Turkey cois report November 2006

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Trafficking
25.01 As noted in the USSD 2005 report:
“The law prohibits trafficking in persons; however, there were reports of trafficking in women and children to, from, and within the country for the purpose of sexual exploitation. There were allegations that police corruption at all levels contributed to the trafficking problem. The law punishes trafficking with prison terms ranging from 8 to 12 years’ imprisonment in addition to heavy fines. The new penal code came into effect in June [2005] and specifically addresses trafficking as a crime. However, prosecutors have mostly tended to use other articles that regulate prostitution, rather than the new law on trafficking, which has rendered the new law nearly ineffective.” [5b] (Section 5)
25.02 The USSD 2005 report continued:
“The government reported that prosecutors opened 75 cases against alleged traffickers during the year through September. Courts convicted 29 defendants and acquitted 75 on trafficking charges during that period. Several cases were ongoing at year’s end… The country was a destination and source for trafficked persons. The government placed at 235 the number of identified trafficking victims during the year. Various NGOs operating in the country and in neighboring source countries estimated the number of trafficking victims to be nearly 10 times that figure.” [5b] (Section 5)
25.03 The European Commission 2005 report stated:
“Articles 79-80 of the Penal Code, which came into force in June 2005, substantially increase penalties for smuggling and trafficking persons. When the offences are committed by an organisation, the penalties are increased further. The Penal Code also provides for the freezing and confiscation of assets of smugglers and traffickers. The Turkish authorities arrested several members of organised human trafficking gangs in the first nine months of 2005.” [71d] (p112)
25.04 The EC 2005 also recorded that “54,810 illegal migrants were apprehended in Turkey in 2004 (compared to 48,055 in 2003). The Turkish authorities apprehended 7,470 illegal migrants in the first quarter of 2005.” [71d] (p111)
25.05 The EC 2006 report noted that:
“Progress has continued in the field of trafficking in human beings. The Government maintained co-operation with the International Organisation for Migration (IOM) in this field. The Counter-Trafficking Programme continued. The free emergency helpline for trafficking victims rescued in total 98 individuals as of August 2006. There was a sharp increase in the number of the individuals assisted for their return to their countries of origin. In 2005, out of 256 persons identified as victims of trafficking, 220 received direct assistance for return. 125 traffickers were arrested in 2005 and 330 were arrested as of September 2006.” [71a] (p65)
25.06 The EC 2006 report further noted that:
“In addition to the Istanbul shelter opened in 2004, an Ankara-based shelter for victims of trafficking was set up. In February, a co-operation and information exchange protocol was signed with Moldova. Turkey's legislation is well aligned with EU legislation on fighting trafficking in human beings; however, increased efforts are needed to enhance the administrative capacity to deal with prevention and repression of trafficking as the problem in the region is on the rise.” [71a] (p64)
25.07 As noted in the US Department of State ‘Trafficking in Persons Report’, released on 3 June 2005:
“Turkey is a transit and destination country for women and children trafficked primarily for sexual exploitation. Some men, women, and children are also trafficked for forced labor. There has been increasing evidence of internal trafficking of Turkish citizens for forced labor and sexual exploitation. Most victims come from Eastern Europe and the former Soviet Union, including Moldova, Ukraine, Russia, Azerbaijan, Kyrgyzstan, Georgia, Romania, Kazakhstan, Uzbekistan, and Belarus.” [5d] (Country narratives – Turkey)
25.08 The USSD ‘Trafficking in Persons Report’ continued:
