InterPress News Service (IPS); 17 September 1996.
Nadire Mater

A closed, largely forgotten community, the small village of Bozlak outside the south-eastern city of Urfa has been torn open by the case of young mother Muzeyyen Isikgoz, left HIV-positive by a tainted blood transfusion.

The virus may have already spread throughout the poverty- stricken village, where medical equipment is so scarce that syringe needles are routinely reused -- even to inoculate animal livestock.

Meanwhile Muzeyyen and her husband Sedat, the village's Muslim Iman, have been driven out by angry villagers, fearful of what they call the 'dirty disease' and ignorant of its means of transmission.

Muzeyyen and her newborn child, her second, were diagnosed HIV positive in August after she gave birth through caesarean section at the public hospital in Urfa. She was given the tainted blood during a routine transfusion.

"Inquiries point to the fact that the responsibility goes to the blood centre," says Dr Muzaffer Keceli of the Turkish ministry of health. He fears there may be more victims as yet untraced.

"In July 1996 recorded AIDS cases in the country numbered 574," he told IPS. "But the real total should be at least 20 times higher."

For weeks after her return to Bozlak life continued normally. The village midwife inoculated Muzeyyen with the same needle she later used on the village livestock. Unaware that she had the HIV virus when Muzeyyen went sick, normal anti-viral hygiene practices were not followed.

But once Muzeyyen's condition was diagnosed as AIDS -- a condition that retains connotations of immorality in the under- educated, highly religious and isolated south east -- her fellow villagers reacted with fear and horror.

Four months later, the villagers are living in fear of what they call the 'dirty disease' and have driven Muzeyyen and her husband from the village, even though the directorate of religious affairs in Ankara has ruled that the family are innocent victims of others' acts and that if they die of AIDS they will be judged as 'martyrs'.

Muzeyyen was infected by blood traced to a Red Crescent blood bank. The bank routinely tests blood supplies for HIV, but will release untested stocks in "emergencies".

"In case of urgency, and in the event there is no tested blood stock available and since the necessary testing time is relatively long, depending on the doctors' requests they (the blood banks) will allow untested blood to be used," said local Red Crescent official Ertan Gonen.

"To test the blood (on the spot) would have taken five and half hours." The chances of the untested blood being tainted with HIV are estimated at 1.5 in one hunderd, so the doctor supervising Muzeyyen's operation took the risk.

The family was charged 20 dollars for the care. "The Red Crescent ruined my life," says Sedat. "For 20 dollars I bought death!" He is still awaiting news of his own tests for the HIV virus. He has demanded a million dollars in compensation and the punishment of the doctors and blood bank staff.

The ministry of health has agreed to pay their medical costs in full and local authorities are preparing to prosecute local health personnel deemed responsible.

The tragedy is an indictment of Turkey's rural health services and the lack of resources that led to the use of unscreened blood stocks. Almost all transfusions in Turkey use whole blood, taken from donors. New technology now widely used in Western Europe would allow the use of safer blood derivatives.

Importing the necessary blood products would add another 45 million dollars to the ministry's budget, so the ministry is now considering building its own blood plasma fractioning facility, at a cost of 25 million dollars, including training and equipment for 100 staff.

The ministry of health does already run various WHO-sponsored programmes on preventing HIV transmission but only through voluntary groups. The ministry say that a government-run programme would deter people from asking for advice or assistance.

"The national AIDS commission considers all aspects, medical or social, of the issue and develops stratagems," health Ministry official Hula Keskin told IPS. "The undertakings cover a vast area from technical services to new institutions and patients' rights."

The widely reported plight of Muzeyyen and her baby may result in action to change things, she said. The medical community has finally woken up to the dangers of using untested blood.

"Doctors will no longer permit use of untested blood, and if there have been similar previous cases, their victims will be encouraged to demand their rights," Keskin noted.

A member of the National Aids Commission, she is overseeing the care of the victims, now in Ankara. "They want to go back to their home village," she says. "But the father still has to be fully tested."

The real number of possible victims of the use of untested blood is unknown, while the likelihood of prosecution may make doctors unwilling to confess to use of untested blood.

Ergun Cretin, 56, from Bursa tested HIV positive after being given a transfusion of HIV infected blood at a public hospital in Bursa in 1995. "Others may have been transfused infected blood as well," he says angrily.

"Initially they lied to me that I had caught the virus in Germany ten years ago and I had bowed to my destiny. Now I revolt. I am going to fight to the end. They should pay for their own fault." (END/IPS/NM/RJ/96)

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