We don’t do gloves!

Sometimes I am greatly amazed by little things in Turkey’s healthcare system.  Like the fancy machines.  You name it.  Turks have it.  Lots of lights and shiny metals.  And the pharmacies.  Sure, you need a prescription for some things, but there’s a lot of good stuff you can get without it.  Not to sound like an abuser.  It’s just, if you know what you need, and your insurance isn’t going to make a difference, why not?

I have been in more hospitals in the past 2.5 years than I ever have since birth.  It’s rather amazing at first blush.  In reality though, most doctors’ appointments take place at the hospitals.  Some doctors do have private offices.  But for the most part, if you need to see your doctor, you are going to the hospital.

Between my husband and me, there’s been eye specialists, diabetes specialists, heart specialists, gynecologists, obstetricians, dentists, dental specialists, dermatologists and emergency services.  Rheumatologists, no.  No rheumatologists.  They are the same as in the States.  If you want to see one, you need to make an appointment many months in advance!  For us, someone is at the hospital at least twice a month.  That doesn’t even count visiting others or trips to the hospitals in the States.

Some of the things that I am now used to seeing here, still make me take notice.  Like the hoards of people.  No one goes to the doctor without taking someone along.  Often the entire extended family will show up.  Or so it seems.

And the dim lights or no lights.  I appreciate they are saving energy.  It just strikes me every time though.

But more often, I am flabbergasted.

Pick a number.  Wait to be called.  Go to the desk to sign in and pay.  Yeah right.  Pick a number.  Wait to be called.  Go to the desk only to be pushed, shoved, and mobbed by people whose number have not been called and maybe by a few who are just curious.

Last week I waited in 8 lines, after seeing the doctor.  One to get a number for blood work.  One to get the blood work.  One for a breathing test.  Again for those results.  One for a number for an EKG.  One for the EKG.  One for a number for an x-ray.  And then one for the x-ray.  Seriously!  There were only 50 people in front of me for the x-ray.  Again, not joking.  So I left and headed to my husband’s university, looking to get the x-ray done there.  Since school was out for the summer, there was no line.  And frankly, I am a little impressed that they have all these machines too.  But I still waited.  The technician was doing a full body scan.

Total time – 4.5 hours.  Having called ahead to question about the appointment we were simply told there would be blood work.

Privacy.  Forget about it!  While you are in with a doctor, numerous people will open the door with a variety of questions.  None of them are medical professionals.   They are usually patients who are supposed to be waiting in line or a loved one of the patient who lost their way because they went out for tea.  I have literally been in a doctor’s office at Parliament.  Doctor, assistant, salesperson, and friend hanging out drinking tea.  Patient comes in.  Goes behind a screen.  No one leaves the office.

Some of my greatest concerns come from the lack of care and/or knowledge about  cleanliness.

For example, it is very rare to see antibacterial soap dispensers for use by the general public.  It is almost as rare to see them for use by the doctors.

It also completely grosses me out that people are touching everything and coughing everywhere.  This may sound the same as in the States, but with the numbers of people on any given day just standing around in Ankara hospitals, it really is a huge difference.  And in the States, people don’t feel the need to touch total strangers.

The fancy machines at the eye doctor are some of the worst when it comes to hygiene!  On each visit, you will use at least 3 or 4 machines.  So you are sitting your chin down on something and leaning your forehead against something else.  Keep in mind, they are pushing patients through as if you are on a conveyor belt.  The chin piece often has a stack of tiny papers, similar to thin post-it notes, to be pulled off for each patient.  Neither the Docs, nor the technicians, nor the patients ever do it.  The forehead piece is naked.  Never wiped down.  So last time there was this older guy who was sweating in the heat and smelled of week-old I don’t know what.  He was in front of me.  Thank God, I don’t leave home without antibacterial wipes.  I love the look of surprise on their faces when I wipe down the machine myself.  Each time, they are encouraged to stand up and rip off that little piece of paper themselves, as if they had already planned on doing it, and twice, even after I had already done it.

And then there’s blood work.  I am told that the use of rubber gloves is relatively new here.  I have had blood taken a few times, and each time, I have kept a keen eye.  Yes, they change the needle.  No, they don’t regularly swab the location with alcohol or anything else.

