Mental patients receive inhuman treatment in Turkey’s hospitals

Mental patients receive inhuman treatment in Turkey’s hospitals. (HD).

A recent NGO report has revealed the poor conditions in all of Turkey’s mental disorder hospitals, where patients are forced to bathe altogether, remain isolated for days, tied to their beds and deprived of proper rehabilitation services.

The Human Rights in Mental Health Initiative (RUSİHAK) prepared the report, “Human Rights in Mental Health 2013,” over the past three years after observations at Turkey’s six mental health disorder hospitals, located in Istanbul, Manisa, Elazığ, Adana, Samsun and Ankara, where more than 3,600 patients stay in total, between September 2011 and March 2014.

The scarcity in the number of doctors and psychologists was stated as one of the major problems seen in all six hospitals in the report.

The patients are exposed to abuse by nurses while the cleaners also beat them, the report said. The patients call the cleaners as corporals in some hospitals and most of the patients told RUHİSAK officials that they were exposed to violence by such “corporals,” the report said.

The report also revealed that all hospitals lacked any rehab or therapy services for patients. “The patients are given drugs and left with no choice but to stay indoors all day, mostly watching TV or wandering around the corridors of the hospital. Therapy and rehabilitation methods are almost not used in all hospitals,” said the report.

Some patients are forced to stay in isolation with no contact with outsiders for years, said the report, giving striking examples. Hmmmm......One more reason not to let Turkey in to Europe.Read the full story here.

Saudi Arabia: Another 4 MERS cases, all in Riyadh.

Saudi Arabia: Another 4 MERS cases, all in Riyadh.HT: Croft.

Via the KSA MOH coronavirus page: MOH: ‘Four New Cases of Novel Coronavirus Recorded in Riyadh’. This takes the Kingdom to 104 cases and 47 deaths. The full statement:

Within the framework of the constant monitoring and epidemic surveillance of the novel Coronavirus (MERS-CoV), the Ministry of Health (MOH) has announced that four new cases have been recorded.

The first case is for a 51-year-old female resident, who was in contact with a confirmed case of this virus, but her health status is stable.

The second case is for a 47-year-old female resident working at the health sector, and she suffers from some mild symptoms.

The third case is for a 39-year-old female resident working also at the health sector, and she suffers from some mild symptoms.

The fourth case is for a 38-year-old male resident working at the health sector. All of them were in contact with a confirmed case of this virus, but their health status is stable, praise be to Allah.

It sounds as if the three healthcare workers were all exposed to a single confirmed MERS patient. Or maybe not. When the reports are so brief, they lend themselves to excessive speculation.

Saudis and MERS messaging - Saudi Arabia was ranked # 158 last year on Press freedom.

YES 149 CASES!

Saudis and MERS messaging - Saudi Arabia was ranked # 158 last year on Press freedom.HT: Croft.
At Avian Flu Diary, Mike Coston has a very interesting post: MERS And Rumors Of MERS. Excerpt:

When it comes to freedom of the press, Saudi Arabia was ranked # 158 last year by Reporters Without Borders; marginally better than Cuba and Egypt, but lower than Iraq and Libya.

The Saudi government has openly prosecuted bloggers and dissidents, maintains strict control over internet content, and in 2012 was listed by the CPJ (Committee to Protect Journalists) as number 8 in the 10 Most Censored Countries. And just this week, KSA passed a law to combat cybercrime, which includes a broadly worded provision to outlaw `the dissemination of ideas that could affect public order or morality.’

All of which makes the appearance of several articles in the Arabic press (h/t Sharon Sanders of FluTrackers) over the past day or two – openly questioning the Ministry of Health’s statements on MERS – a bit surprising.

While I can’t vouch for the accuracy of any of these reports - given the stiff penalties Saudi Arabia has imposed in the past on `dissident’ voices – the mere fact that they are being published at all is remarkable.

On the epidemic blog, Andrew Rambaut has updated MERS-CoV spatial, temporal and epidemiological information. This is as detailed and documented a list of MERS cases as I've seen anywhere, and it's very current. Highly recommended.

"The Silence of MERS" - MERS-CoV cases continue to climb.

"The Silence of MERS" - MERS-CoV cases continue to climb.HT: Croft.

On his VDU's blog, Dr. Ian Mackay writes: MERS-CoV cases continue to climb. Click through to see the chart he refers to.

The latest chart of Middle East coronavirus case spikes by week combined with the accumulating tally of cases.

This paints a picture of unrelenting case growth. The curve took a sharp turn upwards in April and hasn't slowed since. This is in marked contrast to influenza A(H7N9) virus cases which were brought to a screeching halt in south east China earlier in the year.

Saudi Arabia: A note from a MERS hospital

 This morning I got a comment about my memo to the Minister of Health—not from the Minister, but from a doctor who has asked me not use his name. It's an important document, and I'm giving it a post of its own:

I totally agree with this letter and recommendations. We need to disclose the current situation and find out a way to report the cases using clear screening guidelines or even to declare the need for international help.

