Daily reports from the WHO-PDA Pharmaceutical Cold Chain Management on Wheels Learning Experience

 

DAY FOUR:

FOCA –

 

 

            Today we penetrate deeper into the dry and beautiful Turkish mountains and back in time as we continue down the pharmaceutical cold chain. Our first visit was to the Provincial Governor’s office where the Governor (and a host television media from Balikesir) welcomed us to the city - tea first, of course. This region of the country maintains a very successful model for healthcare distribution and administration, providing the benchmark for the rest of Turkey, a fact the Governor was pleased to point out. Upon leaving the Governor’s office we split into four groups and were driven by car to one of four of the nearly 20 Primary Health Centers in Balikesir to see how the Provincial Health Care Directorate (where we visited yesterday) further distributes vaccine to each individual primary health center (or hospital). This enabled us to assess how well storage and transport of cold chain products were maintained at the point prior to administration to the patient.

            Vaccines are delivered twice monthly to the centers in temperature controlled trucks (those we saw yesterday) and monitored for temperature. The center stores them immediately. Patients are individually notified to come to the center for their scheduled inoculations, at no cost to them (it is a national program funded by the government). An outreach program is also administered whereby the doctor, nurse or midwife will go directly to the patient’s home.

            We were warmly greeted by a swarm of nurses, doctors and midwives as we entered Health Center #11. The amount of pride these healthcare workers had in their facility and their patients was extraordinary. The center has 3 doctors and 15 nurses and each doctor sees about 150 patients a day. Cold chain storage and handling practices are very conscientiously maintained at this level of the supply chain.

 

Paulo Froes (foreground) asking questions of the doctor and nurses at Primary Health Center #11 in Balikesir

 

First, we have tea... discussion with staff following our visit the the Primary Health Center in Baliksir where the 2 doctors see as many as 150 patients a day

 

            We had lunch with the Governor at a local kebab and our group conducted our afternoon warm-up on a busy sidewalk in front of the central railway station prior to getting back on the bus.

            The next stop was to enjoy a little free time on the way to our next overnight destination at the ancient ruins of Pergamon,. Pergamon (3rd century B.C.) rose to prominence under the Romans in the 2nd century A.D. It is famed for its ancient medical center built to honor Asklopios, the god of healing. It is also the site of the world’s first psychiatric hospital. Many of its treatments came with a complement of sacred water (later discovered to be highly radioactive properties) and massage and herbal treatments still applied in today’s medical therapies. Quite unlike modern hospitals, many tried to become patients. It was more spa than hospital and patients included Hadrian, Marcus Aurelius and Caracalla.

 

 The Sacred Way, Pergamon

 

            On the way to Foca (pronounced foe-cha, by the way) we toured the manufacturing facility of StoroPack, an EPS and EPP molder who makes, among other things, insulated shipping boxes for temperature-sensitive medicinal products like those used in our Pharmaceutical Transport Challenge. Crossing over the mountains to the Aegean Sea we concluded the day with an evaluation of the day exercise on the beach. Tomorrow, it’s on to Izmir. Good night.

 

Group photo with StoroPack Managing Director Serhat Ozhan and Chief of Production Onder Cubukcuoglo, at their manufacturing facility near Izmir.