Medical care in Turkey

Why Georgians do not trust their own healthcare system and how Turkey became Georgia's main care destination
Georgia has the ambition of becoming a medical tourist destination in the region. Georgian private clinics and hospitals are trying to break into the lucrative international medical tourism market by offering inexpensive and high-quality medical procedures compared to developed countries. In the early 2010s, patients began to come to Georgia mainly from neighboring Armenia and Azerbaijan, who, in addition to dentistry or plastic surgery, resorted to the services of Georgian oncologists, cardiologists, and reproductive specialists.

This trend is declining, however -- the notion of cheap but high-quality Georgian medicine is being debunked and primarily by its own citizens: Georgians trust diagnoses made in their own country less, and now more often travel to Turkey for treatment.

There are several reasons for this, experts say -- the lack of a clear plan for the development of the medical sector and the promotion of Georgia as a destination for medical tourism, the superficial nature of medical reforms, the low level of education of Georgian doctors, and deteriorating medical infrastructure

This piece is about how Turkey became Georgians' hospital. For some, Istanbul represents hope of survival; for others it is the last hope of becoming parents. What they cannot get in their own country, they are given there.

Near a tall building on one of the narrow streets of Istanbul there is a crowd. This is the Kolan Clinic, a multidisciplinary hospital.

At the entrance there is an open cafe. Here people drink coffee and smoke cigarettes. They are waiting for test results or relatives who are being examined. Large wide umbrellas protect them from the scorching sun.

If you walk along the rows between the tables, you often hear Georgian. There are many Georgians among the patients at Kolan. Those who have been treated here for many years are sitting and calmly waiting for the answers of the next analysis. Newcomers are easily spotted -- they are more worried, rushing from corner to corner.

An elderly couple is nervous; it's been two days since they arrived from Georgia. The man was diagnosed with prostate cancer and he is undergoing analysis at Kolan. They will find out his stage and whether there are metastases.

They look for Mariam with their eyes.

“Marie is our angel, without her we would not be able to do anything here,” a woman says.

Mariam Seturidze has been working at the Kolan clinic for eleven years as senior director of the Georgian department. All patients coming from Georgia for treatment to the clinic go through her. She is an organizer, translator, and psychologist.

In addition to solving all organizational issues and helping patients communicate with doctors, over the years she has learned to calm those who are desperate.

Mariam explains the details of upcoming procedures to the couple with a smile.

Her phone doesn't stop ringing. She answers calls and messages one after another, in Turkish, then in Georgian, while trying to communicate with patients waiting in the cafe.

Mariam says that over the past few years the number of patients from Georgia has increased five times. Generally, they come with oncological diseases and for a complete examination.

“Before we had three or four patients with oncological diseases from Georgia in a month; now it is more than thirty per month. Over the past month, about fifty patients have come to us from Georgia for treatment

Why Georgians don't trust their own healthcare system

A large number of cancer patients coming from Georgia to Turkish clinics are not associated with any particular increase in cancer in the country.

There are two other main reasons for this. First, Georgian patients increasingly complain about incorrect diagnoses being made in Georgia. The second reason is that Turkish clinics, which meet international standards, have a well-organized system of relations with patients.
Mariam (far left) and her colleagues from the Kolan clinic
Exactly three days later I returned home with a diagnosis. Everything was done in a very organized manner. Not a minute was lost.
It has become commonplace that Georgians arriving at clinics abroad are told that they have been misdiagnosed in their homeland.

So if they have some money or can borrow from friends or relatives, they choose to travel to Turkey for treatment of serious illnesses such as cancer.

Lela is 52 years old. She found out last month that she had breast cancer.

“Then I got worse. At one clinic I had a biopsy, at another I had an ultrasound, at a third I made an appointment with a doctor, and at a fourth they sent me for something else. I went from one hospital to another. And there are long lines for all well-known specialists. You may have to wait for months if you don't find someone you know who will grab you out of line.

The doctor directly tells you that he will only accept a picture taken by a specific specialist, because he only trusts this one. And what can you do? You have to wait. For example, my friend had serious problems with the vestibular apparatus, and he waited a whole month for the doctor to get back from vacation. It turned out that there is one high-quality specialist in this field in the country.