Last week took the cake.  I was getting blood drawn.  The line in front of me moved faster than any I had ever seen.  Sit down.  Rubber strap on arm.  Needle.  Blood.  Next patient.  That fast.  As I got closer, I noticed that not single patient was swabbed before the needle was inserted.  I also noticed that she had not changed gloves once.  I saw a lot of people go through the line in front of me.  All the same.  (Reminded me of the time the person taking blood went out for a smoke break wearing her rubber gloves, and came back with the gloves still on.)

When my turn came, I sat down and then gave my husband “the look.”  He asked the young woman to change her gloves.  She looked him in the eye and said, “We see 600 patients a day.  We don’t have time to change gloves.”  Of course I didn’t understand the transaction at the time, or I may have just kicked her stand over and ran in fear.  She quickly changed her tone and changed her gloves.  As an added bonus, she swabbed my arm too!  It was barely noticeable, but she did it!  I didn’t have to spend the rest of the day worrying about nasty infectious skin diseases.

I was going to end this post here, but I know someone will likely comment about the differences between public and private hospitals.  “Private hospitals are much better.”  “Private hospitals have less people.”  “Private hospitals are cleaner.”  Let me make it clear to my U.S. readers that the difference between the two here is nothing like it is in the States.  For instance, I like to go to University hospitals.  I believe those doctors are more on the ball because they are teaching, they have to keep up with technology and science.  I mean no disregard for those private doctors who do keep up.  But generally speaking, I expect more from University docs and usually get more.  In Turkey, most university hospitals are public, not private.  Private hospitals are full of doctors hoping to make a name for themselves.  They do have smaller hoards.  They do look cleaner with their fancy curtains, freshly painted walls, and lights!  But I have not seen any difference in their techniques.  I’ve been to both places.  There was no understanding of privacy or attempt to follow higher standards to protect patients from unnecessary illnesses  in the private hospitals.  The doctors certainly were not more knowledgeable.  In fact, those I researched were less likely to have written any texts and less likely to have studied in foreign lands.  You do the math.

Advertisements

26 thoughts on “We don’t do gloves!

  1. I’ve had the same experiences in Ankara. I would always take my mother in law with me as she has the sharp elbows. When I was pregnant, I toured a lot of hospitals – I found the public ones shockingly dirty, but had a very good experience at a private one which was all about the gloves and anti-bac wipes (not that they remembered to put toilet paper in the bathroom of course…) I don’t think you can generalize the whole of Turkey based on Ankara. Fethiye is a lot better – maybe because it is a much smaller town but still has 4 or 5 hospitals. We were in the government hospital the other day and managed to see people in five different departments and were out is about 50 minutes (10 minutes of that time was us being lost.) There is also the bonus that because there is such a high foreign population there is a dedicated foreign language department and we always have the option of going to that bit and jumping all the cues.

  2. real shame that your experiences have all been negative. After 15 years of both public and private hospitals/doctors here in rural Turkey ALL of my numerous encounters (for spinal surgery (inoperable in UK), knee surgery, routine well person clinics, blood and you name what else) I have experienced efficient, hygenic and very professional service. I grew up with the world respected UK National Health Service, which, when compared to my treatments here, looks more like a third-world set-up.
    When my sister suffered a nasty leg injury whilst visiting, she was dealt with at the state hospital, had follow up daily visits to clean and redress the wound and was deeply grateful to the doctors and nurses here. When she got back to the UK she couldn’t get the wound dressed for 10 days by which time gangrene had set in!
    One wonders what it is about Ankara that makes it the exception.

    • Interesting Alan. I doubt though that Ankara is an exception. It’s a huge city. In addition, folks are coming from around the country to hospitals here. And there’s personal perception. I’ve experienced small town vs. big town in the States. I haven’t here. But I imagine Ankara and Istanbul have the best doctors available in Turkey. Definitely pretty machines. Perhaps they just don’t have time for hygiene?

      • My personal theory on this is that although Ankara may have the best specialists, what they don’t have are the best ground level workers. Your blood isn’t usually drawn by your specialist, it’s drawn by a bored junior level doctor or an equally bored nurse who is wishing she wasn’t stuck in a clinic. So far as I am aware the amount government workers are paid varies very little depending on their location. Outside of Ankara your money goes a lot further, so the doctors, nurses and even janitors are in effect paid better in smaller towns, and have a higher incentive to work better and hold onto their jobs.

