The conditions on the prison island of Imrali in the context of health 

I am very honoured to speak in this important panel at the conference and to be able to contribute with my professional expertise as a doctor for the first time in the context of a political conference. 

With the Covid pandemic, the topic of health has come to the fore. However, health does not only mean the absence of illness, but also mental, physical and social well-being. This is also how the World Health Organization (WHO) defines it. This definition forms the basis for the Ottawa Charter, which declares peace, adequate housing and a stable ecosystem to be fundamental health conditions. Unrestricted access to healthcare is also essential. 

Let us take a brief look at these factors in the context of the prison island of Imrali and Kurdish political leader Abdullah Öcalan. 

The island does not have a stable ecosystem. The air humidity, which should ideally be between 40 and 60 percent, is significantly higher on an annual average. Particulate matter pollution is sometimes three times higher than the limits set by the WHO. This has an enormous impact on health, particularly regarding the respiratory tract, skin, eyes, productivity, sleep and stress. The risk of infections is greatly increased. 

Good living conditions do not prevail in a prison in general, and not in the context of Imrali in particular. Mr. Öcalan's room is ventilated by an air conditioning system that is in operation 23 hours a day. Apart from the cold, dry air it produces - with all its health risks - this means considerable noise pollution. Noise also poses a considerable health risk. In addition to affecting the ears, noise also leads to sleep disorders and increases the risk of cardiovascular diseases. 

Regardless of Imrali, access to medical care on an island is often limited. This is all the more true for a prison island. If this prison island is Imrali, we can assume that it is extremely limited. A good example is the issue of a defibrillator, which is repeatedly mentioned in the CPT report. After a defibrillator was purchased after several years of neglect, there was a lack of staff to use it. There is a general lack of health personnel on site. Good medical care also requires regular contact with the same doctor. Imrali, however, is treated by doctors from the hospital on the mainland on a rotating basis. In an emergency, it takes a long time for professional help to arrive. Although Turkey refers to the options of the speedboat and helicopter, this does not seem very credible when you consider how often in the past lawyers have been denied visits on the grounds that the ferry was not working. 

All of these deficits and health problems, which Mr. Öcalan clearly mentioned in conversations with his lawyers, are also listed in the reports of the CPT. In 2019 - 20 years after the arrest of Mr Öcalan and 20 years after the CPT's first visit to the island - the CPT noted that the situation had by no means improved. It should be mentioned at this point that, in addition to the regular visits to Turkey - which normally take place every five years - the CPT has carried out numerous ad hoc visits, always in the context of Imrali. 

All this information can be found in detail in a report I have prepared, which has been added to the conference folder. 

Now we come to the central factor: peace as the basis for health. There is no peace in Turkey and the Middle East. Imrali and Mr. Öcalan have a central function here. Mr. Öcalan has a vision for peace in the region. His democratic, ecological and women's freedom based paradigm forms the central basis for this. A political solution to the Kurdish question, torque in the Middle East, and thus the democratization of Turkey and the entire region, but also ecological stability and gender justice are possible. 

It is therefore long overdue: the gates of Imrali must be opened; for the health of all people, worldwide. 

The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT), in the report on its visit to İmralı Island, draws attention to many important issues concerning the profession and principles of physicians. 

The delegation states that the open area used by Mr Abdullah Öcalan is a 45 m² area surrounded by a 4 m high wall. This area has a very claustrophobic design and its limited size and sandy surface do not allow any real physical activity. 

Physical activity is very important for health. Physical activity is essential for strengthening muscle strength, the heart rhythm, the respiratory capacity, preventing excessive fatigue, accelerating metabolism and thus preventing weight gain and preventing diabetes. Physical activity is also important for blood flow to the brain due to its effects on vascular structure. In addition, the positive effects of physical activity on mental and social health should not be forgotten.

In the first year of his detention, when Mr Öcalan met with his lawyers, he talked about fatigue due to lack of exercise and stated that "Solitary confinement should be changed for health reasons". 

I was still a first year student at the Faculty of Medicine when I read that interview note, but I have never seen anything that health professionals, especially physicians - at least in Europe - have said. 

I won't say it's time for the word, because it's already too late. We have to go beyond words. It is time to take a step. We need to be active in order to expand Mr Öcalan's field of action and to enable him to carry out his activities for peace in a physically free environment. 

I invite my colleagues to be active for peace and freedom and to expand our field of action. 

Turkish: https://www.ozgurpolitika.com/haberi-imrali-aktivite-alani-ve-hekimler-182902 

"To heal people and never to harm anyone. I swear to practice my profession with conscience, honour and observing the principles of good medicine." These two sentences constitute the essence of the Hippocratic Oath. Although this text has changed over time, its essence remains the same. In history, the oath was taken on Asklepios, the god of medicine. Today, the oath is taken on honour. However, not all countries honour the oath at graduation ceremonies. For example, there is no oath at the graduation ceremony in Germany, but there is in Turkey. 

