1. Staying Healthy in Turkey
STAYING HEALTHY
IN TURKEY

2. Turkey – some statistics
• Statistics
• Total population 74,816,000
• Gross national income per capita (PPP international $) 13,420
• Life expectancy at birth m/f (years) 72/77
• Probability of dying under five (per 1 000 live births) 20
• Probability of dying between 15 and 60 years m/f (per 1 000
population) 134/73
• Total expenditure on health per capita (Intl $, 2009) 965
• Total expenditure on health as % of GDP (2009) 6.7
• Figures are for 2009 unless indicated. Source: Global Health
Observatory

3. Health Issues for Turkey
• Rabies
• Water Safety
• Food Safety
• Tuberculosis
• Road Safety
• Earthquakes
• Malaria
• Other issues

4. RABIES
• Rabies is an acute viral infection that is nearly
always fatal. Transmission is usually through
saliva via the bite of an infected animal, with dogs
being the main transmitter of rabies to humans.
The World Health Organization has estimated the
annual number of human rabies deaths to be in
excess of 55,000. Most of these deaths take place
in developing countries, particularly in South and
South East Asia.

6. Rabies in Turkey
• According to the UK’s Public Health Agency,
Turkey is a ‘high-risk’ country for rabies.

8. Human Deaths in Turkey from Rabies
• After a bite from a suspected rabies-infected
animal, the development of the disease can
be prevented with appropriate post-exposure
prophylaxis. In Turkey, approximately 167,000
suspected rabies-infected animal bites are
seen in health clinics each year, and an
average of 1–3 rabies-related deaths occur
annually. Appropriate post-exposure rabies
prophylaxis is very important. Death rate after
contracting rabies is 100%.

10. If you get bitten.......
• Turkish health services have an extremely
organized and efficient system to make sure
that with prompt and correct attention the
fatal ‘worst case scenario’ can be avoided.
• Allocated state hospitals in every district carry
the rabies vaccine and will immunize for free if
a person has been bitten.

11. Ankara State Hospitals that provide
rabies vaccine:
• Saglik Bakanligi Ankara Egitim ve Arastirma
Hastanesi, Ulucanlar, Ankara
• Tel: (0312) 595 3000
• Ataturk Hastanesi, Bilkent, Ankara
• Tel: (0312) 291 2525
• For both hospitals, go to: ‘enfeksiyon
poliklinigi’

13. WATER
• Ankara’s water authority is known as “ASKI”

14. Ankara’s Water Supply
• 7 main reservoirs around Ankara and water
also supplied from the Kizilirmak River (125km
pipeline at a cost of $350 million) in order to
supply the growing needs of the city.

15. Water Testing
ASKİ water testing Laboratory uses the following
guidelines and quality controls: TS-266, ASTM,
Standard Methods, EPA and EEC standards. In
addition, water is tested from 1238 different
sources within the city and the results
published on ASKI’s (water authority’s)
website every week.

16. Ankara’s projected water demand

17. Water and Liquid Precautions
• Water should only be drunk when you are
sure of its purity.
• Try to drink bottled water whenever possible.
• This applies to water used for making ice
cubes and cleaning the teeth.
• Tap water is safe to use for cooking as long as
you are boiling it.

18. Food
• Avoid leftovers or food that may have been
exposed to the air for any length of time.
• Fish and shellfish can be hazardous at certain
times of the year, even if well cooked. Take
local advice about seafood but when in doubt
it is best to avoid.
• Vegetables should ideally be eaten when
thoroughly cooked.

19. Meat
• Meat should be freshly prepared, thoroughly
cooked and eaten hot whenever possible

20. Cheese/Milk
• Cheese and ice cream are often made from
unpasteurised milk and when in doubt, these
should only be bought from larger, well
established retailers where quality can usually
be assured.

21. Salads
• Green salads should be avoided as these are
easily contaminated by soil or flies and are
difficult to clean.
• When buying lettuces/spinach etc. make sure
that you pre-soak them and then wash each leaf
thoroughly with clean water. According to the
WHO, no bleach solution is required to clean the
fruit and veg in Turkey.

