Baby deaths draw eye of health ministry

Moves to quell public anger after the death of more than 40 newborn babies within one month in a leading hospital.

Turkey's infant mortality rate is the second highest in the region, according to a health workers' union.

ISTANBUL // Turkey's government moved to quell growing public anger yesterday after the death of more than 40 newborn babies within a month in a leading hospital in the capital. Trade union officials blamed the deaths on unhygienic conditions. Ugur Dilmen, the head of the maternity department of Dr Zekai Tahir Burak Hospital in Ankara, told Turkish media that 42 of 504 newborn babies that were treated in the clinic in July had died. Dr Dilmen's statement came after the Health Workers' Union, or SES, had raised the alarm over the deaths.

The Turkish health ministry said yesterday it had established a panel to investigate the allegations. In a sign that the ministry was trying to counter growing concerns in the country, it said "all details" of the findings would be made public. A union official said 27 babies died in the hospital within three days last week compared to 170 to 180 deaths in the whole of last year. "The chief doctor and the administration say that these deaths are normal," Ibrahim Kara, head of the SES Ankara chapter, told Hurriyet newspaper. "Twenty-seven babies were lost between July 31 and August 2nd," Mr Kara said. "How normal is that?"

The NTV news channel reported yesterday that another baby had died in the hospital overnight. NTV also said the Turkish cabinet would take up the issue in its weekly meeting yesterday. The hospital, named after a doctor who worked there in the 1920s, is a major birth clinic in Ankara. A total of 26,195 babies were born in the hospital last year, up from 19,247 in 2003, according to the clinic's website.

"All over Turkey, people feel that they are not treated well by hospitals," said Sukran Dogan, an official at the SES headquarters in Ankara, adding that privatisations and cuts in hospital staff in recent years had created problems in the health sector. "The incidents in Ankara are reinforcing this impression." "House of death," read the headline of Milliyet newspaper yesterday, in reference to the Turkish word for birth clinic, dogum evi, which means "house of birth", while the daily Vatan asked: "Why did 27 babies die?"

Canan Aritman, a member of the opposition in parliament, called for political consequences. "If this had happened in another country, the health minister would resign," she told Vatan. Ms Aritman and another opposition parliamentarian, Sacid Yildiz, asked the health minister, Recep Akdag, about the baby deaths under a parliamentary procedure that requires the minister to comment. The answer could take several weeks.

The infant mortality rate in Turkey stands at 23.6 deaths per 1,000 births, SES said, quoting figures from the Organisation for Economic Co-operation and Development. Rates were much lower in European countries, the trade union said. "In our neighbourhood, only Iraq is behind us." In the UAE, the rate is about 13 infant deaths per 1,000 births. It is not the first time that a number of babies suddenly died in Turkish hospitals, but the dimension of the incident in Ankara is unprecedented. Infections killed at least 18 babies in hospitals in three Turkish provinces in 2005. At the time, experts said a lack of personnel played a part in the incidents.

According to SES, similar circumstances are behind the deaths of the babies in Ankara. The main delivery room of the Dr Zekai Tahir Burak Hospital has been undergoing repairs for three months, so births take place in other rooms that are vulnerable to infections, according to the trade union. "Instead of taking precautions, the hospital administration makes the [relatives of the babies] sign a document stating that they accept these conditions," the trade union said in a statement.

Mr Kara said two or three women had been put on the same stretcher before giving birth and that up to three babies were put in one incubator after their birth. "That means that if one baby catches an infection, that infection spreads to the other babies," he said. In addition, one nurse was responsible for about 20 babies at the state hospital, while the maximum number should not exceed 10, Mr Kara said. "In this situation, quality [of care] drops of course."

The hospital administration denied any accusation of a lack of hygiene or care. Leyla Mollamahmutoglu, the chief doctor, said the deaths occurred because the babies were premature and underweight. "About 20 babies have died in the last 15 days," she told reporters in Ankara. "Of those, two were babies [weighed] more than 1,500 grams, the other weighed less than 1,500 grams." Dr Mollamahmutoglu did not exclude the possibility that infections were responsible for the death of some of the babies, "but not all died because of infections", she said. A more detailed analysis would be possible only after the results of tests were made public in the coming days.

Dr Dilmen, the head of the maternity department, said there had been "absolutely no neglect or service mistakes" in the hospital. But relatives of babies that died in the hospital recently said they had been warned of a danger of infections. Ozmen Boyraz, 20, brother of a newborn girl that died last week, told Milliyet that doctors had spoken of a "suspicion of infection" before the girl died. Mr Boyraz also said hygienic standards in the intensive care ward for newborns had been poor. He said visitors were only asked to wash their hands before entering the intensive care unit, but did not have to cover their shoes with plastic and did not have to wear hospital coats over their clothes.

Other newspaper reports suggested that an atmosphere of panic had gripped the intensive care unit late last week. Hurriyet quoted a parent of a baby that died last week as saying that the situation in the unit suddenly changed dramatically. "When I came in on Thursday, everything was normal," the parent, identified only by the initials H B, told the newspaper. "But when I came on Friday, everything was upside down; there was panic. Some of the secretaries were crying. There was chaos in the room for the newborn babies. When a nurse saw us there, she became nervous."

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