Building a bridge from Iowa to Turkiye for Children
By Bahri Karacay, Ph.D.
Amid the hustle and bustle of fast pace American life, some of us keep a certain dream alive: a dream of doing something for Turkey someday. There are those of us who in fact make some dreams come true, and succeed in building a bridge between the US and Turkey. Resmiye Oral, a professor of Pediatrics at the Carver College of Medicine of the University of Iowa, is one of those whose accomplishments in the field of child abuse are both a source of inspiration and a model for those of us who wants to go after dreams.
 (Left to right) Drs. Betül Ulukol, Figen Şahin, and Resmiye Oral |
I was still a graduate student at Nationwide Children’s Hospital in Columbus, Ohio, when I met Dr. Oral. A fellowship program in Child Abuse and Neglect had brought her to Ohio. Dr. Oral’s seemingly never-ending energy impressed me and many others whom she came in contact with. We lost touch after she finished her program and moved away. But, as we say in Turkish,” kader yollarimizi tekrar kesistirdi (destiny converged our roads again)” at the University of Iowa, when I moved there for a postdoctoral fellowship.
Oral’s journey started with a simple e-mail to her colleagues in Turkey. Her goal was to bring services to abused children in Turkey and to establish necessary infrastructure to carry out these services. In her message, she was expressing her desire to carry out educational activities in Turkey for child abuse, and asked if her colleagues would be interested in working with her. She received positive responses from colleagues working at four different universities; Ege, Ankara, Gazi, and Duzce Universities.
She made her first trip to Turkey in the spring of 2002. This six day trip included seminars focusing on establishing/increasing awareness of child abuse. “It was a success, particularly because of working together with colleagues such as Cahide Aydın, Sadık Akşit of Ege University, Ufuk Beyazova, Figen Şahin of Gazi University, Sevgi Başkan, Betül Ulukol of Ankara University, and Bora Büken of Düzce University” says Oral. Something else also happened along the way. “Every meeting became almost a preparation for the next one” she says. “I received invitations from attendees coming from different universities or cities, and we started planning educational activities for these new locations for the following year.”
There were also several colleagues who expressed interest in attending a training program in Child Abuse at the University of Iowa. Oral became a mentor for several trainees who crossed the ocean and spent several months in Iowa. Among the trainees there were three pediatricians, one forensic medicine specialists, and one psychologist who went through “Child Protection Program”, a mini fellowship program that Dr. Oral established at the University of Iowa. “Several of them became leaders of the field in Turkey after returning to Turkey, and their work accelerated the progress” says Oral and adds; “Figen Sahin who became the president of the Turkish Society for Prevention of Child Abuse and Neglect, and Fatih Yagmur, who holds an important post in the Institute of Forensic Medicine played major roles”.
These two-way activities led to the establishment of a “National Collaboration on Child Abuse”. Initially they had an annual meeting, but since 2008 they have been gathering twice a year. Meetings, which featured training activities, were held in multiple cities with three or four agencies in each city. The “International Society for Prevention of Child Abuse and Neglect”, “Turkish Society for Prevention of Child Abuse and Neglect”, universities and private funding agencies provided funding. During these meetings, they trained medical doctors on child abuse and established hospital-based multidisciplinary teams to provide child abuse services. Over the years, the number of such teams in educational hospitals increased from four in 2002, to more than thirty nationwide today.
“At this point, we realized that we needed to reach the Ministry of Health to make the next step which was to establish multidisciplinary centers around the country” says Oral. A child abuse case which captured the attention of the media outlets helped Oral and her friends’ cause. Two senators, Aşkın Aşan and Alev Dedegil reached Dr. Oral and her long-time collaborator Dr. Betül Ulukol, in their search for a proper response to particularly, child sexual abuse cases. Dr. Ulukol became a major player in the establishment of child protection centers of the Ministry of Health of the Turkish Government. This was the beginning of so called “Cocuk Izleme Merkezi- CIM” (Child Advocacy Center). The completed project will have twenty-nine CIMs throughout Turkey.
“Considering the circumstances in Turkey, we realized that the representatives of several agencies including police, gendarmerie, district prosecutor, and social services had to be present at these centers to provide an effective service” says Oral. “Now, in addition to healthcare providers, representatives of the related agencies work at CIMs”. As a result, a child reporting abuse is brought to CIM, regardless of the agency contacted initially. A trained professional interviews the child only once, and the interview is observed by a prosecutor from behind a one-way mirror. The child is medically examined once, and the case report is prepared. The final forensic report is used in prosecution of the perpetrator and protection of the child. “All these activities are completed within a half day, because all the related agencies are represented there” says Oral. “This way an extraordinary importance is given to patient confidentiality and the whole process is finished within a day, which would otherwise take one or two weeks”. Ankara CIM alone served more than 1500 children since 2010.
Oral also supports the “Cocuk Koruma Merkezleri (CKM).” CKMs are established by the universities with the same purpose. “Although CIMs and CKMs are working independent of each other at the moment, I hope these two models will be joined in a near future under the same umbrella” says Oral. “Because as the public becomes aware of the humanitarian and rehabilitative management of child abuse, more cases will come to light, and the number of reported cases will increase”. This, she predicts, will force CIM and CKM to join forces.
The success of Dr. Oral and her colleagues has not escaped from the attention of the International Society for Prevention of Child Abuse and Neglect’s organizers. As a result, the 19th World Child Abuse Meeting was held in Istanbul, in 2012.
Dr. Oral says seeing the fruits of her and her colleagues’ efforts is extremely rewarding for herself as well as for her colleagues. Recently, another circle added to Dr. Oral and her colleagues’ chain of success; lawmakers added a section on child abuse to the new Turkish Constitution.
Bahri Karacay, Ph.D. is an adjunct associate professor of pediatrics at the Carver College of Medicine, at the University of Iowa. He is a member of the “Health and Biomedical Sciences Technical Group” of TASSA. bahri-karacay@uiowa.edu
(Left to right) Drs. Figen Şahin, Betül Ulukol, and Resmiye Oral