22. Tuberculosis (Tb) Incidence
According to the WHO, a country with an incidence of 44+ per 100,000 is classed as a
‘high-risk’ country...
Country Year Incidence of Tb per
100,000 per year
Turkey 1990 58
Turkey 2010 24
United Kingdom 1990 12
United Kingdom 2010 13

23. How Tb is spread...

24. Avoidance...
• Avoid crowded areas such as public transport
during rush-hour...

25. PPD Skin-testing for Tb
• In the US, annual PPD skin-testing is
recommended for folk living overseas in areas
with high incidence of Tb.
• For Turkey, have a PPD on arrival in the
country and prior to leaving Turkey.

26. Road Safety
http://www.youtube.com/watch?v=Xr
GIyWDUrX4

27. • Nearly 10,000 people lose their lives due to
traffic accidents in Turkey each year.
• And it has a lot to do with mentality. “There
really is no culture of road safety in Turkey. It's
just not part of the mentality yet,” said Dr.
Etienne Krug from the World Health
Organization (WHO)
• The total socioeconomic cost of last year's
traffic accidents could be as much as TL 16.5
billion
(source: Today’s Zaman, August 27, 2012)

28. • Only 22 per cent of drivers wear a seat belt in
Ankara
• Not wearing a seat belt, together with excess
speed, is one of the leading causes of deaths
and injuries on the road in Turkey
• Turkey, with over 23 million drivers and more
than 16 million registered vehicles on the
road, aims to cut the number of road
casualties in half in 10 years.

29. Turkey is making progress…
• In the last 10 years, deaths from accidents has
decreased by 8 percent. Compared to 2010,
the number of fatal crashes in Turkey
decreased last year by 3.6 percent, while the
number of people who lost their lives dropped
by 5.2 percent.

30. So…
• Always expect the unexpected
• Always buckle up

31. EARTHQUAKES
Turkey’s most seismically active areas......

32. • 1999 – Devastating earthquake in Istanbul
area... 17,127 killed and 43,959 injured, but
many sources suggest the actual figure may
have been closer to 45,000 dead and a similar
number injured

33. Earthquake Survival Kits
• Keep an earthquake survival kit in your
homes. For more information, go to:
http://72hours.org/index.html .

34. What to do in an earthquake...
http://www.earthquakecountry.info/d
ropcoverholdon/

35. Malaria

36. Malaria statistics…
• 9 cases of confirmed malaria in Turkey in 2010
• Prophylaxis is recommended for the
southeastern part of the country. Peak
transmission occurs from May to October
• Use insect repellent precautions

37. Other issues…
• An outbreak of Crimean-Congo hemorrhagic
fever (CCHF) was reported in May 2012 from the
Black Sea Region, causing five fatal cases: three in
residents of Kastamonu province in northern
Turkey, a shepherd from Tokat district in Tokat
province, and a farmer from Corum province. As
of June 2008, a total of 1315 confirmed cases and
63 deaths had been described. Five cases
occurred in health care providers. In the first
eight months of 2009, a total of 274 cases were
identified, of which 61 were fatal
(see Eurosurveillance and ProMED-mail).

38. • Crimean-Congo hemorrhagic fever is a life-threatening
viral infection which is usually
transmitted by ticks (less commonly by direct
contact with infected animals or by exposure to
an infected person). In Turkey, most cases occur
between May and September and most are
reported from the eastern provinces of Tokat,
Yozgat, and Sivas (see Emerging Infectious
Diseases). Initial symptoms may include fever,
muscle aches, backache, joint pains, headaches,
dizziness, and light sensitivity. Complications may
result from hemorrhage into the skin, intestine,
or other sites.

39. Use insect precautions…

40. Tick removal

41. Pharmacies/Eczanes
• Open 08.30 – 19.00 Mon-Friday
• Open 08.30 – 18.00 Saturday
• Sunday – check online for on-call pharmacy in
your district:
http://www.asm.gov.tr/eczane.htm

42. Ambulances and Hospitals
• Turkish State Ambulance 112
• MedLine Private Ambulance 4441212
• Guven Hospital 4572525 (English-speaking
coordinator's direct line = 4572535)
• Tobb Etu Hospital 2929995
• For hospital/clinic in your area when
travelling, go to: www.hastane.com.tr

43. Any questions?