ANALYSIS: Turkey’s healthcare system: an example to follow

The novel coronavirus (COVID-19) outbreak has turned healthcare systems upside down in most European countries. It has exposed numerous inadequacies, with most healthcare systems across the globe struggling hard to cope with the challenges.

The decade-long austerity measures [1] in countries like Italy, Spain, Portugal and the UK have led to substantial budget cuts and lack of investment in national public healthcare systems. These policies resulted in serious shortages in critical equipment, hospital beds and medical personnel.

In contrast, Turkey’s healthcare system has responded well to the pandemic through effective crisis management, as well as a robust infrastructure that has been built in the last decade by the AK Party governments.

- Insufficient medical equipment and testing kits

The lack of testing and shortages of Personal Protection Equipment (PPE) remain frustrating problems in many European states. In Spain, which has one of the highest COVID-19 deaths in Europe, the government has been severely criticized for not stocking up medical equipment early enough.

More than 31 thousand healthcare professionals have been exposed to COVID-19 due to lack of PPEs, according to El Pais [2] newspaper. On 21 April, the Spanish Health Ministry admitted that shortages of PPE led to infections among many medical workers [3].

Similarly, the UK is in desperate need of PPEs. Following Turkey’s medical aid to the country on April 10, the UK formally requested Turkey to provide another 400 thousand pieces of PPE, including N95 face masks for the UK’s National Health Service (NHS). A plane with thousands of surgical gowns and 84 tons of PPE from Turkey [4] reached the UK on April 22. It comes at a perfect time to assist Britain in its fight against the pandemic.

In addition, the UK is also conducting far less testing than its fellow European states. Despite the promise of Health Secretary Matt Hancock to rump up the testing to 500 thousand a week by late April [5], the UK is still conducting around 20 thousand tests a day, which is much lower than the government’s initial target.

While many European countries require more and more PPE and cannot provide sufficient equipment for its medical staff, Turkey produces its own PPE and has been providing masks to its citizens and official residents free of charge [6]. Turkey launched a website where its citizens and official residents can register to receive five surgical masks per week, which are delivered to their door by the national postal service for free.

Although it is true that the pandemic reached Turkey at a later time than most European countries, testing is conducted in Turkey at a much higher pace than many European countries. Since the first COVID-19 case on March 11, Turkey has conducted over 800 thousand tests. This ranks Turkey number seven in the world in terms of COVID-19 testing.

- Health systems in decline

The lack of intensive care units (ICU), ventilators and hospital beds is a common problem in Europe. The capacities of hospitals in France, Spain and Italy have been strained to the maximum. Consequently, ships, trains and exhibition halls have been transformed into giant health centers.

Countries, such as Spain and Italy, experienced a serious shortage of ICU and intensive care staff. Hence, doctors were forced to prioritize ICU care for patients with the best chances of survival [7].

Despite the rising number of COVID-19 cases in Turkey, which reached almost 120 thousand, the ICU occupancy rates in Turkish hospitals have still not reached 70 per cent. Turkey has the largest number of ICU bed capacity per 100 thousand people compared to most European countries. In Turkey, there are nearly 46 ICU beds per 100 thousand people, according to 2018 data of the Turkish Ministry of Health, while the US has 34.7 and Germany 29.2 beds [8].

‘The City Hospitals’ were built as part of Turkey’s Health Transformation Program (HTP) [9]. This program was implemented between 2003-2013 to improve the health sector in Turkey by the successive AK Party governments. It is not revealing its vital importance and immense value in the fight against the coronavirus.

The Basaksehir City Hospital, which is expected to serve 32,700 patients daily with its 2,682-bed capacity in total and an indoor construction area of 1 million square meters was partially opened on April 20 to serve as a pandemic hospital until the crisis is over. According to Turkish Health Minister Fahrettin Koca, the hospital would be the largest in Europe in terms of its ICU capacity once it is completed [10].

As for the additional measures, President Erdogan has recently announced that two additional hospitals will be built in Istanbul. They are expected see completion in 45 days and will also serve as pandemic hospitals. Each will have 1000 beds.

In addition, Turkey’s Industry and Technology Ministry has initiated a private-public venture and introduced its first batch of nationally-produced ventilators. As a first delivery, 100 ventilators were sent to the Basaksehir City Hospital, and another 5000 will be delivered in May.

Turkey’s mortality rate in this period is also one of the lowest compared to many European countries. The mortality rate in Turkey is %2.3 compared to .5 in Spain, .2 in Italy, .3 in France, and .5 in the UK [11].

- A model to emulate

Turkey’s fight against the pandemic has been remarkable. The country’s crisis management strategy and healthcare system, which has been considerably upgraded during the last decade, represent a lesson for many countries today.

COVID-19 has challenged most European countries to limits and exposed deficiencies in most healthcare systems. However, this pandemic paves the way for rethinking the health strategies in Europe and the world.

Turkey’s healthcare model embodies adequate planning, resilience and commitment that all nations would do well to emulate.

By Enes Guzel

- The writer is deputy researcher at the TRT World Research Centre.

* Opinions expressed in this article are the author’s own.