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Mene, mene, tekel, upharsin 297

the grounds that the foreign contractors were cheating them. As a result,
construction of the first fifteen hospitals had not even begun by 1978.
Even if the hospital construction programme had by some miraculous means

been implemented, there was not the slightest chance that the Persians them­
selves could have staffed the hospitals. Medical education in Persia was in no
better condition than higher education in the country generally. A relatively
high proportion of the thousands of Persians studying at universities and
colleges abroad were reading medicine, though less, it seems, out of a sense of

vocation than because it offered the promise of a highly lucrative career on their
return home, whether they entered practice or obtained a post in the bureauc­
racy. Not all the Persian medical students at American or European univer­
sities, however, succeeded in graduating, and of those who did a fair pro­
portion elected not to return to Persia. As the output of Persia’s own medical
schools was limited, there was a fairly desperate shortage in the country of
qualified doctors, as well as of nurses and medical technicians, a shortage

which could not be erased simply by the recruitment of foreigners. What made
the situation even worse was the low level of professional competence (and in
the eyes of foreign observers, of professional ethics also) displayed by a high
proportion of the Persian medical fraternity. Most of them, furthermore,
refused to consider practising anywhere except in the major cities - or, for that

matter, anywhere outside Tehran. Taken together with the high cost of
medical treatment, the insufficiency of urban and rural health clinics, and the
general inefficiency of those who staffed them, these various drawbacks made
the prospect of adequate medical care for the great mass of the Persian
population little more than a mirage.
Higher education in Persia presents much the same picture as it does

elsewhere in the Middle East. There are far too many students for either the
size or the needs of the country, and too many of them are motivated not by a
desire to acquire knowledge but by the conception of a university degree or
college diploma as the passport to an agreeable sinecure in the bureaucracy.

While Persia has a far larger number of students abroad than any other
Middle-Eastern country, she has at the same time fewer students than most of
them at her own higher institutions of learning. To recover the loss of face
which he believed he suffered by this circumstance, Muhammad Reza Shah
decreed a major expansion of the Persian student body, which was accomp­
lished in large measure by the foundation of several new universities and
technical institutions, most of which were graced with either his name or that

of his father, or with one of his several titles. Between 1970 and 1977 the
student body almost trebled in size, from around 65,000 to over 170,000, by
the simple expedient of lowering academic standards, which had never been
igh at the best of times. The expansion of higher education was all of a piece
with the shah s other ostentatious endeavours to portray himself as a patron of

earning, such as his donations to American and European universities to