Syrian doctors can't get licenses to practice in Turkey, leaving millions of new refugees fighting to find care

Hundreds
 of Syrians line up every evening at 5:30pm on a sidewalk in Istanbul’s 
Fatih district, spilling onto the street and causing a traffic jam. Most
 are mothers toting children, hoping to see a doctor at one of the 
city’s only clinics that offers them medical care. Every evening since 
last November, Bezmialem Foundation University Fatih clinic transforms 
into a facility for Syrians, where seven Syrian doctors and a handful of
 nurses treat more than 300 patients a day.  
The facility can only offer basic 
services like blood tests, x-rays, and advice on what kind of medicine 
to get, but doctors and patients say many more such clinics and more 
resources need to be devoted to meet the needs of nearly 3 million 
Syrian refugees in Turkey. With no end in sight for the war, a central 
point of concern is whether or not Syrians can find a place to call home
 in Turkey.
At the clinic’s registration desk, men 
and women form separate lines waiting to register themselves and get 
assigned to the appropriate medical specialist. In order to receive 
care, they must present a Turkish kimlik, an identification card they 
receive after registering with authorities as Syrian refugees, in order 
to qualify for temporary protection in Turkey.
Syrian refugees who have a kimlik can 
theoretically receive free medical care in Turkish public hospitals, but
 the facilities are often overcrowded and the doctors and staff do not 
speak Arabic or English, making it difficult or nearly impossible for 
patients to communicate.
“I see around 50 patients in 4 hours, 
compare that to what a Turkish doctor might deal with, say 50 patients 
in 8 hours,” says Zakaria Sallan, a pediatrician who came to Turkey two 
years ago from Damascus. “We need more clinics like this, but one 
problem is we Syrian doctors cannot get medical licenses here,” he says.
In order to practice in Turkey, 
physicians educated abroad must pass a series of exams to obtain a 
license, but currently the Turkish Ministry of Health does not, as a 
policy, allow Syrian doctors to obtain this license. “Turkish officials 
usually need an official body in the country the physician is coming 
from to certify their background, but for Syria, no such link exists 
since the start of the war,” explains Sallan. “And our Syrian leaders 
[for the refugee population in Turkey] don’t seem to care about solving 
this problem, they are not trying to cooperate with Turkish authorities 
to develop a system. If you solve the problem of licensing for Syrian 
doctors, all our other problems will be solved as well.”
Because the Bezmialem Clinic is 
technically a humanitarian facility, the doctors there cannot write 
proper referrals to Turkish hospitals, and the prescriptions they write 
are only accepted at a handful of nearby pharmacies where the workers 
overlook laws that require proper licensing for the scripts.
To cater to the demand for medical care, 
private clinics have sprung up around Istanbul where Syrian doctors 
without local licenses provide medical care. At the nearby Noor Clinic, a
 schedule on the wall lists days you can see an orthopedic specialist, a
 gynecologist, a dentist, an optician, a neurosurgeon, and other 
specialists. The clinic sees about 200 patients a day, and more than 27 
Syrian physicians are on hand. A pharmacy inside the clinic is stocked 
with basic medicines so the patients do not have to go to Turkish 
pharmacies except for a handful of tightly controlled drugs.  Patients 
pay only 15 TL ($3) to be seen by a doctor and small fees for tests.
Muhammad, 26, waits to see a pediatrician
 for his eight-year-old son, who has had a fever for a few days now.  He
 declined to give his full name because he still has family in Syria. “I
 came here because it is cheap and because in my experience the Turkish 
hospitals don’t care if you are a Syrian. They see you as a refugee and 
not as a person.” 
Muhammad says the situation has gotten so
 desperate some Syrians go back to the war zone to get medical 
treatment.  His 21-year-old brother went to a Turkish dentist last 
August to have a tooth removed. The next day his cheeks and his eyes 
were all swollen up. “So he went to the emergency room at a Turkish 
hospital and the doctor didn’t even examine him really, he gave him an 
injection and didn’t explain what it even was.” The swelling got worse, 
and over ten days Muhammad’s brother visited two government emergency 
rooms but got little attention, so he finally decided to return to a 
rebel-controlled area in Aleppo to see a doctor there. “He convinced 
some Turkish border guards at Bab al Hawa [border crossing] to let him 
through,” Muhammad explains, “and it took him a month to find a doctor 
in Aleppo, but he did, and he eventually returned to Turkey.”
“That’s the medical system here for us, 
my brother had to go back to Aleppo to get a simple thing like an 
infected tooth looked at.”
“At a Turkish hospital, first you need a 
kimlik, and even if you have one, the main problem is translation, 
sometimes they are not even trying to translate,” explains Hassan, a 
former anesthesiologist now moonlighting as a dermatologist at the Noor 
Clinic. “And there is a big disconnect between Syrian patients and 
Turkish doctors. For many simple problems they [Syrians] go to a Turkish
 hospital and they don’t treat them well, or they don’t give proper 
attention, and the problem gets much worse, even for simple things.”
Dr. Sallan, the Syrian pediatrician at 
the Bezmialem Clinic offers the example of a seven-month-old baby boy he
 recently treated. The child, named Ahmet, belonged to a family that had
 lived in Istanbul for two years, and came to see Sallan when the child 
had problems breathing. “It was a very clear problem, the child was 
malnourished because of a metabolic condition from birth, and he was 
suffering from hepatomegaly [an expanded liver].”
The family was too poor to go to a 
private clinic, so Sallan advised them to go to a public Turkish 
emergency room. The emergency room physicians though, told Ahmet’s 
family to simply give the baby more milk, so a few days later the father
 brought the child back to Sallan. “I told him the child needs glucose, 
he needs oxygen, and he needs to be constantly monitored. I don’t have 
anything to give to your child, take him again to an emergency room.” It
 took three tries before Ahmet was finally admitted into a Turkish 
government hospital, says Sallan.  “They kept him for three weeks, and 
every day the father would come visit me to tell me how the baby was 
doing. Then one day he came to tell me the baby died.”
“That baby’s condition was a clear well 
known problem, and it only got worse because he was not given proper 
attention,” Sallan says.  
“Out of say a hundred good cases, I see 
ten where [Turkish hospitals] don’t give proper attention. That’s a big 
number.  Someone should go and investigate the doctor who examined that 
baby that eventually died.”
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