“The Government of Turkey does not fully comply with the minimum standards for the elimination of trafficking: however, it is making significant efforts to do so. Over the last year, the government stepped up its training of law enforcement personnel to increase victim identification and end the automatic deportation and removal of victims. As a result, Turkish officials have improved their screening and identification of victims. However, the government needs to take more preemptive steps to ensure that there is a corresponding increase in convictions and sentences for traffickers. Despite the government’s increased efforts to raise understanding of the trafficking phenomenon, the level of awareness among some members of the judiciary and the general public remains low.” [5d] (Country narratives – Turkey)
25.09 The Trafficking in Persons Report 2005 continued:
“The Government of Turkey has taken substantial measures over the past year to improve its enforcement efforts. In October and December 2004, Turkey made significant revisions to its penal code and code of criminal procedures, including expanding investigative tools in trafficking cases and increasing punishments for traffickers. The government funded domestic and international anti-trafficking operations, specifically for training. In 2004, this covered more than 400 police, 120 Jandarma, and 160 judges. The government reportedly initiated 142 prosecutions for suspected trafficking crimes during 2004, a large increase over 2003 figures. Five cases for which information was provided produced convictions. The government failed to provide detailed follow-up information on the remaining cases.” [5d] (Country narratives – Turkey)
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25.10 The Trafficking in Persons Report 2005 further noted:
“The Government of Turkey has taken significant steps to halt past practices of automatic deportation of victims. The police and Jandarma are actively cooperating with an NGO shelter and implementing a protocol for victim referrals. As a result of training and awareness campaigns, law enforcement successfully identified 265 victims in 2004, an exponential increase over the handful identified in 2003… The government has implemented a new policy to provide full medical assistance to victims of trafficking. In addition, the government issued humanitarian visas to 13 victims, allowing them to stay in Turkey and receive government services. The Turkish Jandarma printed and distributed 9,000 anti-trafficking brochures to police precincts and citizens throughout Turkey. Although the government established a hotline for trafficking victims in 2004, it has not yet implemented a large-scale, targeted information campaign. Most recently, the government publicly launched its 2005 counter-trafficking campaign, which is too recent to show results.” [5d] (Country narratives – Turkey)
25.11 As recorded in the International Helsinki Federation for Human Rights (IHF) report of June 2006:
“In 2004, a paragraph was added to article 90 of the constitution, recognizing the supremacy of ‘international agreements in the area of fundamental rights and freedoms duly put into effect’ over national law. A series of laws that came into force in June 2005, amending key provisions that had led to the prosecution of peaceful speech and introducing provisions against ‘honor killings’ and the trafficking of women as well as for the protection of children and combating the impunity of officials involved in gross human rights violations.” [10a] (p435)
25.12 As recorded on the website of the Turkish Ministry of Foreign Affairs last updated on 16 September 2005:
“157 the toll free, tip-off number/emergency helpline for the victims of trafficking, open 24 hours a day, seven days a week, accessible throughout Turkey including mobile phones will be operational soon. A shelter in Istanbul has been established for the victims of trafficking. Victims can benefit from this service free of charge.” [60c]
25.13 The European Commission 2006 report further stated that:
“Overall, some progress can be reported, particularly in the areas of asylum, border management, fight against trafficking in human beings, customs and police cooperation. Alignment with the acquis in this chapter is underway but considerable and sustained efforts are required in areas such as migration, the fight against organised crime, money laundering and judicial cooperation in civil and criminal matters.” [71a] (p65)
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Recent developments in counter trafficking

