The Coronavirus Meets Authoritarianism in Turkey
So, first of all, we can compare Turkey to the European Union and O.E.C.D. countries. Italy has 2.5 times more medical doctors and nurses per thousand people compared to Turkey. Or, when you compare Turkey with any other O.E.C.D. country, it has fewer medical doctors and nurses per person. After this coup attempt, many people lost their jobs in many sectors. And this also includes many medical doctors and nurses, and many academics, as well. And, in addition to this, for instance, many academics—and I’m one of them—signed a petition in 2016 to ask for peace in the Kurdish question. Several professors in the medical schools also lost their jobs from that. This has an effect also on our response, but there are also structural problems.
There have also been reports that doctors who have spoken out about the threat of the coronavirus in the last few weeks had been arrested and then, in some cases, recanted their statements under pressure. Is that something that you’ve heard about?
Yeah. Turkey has a good history of medical doctors’ organizations. The Turkish Medical Association represents eighty-four per cent of the Turkish medical doctors. And from the first day they have been asking to be a participant of the process of fighting this pandemic. And, unfortunately, the Turkish government doesn’t coöperate with them. They had been asking for transparency in the process, and there is no transparency. And from the first day they have been trying to have enough P.P.E. in the hospitals. According to the Turkish Medical Association, we have a hundred medical professionals that are in Istanbul and seventy-five medical professionals in Izmir who are already infected. But this is not the only problem.
There was an infectious-disease doctor, and she was giving an internal seminar for the other medical professionals in Ankara University Hospital. And she said the cases were being underreported, and that we have to be really careful and we have to protect ourselves. And someone recorded it. A medical doctor was trying to educate other medical doctors and nurses to tell them that this is serious, but then she ended up having to apologize to the public. And this happened again two days ago. A professor who is the head of a university in Izmir said that the cases are increasing, and that the situation is more serious than in Italy. And, again, he needed to apologize. Since 2013, oppression in Turkey has unfortunately become our normal living condition.
Turkey has been a place where a lot of refugees have come from North Africa, from other places, but especially from Syria after the civil war, which displaced millions of people. How much has that strained Turkey’s medical system in the past several years?
So, it is a general rule that infectious diseases always affect the weakest in the society—poor people, working-class people, refugees, the people in prisons. So, in Turkey, we have approximately four million refugees. Turkey and the E.U. had an agreement several years ago, and these people stayed in Turkey. But in the last three weeks, even in the Turkish media, I haven’t seen anything about refugees. And of course these groups will be hit very hard by this pandemic.
The population of Turkey is already eighty million. So you are adding four million people, and it means hundreds of thousands of new potential patients to your system. The medical system is one of the best medical systems in the Middle East—I’m not saying that it is a bad medical system. What I am saying is that it is not as strong as those in the E.U. or in other O.E.C.D. countries, but, in addition to this, there has been the privatization of the hospitals. The Erdoğan government has made several changes and privatizations that weakened the system, as well.
What were they, and why did they occur?
This is a model that is coming from the United States, actually, that exports it to other countries. We didn’t have private insurance in Turkey, but, in the last ten years, people started to have private insurance. We had very few private hospitals in Turkey. Right now we have so many private hospitals, and, unfortunately, the Turkish Health Minister is the C.E.O. of one of the main private hospital chains in Turkey. So they started to see health as a commodity to make money. Health became a service, as we have here in the United States. This did not used to be the case. Health was a right in Turkey—for everyone. And everyone was covered. Right now it is still much better than America, in terms of coverage. But, still, it is not enough. And it is weaker.
What have your friends who are doctors in Turkey been saying to you recently?
I have talked to many medical doctors. First of all, they have been complaining about the equipment, the P.P.E., and about the lack of transparency. For example, they do tests today, and the results come in four days, but they want to get the results the same day, and they’re very concerned about the violence that will come from the patients’ relatives. Just before the pandemic, the Turkish Medical Association was planning to organize a very big meeting in Ankara to protest violence against medical professionals. And right now they’re worried that, as the intensive-care units will be full soon and the people will be so stressed, there will be many more deaths, which might lead to an increase in the violence.
But their main concern is the P.P.E. and working conditions. And the Turkey Medical Association’s main concern is transparency and how the Turkish government is managing the process.
Do you have a sense of why Erdoğan has reacted the way he has? Some leaders of his ilk have not taken this seriously, but others, such as Narendra Modi or Xi Jinping, have, whatever you think of them or their methods.
I was hoping that, after I saw this interview with the Minister of Health, that they would take this seriously. They have been following what is going on in the world, and I was hoping to see some lockdowns of infected cities. They closed down schools and universities, but there is not a city in Turkey that is locked down or quarantined yet. And the second thing is that the number of the tests were so low. We are really not ready for this pandemic. And if we cannot protect our health professionals from the virus in the next two weeks, we will lose people who are fighting this virus. I was hoping to see more, because we have had some time, Turkey and the United States, but, unfortunately, the government didn’t see the tsunamis coming to us. A tsunami is coming to our cities.
There are many similarities between Trump, Erdoğan, Bolsonaro. And, unfortunately, they also have a role. This is a historical moment, and in the future historians will write about this, and I think that this will be one of the factors: Was there an authoritarian leader in the country or not?
Thank you so much for talking.
Can I make one more point? In Turkey, we have approximately three hundred thousand people in prison. Of these people, many of them are over sixty, and many have chronic conditions. In addition to this, Turkey is one of the top countries that imprisons journalists, politicians, students, lawyers. So right now, in these very crowded prisons, there’s a huge risk that we might have infections, and it might kill many people. And you saw in the news in New York, which has three people per a thousand infected. In Rikers, there are twenty-seven people in a thousand that are infected. This can cause massive deaths in prison, so we have to think about these people in prison, as well. We need reform. And in Turkey they have been talking about this, but they are excluding all political prisoners.