Health Management in Community-Led Mass Gatherings During Wartime: Evidence from Iran’s 2026 Ramadan War
| Author | Abdolreza Pazzouki | en |
| Author | Erfan Yousefzadeh | en |
| Author | Hesam Seyedin | en |
| Author | Mohsen Nouri | en |
| Orcid | Erfan Yousefzadeh [0009-0000-1281-1845] | en |
| Orcid | Mohsen Nouri [0000-0003-4849-8568] | en |
| Issued Date | 2026-04-30 | en |
| Abstract | Background: Community-led mass gatherings occurring during armed conflicts remain poorly understood in mass gathering medicine. In late 2026, following a large-scale military conflict in Iran, spontaneous nightly mass gatherings emerged across major cities as expressions of collective solidarity and societal responses to the crisis. These events were distinctive in being repetitive, spontaneous, emotionally charged, and conducted amid heightened national psychological stress and disrupted public health infrastructure. Despite their scale and persistence, little is known about the associated health system challenges and informal response mechanisms. Objectives: This study aimed to explore and analyze the health-related challenges, safety concerns, and adaptive responses associated with community-led mass gatherings during armed conflict in Iran, with a focus on identifying lessons for Mass Gathering Medicine and emergency health system preparedness. Methods: A qualitative phenomenological design was employed. Data were collected through 12 in-depth, semi-structured interviews, one focus group discussion, and extensive field observations conducted during nightly mass gatherings. Participants included healthcare volunteers, emergency responders, psychologists, public health professionals, and attendees. Data were analyzed using conventional qualitative content analysis. Credibility was enhanced through triangulation, member checking, and peer debriefing. Ethical approval was obtained from the Iran University of Medical Sciences Ethics Committee (IR.IUMS.REC.1404.509). Results: Six major themes were identified: 1) medical care and health services; 2) safety, emergency preparedness, and operational readiness; 3) welfare infrastructure, environmental health, and logistics; 4) psychosocial and cultural services; 5) accessibility, inclusiveness, and volunteer-based management; and 6) organizational learning and adaptive capacity. The findings demonstrated strong, community-driven health response systems, including volunteer-based medical stations and informal emergency support structures. However, critical gaps were identified in evacuation planning; emergency medical equipment, including automated external defibrillators and oxygen systems; mental health services; accessibility for vulnerable populations; and standardised incident reporting systems. Conclusions: Community-led mass gatherings during armed conflict demonstrated remarkable social resilience and spontaneous health system mobilization. However, these strengths were accompanied by substantial structural vulnerabilities that could pose serious risks under different circumstances. Integrating formal Mass Gathering Medicine frameworks into emergency preparedness planning is essential to ensure safety, inclusiveness, and effective health system responses in future crisis-related mass gatherings. | en |
| DOI | https://doi.org/10.69107/mgmj-172849 | en |
| URI | https://brieflands.com/journals/mgmj/articles/172849 | en |
| Keyword | Mass Gatherings | en |
| Keyword | Spontaneous Mass Gatherings | en |
| Keyword | Armed Conflicts | en |
| Keyword | Community Health Services | en |
| Publisher | Brieflands | en |
| Title | Health Management in Community-Led Mass Gatherings During Wartime: Evidence from Iran’s 2026 Ramadan War | en |
| Type | Research Article | en |