REPUBLIC OF TURKEY MINISTRY OF HEALTH Department of Foreign Affairs REPUBLIC OF MOLDOVA AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA Ceadir-Lunga Comrat Vulcanesti Turkey, with her economy, foreign policy, democratic structure and reforms, has ascended as a country which is followed with appreciation and attention all over the world. For sure, we achieved this by believing, trusting in ourselves with self-confidence. We are doing in the same way. How it was done, how it was achieved in the history is a foundation for us. We are succeeding in the same way. Recep Tayyip Erdoğan Prime Minister of the Republic of Turkey AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA Turkey considers Moldova as an important cooperation partner and a close friend country in the Region. Within the relations with Moldova, Gagauzia has a special importance for Turkey due to our language and cultural ties with its people. We believe the presence of Gagauz people is an enriching and consolidating factor in our relations with Moldova. Prof. Dr. Recep Akdağ Minister of Health of the Republic of Turkey H.E. Minister of Health Prof. Dr. Recep Akdağ and Governor of the Autonomous Territorial Unit of Gagauzia Mr. Mihail Formuzol during a bilateral meeting 2 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA In parallel with Turkey’s increasingly intensifying and diversifying international relations, the foreign activities of the Ministry of Health has been accelerated. Our Ministry shall continue its cooperative activities with the countries of the region in the field of health with full attention and enthusiasm. Prof. Dr. Nihat Tosun Undersecretary of the Ministry of Health of the Republic of Turkey Undersecretary Prof. Dr. Nihat Tosun welcomes Mihail Formuzol, Governor of the Autonomous Territorial Unit of Gagauzia, Republic of Moldova 3 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA • Gagauzes, a small Turkic population, today mostly lives in primarily Moldova, Ukraine, Romania, Bulgaria, Turkey, Kazakhstan and Kyrgyzstan. • Gagauzes speak Anatolian Turkish with their own accents and variant sentence formations. • According to Gagauzian sources, there are about 250.000 Gagauz people around the world. Among them, 170.000 Gagauzes live mainly in Moldova and mostly in the southern regions of the country. 4 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA • The Gagauzia region is mainly an agricultural region. Viticulture and fruits are the leading agricultural products. The household income of the Regionis low. The life standard in the region is lower than the Moldovan average. Weak industry, agriculture based economy and sporadic drought lead economic underdevelopment in the Gagauzia. • 4% of Moldova’s population (totally about 4 million) consists of Gagauzes. 5 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA • During the “Referendum on Independence” in December 1991, 80% of Gagauz people voted for establishment of “Republic of Gagauzia. • The administration established by Gagauz people was not recognized by central authorities of Moldova; however, the parties did not break the ties and searched for a peaceful solution to the dispute. AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA • In order to find a solution, the Moldovan Government prepared a draft law in the late 1992 and initiated negotiations with the Gagauz Party. The negotiation process continued for about 2 years. 6 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA • Unlike the separatist Transnistria movement in Moldova, the Gagauzes did not insist on “state status” and this facilitated the negotiations regarding the special status of “Gagauzia”. • The Parliament of Moldova ratified the “Law on Special Legal Status of Gagauzia” in the framework of 111th Article of the new Moldovan Constitute, (27 August 1994) envisaging that special status could be given to Transnistria and Gagauzia on 23 December 1994. • Turkey pays special importance on the relations with Gagauzia and considers Gagauz people as a bridge consolidating the relations with the Republic of Moldova. 7 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA BASHKAN (GOVERNOR) OF AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA VISITED OUR MINISTRY • Governor of Autonomous Territorial Unit of Gagauzia, Republic of Moldova Mr. Mihail Formuzal and his accompanying delegation visited H.E. Minister of Health Prof. Dr. Recep Akdağ in the Ministry of Health on 29 January 2009. Governor of Autonomous Territorial Unit of Gagauzia, Republic of Moldova Mr. Mihail Formuzal in the Ministry of Health (29 January 2009) 8 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA MEETINGS During the meeting held in our Ministry; Governor of Gagauzia Mr. Mihail Formuzal stated that they would like to send specialist physicians and health personnel to Turkey for short term trainings and would appreciate such kind of training opportunities from our Ministry. Mr. Formuzal also expressed that they would like Turkish private sector to be active in the field of health in Gagauzia, there were big shortfalls in Gagauzia in terms of both physical structure and medical devices and materials, and