25.14 As recorded on the website of the Turkish Ministry of Foreign Affairs last updated 16 September 2005:
“Ministry of Foreign Affairs is responsible for national coordination of issues related to Trafficking in Human Beings (THB) in Turkey. The National Task Force has prepared an ‘Action Plan on Combating Trafficking in Human Beings’ which was approved by the Prime Ministry. In accordance with this Action Plan, under the guidance of the Ministry of Foreign Affairs, a shelter in Istanbul is established for the victims. A protocol regarding the shelter was signed between Istanbul Metropolitan Municipality and Human Resources Development Foundation (HRDF) during the NATO Summit in June 2004, with the participation of Deputy Prime Minister and Minister of Foreign Affairs Abdullah Gul and former Secretary of State of the USA Colin Powell. Establishment of shelters in Ankara, Izmir, Antalya and Adana / Mersin is also planned.” [60d]
25.15 The same website also noted that:
“In order to inform the foreigners visiting Turkey regarding THB issue, leaflets including necessary info and helpline number ‘157’ have been designed, within the framework of the project aiming to assist victims of trafficking which has a budget of 700.000 USD. These inserts will be distributed at the border gates, primarily Istanbul Ataturk and Antalya Airports. In conjunction with this project that is realized in cooperation with the International Organization for Migration (IOM), there will be spot programs in Turkish national TV Channel TRT. Furthermore, trainings for law enforcement officials are also planned in this context. Within the framework of the National Action Plan, financial support from the Social Aid and Solidarity Fund is available for the victims of trafficking.” [60d]
Training activities
25.16 The Turkish Ministry of Foreign Affairs noted that:
“In 2004, 516 police officers, 266 gendarmerie personnel, 164 judges and prosecutors have received training on counter trafficking. Combating trafficking in human beings is also included in the curriculum of the Gendarmerie Schools.” [60d]
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Medical issues
Overview of availability of medical treatment and drugs
26.01 As noted in the United Nations Development Programme (UNDP) Human Development Report 2005 (Country Fact Sheets, Turkey) “Turkey is ranked 94th in the 2005 Human Development Report, with an HDI value of 0.750.” The HDI rank for 2003 (177 countries) was 94, with an HDI value of 0.750. [35a]
26.02 As noted in a letter from the British Embassy in Ankara to the Home Office dated 11 April 2006 “According to the Turkish Health Ministry, in 2003 there were 1,130 hospitals with a bed capacity of 164,897. The total number of physicians was 93,200 with 748 people per physician.” [4m]
26.03 The Foreign and Commonwealth Office reported in 2001 that if the patient has contributed to a social security scheme (SSK, BAG KUR, EMEKLI or SANDIGI), his or her cost of treatment will be met. A person who has not made social security contributions and who does not have his/her own financial means and can show that he/she is penniless, is provided with free treatment by the state. [4a]
26.04 On 21 February 2005 the Turkish Daily News reported that a law to transfer ownership of Social Security Authority (SSK) hospitals to the Health Ministry had come into effect over the weekend.
“The law also transfers health facilities owned by Postal and Telecommunications General Directorate (PTT) and Ziraat Bank to the ministry. SSK hospitals will from now on be run like other state-owned medical facilities. SSK members will still have to obtain referrals from their local hospital for treatment at university hospitals… Numerous political parties, nongovernmental organizations and labor groups criticized the government decision to transfer the hospitals to the Health Ministry. Those opposing to the law said the government intended to privatize the health sector, with many people only getting the treatment they could afford. The government decision is a small part of the social security reform process currently under way to ease the burden on taxpayers. Despite being owned by the SSK, hospitals are a drain to the state because of the huge losses they incur.” [23p]
26.05 As reported in the letter from the British Embassy in Ankara to the Home Office dated 11 April 2006 “AKP contacts recently told the Embassy that the government would shortly pass two critical pieces of legislation regarding the health and social security system. One would bring three separate social security institutions under a single roof and the other would introduce general health insurance and a GP system in Turkey. These two pieces of legislation were cleared through the Parliamentary Committee stages in March 2006.” [4m]
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26.06 The US State Department’s Consular Information Sheet on Turkey dated 3 August 2006 and current at 04 October 2006, stated:
“Turkish hospitals vary greatly. The new, private hospitals in Ankara and Istanbul have modern facilities and equipment, and numerous U.S.-trained specialists, but still may be unable to treat certain serious conditions. Those planning to remain in Turkey should consider bringing a six-month supply of necessary chronic medications (e.g., heart medications, birth control pills). Nursing care and diagnostic testing (including mammograms) are not up to American standards. Health care standards are lower in small cities in Turkey in comparison to bigger cities such as Ankara, Istanbul, Izmir and Adana.” [5f]
26.07 The Emergency Medicine in Turkey website last updated on 14 June 2006 noted that:
“More than 5000 public health care clinics are located in cities and villages around the country. Many people visit one of these or a pharmacist directly, for care of simple illnesses. If a person obtains a certificate from the neighborhood representative, he or she can receive free health care from government hospitals. Most of the almost 1300 hospitals belong to the government and are known as government hospitals, social insurance hospitals, or university hospitals. Persons are bound to receive care at one type of hospital on the basis of their health insurance type; however, approximately one third of the population has no health insurance. Recent efforts have been started to centralize the care given by the government and social insurance hospitals. The government is required by law to only provide primary medical care to Turkish citizens in the government hospitals.“ [59] (eMedicine)
Pharmacies
26.08 The Middle East Expats Online Community Resources & Forums website last updated on 6 January 2006, recorded:
“Eczanes (Pharmacies) are open from 09:00 -19:00 on weekdays and Saturdays. They are closed on Sundays but there is always one, open 24 hours in each neighbourhood. Every pharmacy will have a display in its window (which is posted each evening, on Sunday, and on statutory and religious holidays) listing the name and location of the pohen pharmacy, or Nöbetçi Eczane.” [50]
26.09 The same website also recorded:
“Private hospitals are preferred by patients of middle and upper classes. Despite the fact that state hospitals are sometimes better equipped than the some of private hospitals, many patients prefer going to a private hospital because of the personal and friendly care offered.
 Acibademköy – Istanbul. Website: http://www.acibadem.com.tr/English/

