Hospital deaths of 40 newborns shocks Turkey

[September 27, 2008]  ANKARA, Turkey (AP) -- Outside the Zekai Tahir Burak maternity hospital stands a bronze statue of a mother nursing a baby with an inscription from the Prophet Mohammed: "Paradise lies at the feet of the mother."

In July, the Ankara facility became the scene of any parent's hell. A total of 27 newborns died there within two weeks, most of them from infection.

Now Turkey is reeling from a similar tragedy at another hospital, this time in the western city of Izmir, where 13 premature babies died last weekend within 24 hours, apparently from tainted IV treatment.

The deaths at two of the nation's most modern maternity hospitals go to the heart of Turkey's uncertain status as a country energetically seeking to modernize in its bid to join the European Union - but held back by problems associated with the developing world.

The scandals have exposed a shortfall in the number of specialized neonatal units dealing with premature and high-risk babies as well as a shortage of qualified staff in a country of 70 million.

Most hospitals lack specialized premature birth units, and high-risk or premature babies are often transferred to larger hospitals in cities like Istanbul, Ankara or Izmir. Transfers and a high concentration of newborns in the same place increases the risk of infections, experts say.

Most of the infants who died in the Izmir hospital had been transferred there.

"There just isn't the facility that allows a premature baby to survive in the hospital that it was born in," said Bedriye Yorgun, who heads the Ankara-based Health and Social Services Workers' Union, which advocates improved health services. "When the babies are transferred, there is a higher chance of exposure to infection and of spreading an infection."

The government has acknowledged a shortage and has said it plans to increase the number of neonatal wards nationwide from the current 156 to 200 by 2010. It has also admitted to a shortage of more than 400 specialized doctors and thousands of nurses.

After the first deaths at the capital's Zekai Tahir Burak maternity hospital, a team of government-appointed doctors said a staff shortage had increased the risk of infection.

"There were four high-risk babies for every nurse," Dr. Fahri Ovali, one of the doctors, told reporters.

The Izmir tragedy caused a renewed explosion of outrage in this country where children are cherished and people will often stop to show affection to other people's kids.

"Such shame does not exist elsewhere in the world," read a headline in Bugun newspaper. "13 mothers' arms left empty," said Aksam newspaper.

A preliminary investigation concluded that the infants died of a bacterial infection spread by IV treatment. Further investigation is under way to see how the bacteria got mixed with the intravenous solution used to treat the infants at Izmir's Tepecik hospital. The bodies of three of the babies, who were buried immediately after their deaths, were exhumed to help with the investigation.

Some of the families have filed complaints against the hospital accusing its directors of negligence. A local prosecutor has also launched a criminal investigation into the deaths, while the main opposition party has called for a parliamentary debate on the issue.

Izmir health department head Mehmet Ozkan said the hospital believed the babies were not neglected. After the 13 deaths, the unit was placed under quarantine and no new babies have been admitted.

A chief obstetrician at Etlik Zubeyde Hanim hospital said a government decree forcing hospitals not to turn away any patients was to blame. At the Ankara maternity hospital, some of the infants had been doubled up in incubators because there were not enough, officials said.

"If there are no spare incubators and you are forced to admit more and more babies, what do you do? You have to put two babies into the same incubator, which increases the possibility of infections," he said. He spoke on condition of anonymity because of the sensitivity of the issue and because as a state-employee, he is not authorized to speak to journalists.

Yorgun, who heads the health workers' union agreed.

"The government is telling the people that no one will be turned away from hospitals, but it is not creating the conditions to allow doctors to treat everyone," she said.

[Associated Press; By SUZAN FRASER]

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