At home we spend and spend a lot of money, and just get more and more nervous. A friend advised me to go to Turkey. I contacted the Anadolu clinic, sent the results of my tests translated into English. They contacted me the next day and described everything in detail: what studies would be carried out, how long I would have to stay there, how much it would cost.

When I arrived I was met at the airport, brought to the clinic, and on the same day I started my examination. Everything was in one space, in one building. Exactly three days later I returned home with a diagnosis.

Everything was done in a very organized manner. I didn't waste a minute. For all this I spent about two thousand dollars. It turned out that the diagnosis of the Georgian doctor was correct, although the approaches to treatment are different. I'm so glad I went there, now I'm calmer. Fortunately my illness is at an early stage,” Lela says.
Turkey - the center of medical tourism
дNear one of the most famous landmarks of Istanbul, the mosque of Sultan Ahmed, there is a group of men with identically bandaged heads. A woman stands in front of them speaking Arabic and pointing to the mosque, telling its story. And the bandaged men around her are medical tourists. They recently had a hair transplant procedure and are now walking around Istanbul.
We met the same men in the lobby of our hotel.

Earlier, on Istiqlal, Istanbul's main shopping street, we saw a group of women with bandaged noses. They held bags in their hands and moved from store to store.

This is a common spectacle for Turks and foreign visitors.

Year by year the number of foreigners coming to Turkey for medical procedures is increasing.

Savvy Turkish travel companies offer their clients special packages -- they bring groups of people who want to undergo a hair transplant, rhinoplasty, facelifts, or detox programs for weight loss.

Low prices compared to Europe, modern medical care, several days of excursions and relaxation in Istanbul are a tempting offer.

Medical tourism is one of the fastest-growing industries in Turkey.

The scale is much larger than plastic surgery or hair transplantation, of course. In hospitals, departments such as oncology, cardiology and organ transplantation are overflowing with foreign patients.

People come to Turkey from all over the world -- from Europe (we saw a lot from Bulgaria, Romania), Arab countries, Central Asia, Russia, Ukraine, etc.
According to official data from TURKSTAT, 662,000 medical tourists went to Turkey in 2019, bringing the country an income of 1.65 billion USD.

Due to the pandemic in 2020, their number was reduced to 388,000, but in 2021 it increased again. In 2022, 642,000 medical tourists have netted 1.49
billion USD.

In the first quarter of 2022, there were 285 thousand medical tourists, the country's state budget revenue amounted to 332
million US dollars.

In the first quarter of 2022, there were 285,000 medical tourists, and the country's state budget revenue amounted to 332 million USD.
Local and international companies have already seen the great potential of Turkey's healthcare system. There are many companies and services focused on this area.

All clinics have special departments where people like Mariam help foreign patients and offer maximum comfort in addition to quality treatment.
The development of medical tourism was possible because the Turkish medical system has seen massive growth in recent years.

According to doctors working in Turkey, the development of the system at a high level is the result of sound policy in the field of education.

“The medical system in Turkey has developed a lot over the past thirty years. This success, in my opinion, is the result of sound government policy. The state has invested a lot in improving the education system, and today we treat patients from the USA and UK,” Sadiq Yildirim, professor and general and oncological surgeon, says.
Road from Georgia to Istanbul

A significant contribution to the development of medical tourism in Turkey is made by its much poorer neighbor, Georgia.

There are no exact statistics on how many people travel from Georgia to Turkey for treatment.

In the case of Georgia, the most popular item is the treatment of cancer and in vitro fertilization. Verification of diagnosis, surgery, biopsy, radiation -- for all this, Georgians turn to Turkey.

On Facebook you can often find posts about raising money for seriously ill people, often children. “The family has sold everything. All funds have been exhausted. Money is needed for treatment in Turkey.”

If the patient decides that they prefer to clarify a diagnosis made in Georgia or continue treatment in Turkey, they can quickly find contacts for representatives of the Georgian department of any clinic in Turkey through acquaintances. Such as Mariam, who works at Kolan.

