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The novel coronavirus (COVID-19) outbreak aside, physicians in Turkey's southeastern province of Antep have been dealing with another health problem since pre-pandemic period: Increasing infant mortality rates.
According to the statistics shared by the Turkish Statistical Institute (TurkStat), while the infant mortality rate was 9.1 per thousand across Turkey in 2019, it was far above this average in Antep with 16.2 per thousand.
Dr. Doğan Eroğulları, the Chair of Gaziantep Family Medicine Association, notes that the major reason behind infant mortality is premature labor, which is itself caused by pregnancies in marriages under the age of 18.
'Province with the highest infant mortality rate'
"If you want to see how developed a country is, you can just look at maternal and infant mortality rates there," says Dr. Eroğulları and briefly adds:
"With 15.3 babies per thousand, Gaziantep seems to be the province with the highest infant mortality rate in Turkey. The death of infants is one of the most important indicators in determining how developed a country is. In that sense, these statistics are not good for our province in any way at all.
'Refugees not included in the data'
"When these data were first announced, it was said that the Syrian population in Gaziantep was effective. However, only the citizens of Turkey were included in those statistics. Therefore, these figures are only about those who are citizens of Turkey and officially reside in our province.
"There are several factors leading to death of infants; however, what we see in our province is that premature labor is the major reason for that.
'Pregnancy at an early age is the major factor'
"What are the risk factors for premature labor? Marriages under the age of 18 and pregnancies at an early age... On the other side, giving birth at frequent intervals is another factor: Getting pregnant frequently due to the lack of an effective birth control method and resulting premature labor...
"We unfortunately lose our babies who get infant infection. Genetic factors are also effective in high child mortality rates.
"What we tried to do about it in Gaziantep was this: We first did a field research with the relevant parties. We, an an association, worked with the Provincial Directorate of Health and Gaziantep Faculty of Medicine. We tried to put forward the reasons behind infant deaths.
'Works interrupted by the pandemic'
"In order to determine what precautions to take, we had a large meeting with the participation of Gynecology, Pediatrics and Infant specialists, Directorate of Health, Municipality, universities, private and public hospitals. We had to take several precautions in the short, medium and long term.
"We prepared a serious infrastructure, but these works have been a bit interrupted due to pandemic. Gaziantep is one of the provinces with the highest number of cases, so we are also seriously dealing with the outbreak.
"In our works about infant deaths, we first focused on primary care, so the follow-up of family physicians, then the referral of risky pregnancies to hospitals, ensuring that child labor will take place in suitable conditions and necessary intensive care procedures in the event of premature labor.
"However, social factors underlie all of these reasons. We can name a few, such as marriages at an early age, births at frequent intervals and genetic factors, which is itself triggered by consanguineous marriages. Precautions need to be taken against it in that regard."
Infant deaths on Parliamentary agenda
On the other side, main opposition Republican People's Party (CHP) Gaziantep MP İrfan Kaplan has addressed a Parliamentary question to Health Minister Fahrettin Koca about the high infant mortality rates in Antep.
Asking the Minister why Antep is the province with highest infant mortality rate and why this rate has been constantly increasing, the MP has briefly questioned:
"How many of the babies who died in Gaziantep between 2017 and 2020 were the babies of Syrian refugees?
"Were any preventive works undertaken in Gaziantep following the examination conducted by the Ministry of Health in 2018? If yes, what are they?
"How would you explain the reason why the works undertaken by your ministry has not helped to decrease infant mortality rate?
"Are necessary follow-ups and inspections done by the Gaziantep Provincial Directorate of Health about it? If yes, what are they?" (AÖ/SD)