 Acibadem Hospital, Carousel, Istanbul - Website: http://www.acibadem.com.tr/English/

 Acibadem Hospital, Kadiköy - Website: http://www.acibadem.com.tr/English/

 Amiral Bristol American Hospital - Güzelbahçe Sokak, 20 Nişantaşı Istanbul.

 German Hospital, Sıraselviler Caddesi, 119 Taksim Istanbul.
State Hospitals – due to limited funding, Turkish state hospitals don’t have the best sanitary conditions. They are always full of patients and have endless queues. The lack of hygiene, lack of staff and lack of care is easily felt. Ironically however, they have some of the most well-known and respected doctors on staff, particularly at the university hospitals.” [50]
HIV/AIDS – anti-retroviral treatment
26.10 Acquir Immune Defic Syndr journal published a letter to the editor 5 December 2004, and noted that:
“Since 1985 when the first AIDS case was reported in Turkey, the number of persons with HIV infection has increased. By December 2003, there were 1712 HIV-infected patients. The striking increase in the number of HIV patients in recent years suggests that HIV/AIDS will become a priority public health concern in Turkey in coming years. Antiretroviral therapy is a key element in the overall management of HIV infection. Antiretroviral treatment guidelines are changing at an enormous pace. AIDS has yet to be taken seriously in our country, mainly due to the low number of known cases… In March of 2004 the Department of Health and Human Services (DHSS) updated the Antiretroviral Treatment Guidelines, including recommendations regarding ‘preferred’ and ‘alternative’ treatment modalities… Efavirenz is referred to as a ‘preferred’ drug, but the drug has yet to be marketed in Turkey. Conversely, the preferred protease inhibitor (PI) lopinovir/ritonivir is available in Turkey…” [46]
26.11 As reported by the Turkish Daily News on 5 December 2005:
“The number of HIV patients registered in Turkey in the past 20 years is less than 2,000, but officials warn that the true figure of those infected is estimated to be at least five times higher… Turan Buzgan, general manager of the Health Ministry’s Basic Medical Services, said they had initiated a program aimed at providing an education in AIDS risk and prevention for hard-to-reach groups, including gays and lesbians, prison inmates, prostitutes and drug addicts. Buzgan claims Turkey has approximately 2,000 people infected with AIDS…As of the end of 2004, there were 551 AIDS sufferers and 1,371 carriers, he said, noting that they believed the official figure would surpass the 2,000 mark in 2005.” [23o]
26.12 The United Nations Programme on HIV/AIDS reported in December 2003 that “At the end of 2002, Turkey had a cumulative total of 1,515 reported HIV/AIDS cases. 1.98% are among children under 15 and 33% are among women… To ensure blood safety, commercial blood donation has been fully abolished. The government ensures that all HIV infected patients receive antiretroviral treatment.” [39]
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26.13 In December 2001 the Foreign and Commonwealth Office contacted Hacetepe University, Ankara, which provides world-standard treatment for HIV and AIDS. The University confirmed that such drugs such as thyroxine, sequinavir, D4T, 3TC, acyclovir, zirtek, diflucon and metoclopramide, or their substitutes, are available in Turkey. [4a]
Cancer treatment
26.14 The International Observatory on End of Life Care website, dated 2006, stated that:
