In Turkey’s COVID-19 fight, the credit goes to...
My sister is a doctor. If I need medical advice, she might be the last person I call. She might return my call after I have given my last breath. Patients come first, even when off duty. That’s the type of dedication you can see in the overwhelming majority of doctors in Turkey.
Being a medical student is like getting commando training in the army. Internship means sleepless days in hospitals. “Coming home, I am faced with a dilemma; I can either take a shower and fall asleep or eat and fall asleep. I don’t have any energy left to do both and go to sleep,” an intern physician once told me.
Numbers are important, but there is a human factor behind every success story. Turkey’s relatively good handling of the novel coronavirus crisis has been attributed to its health system, among others.
I am among those who have explained the Justice and Development Party’s (AK Party) success in elections until the mid-2000s with the tangible changes it made in the lives of lower-income families, rather than its members attending Friday prayers. Health care was a priority for the AK Party. The country saw significant increases in health expenditures until 2008.
While Turkey currently has 2.81 beds for 1,000 people, putting it far behind countries like Germany or France, it is one of the top countries in Europe in the number of Intensive Care Unit (ICU) beds per capita – something that mattered in the fight against COVID-19.
In an excellent article, Evren Balta and Soli Özel explained why a country with a relatively young population has this many ICU beds.
“The answer lies in the privatization of the health sector. Almost 60 percent of the intensive care beds are in private hospitals. Intensive care services are the most expensive medical service, the costs of which services are covered by the state insurance system if the patient cannot afford their treatment. Previously, there were a multitude of reports on how private hospitals were abusing the system by unnecessarily and extensively putting patients in ICUs and charging the public for that,” wrote Balta and Özel.
But what was a source of criticism turned out to be an advantage, just as it has been with the use of computerized tomography (CT).
“There has been criticism in the past for the overuse of CT as it entails radiation risks. But this turned into an advantage in solving the diagnosis problem, since the accuracy rates of the tests stands at around 60 percent,” said Professor Önder Ergönül of Koç University. Doctors started treatment for COVID-19 by looking at CT results, which played a role in the lower fatality rates.
Yet this is also precisely at the heart of the controversy over the death toll. Only the deceased who tested positive are registered as having died from COVID-19. A patient who received COVID-19 treatment, but died without being tested, is registered as a “death due to an outbreak” or “pneumonia.”
Critics claim the number of deaths due to the pandemic to be three times as high. But if the fatality rate was twice as high, for instance, even that would mean that Turkey has handled the crisis well, especially compared to developed Western countries, according to Ergönül.
“Turkey should be proud. I think authorities need to feel self-confident and be more transparent; there is no need to hide anything,” said Ergönül.
The numbers for each city, for instance, were made available to the public only on May 27 and only partially. Once doubt creeps in due to a lack of transparency, subsequent statements won’t suffice to promote the well-merited success story.
When seeing the underperformance of some of the world’s most advanced democracies, people have difficulty understanding the relative success of developing countries, especially those where democratic standards have seen setbacks.
But where does the credit go? First of all, there are multiple factors that contributed to the relative success, including the young population, as in the case of Turkey. No doubt the Turkish government should also get credit for having invested in the health sector, which was not overwhelmed by COVID-19 patients. But let’s not forget the human factor. Turkey has skilled health care workers. In addition to their scientific abilities, Turkish physicians are used to heavy workloads.
Treatment protocols are not prepared by politicians, but by physicians, who are the students of previous generations of the health army of the Republic.
The Health Ministry’s decision to impose an additional barrier to scientific research on COVID-19 will do tremendous injustice to the physicians currently working in the field as well as to the memory of those who passed away. After all, the success story of Turkish physicians needs to be told to the world.
Those willing to do research and publish their findings have to get the consent of the ministry. This will only hamper efforts to promote Turkey’s success as it contradicts its humanitarian foreign policy. Other countries should not be deprived of knowing Turkey's best practices.