First, the patient sends the results of studies already conducted in Georgia to the clinic. The patient's history is discussed by doctors and professors. After that, the clinic informs the family about the details, what tests they need to take if they come to Istanbul, how long they will have to stay and how much it will cost. The clinic also helps the patient buy a plane ticket and book a hotel room. Transportation of patients from Istanbul airport to the clinic is also provided
"It is very important to deliver patients from the airport not to the hotel, but first to the clinic. We meet them, get to know them and comfort them. In many cases people arrive very nervous and stressed out. We try to calm them down, and then we start the process,” Mariam tells us.
Istanbul airport. Photo:: Alireza Akhlaghi

Results of the tests are ready in three to four days. During this time the patient stays in their hotel and waits for answers. After receiving the results, a council of doctors decides how to continue treatment.

“Of course, if the patient gets here in time, we have a much better chance of helping they,” Mariam says.
Istanbul airport. Photo Art Bryzgalov

Initial examinations of cancer patients in Turkish clinics cost from $1500-2000.

This amount does not include more expensive genetic studies carried out in third-party laboratories. However, as Mariam tells us, patients rarely require such studies.

The cost of operations starts from $3000, and in the case of plastic surgery, it can reach up to $30,000.

“It is not easy for Georgians to suddenly find money, come to another country and do everything. So we are trying very hard to reach at least some stage so that the patient can continue treatment in Georgia. In this case, we stay in touch with them until the end and control the process. We give advice on what medicines to get and son,” Mariam says.

In Georgia, where the average salary is 1,500 lari [approximately $500] and the pension is 260 lari [approximately $80], not many people have the chance to be treated in Turkey. Usually when a family member is diagnosed with a serious illness, the family has to sell property or borrow money.

There is a government program that, in the case of cancer, finances a doctor's consultation, diagnostics, surgery, and chemotherapy/injection therapy for citizens under 18 and over 60 years of age. But state insurance does not cover treatment in other countries.

What is wrong with Georgian hospitals
Talking about the problems of the Georgian healthcare system, pediatrician and associate professor of the Department of Pediatrics Kote Chakhunashvili says the main thing is the poverty of the Georgian economy.

“Everything comes from the economy. In a country with a population of three million, economically occupying almost the last place in Europe, it is impossible to create clinics like in Turkey and still make money. Our healthcare system is also technologically backward. Some studies are not carried out at all because it is not economically viable -- the patient cannot pay for this study.

According to him, the problem is also that the bulk of the medical sector can't transcend Soviet medicine and doctors have no chance to develop.

“A doctor must look after their own development and progress, read specialized publications, publish, get acquainted with global innovations in research. But most of our doctors work 28 days a month with almost no days off, in several clinics at the same time, in order to provide themselves with at least a minimum income. Thinking about progress and development is a luxury.”

Chakhunashvili considers it a huge problem that employees in the Georgian medical sector have not yet learned how to properly communicate with patients.

“Patient healing depends on mutual understanding between doctor and patient. We often have a rude attitude towards the patient. Hopefully the new generation will fix this."

Doctor of Medical Sciences, professor and neurosurgeon Irakli Cheishvili says that today Georgian medicine focuses on the person, not on the system:

“Because we don't have a system, patients go to a specific doctor they know to be good. Everything is based on personality. There are very good doctors who individually work very well. But there is no guaranteed quality standard in clinics.

“As in everything, we need education and systemic development. In Turkey they worked very quickly and correctly. Thirty years ago medicine had a very bad reputation there. The government invested a lot of money in this area. First of all in education. Young people were sent to study in Europe and America, then they were provided with jobs and very high salaries in Turkey. In Georgia the government has the policy of high quality at the lowest possible price. It is clear that money is scarce. But medicine is a very expensive field and nothing will come of this approach, so it is impossible to reach a certain level,” Cheishvili says.

Nana, 65, is in Istanbul for the third time. The treatment of her breast tumor was successful, and now she comes for examination every six months.

She basks in the autumn sun of Istanbul and drinks coffee. Before she found this peace, however, she had a lot of trouble finding adequate care.

“We have excellent doctors in Georgia whom I trust a lot,” Nana says. "This is an ultrasound doctor,who was the first to see a very small tumor in me. But if there is an opportunity, I recommend coming here to anyone. In Turkey the system is built in such a way that you do not have to worry about anything. Everything is planned and decided, which Georgia is very far from. In the clinic everyone smiles at you, and everyone knows how to find an approach to patients. And in Georgia some doctors can't do these basic things,” she says.
ТекText: Maradia Tsaava
Video/Photo: David Pipia
editor: sopho bukia
Photocredits: Unsplash
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