  3. Sorry to hear about your bad experience in Ankara; shame, when we were there last year, both my husband and I were so impressed with the general look of the city – tidiness etc. They need to sharpen up the healthcare though, hope so. I also had very good experiences elsewhere in Turkey, particularly in small towns. As a matter of fact, my parents go for their medical check ups at their hometown Antakya, rather than in Istanbul; cheaper, cleaner, great personal attention. Hope your next one is a much better experience!

    • Looks like I lost the reply I wrote to you Ozlem. I’ll try to remember. .. It’s really interesting that your parents leave Istanbul. I had a similar experience when I first moved to Philly. I missed the personal touches, the bedside manner, the carpeting! then I realized I was getting great healthcare. True about Ankara generally, the city is much more clean than when I first visited many years back. The municipality is doing a better job of trash pickup, planting flowers, etc. But people here still seem to throw their trash everywhere – you know the fear of bombs in trash cans! (that one always cracks me up.)

      Back to hospitals – I would rather get the good care from the doctors, and a little interest from the staff, and better hygiene than have wallpapered rooms and fresh paint. I don’t need it. Don’t need the lights either. Just a little higher standard of cleanliness.

  4. Healthcare is improving in Turkey in leaps and bounds. I would now choose to be treated in Turkey rather than the UK. Sorry you had bad experiences. The privacy issue is a problem, but I’ve always found if you explain to the doctor that you are used to no interruptions, he or she will tell the secretary to lock the door.

    • Yes it is improving. But it is still only recognized as a developing country. I have had way more experience with doctors here than I would like and I can not say that I prefer it. Y’all are making me wonder what the heck is going on in the UK?

      • healthcare in the UK is fine once you get it, but the waiting lists can be dangerously long, and the treatment usually deals with a problem that is already there, rather than correcting something that might turn into a problem later. Private care is very expensive, the NHS hospitals while perfectly adequate seem crowded and shabby when compared to the (comparatively) reasonably priced private hospitals in Turkey.

  5. I didn’t take away a totally negative picture from this story, as other commenters have. I don’t think it was meant to be 100% negative. And I agree almost entirely with the post.

    The hospitals here clearly have had money spent on them. There is an abundance of modern fancy equipment, and there are always loads of doctors and nurses working (although find me a place here, any place at all, that isn’t overstaffed and I’ll buy you a Cornetto!)

    The only thing missing, as so often, is some level of professionalism. You go to see a doctor and he’s chatting to his friends, or browsing facebook. He probably won’t stop doing so until he’s finished. The nurses are texting on their iPhones, or playing mobile games. No-one seems to clean their hands between doing anything, be it mundane thing as above or more worrying things like taking blood, moving bins around, carrying samples. Machines and even beds look positively dirty sometimes – including a blood stain on an examination table the last time I was at a hospital.

    I’ll stick to the same mantra I lived by in the UK and would in any country. Stay out of hospitals if at all possible. Hospitals are full of sick people!

  6. Its two tier here.. Oh may be three tier or may be four. Depends how much research you do before making an appointment, which doctor and which hospital and which clinic you go to. Whether you are referred to that dr by an acquaintance blah blah blah.
    I was yelled at by a US dr that I shouldn’t bother transporting my mom to US for brain surgery as the dr he referred us to in Turkey was better than the best in North America. I was like holy shit.
    Then I sprained my ankle once and went to a very famous private hospital in Ankara and almost (!) yelled at the dr that he is a retard. Then my dad showed up and yelled at them and so I was surrounded with an army of drs and nurses.
    Then my US and Canadian dr friends keep telling me how easy access we have to new meds and specialists in Turkey.
    But then I became such good friends with my family doc in Canada that she would refer me to any dr I asked for in a heart beat.
    In my experience, no matter where you go, its all about good research and good networking and unfortunately, knowing the right people. Even in Canada!

    • Also true Beyza – doesn’t necessarily address hygiene or the quality of the staff, but does address the issue of a good doctor. I won’t go to one here unless I have seen they have written several articles in the specific area of expertise I need. Bonus points if they have studied abroad. (I don’t like the system of making near-teenagers doctors – skipping 4 yr university plus med school for just med school).

      We went to an eye specialist in DC. He completely agreed with the treatment by the Turkish doctor. Don’t think he would have treated his fancy machines so poorly though.