“Turkey is an area where supportive care with hospice/ palliative care is linked to the development of other services, particularly within hospital based oncology units… There are no specialist palliative care services in Turkey. Medical oncology units and departments of algology (pain) at major hospitals in the country provide pain control and symptom relief. Oncologists and pain specialists in seven hospitals report actively working to establish the concepts of palliative care... The majority of cancer patients are treated in university hospitals that support units with pain specialists and medical oncologists… Some specialist cancer state hospitals such as the Dr Ahmet Andicen Oncology Hospital and Demetevler Oncology Hospital will provide pain relief and symptom management. No information, however, is currently available about the development of palliative care services in the state hospital system or the development of training in the 57 medical schools around the country. There are around 30 specialist ‘pain centres’ and 20 medical faculties with departments of algology in Turkey. There are no reported activities for paediatric palliative care.” [33] (current palliative services)
26.15 The same website also noted that:
“Individual physicians (and their colleagues) have reported active involvement in developing the concepts of palliative care within departments and units in three main areas of the country; in Ankara, a pain specialist at Hacettepe University Hospital, three oncologists, one at Başkent University Hospital, one in the Gulhane Military Academy, (GATA) and one at Gazi University Hospital; in Istanbul, a pain specialist at the Istanbul University Medical Faculty and two oncologists at the Marmara University Medical Faculty; there is one pulmonary specialist developing concepts of palliative care at the Pamukkale University Medical School, Denizli. Medical and nursing professionals have also expressed interest in palliative care at Ankara University Faculty of Medicine.” [33] (current palliative services)
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Kidney dialysis
26.16 The Oxford Journal dated 2002 stated that “The majority of dialysis treatments in Turkey are carried out in centres belonging to the Ministry of Health and in private centres. In the last decade, private centres have played an important role in providing sufficient beds for haemodialysis patients.” [32] Some of the dialysis centres listed by The Middle East Expats Online Community Resources & Forums website are:
Kidney Health & Dialysis Hospital

Address: Osmaniye Mevkii E-5 Karayolu Üzeri

Bahçelievler, Istanbul
Elmalik Dialysis Center

Elmalik Köyü Elmalik, Ankara, 06490 Turkey

Alanya Hospital And Dialysis Center

Saray Mah.Yunus Emre Cad.No:1, Alanya, 07400 Turkey

[50]
Mental health
26.17 As recorded in the World Health Organisation’s (WHO) Department of Mental Health and Substance Dependence Mental Health Atlas 2005 the country has disability benefits for persons with mental disorders. “After being approved by a mental health board as a chronic mental health patient, the patient can benefit from the social security services… Mental health is part of the primary health care system. Actual treatment of severe mental health is available at the primary level… Mental health in primary care is available in only some provinces… Regular training of primary care professional [sic] in the field of mental health is present and the approximate number of personnel trained over the last two years totalled 3,000.” [37a] (Section on Mental Health Financing)
26.18 The WHO Mental Health Atlas 2005 further states that there are 1.3 psychiatric beds per 10,000 population, one neurosurgeon, one neurologist, one psychologist and one social worker per 100,000 population. [37a] (Section on Mental Health Financing)
26.19 The Foreign and Commonwealth Office contacted Hacettepe University Hospital Psychiatric Department in April 2002 and confirmed that antipsychotic and antidepressant medication is available in Turkey. [4b]