigrants’ Affairs of the Ministry of Interior, and Iran Salamat Insurance. This government-implemented plan provides health insurance for all foreigners, including Afghan refugees. People must pay for the insurance, while it is free for those with certain diseases, including hemophilia, thalassemia, kidney failure, kidney transplants, and multiple sclerosis.Footnote ¹⁵

Dr. Saba, an academic at Tehran University of Medical Sciences with special expertise on Afghans living in Iran, explained the costs for Afghans without insurance: “Medical costs for them are based on the free market rate (without subsidies), not more.” However, it seems to be different in practice. Mr. Hamidi (25) used to work at two public hospitals in Tehran as an intern. He shared his observations about the medical rates for Afghans:

This indicates that although regulations state that Afghans must pay based on the free market rate, hospitals changed their financial policies and charged above that rate, due to the increasing economic difficulties during the sanctions. Further, the number of Afghans who are coming to Iran for healthcare is increasing, so realistically they can be seen as medical tourists, who are subject to higher rates. Because most Afghans in Iran are undocumented, cashiers in hospitals consider them as medical tourists and charge them three and a half times more than those who are documented. However, this varies depending on the type of diseases and immigration status. The increase in medical prices has an impact on people’s access to medical services. Ms. Sahami (25) related her mother’s condition. They are refugees and have insurance:

The situation was even worse for the undocumented participants from the lower classes, although it was unchanged by the sanctions. Afghan migrants from lower income families did not have access to doctors before the intensified sanctions; and thus, their access to medical care did not change when healthcare became more expensive and less available. Mrs. Toranj (52) has some serious gynecological diseases in addition to arthritis and osteoporosis. She stated: “I have no insurance and have never been able to receive any help. So I have never been able to go to a doctor. I must live with this condition till the end of my life.”

NGOs have been a significant source of free healthcare services for Afghan migrants, to supplement the services provided by the Iranian government, or services available on a paid basis. Afghans have a strong and supportive community in Iran. They quickly inform each other about their rights and any free services. Mr. Mani, who heads two NGOs with five branch offices in various cities, offered his observation of Afghans: “Afghans use the maximum number of services and facilities. Under economic pressure, their referral to NGOs for free services sharply increased.” However, due to the economic difficulties, NGOs faced a decrease in donations, and they were often forced to reduce their services. This has further reduced the availability of healthcare to Afghans in Iran.

Mrs. Noori (37) used to receive financial help from the Iranian dialysis center. She elucidated: “They do not provide me with financial help anymore, but sometimes the center or other people give me free medicines.” In corroboration, Mr. Masoodi (35) who is the head of one Afghan NGO, described the changes in NGOs’ services during the sanctions era: “I would say that the NGOs’ free healthcare services to Afghans significantly decreased in the past two years.”

Therefore, the sanctions directly or indirectly caused a decrease in free or low-cost healthcare available from the state for Afghan migrants. While other options were available to them through insurance, that has not been sufficient to meet the need for affordable and adequate healthcare for this population. Afghans increasingly turned to the UNHCR and NGOs; however, those services did not increase to meet the additional demand, but rather decreased due to economic difficulties.

Conclusions

The intensification of sanctions has severely affected the country’s economy. Despite the government’s numerous managerial and policy issues, the sanctions are the primary cause of the changes. Over the last four decades, the government, its structure, and basic economic management methods have largely remained unchanged. Sanctions were a novel phenomenon that caused numerous crises in the country, both directly and indirectly.

Consequently, the sanctions affected the Afghan migrant population in Iran in several regards. In some contexts, Afghans were affected in the same ways as Iranians, but in other contexts, Afghans were affected differently, and more adversely. In the face of its economic limitations, the government changed its policies to be more restrictive toward the Afghan migrant population, reducing employment options for Afghans, in the face of growing unemployment on the part of Iranians. Although those in the working class were still always able to find employment, it was often for lower pay, and under worse conditions. The sanctions had a greater impact on the economic and health security of middle-class participants, through increased unemployment and inability to afford health expenses; and some in the middle class dropped to a lower economic class. The wealthy were not greatly affected in regard to economic security or access to healthcare, although their ability to maintain their businesses was often compromised, due to declining markets and reduced imports.

In regard to healthcare, if the government had responded differently to the sanctions, the harm could have been lessened. Further, if the UNSC and UNHCR provided special support for people, particularly in terms of health, the impact could have been mitigated. If the sanctions had in fact been “smart sanctions,” they would have had a less severe impact on ordinary people. However, it is clear that the sanctions, either directly or indirectly, have been a precipitating cause of the general reduction in healthcare, which disproportionately impacts migrants.

The countries and institutions imposing sanctions on Iran often claim that the sanctions are not intended to harm the civilian population in Iran. In fact, the sanctions have triggered a series of economic crises that affect not only the human security of the Iranian population but also have additional consequences for migrants, who are particularly vulnerable.