I wonder why we do not involve people who faced SARS a decade ago to hear from their experience. Hajj is coming where 2-3 million Muslims will come to Saudi Arabia to gather in one place for few days! Then they will go back to their countries! What are the precautions that we took in action? (Not clear) 

As a medical staff I feel embarrassed with the performance of Ministry of Health so far and I feel unsafe from acquiring the virus based on the current actions. I am writing this reply while one of our residents in ICU with MERS and one ER nurse declared dead in the same hospital this week.

In fairness to the Ministry, it invited Dr. Allison McGeer from Canada, who gained a great deal of experience with SARS, to be part of a three-person team advising the Ministry on MERS late in the spring. But I'm grateful that this doctor is in touch, and I hope he'll write again; it's invaluable to have a sense of how healthcare workers are dealing with MERS in their own hospitals.

Saudi Arabia: Four new MERS cases; 3 are asymptomatic

Thanks to DesCellBio for tweeting the link to the Arabic site of the KISA, which Google Translate renders as: Health) announce (4) cases of infection Corona new...Riyadh and the city. This brings the Saudis' total to 100 cases, 47 of them fatal. It's notable that three of the cases (one a healthcare worker) don't show symptoms. Presumably they were tested as contacts of confirmed cases. The full report:

Continued within the follow-up work and investigation carried out by the Ministry of Health virus (Corona) The new strain of the Middle East's syndrome respiratory (MERS-COV, has declared for the registration of (4) four new cases of the virus. 

First of a citizen at the age of (22) years, Mkhalt to confirmed infected with the virus, and in Medina, it did not show symptoms. 

The second case is a citizen at the age of 24 years, working in the health sector in Medina, as well as it did not show symptoms. 

The third case of a citizen at the age of 60 years area Riyadh, Mkhalt to confirmed infected, it did not show symptoms as well 

The fourth case is a citizen at the age of 47 years area Riyadh, Mkhalt to confirmed infected, and in stable condition, thankfully.
We ask God Almighty to heal the injured and Yemen They wellbeing.

Saudi Arabia: MOH complains about online MERS rumours, swears HCWs to secrecy.

Saudi Arabia: MOH complains about online MERS rumours, swears HCWs to secrecy.Croft.

Thanks to Lucie Lecomte for this post on the Arabic website of the Saudi Ministry of Health. Again, the Google translation is awful; I've done very minor editing.

Batin - Fahad Martian Directorate of Health Affairs what has been circulating in the social media in Hafr Al-Batin about the spread of the disease "Corona" in the province, confirmed the rumors untrue. The Directorate "We hope accuracy and take the information from its source in the future, as the Ministry of Health has allocated the portal has a comprehensive site for disease Koruna be announced through all cases detected, confirming that these news are baseless and can not hide such news, and demanded citizens and residents not to listen to rumors fired by some psychopaths.

's message had spread on Twitter and Alwatsab stating "باستنفار and panic among the staff of King Khaled Hospital Hafr Al-Batin after injuring three nurses Pkorona and the death of one of them, and injuring seven nurses and put them intensive care, and three deaths yesterday of Reviewers of the hospital and Mkhaltin for patients, and discreetly severely Mdercún health and taking pledge from staff not to talk about the subject at all in any media or social, "and signed the letter (b nurse and administrative at King Khaled Hafr Al-Batin and familiar with the events.)

To the extent that this is understandable, it's alarming: People passing along rumours are "psychopaths," and it sounds as if a lot of previously unknown cases have occurred among the nurses of King Khaled Hospital. And staff are being sworn to secrecy about what's going on—a step clearly borrowed from Cuban public health's response to cholera.

Dr. Ian Mackay - MERS cases jump by 8 today...biggest 24-hours in 15-months?

Dr. Ian Mackay - MERS cases jump by 8 today...biggest 24-hours in 15-months? HT: Croft.

On VDU's blog, Dr. Ian Mackay has a must-read post: MERS cases jump by 8 today...biggest 24-hours in 15-months? I was sorely tempted to run the whole thing, but here's an excerpt (with his bolding); then get out of here and go read the rest of the post.

The Kingdom of Saudi Arabia's (KSA) individual list of Middle East respiratory syndrome coronavirus (MERS-CoV) cases that have been acquired within its borders (and that's just to the best of my knowledge) is at 101. It's just a number but it's also 81.5% of all laboratory confirmed cases to date. And it rose to 124 by a jump of 8 cases today (VDU time that is).

The latest KSA cases continue to pop up in Hafr Al Batin (Batin) Medinah (Medina) and Riyadh. Contacts (~4/8), healthcare workers (~1/8) and comorbidities (~3/8) feature heavily - and that's just among the ones with those details included. We're missing sex on most and dates of onset have been getting more rare since May.

Within those 8 cases are 3 deaths (37.5% of those cases). Are these the first reports of these people? How long is the turnaround time for testing currently? This proportion is below the global proportion of fatal cases (PFC) which as of just now stands at 46% (57 deaths have data available to use in this calculation).

