Turkish healthcare workers demand priority for PPE ahead of foreign states

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With thousands of healthcare workers already testing positive for the COVID-19 coronavirus in Turkey and dozens of fatalities recorded, the safety of the country’s healthcare workers has become a pressing concern. Medical organisations say the high rate of infection is due to a lack of personal protective equipment (PPE), and that some medical centres are still poorly equipped to handle the pandemic.

Yet while bodies like the Turkish Medical Association (TTB), Union of Healthcare Workers (SES) and Union of Turkish Pharmacologists (TEB) have been crying out for the government to hand over more PPE and solve problems in the distribution network, the Turkish government has made it a priority to ship urgently needed medical supplies to dozens of foreign countries.

“Even though we ourselves need medical equipment, we have extended a helping hand to 34 countries, including our important allies like Britain, Italy and Spain,” said Foreign Minister Mevlüt Çavuşoğlu in a video conference with the Washington-based think tanks Atlantic Council and the Turkish Heritage Organisation. “And we did not do this out of political concerns.”

Hülya Ulaşoğlu, the Izmir province co-chair for SES, told Ahval that she first thought Çavuşoğlu’s comments were a joke. “They are acting with an absolute lack of planning,” she said. “They do not have ulterior motives, but they don’t listen to public health experts or act in line with the science.”

Turkey’s healthcare workers say the government should first provide the necessary equipment to the country’s own medical professionals and citizens, and export PPE only if there are enough supplies left afterwards.

Mustafa Tamur, deputy chairman of Istanbul Family Physicians Association, told Ahval that there were serious problems and discrepancies in access to PPE in different provinces.

Family physicians’ practices in some Istanbul districts were sent a singly box of gloves, 100 single-use N95 protective masks, and one litre of hand sanitiser to last a week, Tamur said.

“When we ask the ministry, they tell us they’ve sent the equipment. In that case, either the PPE we need gets lost before it gets to us, or there are serious issues with distribution,” Tamur added. “There is no way to track the equipment.”

This is a pressing concern, Tamur said, because dozens of healthcare workers are becoming infected solely because of a lack of PPE.

Nurses and technicians have to take samples wearing only a surgical mask, which is not very effective to protect persons exposed to high concentrations of the virus, Tamur said, adding that medical staff should either be kitted out in full single-use protective body suits or should be isolated in sterilised cabins while doing so. “When you don’t do that, it is easy to fall sick.”

There have been cases of COVID-19 among district healthcare directorates, emergency services, and reception workers. Most of them are asymptomatic, and thus not tested, which results in healthcare workers spreading the virus themselves. “There is a failure in organisation in Istanbul, but in Ankara healthcare workers have started to be regularly tested,” Tamur said.

It is not only doctors and nurses who need PPE, according to Tamur. All hospital workers, including receptionists, information point advisers, cleaners and security personnel, should be provided with adequate protection. When they are covered, the efforts should extend to pharmacists, as they constantly interact with patients.

The next priority group to receive PPE should be public transportation workers, supermarket cashiers, and delivery workers, Tamur said.

Ulaşoğlu agreed that PPE should be extended to other essential workers, and added that controlling the contagion requires planned action and equally-distributed precautions.

The Istanbul Metropolitan Municipality has fitted buses and metrobuses with isolation cabins, provided drivers with PPE, and stopped using the front doors, which is a good practice, Tamur said. But all workers who have daily contact with the general population should be provided with cabins, gloves and goggles, he said, noting that several pharmacists had already died after contracting COVID-19.

Yet the Health Ministry had initially limited its provision of PPE to pulmonology specialists, leaving many others unprotected, Tamur said. And, instead of receiving bonuses, family physicians will lose up to half their salary if they are infected and need sick days, or if they are placed under quarantine, he said.

All healthcare staff should work wearing PPE at all times and should work on the assumption that everyone they come into contact with has the virus, Ulaşoğlu said, adding that personal protection also entails a safe place to stay, as in its absence the staff may end up infecting their own families at home.

Sharing information among doctors and other staff is another crucial step, public health expert Kayıhan Pala told Ahval. As the virus is a new variant and knowledge of it is scarce, information on how healthcare workers can protect themselves should be shared with all involved, including ambulance drivers and cleaners.

Stressing the importance of a sense of security, Pala said staff with mild symptoms need to be isolated in a way that would allow them to avoid risking their loved ones, including possible elderly parents or immunocompromised people.

Ahval

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