  7. Interesting post and İ also didn’t find it totally negative. İ have had good and bad experiences. İ come from Finland where the state healthcare is still excellent and free for everyone. İ also think the lack of professionalisim among staff in Turkey is a problem. İ gave birth in Ankara and had a great doctor, check-ups and everything went smoothly. The thing İ like here is that you don’t need to waite, İ can get appointment to our closest clinic normally for same day, it’s cheap with SGK and most doctors are good but İ wouldn’t go for surgery there. İ had a small surgery this year and İ was pleased to pay for specialist and private hospital service. There has been a huge change in the system in 10 years and nowadays in many cases İ choose the treatment in Turkey and not in Fİnland. The most annoying thing for me with doctors here is that they act as they are from different world, they don’t need to explain for the patients anything and as the patients don’t need to know. İ hate that because İ want to know every detail about my treatments.

  8. We actually just got back from getting our 4 year old some vaccinations and an eye exam. Gloves, alcohol, sterile needle, and made us wait a while to check the spots for any complications. It’s worth noting that there are American-trained English speakers in town who do the right job and will refer you to other such doctors if you’re willing to pay the price$$.

  9. My experience in Ankara has been nothing like that, wether at university hospital or private ones. I guess you are talking about ODTU’s hospital here, which is the I used to go to back when I was a student there, and I cannot relate to what you wrote here.

    • Hi Reyhan, we haven’t heard from you in a while. Welcome back! No, ODTU doesn’t have a hospital. It has clinics for students and staff. I’ve been to many hospitals here, Baskent, Ankara, Ataturk, Guven, and more.

      I believe you are in another country now, but not Europe or the US, right? Have you ever spent time in hospitals in those places? It may give you a different perspective on hospitals here.

      And to all of my commenters on this post, thanks for the interest! It tried to respond to all of you. However, many of my comments were eaten by the internet yesterday. I don’t know where they went and finally gave in. But I appreciate the input.

  10. I am actually an European and until I moved to Turkey I have lived in the aforementioned continent. Also, I have visited the U.S. and had to go to hospital there once. Therefore, as somebody who has seen Europe and the U.S. I can say that the quality of the heathcare provided in Ankara is overall good.

    I have been both in hospitals and in clinics while in Ankara (I thought that building in ODTÜ was a small hospital, still it’s cheap (1TL) and the attention was good everytime I went there) and I have only had good experiences. No people opening and closing the door or staying in for no reason, the proccess was smooth, and the treatment was always the right thing.

    Also, I got my blood drawn several times and everything was hygenic, nothing like what you have described here. My only bad experience was with an ecography, but I had it done again and I was not charged for it.

    Also, as a student by paying only 33TL per month I can afford going to doctor and receiving quality attention anytime I need it for a really reasonable price.

    • Interesting background Reyhan! I guess we can all agree that the healthcare in Turkey is generally good, it’s our personal views on the cleanliness levels, and care and attention by the rest of the staff where we differ.

  11. I’m just entering the adventure of having a baby in Turkey. I never, even for a split second, considered going to the public hospital. Dirty, crowded and chaotic…I’d rather do it at home! I’m waiting to tour the brand new private hospital here. I’ve chosen to see a doctor with a private clinic because he’s supposed to be the best. I’d considered Izmir too, but I’m going to put my faith in the local system here, as really it all sounds the same. Great pre-natal care and post-delivery care that leaves a lot to be desired. The clinic is clean, modern, high tech…and expensive, unfortunately. You even have to wear little disposable booties over your shoes. However, no gloves for my blood draws…but she does swab with alcohol! 🙂
    I have to say that as much as people give healthcare in the US a hard time, I’ve had nothing but excellent experiences. Of course it’s not without problems, and I was always fortunate enough to have insurance. I also came from MA where the health care is known to be among the best. I just never questioned that the quality was good, as I find myself doing here. Perhaps that’s just because I was more comfortable, or because doctors in the US are very open to answering questions. Here, you feel as if you’re questioning God when you ask anything, or heaven forbid, differ from his/her opinion 🙂 In general, despite my concerns, I’ve always gotten good care here too..knock on wood.
    Ok, novel finished. It’s always interesting to compare!

  12. I have to agree with the people who didn’t find the post totally negative. In fact, I have to tell that the writer even did not criticize enough. Hygiene issue is a mess in public hospitals. I don’t even mention the crowded corridors of public hospitals which you can’t even walk through, and hours of waiting just to see a doctor.

