Graphic photos of mangled metal and twisted wheels attest to the roughly 38,000 Iranians who die each year in vehicle crashes.

It's said to be the highest auto death toll in the world, said Dr. Mohammad Mazaheri. "Just imagine how many people are injured."

But he did more than imagine.

The Lancaster Cleft Palate Clinic physician has revisited his native country frequently since 1995 to treat cleft patients and teach native doctors how to operate on them.

In 2000, at the behest of the University of Tehran, he and other doctors began giving first aid to Iran's emergency medicine system.

They found that the Iranians were ill prepared to handle road crash casualties, let alone victims of heart attacks, strokes, burns, cuts and other urgent maladies.

None of the roughly 100 hospitals in Tehran had emergency rooms eight years ago, Mazaheri said.

Now, nearly all do. And though officials have given him no hard statistics, Mazaheri said, they are claiming a significant drop in the accident mortality rate.

The "people-to-people" humanitarian program will continue this spring when Mazaheri accompanies another American delegation to Iran.

The political relationship between the two countries may be on the critical list in the opening months of 2008.

But, Mazaheri said, "you have to forget about the politics and look at the people."

Iranians are "extremely hospitable" and eager even to help visitors who are supposed to be their enemies, he added. "We have made a lot of good friends in Iran."

Not a small thing
Iran is an ancient country with about 65 million people. Mazaheri grew up on a farm outside the largest city, Tehran.

He was 20 when he came to this country in 1949. He holds advanced medical degrees from the University of Tehran and the University of Pennsylvania.

The naturalized American citizen has long specialized in dental and maxillofacial prosthetics.

He is known for starting the Happy Face Foundation and giving free treatment to Iranian kids with cleft palates.

However, during an interview in his office on North Lime Street recently, he was clearly excited by the emergency medicine exchange.

"It's not a small type of thing," said Mazaheri, a compact man wearing a tie and a crisp white lab coat. "It's benefited thousands of people."

Assessing Iran's emergency medicine scene with experts from the Penn State Milton S. Hershey Medical Center and George Washington University Hospital in 2000, Mazaheri beheld a mixed lot.

The nation's emergency hot line, which Iranians call the 114 system, is staffed by nurses backed up by doctors.

But while Iran has many more nurses and doctors than Americans per capita, Mazaheri said, medical personnel are generally not as well trained.

And unlike American paramedics, the doctor added, many Iranian first responders lack such technology as defibrillators.

Nor are there nearly enough ambulances to cover the crowded city streets and long stretches of desert highway, where the government uses military helicopters to airlift crash victims.

Alcohol and firearms are outlawed in Iran, Mazaheri said, so ERs there rarely see gunshot wounds or drunk-driving injuries.

But they see plenty of accident victims.

Iranians do not drive timidly, Mazaheri said. That contributes to the high number of wrecks. So does the heavy traffic and the large fleet of ancient French, Japanese and Korean cars without safety features such as airbags.

The American doctors got busy.

In 2001, Mazaheri said, they brought nine Iranians to this country to study emergency medicine at Hershey and George Washington University.

The next year, according to Mazaheri, they coordinated a four-week workshop in Iran for 800 doctors and nurses. Thirteen doctors from across the United States helped teach triage and other emergency medicine techniques.

Four Iranian students are now studying medicine at George Washington, added Mazaheri, who returned from his latest trip to Iran in early December.

The majority of Iranians live in cities, Mazaheri noted.

Besides Tehran, American emergency medicine experts have visited the population centers of Esfahan, Shiraz, Tabriz and Mashad.

The Iranian government helps sponsor such trips, Mazaheri said.

Supporting the exchanges locally are Lancaster General Hospital, the Rotary Club of Lancaster and Johnson, Mirmiran & Thompson of York.

Dr. Jim Holliman of the Hershey Medical Center was deployed in Afghanistan last week and could not comment for the story.

But a Hershey plastic surgeon who worked with Mazaheri treating cleft palate children said he found the Iranians to be "friendly, warm people" interested in the main in modernization and Westernization.

"You got fed vast amounts of delicious food" by your hosts, recalled Dr. Mark Boustred of his trip in 2002.

Boustred said medical humanitarian missions are "a wonderfully uniting force" that allow people to get to know one another "without the barriers erected by politicians."

Much remains to be done, said Mazaheri, who is also working on a project to improve family health care in Iran.

American doctors are in the process of evaluating natal care, vaccinations and other preventive medicine programs, Mazaheri said.

"We're trying to create a more sophisticated health-care system. It helps the two countries to get along."

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Jon Rutter is a staff writer for the Sunday News. His e-mail address is jrutter@lnpnews.com.