Contributed by Lauren Barron, MD

TRIP TO TURKEY August 1999

Day One:  Arrived in Istanbul at 10:30 am on Aug. 20^th and were picked up by a group of Americans who lived in Turkey.  There were two family physicians, a hospital administrator and a nurse among them, also a Turkish midwife named Aisha, and a German family physician named Barbara.  We traveled immediately to Izmet and Golcek by bus (approx. 2 hours from Istanbul), with a policeman who expedited our trip since he wanted to check on his own family in that area.  We saw massive damage everywhere.  It was tremendously noisy and chaotic due to traffic, helicopters, digging equipment, ambulance sirens and shouting.  We checked in at several hospitals, clinics and mobile treatment areas.  There were very few patients coming in at that time, although the initial casualties had been massive.  We spent the night at a US Navy Field Hospital, much like a MASH unit, located in the parking lot of the soccer stadium and ice skating rink in Izmet, where bodies were brought for storage.  We ate military rations and slept that night on gurneys. We were unable to contact the team of physicians from Humedica, who we were supposed to link up with, since the phones were not working and all means of communication were knocked out. 

Day Two:  Three patients, all members of the same family, came to the field hospital this morning.  The father had impressive swelling of his right arm with compartment syndrome, and was taken to surgery.  The son and daughter had soft tissue injuries from a wall falling on them.  We were still unable to connect with the Humedica team, so we decided to separate to look for them.  Mona and I hitched a ride to the governor’s office with some British press (who were very rude and kicked us out half way there!).  The “governor” is a county official and we met with him personally.  He instructed us to go the University Hospital in Izmet to help there.  Our little group now consisted of Mona,  Aisha, her friend Aidan, his cousin Ozgur, Barbara, Omar (a Turkish medical student who attached himself to our group) and myself.  We arrived at the hospital in Izmet to find more chaos.  The lunchroom of the hospital (a one story structure outside the main building) had been turned into the major treatment area. We were given food and a tent, and were told that the medical staff (what was left of them) would meet and determine how we could help.  The hospital had around 500 patients that were evacuated at the time of the earthquake.  It had not collapsed, but was dangerously unstable inside.  Many of the physicians practicing at that hospital had been killed in their homes during the earthquake.  A surgeon named Oguzhan Buyukgebiz (Oz) was orchestrating efforts at this hospital and was our primary contact there.   

Day Three:  We were asked to gather up medical supplies and go out to the rubble and tent cities to distribute supplies and treat injuries and illnesses.  We started off the day by unpacking boxes of medications to help supply a makeshift pharmacy for the hospital. (Many of the donations included expired medications!)  Then we went out to some tent cities and to the rubble in and around Izmet.  Many of the patients had wounds which we cleaned and dressed.  More of them had chronic conditions such as asthma, diabetes and hypertension, but were out of and unable to get their medications.  Scabies was also very common.  Antibiotics, antihypertensives, diabetic medications and pain medicines were the drugs most in demand.  We met a child who had been rescued from the rubble by his father after digging for two days.  There was no shortage of food or water that we could see.  Everywhere we went, the Turkish people thanked us and not infrequently offered us gifts of food or drink.   

This evening, a Turkish pulmonologist who had accompanied us on the bus invited us to her home and offered us a shower.  (We needed it, as it was hot and this was our second day without!) Her mother prepared a wonderful meal for us that included bread, olives, green beans, stuffed grape leaves, pasta, and a salad of tomatoes, cucumbers, onions, vinegar and salt and pepper.  We ate outdoors, under a tarp where her family slept for fear of another earthquake.  The sister-in-law had barely escaped with her life in Golcek and told us about how much difficulty she was having sleeping since then.  No one could talk of anything else other than the earthquake.  We had watermelon for dessert and Turkish tea afterwards, and I tried (unsuccessfully) to learn how to hold the cube of sugar under my tongue the way many Turks do when they are drinking tea.  This meal was just one example of the wonderful hospitality extended to us by Turkish people.  We slept in our tent again, back at the hospital after many unsuccessful calls to try to hook up with the Humedica team. 

Day Four:  We were ready to go out in our bus with supplies again today, but Oz asked instead for two doctors to help give tetanus immunizations at a Turkish naval base.  Mona went with Omar to do this, since they needed at least one translator.  I stayed behind with the rest of our team.  We helped to put up tents that would be used for the hospital.  A storm was coming in, and we had to hurry to get them up.  We were told that we must stay out of the rain, due to concerns about “acid rain” related to the refinery fire.  Mona returned from the navy base, and after much discussion and consideration, we decided to return to Istanbul, as there were very few patients and we had been unable to connect with Humedica.  Just then, one of the Americans who had picked us up at the airport appeared out of nowhere and offered us a ride back to Istanbul (on a nice air-conditioned bus!).  He was with a group of Americans who were working out of a church called Hope International.  He offered to help us get a room at their hotel, The Senator, in the old European section of Istanbul.   We exchanged addresses and said our goodbyes to Aisha, Barbara, Omar and our other Turkish friends.  We were not unhappy to have a real roof over our heads and a shower, but we did feel aftershocks in the hotel that night and noticed a crack on ceiling.  

Day Five:  We were unable to get a flight out of Istanbul until the next day, so we decided to see some of the city.  We took a half-day tour that included the Blue Mosque, Aya Sofia, the Hippodrome, a museum and the Grand Bazaar.  It was all amazingly beautiful and an incredible history lesson.  The mosques and minarets make the skyline different from any city I have ever seen.  Istanbul is the only city in the world that strides two continents:  Asia and Europe.  It was the old Constantinople, one of the most ancient centers of Christianity and, of course, a major focus of the Holy Wars.   I was also amazed to learn that Tarsus (as in Saul of Tarsus) was in Turkey, and that all of the seven churches in the book of Revelation are located in Turkey, called Asia Minor in the New Testament. 

