Medical and Dental:

There are no Med Admin personnel to support personnel in Turkey.  All routine and secondary medical and dental treatment is private with authorized providers and the Support Unit pays bills.  Personnel should note that for prescription charges to be reimbursed, they will need to present the prescription and an itemized receipt or box lids.  If third line care is required, this will be dealt with on a case-by-case basis either in UK, Germany or Turkey.

  Authority for dental treatment is required and, in some instance, personal contributions will be required.

  In Ankara and Izmir, Tri-Care provide clinical governance whilst it is provided from the Secondary Care Agency (Germany) for Istanbul.

ISTANBUL

Inoculations.   If you are given sufficient warning of posting, vaccination programmes should be started at least 6 months before departure for Turkey.  (However, programmes can be completed after arrival, if necessary.)  DPRC will supply a form for all family members to obtain inoculations (from the family GP) at government expense.  Anti-malarials are not required: only South East Turkey is theoretically a malarial area; Istanbul definitely is not.                

General Immunisation Needs.   All Service personnel and dependants posted to Turkey should be up to date with the full UK schedule of primary immunisation for the area.  Medical staff will be able to advise on what inoculations are required, but currently these are:

• Triple (Diphtheria & Tetanus & Whooping Cough) and Polio.
• Measles, Mumps & Rubella.
• Diphtheria, Tetanus & Polio Boosters.

Tuberculosis (BCG).  There is a high incidence of Tuberculosis in Turkey, but we understand that since July 2005 the BCG vaccine is no longer given universally – the new programme only vaccinates babies ‘at risk’, after testing for sensitivity to the tuberculoprotein (Heaf or Mantoux test).  The Heaf test can result in a nasty boil, which in young children can last up to 6-8 months.  You should therefore seek advice on this as early as possible.                                               

Specific Immunisations for Turkey.  There are no immunisations required by law for travellers to Turkey.  However, you should be aware of the following diseases against which you should be protected:

• Typhoid.   This disease is still common in countries with low standards of sanitation and hygiene, and the organism is acquired through consuming infected food or drink.  Protection is given by immunisation with 2 doses of typhoid vaccine separated by 4 - 6 weeks with a booster given every 3 years.
• Malaria.   A potential malaria risk exists from March to the end of November in the Adana area, and from mid-May to mid-October in South Eastern Turkey.   Both regions are over 500 miles from Istanbul so precautions need not be taken unless you are actually planning to go there on holiday or duty.
• Hepatitis.  You should be protected against Hepatitis A and B
• Rabies.  There have been a few instances of rabies in Istanbul, resulting in human deaths recently.   There is a prevalence of stray dogs in the city and it is recommended that all members of the family, including ‘boarding school’ children,  have the rabies jabs, as an extra precaution.  Despite this, you should not worry unduly about stray dogs, just be sensible.

Some of these vaccinations require 2 or 3 jabs at precise intervals, which need to be carefully coordinated, so start these early to guarantee full cover. 

General Medical Preparation.   Service personnel must be medically and dentally fit on posting.  Serving members and family members are not allowed to visit the dentist in the first or last 3 months of the overseas tour, unless there is a need for emergency treatment.  Furthermore, family members should have a thorough medical and dental check up before departure from UK/Germany.  Facilities in Istanbul are good, but expensive.  The British military community uses the Out Patients Clinic of the American Hospital, located in Zekeriyaköy, which delivers routine medical care for families and provides a first class service.  If necessary, patients are referred to the Amerikan Hospital in Istanbul itself.  This system works well.  Dentists are easy to find and the NSE uses a very good practice called Confident, also located in Istanbul  The NSE has established a NATO account for both medical and dental treatments on production of a NATO ID Card.  Procedures for using these facilities will be explained on arrival.

Suggested List Of Medical Supplies.   Most medical supplies can be obtained, usually without a prescription, though drugs may be marketed under a different name or be expensive/difficult to find.  Specific brand names may not be available and where they are relied on (Calpol, types of antihistamine, etc), it may be wise to bring a stock from the UK.  In addition, local Med Centres may make up a basic supply, in which case the following are recommended:

• Good mosquito nets, repellent, coils, vaporisers (mainly needed for travel within Turkey and repellents, coils, etc, can be bought locally).
• Elastoplasts - they can be expensive and of poor quality in Istanbul.
• Antiseptics.
• Imodium.
• Analgesics (eg Paracetamol, UK Lemsip, etc.)
• Deep heat treatment.
• Anti fungal cream.
• Oral re-hydration powders.
• Sunscreen cream, and after sun cream.
• Undiluted antibiotics - especially if allergic to certain varieties.
• Calpol.
• Expectorant.
• Arnica.

However, although standards of hygiene in Turkey are not always the same as those in the UK, there are no significant problems.