In the countries where the oath is taken, the oath of medicine in the Geneva Declaration of the World Medical Association is generally used: "As a member of the medical profession, I pledge to devote my life to the service of humanity. The health and welfare of my patient shall be my primary concern. I will respect the autonomy and dignity of my patient. I will show the highest respect for human life. I will not allow age, illness or disability, belief, ethnic origin, gender, nationality, political opinion, race, sexual orientation, social status or any other factor to come between my duties and my patient. I do this solemnly, freely and on my honour." 

The translated text of the Turkish Medical Association also ends with the words "I swear solemnly, freely and on my honour". 

In the statement titled "War is a public health problem" published by the Turkish Medical Association in 2018, the following points are emphasised "Every conflict, every war causes irreparable problems in terms of physical, mental, social and environmental health and brings along a great humanitarian tragedy." This is in line with the World Health Organisation's President's statement "The basis of health is peace", which was frequently expressed at the World Health Summit. 

Unfortunately, this condition, which is/should be universal, does not apply to a very important place. This is the Imrali island prison where the Kurdish people's leader Mr Abdullah Öcalan is imprisoned. 

Mr Öcalan has not been allowed to meet with his family and lawyers for about 3 years. Just a few days ago Asrin Law Office lawyers announced that Mr Öcalan was given a new disciplinary punishment. 

In 2011, the United Nations Special Rapporteur on Torture, Juan Ernesto Méndez, published a report concluding that solitary confinement for more than 15 days should be considered a violation of the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. Mr Méndez defined solitary confinement as any regime in which prisoners are isolated from other inmates, excluding guards, for at least 22 hours a day. 

The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) states that the maximum period of isolation should not exceed 14 days and should preferably be less. It states: "The CPT has always attached particular importance to solitary confinement because of its extremely harmful effects on the mental, physical and social health of prisoners. This detrimental effect may be immediate and may increase with the duration or indefinite duration of the measure. The most important indicator of the harm that solitary confinement can cause is the significantly higher suicide rate of prisoners in solitary confinement compared to the general prison population. Solitary confinement in itself therefore clearly raises issues relating to the prohibition of torture and inhuman or degrading treatment or punishment. It may also create an opportunity for targeted ill-treatment of detainees away from the attention of other detainees or prison officials." The CPT recommends: "In order to examine whether a particular application of this measure is justified, it is appropriate to apply the traditional test set out in the provisions of the European Convention on Human Rights and developed in the case-law of the European Court of Human Rights".

The United Nations, the World Health Organisation and similar institutions of capitalist modernity remain silent on İmralı. The CPT has not yet published its report on its visit to the island in 2022. It responds to insistence on this issue by pointing to its functioning. The OPCW had/has a similar stance on the use of chemical weapons. 

However, the real problem is the silence of Kurdish physicians. 

Turkish: https://www.ozgurpolitika.com/haberi-tecrit-ve-hekimlik-ilkeleri-182715 

On 15-17 October, the World Health Summit was held in Berlin with the participation of people from more than 100 countries. It was chaired by German Chancellor Olaf Scholz, French President Emanuel Macron and Dr Tedros Adhanom Ghebreyesus, President of the World Health Organisation (WHO). The more than 300 speakers included health ministers, senior officials of the WHO, representatives of civil society organisations and renowned academics and researchers. Over 60 panels were took place over the three days.

Priority topics included the health impacts of pandemic(s) and climate change. The effects of wars and migration on health were also on the agenda. Future perspectives were also discussed. 

War, migration, climate, pandemic; all these issues are of particular concern to us Kurds. But none of the speakers gave the example of Kurdistan/Kurds while discussing these issues. Now you will say, of course, in the system of capitalist modernity, we cannot expect us and our problems, who question this system, to be mentioned. 

I say this is partly true, but I add the word but. The leaders/speakers of the World Health Summit may not mention us and our problems. But they have to answer questions. This requires someone to ask the question. Kurdish physicians and health professionals were almost non-existent at the summit. There were only two of us. 

However, we Kurds have professional experience and the history of struggle to analyse problems and present our perspectives on the future. But not only do we have experience, we also have a (professional) responsibility towards our people and humanity. 

Because health is not indexed to the individual. Only if life and living spaces are healthy as a whole, we will fully fulfil our responsibility. 

Dr Tedros Adhanom Ghebreyesus, Director of the World Health Organisation, frequently stated at the World Health Summit: "Health is the basis for peace." 

I call on my colleagues to take responsibility and contribute to a healthy and peaceful life. 

For a healthy future and a strong and free Rojava, I am looking forward to your contribution to the aid campaign called Impuls Rojava, which we started with Dr Zeynep Binici-Çetinkaya and Dr Eray Öztürk: 

Kurdistanhilfe e.V.

Hamburger Sparkasse

IBAN: DE 40 2005 0550 1049 2227 04 

BIC: HASPDEHHXXX

Verwendungszweck: Impuls Rojava

Turkish: https://www.ozgurpolitika.com/haberi-dunya-saglik-zirvesi-ve-kurt-hekimleri-182472