Day Six:  Last Night we met two reporters from Dallas in the hotel restaurant.  We also met a man named Mel Goodwin from the Texas Baptist Men who provide disaster relief. They tried to persuade us to stay and gave us the names of more possible contacts.  We were not very optimistic, since we had talked with several of these people already.  However, this morning, we decided to try one last time to find a place to work, so we went back to Hope International to talk it over.  We found two crates of medical supplies, enough to supply a mobile clinic.  We spoke with Mike Jackson there, who agreed to help us arrange a medical trip the next day.  We were able to change our flight out to the 29th, so decided to stay.   Meanwhile, we went to a pharmacy in Istanbul to buy more medicines and supplies that we would need.  We also learned to ride the “metro” (an electric train), and took it out to Sultanhamet Square where we visited Topkapi Palace.  Later that evening, we ate at a Turkish restaurant down by Aya Sofia.  We asked the restaurant owner to sit with us and teach us some Turkish words.  He was delighted to help us, and when we told him we were helping the earthquake victims, he insisted on giving us baklava and Turkish tea “on the house”. 

Day Seven:  We hitched a ride on a bus going from the Senator to Hope International.  We met up with Chris Crossan, an American who spoke fluent Turkish and who was responsible for sending out the email on behalf of Humedica asking for physicians!  He had heard of us and knew our situation, and was invaluable in making arrangements for renting the van, and helping with our project.   His friend Louis helped us as well.  The reporters, Jay and Billy from CBS in Dallas followed us around all day, trying to get one of five stories they needed on “Texans in Turkey”.   We drove out to Golcek and stopped at a municipal center there that had a makeshift pharmacy.  We met a Turk named Aysen who joined us after hearing our plan.  She helped us to get several boxes of medications and then served as our guide out to the village areas outside of Golcek.  Our first stop was at a field that held over 200 fresh graves.  We met a man there who had jumped from a three-story building, with one of his children in each arm.  We cleaned his leg wounds and he showed us 15 graves in that field that were the graves of his own family.  He was so thankful to us, and gave us fruit from his orchard.   We met some elderly women on the road as well, who cried with us and gave us more grapes than we could carry. 

Day Eight:  This morning we were late getting started, since the bus from Hope did not show up at the hotel.  We finally hitched a ride with another reporter (who had lived in Waco!) and met Chris and Louis.  Louis brought his wife today, who was a great help, since she was a nurse.   We were running far behind schedule and decided to try to take a ferry across the Sea of Marmara to Yalova.  It turned out to be a very expensive ferry (about $60.00 for the van!), but when Mona and I jumped out of the van in our scrubs with our stethoscopes and showed copies of our credentials to the official, he let us on for free. This was almost unheard of,  according to our Turkish friends.   We arrived in Golcek and were given more boxes of medications.  We headed out to the first village and Mona treated patients while I walked with Chris to the home of a patient we had seen the previous day with cellulitis of the leg.   Her granddaughter said it was “only a short walk” but it turned out to be about a mile and a half straight up the mountain.  Fortunately her grandmother’s leg was improving significantly.  We sat and talked under an arbor outside their house that was covered with grapevines and clusters of ripe grapes.  They offered us hazelnuts from their trees and a salted yogurt drink called ayran that is very popular.   We went to two more villages and saw about 40 patients that day.   We arrived back in Istanbul quite late and ate kebaps at a small diner across from the hotel. 

Day Nine:  This morning we just happened to see Aysen, standing by the side of the road in Izmet, so she rode with us to Golcek—what luck!  This is our third morning in the villages outside of Golcek, to the south.  We have been to Selimiye, Lutfiye, Sofular and Baskiraz.  We have treated many patients with chronic conditions who are unable to get their medications, also many URI type symptoms.  There have been a moderate number of wounds and lacerations related to the earthquake.   We treated one man with presumed rib fractures, who had been crushed in his home but escaped.  Every person has an amazing story to tell about where they were and how they survived the earthquake.  Many date any new problems they are having to the quake, and report headaches or stomach upset since that time.  One man had buried his brother’s children who were missing hands and feet, another woman washed the bodies of her dead relatives and told how they just came apart in her hands.  It is not hard to understand why so many are having difficulty sleeping or having other manifestations of anxiety and depression.  I found it very ironic that we had only one tiny box of antidepressant medications in all of our supplies. 

On the way home, we stopped in the first village we had visited two days ago for lunch.  We tried to pay for our food but the shopkeeper would not allow us to pay.  A prominent men in the village insisted on bringing us tea and snacks.  We had a very long talk with him about everything from dating and marriage traditions, the practice of Islam, and burial practices.   His nephew had been killed in the earthquake.   I asked if people were angry at God and he laughed, “Who are humans to be angry at God?”  We shared a very emotional goodbye with him, knowing that we were leaving the next day.   We donated all our extra and unused supplies to the pharmacy in Golcek, and headed back to Istanbul where we said goodbye to Chris and Louis, and our trusty van driver. 

We rode the metro down to the waterfront and walked across a bridge over the Bosphorous at sunset.  Istanbul was beautiful at that time of day, with all the mosques glowing.   Then we took a taxi to an area called Taxim where we shopped and ate more Turkish food.  We chose an Ottoman style restaurant where they made stir fry dishes and stuffed crepes, also a dish like ravioli served in yogurt sauce.  Back at the hotel that night, we packed and fell asleep listening to drunken men outside on the street, four stories down, singing in the park beneath our window.