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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