End Excessive Force in Turkey

The Turkish Medical Association (TMA) has drawn our attention to hundreds of cases of injury and detention following police confrontations with protestors that began in response to demonstrations in Gezi Park Istanbul May 27. The majority of those injuries according to the TMA were caused by the use of water cannon and tear gas.

At the request of the TMA, the World Medical Association (WMA) sent a letter over my signature to Prime Minister Erogan June 4 condemning strongly “crowd control or riot prevention technology – such as tear gar and water cannon – that is misused, including to perpetrate human rights abuses or that is used in a manner out of proportion with the need, or against populations with particular vulnerabilities.”

In addition, the letter called on Minister Erogan “ to immediately end the excessive use of force against peaceful protestors and to ensure the right to freedom of expression and assembly.”

Unfortunately, as the world has witnessed, the violence has continued and become even more alarming. The TMA, the Human Rights Foundation of Turkey and Physicians for Human Rights (PHR) have gathered medical evidence that is a horror story of abuse of people and those in the health care community caring for them. The report indicates that:

• Police have systematically used tear gas as a weapon on hundreds of thousands of demonstrators, firing tear gas canisters and capsules directly at protestors at close range and in closed spaces, or with no outlet for escape.  Some 130,000 canisters reportedly have been used against protestors.
• The police have fired rubber bullets and live ammunition directly at protestors at close range, used water cannons spiked with tear gas, and beaten and illegally detained hundreds of protestors.
• As of July 2, 2013, the Turkish Medical Association (TMA) collected medical information on more than 8,000 injuries due to tear gas, rubber bullets, water cannons, beatings and live ammunition. Fifty-nine protestors have been seriously wounded and 11 others have lost their eyes. There have been six deaths related to tear gas canister injuries to the head at close range and/or gunshot wounds.
• The Human Rights Foundation of Turkey has conducted approximately 200 medical evaluations of injured protestors in accordance with the Istanbul Protocol standards. The physical and psychological evidence in each case is consistent with torture and/or ill treatment. Independent autopsy findings indicate that deaths by gunshot wounds and/or tear gas canisters were caused by direct shots at close range.
• In addition, the police and other law enforcement officials have deliberately attacked clearly identifiable, independent medical personal and medical facilities with tear gas, water cannons and rubber bullets. Police have beaten and illegally detained dozens of physicians and other medical personnel for providing emergency medical care to those injured by police.
• In the absence of adequate emergency services by the Ministry of Health, thousands of independent physicians and other medical personnel have provided emergency care as individuals and through the organization of the Turkish Medical Association.
• The Ministry of Health has required medical personnel to report the names of injured demonstrators and medical personnel providing care to the injured.
• One week ago, the Ministry of Health submitted a health bill to Parliament, which would criminalize the provision of emergency medical care, not only to demonstrators, but anyone in need of emergency medical assistance in Turkey.
• In addition, on July 8^th, 2013, Dr. Ali Çerkezoğlu the Secretary General of Istanbul Chamber of Medicine (*) was detained with 35 other Taksim Solidarity Platform members while on their way to Gezi Park. His home was searched without a warrant and he continues to be detained after more than 40 hours (#).

It is a reality that in areas of armed conflict around the world noncombatants are injured and killed. In addition, health professionals and facilities frequently are not afforded the status of neutrality and are subject to violent attacks even as they provide medical care. In response to the crisis in Turkey, Otmar Kloiber, Secretary General, WMA, addressed the Annual Assembly of the TMA in Ankara, June 29. Dr. Kloiber spoke on “Professional Autonomy and Self-governance as a Public Service to Patients and the Population”. He emphasized the importance to patients and the public of physicians being able to exercise their professional judgment in the care and treatment of patients without undue influence from others.

Speaking in the shadow of the conflict threatening the people of Turkey and the medical profession he concluded:

“Professional autonomy and clinical independence are derivatives of patient rights; including the right to be served by a physician who is independent from undue influence and who can serve his or her patients to the best of his or her knowledge and skills and to the best of his or her ability.

We stand for a responsible system of professionally led regulation by the medical profession that is fair, reasonable, transparent and not self-serving.

We guarantee the safety, support and confidence of the general public, as well as the honor of the profession itself.

And we do this better than governments will ever be able to do it.

In a democratic society, self-governance is an element of horizontal power sharing and therefore an important pillar of civil society and democracy itself. To remove self-governance is to remove a viable element of democracy. Removing self-governance is destructive to the social fabric of our societies.

Dear Colleagues, we are proud to stand with you. The impartial services that have been rendered by your physicians to the wounded during recent weeks deserve our respect. We ask all parties, and especially the Turkish government, to guarantee medical neutrality – even in times of conflict.

This is the only way to respect humanity in a manner befitting the great culture of this nation.”

I share the hope of Otmar Kloiber, the TMA and the people that the Turkish government will immediately end the excessive use of force against peaceful protestors and ensure the right to freedom of expression and assembly. And that it will respect the need for medical neutrality to allow physicians to meet their ethical responsibility to care for those who are ill or injured regardless of their status on either side of armed conflict.

* chamber of medicine – a.k.a. medical society or medical association
# word was received this morning from the TMA that Dr. Ali and others have been freed.