The other thing we should factor in is co-infections with other respiratory viruses, and with bacteria. The viruses, as noted in my previous post, may now be starting to increase in prevalence as the "cooler" months affect the region. None of the broader testing data (presumably they were screened for other pathogens as well) are available on recent cases and few details available on earlier cases.

The KSA MOH announcements are here and here. Mike Coston has a post about the cases, and Helen Branswell is making some perceptive comments on Twitter.

Useful MERS infographic: QuikStats: MERS-CoV (September 2013).

Dr. Mackay: Hafr Al Batin MERS-CoV cluster grows......

Dr. Mackay: Hafr Al Batin MERS-CoV cluster grows......HT: Croft.

On VDU's blog, Dr. Ian Mackay writes: Hafr Al Batin MERS-CoV cluster grows... Excerpt:

Apart from Riyadh's latest flurry of cases, Hafr Al Batin (Batin) has been hosting cases in healthcare workers (HCWs) since July. Lately though, we've seen seeing more HCWs - with reports suggesting as many as 10 in the cluster, and the possibility - raised via numerous local media and other reports - of more in this cluster. As with most clusters, cases seem to include human-to-human transmission events.

Is this a hospital based outbreak, a change in the virus to something more transmissible or some particular activity that is exposing people in this region to more animal host infections?

Those long-awaited MERS-CoV full genome sequences we heard about recently are still not here, but if they were, they likely won't include recent strains like the ones in Batin. We really need to get over this whole-genome fetish and get some subgenomic sequencing going to reduce turnaround time.

His post also includes a useful map of Saudi Arabia, showing Hafr Al-Batin in the northeast corner of Saudi Arabia, very close to both Kuwait and Iraq.

Arabic media reporting 5 suspected MERS cases in Turkey, Three of the family members have been "evicted" (evacuated) back to Saudi Arabia

Arabic media reporting 5 suspected MERS cases in Turkey, Three of the family members have been "evicted" (evacuated) back to Saudi Arabia.HT: Croft.

Via Mike Coston at Avian Flu Diary: Arabic Media Reporting Suspected MERS Cases In Turkey. Excerpt:

Sharon Sanders of FluTrackers has picked up a media report from the usually reliable Al Sharq, that indicates Turkey is investigating five suspected MERS-CoV cases.

Our only source on this story at present is a syntax-challenged report appearing in Arabic press. I tend to view these reports cautiously, as machine translations are inexact, and can sometimes be misleading.

The cases are supposed to be in Trabzon. The local paper has nothing about them, nor do the major national news sources. But I'll keep checking.

Via Al-Sharq, a Saudi newspaper, the report that started a lot of digging today: The death of Saudi Arabia 'Corona' in Turkey and the evacuation of 3 cases to Riyadh. A Google translation and then a comment:

Revealed the Saudi ambassador in Turkey just Mirdad for the death of Saudi woman in middle age in a hospital in Trabzon suspected of being infected with HIV Coruna.

said in a statement «East» that there are five cases suffered ill and entered the hospital, including diseased heart was organized work her out, as has been transfer of three other cases of eviction medical to the Kingdom, in addition to the case of death.

explained that the four cases and اجهتهن problems in communicating with the medical staff in the hospital by virtue of that they do not speak English or Turkish, and the hospital staff does not speak Arabic or English, called the embassy to intervention; since sent the President of the Consular Section and one of the translators of assets at the embassy to Trabzon and do the process of translation and other actions that helped them communicate.

explained that if the death was of a woman in middle age and was accompanied by her son and daughter did not write God a cure for the ill and their health status, and the embassy move her body to Istanbul, and made ​​her sons embassy and condolences, and revealed to them the situation they were in their mother and an understanding of all the details.

As has been their help in travel procedures were booking them and then went to Riyadh. And that there is a state was suffering a disease of the heart and put her pacemaker and discharged from the hospital.

between Mirdad that there is suspicion of disease Corona has not been confirmed, pointing to the attention of the Ministry of Health Turkish SUBJECT after continuing the embassy with her. explained that the charge of Turkey's senior Ministry of Health showed a keen interest in the cases, and spoke to the hospital Trabzon directly and sent a medical team sampling of cases, pointing out that the sources of the Ministry of Health Turkish suggested suspicion of injury Pkorona. , and has shown that the nature of city ​​high above sea level to 1350 meters affect human health, negatively especially those with weak infrastructure.

If I understand the basics, a Saudi family in Trabzon appears to have contracted a disease with MERS symptoms, and a female member, with heart problems, has died. What the family was doing in Trabzon (or in Turkey, for that matter) is unexplained. Nor do we know how long they had been there. The Turkish Ministry of Health (whose own website has nothing to say about this) has taken an interest in the case. Three of the family members have been "evicted" (evacuated) back to Saudi Arabia, as well as the woman's body. The Minister of Health has taken an interest in the cases, and has sent a team to Trabzon to obtain samples from the cases.
Given this level of official interest, it's surprising that the Turkish media don't seem to have anything on this story, but we can hope for more details as the weekend continues.