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In April 2009, a group of 6 Kybele team members all split up for a week and went to the following cities all around Turkey - Bursa, Ankara, Maras, Eskisehir, Adana and Samsun. In most centers, regional anesthesia is being used with increasing frequency for C/S...a bit less so for laor analgesia. There have been definate strides and improvements in Turkey since the first trip in 2004, and the hospilality and food in Turkey continues to be wonderful.
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In September 2004, eight obstetric anesthesiologists from 4 countries arrived in Istanbul, Turkey for the first Kybele teaching trip. Turkey is a country with 70 million people (25% of the US population) and one million annual births. Regional (epidural and spinal) anesthesia for obstetrics is relatively new in Turkey and not widely practiced. In fact, most women in Turkey receive general anesthesia for cesarean delivery and are unconscious. This increases their health risks and denies them the memory of their child’s birth.
Our goal was to demonstrate regional anesthesia techniques for obstetric patients and to serve as a “safety net” for physicians learning management skills and protocols. After a 2 day orientation about Turkish culture and the medical system, doctors dispersed to work individually in 10 academic hospitals throughout Turkey. The visiting doctors presented formal lectures and bedside teaching on numerous aspects of obstetric anesthesia. What followed was a wonderful exchange of medicine and culture for all involved.
Dr. Idil Tekin from Celal Bayar University wrote, “Through this program, we had the opportunity to meet esteemed, distinguished scientists. Instead of going to conferences and being able to discuss only limited topics in limited times, they came here and paid attention to only our problems for a whole week. Together with beautiful memories, pictures, friendships, and cultural awareness, this program helped us realize what we’re doing, plan future projects, and set new goals. As one of the best parts of this program, we’ll keep in touch and continue to communicate.”
And from Dr. Bilgi Karsli from Akdeniz University, “We organized a seminar together with the obstetrics clinic. Our guest talked about his studies and the obstetricians were very impressed. Now, obstetric analgesia is rapidly increasing in our hospital. Before this program, it was our job to convince the patients; now the obstetricians guide the patients to us for obstetric analgesia. This program was very beneficial for us. Thank you again for giving us this support.”
In Turkey, Kybele’s novel program made national headlines with a front-page article in a major Turkish newspaper and the first televised cesarean section of an awake delighted mother with spinal anesthesia on prime time national news. Obviously, Kybele related issues were of interest to the Turkish public at large, in addition to medical professionals. One reason for this widespread interest is that in Turkey the cesarean section rate is 75-90% in many hospitals and general anesthesia is almost universally utilized! (General anesthesia administered for cesarean section carries a 9-17 times greater chance of death compared to regional anesthesia).
The trip also demonstrated the effectiveness of a group oriented, short term teaching effort in sustaining advancements in medical care. A detailed questionnaire sent to participating hospitals 2 months after the visit found host hospitals highly rated their experience with the Kybele program. In fact, seven of ten hospitals made changes in their clinical practice after the program, 6/10 hospitals reported help with clinical research and manuscript writing and all hospitals have maintained contact with their guests. Kybele’s first textbook of Obstetric Anesthesia has been published in Turkey in 2006 to provide ongoing information to physicians to meet the growing demand.
 
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