Iran International
The Western Iranian province of Ilam has emerged as one of the epicenters of nationwide protests, with some of the deadliest confrontations yet between demonstrators and security forces.
Roughly half of all reported fatalities so far—around 20 protesters—have occurred by direct gunfire in western provinces, according to activist and local reports.
Many of the deaths have occurred in Ilam, Lorestan, Chahar-Mahal and Bakhtiari, and Kohgiluyeh and Boyer-Ahmad, areas that have long ranked among Iran’s most economically deprived and are home largely to ethnic Kurdish and Lor populations.
The scale of unrest has been especially striking in Ilam.
On Tuesday night, videos showing large crowds protesting peacefully in Abdanan, a city of about 25,000, circulated widely on social media, surprising many Iranians.
A day later, similarly large demonstrations took place in Aligudarz, a city of fewer than 100,000 in neighboring Lorestan, where crowds chanted slogans against Supreme Leader Ali Khamenei.
Witness accounts and videos suggest participation levels unusual for cities of that size—an indication, activists say, of how deeply economic grievances and political anger have penetrated Iran’s smaller, poorer communities.
Despite this, state media have continued to minimize the protests.
The state-affiliated Tasnim News Agency described demonstrations in Lorestan as failed “riots,” claiming people “did not show up,” while acknowledging that inflation there has exceeded the national average.
Attack on hospital
Anger across Ilam intensified further after events at Imam Khomeini Hospital in the provincial capital on Sunday, following the transfer of wounded protesters from demonstrations in Arkavaz, the center of Malekshahi county.
State outlets accused protesters of attacking the hospital, saying police entered the facility to restore order. Eyewitnesses, however, described a security raid in which tear gas was fired inside the hospital and injured protesters were removed.
A rare on-the-ground report by the moderate daily Ham-Mihan, citing multiple witnesses and medical staff, said protesters arriving at the hospital were unarmed and had been shot after a peaceful march.
Several were already dead on arrival, while others later died from gunshot wounds, including injuries caused by military-grade bullets. Some families, the report said, rushed wounded relatives out of the hospital to prevent their arrest.
The incident drew a rare official response from the government.
The Health Ministry stressed the “sanctity” of medical facilities, saying any entry by security forces into hospitals or harm to patients violated humanitarian principles.
Government spokeswoman Fatemeh Mohajerani said damage to medical centers was unacceptable “under any circumstances” and announced that President Masoud Pezeshkian had ordered an investigation, dispatching a representative to Ilam to prepare a report.
For many residents, however, the episode has come to symbolize a broader breakdown: a protest movement spreading from Iran’s margins, met not only with lethal force in the streets, but—according to witnesses—even inside places meant to offer refuge.