requested Turkey to assist them in this aspect. Then, Mr. Formuzal conveyed a list of requirements for medical devices in Gagauzia to Mr. Minister. After listening to Governor of Gagauzia, H.E. Minister Prof. Dr. Recep Akdağ expressed Turkey’s enthusiasm in offering all kinds of assistance to Gagauzia within the spirit of friendship and brotherhood, and added that trainings to be given in Turkey for the health personnel of Gagauzia would be convenient for our Ministry and if they informed our Ministry about the required training fields and the number of personnel, we would start the necessary activities. Prof. Dr. Akdağ stated that our Ministry would conduct relevant efforts regarding the medical devices and materials which were requested by Gagauzia as donation and then inform our counterparts about the situation. 9 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA THE DELEGATION OF OUR MINISTRY IN THE AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA (1-4 April 2009) In order to observe the situation and determine the requirements in the Autonomous Territorial Unit of Gagauzia, Kamuran Özden, Head of the Department of Foreign Affairs of the Ministry of Health and Dr. Adnan Hasanoğlu, Chief Physician of Ankara Training and Research Hospital/ Ministry Advisor, paid a visit to Moldova on 1-4 April 2009. Meeting with Mihail Formuzal, Governor of the Autonomous Territorial Unit of Gagauzia, Republic of Moldova 10 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA Population of the Autonomous Territorial Unit of Gagauzia Adult Child Total There are three provinces in the 1. Comrat Region 51.570 17.690 69.260 Autonomous Territorial Unit of 2. Ceadir-Lunga Region 49.781 15.457 65.238 Gagauzia 3. Vulcanesti Region 20.288 4.931 25.219 • Comrat Total 121.639 38.078 159.717 • Ceadir-Lunga • Vulcanesti Three stars in the flag symbolize the three provinces. 11 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA There are three hospitals in these three provinces. In addition to the hospitals, there are also three family medicine centres. Family Physicians are working in the family medicine centres. There are 157 family medicine physicians in Gagauzia. Furthermore, there are health posts in every village. In the health posts, one physician, phsyio-therapist, midwife and nurses are working. 24 hours serving emergency centres are available in the health posts in bigger villages. In these emergency centres, one ambulance and operators are working. In the cities, emergency centres are located in the garden of the hospital or within the hospital. Bed Capacity 1. Comrat Hospital 255 2. Ceadir-Lunga Hospital 237 3. Vulcanesti Hospital 100 TOTAL 592 12 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA Number of Physicians 1. Comrat Hospital 125 2. Ceadir-Lunga Hospital 129 3. Vulcanesti Hospital 56 TOTAL 310 Number of other health personnel 1. Comrat Hospital 412 2. Ceadir-Lunga Hospital 414 3. Vulcanesti Hospital 183 TOTAL 1.009 Visit to Çeşmeköy Health Station 13 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA MOLDOVA AND AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA • The number of cancer diseases shows an increasing trend in the Gagauzia Region. Though it was 183.6 in 2002, it increased to 215.3 in 2008. • 30 % of cancer patients can be diagnosed at the latest stage of the disease. • Tuberculosis disease rate in the Gagauiza Region is 72/100,000. • Family medicine system is implemented in the Gagauzia Region. • Cardiology, cardiovascular surgery, neurosurgery, plastic surgery and medical oncology cannot be performed. • Number of notified AIDS (HIV) patients is 40. Republic of Moldova Gagauzia Region 2006 2007 2008 2006 2007 2008 Birth Rate 10.3 10.3 10.9 11.7 11.7 12.1 Mortality Rate 13.2 13.0 11.7 11.6 12.3 10.9 Child Mortality Rate 9.6 9.9 12.1 10.8 12.4 8.3 14 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA RESULTS, OBSERVATIONS, SUGGESTIONS At the end of the meetings and observations by our delegation in Comrat, Vulcanesti and Ceadir Lunga, the remarks and suggestions have been summarized as follows: 1. Health services in Gagauzia are delivered based on family medicine system. 2. The delivery of health services is quite insufficient both in terms of building facilities and medical devices and materials. 3. The health personnel need vocational training. 4. The number of health personnel is adequate. 5. There is no cardiology department. Cardiovascular Surgery, Plastic Surgery, Neurosurgery and Medical Oncology cannot be performed at all. 6. There are almost no imaging services. 7. 2 new USG devices are seen in the entire Gagauzia Region and X-Ray devices are 40-50 years old. 8. The operating rooms are not sterilized. 15 AUTONOMOUS TERRITORIAL UNIT OF GAGAUZIA RESULTS, OBSERVATIONS, SUGGESTIONS 9. Devices in the operating rooms are 40-50 years old. 10. Only one autoclave device (almost 100 years old) is seen the entire Gagauzia Region. 11. Sterilization can be performed with old small desktop autoclaves. 12. No new or complete set surgical materials are seen. 13. Laboratory, USG, X-Ray services and operating room are in the same building in the new hospital constructed in Ceadir Lunga.