Part IV: (1975 – today) in which we learn of her great work for Health Services in North Cyprus

In Part III  we ended saying: …We come to one of those days in 1975, when Dr. Ayten and Cemaliye had to go up to Nicosia on their monthly visit to the North where she was told by the authorities not to go back to Limassol again as it was too dangerous. It was the 20th of July 1975. The hospital in Limassol was more or less empty. Her job was done. She felt, that she could stay in safety now, she had done her duty as the captain of her hospital.

The first thing she did when she accepted that she would stay in the Turkish sector was taking a short leave in Turkey, her first one after a long time, to repair her shattered physical condition; on her return she had to replace Dr. Ali Atun, doctor in charge at the Famagusta Hospital who was just as exhausted as her. It was a time for her to think about the future, how and in what position she could serve her country best.
“On Oct 1, 1975 I was appointed Assistant Director in the Health Service Department with the director and the undersecretary over me. I was responsible for the public health section and I did this job for three years. During this time I tried to reorganize Health Service: we established new health centres especially since Turkish settlers had come into the country, one health centre for ten to twelve villages; i.e. we had managed to establish about eight centres in the beginning. All these places had to be visited, the staff trained and controlled. The health Minister and I often went on these control visits together.”

In 1975, the construction of the new General Hospital was taken up again after four years of construction standstill. The health minister B. Nalbutoglu had fought for the continuation and finally the new building was opened in 1978. Ali Atun was the Minister of Health this time in 1978. The construction of the hospital was financed by Turkey, the equipment donated by USAID and UN but channeled through Red Cross and Red Crescent authorities. “It was a great day for all of us and the hospital was named after the doctor who had fought for it for so long. B.Nalbutoglu Hospital.

In 1978 Dr. Ayten Salih became Assistant Undersecretary for four years; and in 1982 Undersecretary until 1991 when she retired. “I saw my duties in improving the health system in our country and to establish new units to the general hospital. For this purpose I travelled to many countries, to listen to experts at symposia and conferences, I studied the conditions in hospital units abroad to learn what was required for the establishment of our own units. How can I teach before I know what to teach? Is it not so?” I agree with her totally and thanks to her attitude she pulled through so many urgent projects.
“The first two important ones were the anti-malaria project in 1976 and anti-tuberculosis project in 1978-79. The Greek side had complained internationally that the new Turkish settlers had brought in tuberculosis and Malaria. Malaria was actually eradicated in Cyprus thanks to Dr. Aziz, the father of Matron Aziz in 1948 by draining wetlands and standing waters.  But regular methods were required to keep it under control, so spraying of any standing waters every ten days became mandatory, especially in times when the mosquito larvae were developing. It became a governmental practice and was controlled by inspectors of health who were assigned by the health centres and health department.  I myself put on my yellow rubber boots and undertook the controlling many times. Today the municipality controlled spraying is not efficient as it aims to kill the adult mosquitoes only - and thereby kills good insects too - it should, however, be aimed at the larvae in the standing waters.”
“With respect to tuberculosis we managed for a team from Turkey to come; they did screens of  80 000 people with micro films; then a dispensary was opened in Nicosia Health Centre;  a lady doctor, Dr. Aydın, was sent to Turkey for training and she became doctor in charge of the Lung Disease Hospital in Gönyeli. Regular health checks were finally carried through at schools, first at the age of six with control checks after six years again to see if there was any increase. There wasn’t one up to today.”
“One big project of ours was the fight against Thalassemia,  a hereditary  sickness especially in Mediterranean countries. Initiated by Dr. Modell from England a committee was formed in 1978 to fight the sickness – children hardly survived 12 years of age.”
Why by a doctor from England, I asked?  “Because many Cypriots lived in England and she had recorded the cases. In the beginning our patients were sent to England for screening and examinations. But there was also a scientific committee in Turkey who cooperated with us for the first years.”
I include here an abstract to emphasize the importance of the project written  by Dr. Boskurt who was a pediatrician and became an hematologist for the project.

Abstract : Thalassemia was a serious health problem in Cyprus. The first scientific studies on thalassemia started in 1976 after a seminar which was organized by the Turkish Hematology Association. At the end of the seminar it was decided that a thalassemia prevention program would be effective to control this problem as thalassemia was a hereditary disease and possible to prevent. The aim was to stop the affected newborns and provide good treatment facilities to the existing thalassemic patients. In 1979, high risk families started to be screened for thalassemia. In 1980, premarital screening was made compulsory by law. In 1984, prenatal diagnosis was started with fetal blood sampling techniques. DNA techniques replaced fetal blood sampling in 1991. After prenatal diagnosis started in 1984, affected birth rates showed a sharp decrease in contrast to an average of 18-20 cases per year before the implementation of the "Thalassaemia Prevention Programme." Between 1991 to 2001, only five thalassemic babies were born, one in every 2-3 years. No thalassemic babies have been born in the last 5 years. Thalassemic patients live longer with a better quality of life because of more effective treatment modalities. A great majority of the patients are over 25 years old (66%), living and working as the normal population. Thirty-eight percent of them are married and have children.
Source: North Cyprus Thalassaemia Centre, Nicosia,Cyprus. Boskurt G.
The new Thalassemia Building in Nicosia was opened on 14 March 1988 – the construction took 4 years – and the 2nd International Meeting on Thalassemia was held at the same time with participating colleagues from Turkey, England, France and Italy/Sardinia. Another proud day for an unrecognized country!
“Today the disease is under control and Thalassemia couples can lead a normal life, can marry and have D.N.A. tests made when women are two months pregnant with the important support of Dr. N.Yesilada. A parents association was formed in 1978 but when they wanted to be included in the international association the Greek side opposed it with the reason of us being an illegal state.”  Bitterness in Dr. Ayten’s words.
In her time as Undersecretary other units were added to the hospital : First they set up twoplants to produce O2 and N02 gases. Then Old People’s home in Lapta in 1976.
In 1981, Psychiatry and Neurology hospital (with the support from the US and Dr. Vamik Volkan from the University of Virginia, a Turkish Cypriot, I had the chance to meet for an interview in 2010);  see his report on the matter: http://pdf.usaid.gov/pdf_docs/PDAAI868.pdf
In 1982, a Neurology operating theatre and a dialysis unit for kidney failure were implemented;  in 1983, a Coronary Care Unit; in 1986 a Chronic Hospital and Lung Disease Hospital in Gönyeli; In 1989, a Radiotherapy unit for the oncology department was established; in 1990 a spastic children centre was opened. The construction of the buildings  was realized with the financial help of Turkey. The equipment was given by USA through UNHCR; the British High Commissioner and Turkey helped with medical training courses for the staff for diverse disciplines.  A great achievement.