    When I started to read the post, I was thinking about how doctors drove me crazy by acting like God almighty. I met only one doctor who was behaving like an ordinary human being and later I found out that he got his degree in Germany.

    By the way, I loved your blog 🙂

  13. I see what you mean, and I agree. It’s about the perception of hygiene – and not just our perception, but the hospital staff’s as well. And it doesn’t matter if it’s a public or a private hospital.
    I have a medical condition that requires me to go to the doctor every 6 months and get myself checked. This checking usually means having my blood drawn, occasional ultrasounds and the doctor physically checking my neck with his/her hands. This has been going on for 15 years now, and I can hardly remember a time when they touched my neck wearing a rubber glove. No, it’s usually bare hands smelling like cigarettes, and I always felt uneasy about that.
    However, that’s nothing compared to the things I had to or refused to endure while having my blood taken. At one time, back when I was a 8-year-old, I got treated so badly that my mother fainted because of what she saw. It was at a public hospital here in Ankara, I had waited a long line until it was my turn to meet the needle, and it was really crowded and chaotic. The so-called nurse was sitting on the chair that the patients were supposed to sit, and she made them sit on a spinning stool. Although I knew that was wrong, I couldn’t do anything about it because I was too shy, and they hadn’t let my mother in the room because it was already packed. I took my place on the stool, my feet didn’t touch the ground so I wasn’t able to fix myself to the point, and I had nowhere to rest my arm on while I’m stuck with the needle. The vampire/witch – sorry, the nurse(!) swabbed me alright, but she didn’t wear gloves. She told me to hold my arm up in the air and hold still, and then she stuck me with the needle several times until she said she couldn’t find the vein in this arm, and I should give my other arm. I was crying and it seemed to bother her so she told me to shut up. I was absolutely terrified, I gave my other arm and she stabbed me some more, that’s when I started screaming my head off. That’s when my mother barged in, and saw what was going on, and fainted. It was an absolute trauma for me and it took a long time until I could give blood without shaking like a leaf.
    Of course, now things are different. In the past few years there have been serious improvements in the system. Nevertheless, I didn’t go to that hospital again unless I absolutely had to, but never gave blood there ever since. I just used private labs and when they got really expensive, I took to the small clinics that the university doctors reside. (Like Başkent or Gazi’s clinics – small buildings, few patients, ready and able crew) 10 years ago I couldn’t have trusted these establishments since they were small, but now the system is way better and I’m guessing it’s easier to keep up with the regulations when you don’t have a huge building full of hundreds of sick people.
    Of course, it had drawbacks when I encountered bored interns (as someone above said in their comment), but I never had an experience this bad again. And over the years, I learned to demand hygiene, like the thing you do with your antibacterial wipes and then everyone remembers to be clean. Sometimes they just seem oblivious to my “demand” so I just tell them that they shouldn’t touch me without gloves or make me use those filthy stuff etc. The worst I get is unpleasant looks from them, but they know that I am right about those cleanliness rules so they just go with it. What I’m trying to say is, I think the issue is not about the healthcare system, it’s about the people. Still, I hope you have better luck from now on.

    • Wow Asli. Thanks for sharing your story. It’s strange how we can remember every detail so easily of things that were traumatic to us, but forget what we ate for breakfast this morning. And thanks for the message too, I needed the reminding that it’s the people. Hope you are well!

      • I didn’t realize you posted a reply to my comment, sorry for getting back so late! I’m well, thanks, except I don’t remember what I ate for lunch, let alone the breakfast. 😀 I guess I should be thankful that it wasn’t a traumatic meal, hehe. 🙂
        I’m really enjoying your blog, by the way.
        Wishing you all the best.
        Goodnight.

      • Good luck to you. My friend just had a baby at Guven. I’m not sure about how it would be at the govt insurance side, but she was well taken care of in the private side. Nice rooms. Nurses constantly checking on her and the little one.

        Hospitals really vary. So keep up the good work with your research. I totally agree about how docs are referred bc of language skills. you may do better to find a person who is very good at translating. (and look up what makes a translator good, bc it is not knowing the languages).

        One side note, if you want a natural birth, you really have to push for it. Docs here seem to prefer c-sections. They make more money and they can schedule them. When I was pregnant, I had many women tell me that the doctors said they would do natural birth, but when it came time, they came up with excuses of why they needed to do a c-section.

        Best to you!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s