But such units would not work without educated doctors, sisters and technicians and so Dr. Ayten Salih furthered the staff to obtain the required specialist education. “I fought for it and got people sent to England, to Turkey,  Beirut, USA,  Sardinia and to Australia.
I myself had gained the knowhow and the training because I knew that I can only teach and initiate things when I submitted myself to this philosophy.”
In 1981 she took part in a 3-months hospital management course in England. She became a member of the IHF - International Hospital Federation, the membership of which she gave up only recently.

“In order to run health service properly, much more had to be done in those years: a State Laboratory was built for the regular examination of water, food and forensic science, and a new lab was established as State Laboratory near Ledra Palace, which today is in the Kaymakli area.  Production plants for Oxygen and Nitrooxygen were developed since the supply was irregular and we could not expect any assistance from the Greek side.”

Besides all her duties she did voluntary work in many fields which I suppose left her no time for privacy.
1970-71:  Chairwoman of Doğan Türk Birliği; football club (the first to be chairman in a men’s football club.
1970-1974:  Chairwoman of Turkish Crescent Society of Limassol;
  Chairwoman of ‘Save the children Foundation’ in Limassol;
  Chairwoman of the Girl Guides Committee in Limassol;
1969-71 Chairwoman of Civil Servants Committee in Limassol;
1976   Association of Turkish Medical Doctors – (General Secretary)
1978-1994 Member of Sports Committee in Ministry of Sports
1980-1994  Member of Turkish National Olympiad Committee
1981-2010  Member of IHF International Hospital Federation
1982-1990  Member in British Sport Medicine
1984-1989  Member of WHO Working Group of Thalassemia (first time a Turkish Cypriot became a member)

In 1991 she retired as Undersecretary and from so many other obligations.  A life time dedicated to her country.  Within 15 years a functioning health service was put into operation across the island, projects were successfully carried through, to existing hospitals new additions were added and health centres erected, and when she retired there were 14-16.
Today many private clinics are available besides the state-run hospitals.

After her retirement Dr. Ayten Salih put away her agendas and directed her main interest on to her family, partly living in Turkey, partly in Australia.

“After my retirement I undertook a long visit to my relatives in Australia and travelled across this very beautiful country with them. I enjoyed my stay of six months very much. The news reached me that my niece had a kidney failure and I went to Turkey for four years to care for her. I am glad I was able to help her and other relatives being a doctor.” 

When Dr. Ayten returned to Cyprus in 1995, President Rauf Denktaş called upon her and appointed her to become first lady member of the Public Service Committee to appoint civil servants. She held this position for nine years. 

The years went by and she spent the years in Turkey with her family and in Cyprus where she has many friends. Life has become more quiet, although many institutions approach her and honour her for her achievements, her sports friends, her medical colleagues and people like me who want to learn about her life. A life spent under most difficult conditions. I had asked her what kept her going in those years and if she did not know fear and exhaustion, and she replied: “Oh, I was afraid and desperate sometimes, but when you have a hospital to run and people depending on you, you have to put your anxieties aside and do what has to be done. And, I had the support of so many and I would want to express my thanks here and now because without them I would not have been able to do my duties as I did them:
I am grateful to my parents for sending me to Turkey for higher education; I am grateful to the authorities for their support in getting my specialty degree and management courses. I want to thank I.H.F. for accepting me as a ‘C’ member enabling me to participate in medical meetings in various countries. I also want to thank the Turkish Cypriot authorities which believed in me and appointed me as an Undersecretary where I was able to get through many important projects.  I want to thank all Turkish universities and medical associations from Turkey to have their meetings, conferences in North Cyprus, also to the German Sport Medicine Associations, and all those who helped with Thalassemia and other projects. I also want to thank my staff friends and all those with whom I worked. Thanks to them and with their help I was able to serve my country. And, I want to thank you, Heidi, for spending so many hours to listen to me…”

This is my story of Dr. Ayten Salih Berkalp’s life, a woman I have one day met at a reception on the occasion of International Women’s Day. It was her magnetic personality that drew me to her, her erectness and the wisdom in her eyes.
In the many hours I spent with her I learnt to appreciate her not only as the most dedicated doctor she is, but also as a great human being. I also learnt from others I spoke to about her that she is highly respected and will never be forgotten. A Turkish Cypriot from Limassol whom I know said to me: “Without Dr. Ayten Salih and her matron Cemaliye so many of us in Limassol would not have survived. She was with us in the darkest moments of our life.”

When I asked Dr. Ayten, if there was anything else she would have liked to do in her life and hadn’t done, she said: “Oh yes, I think, I would have been a very good tennis player!”