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Infection of the Invisible: Impressions of a Tuberculosis Intervention Program for Migrants in Istanbul

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Abstract

This paper reviews the experience of the Istanbul Tuberculosis Aid Program, which targeted tuberculosis (TB) disease in the growing irregular migrant populations of Istanbul. This experience illustrated the importance of community-based public health interventions when dealing with an infectious disease like TB among vulnerable groups. Our data is derived primarily from a qualitative study carried out with program stakeholders. We summarize lessons for success of ITAP as: (1) Strengthening impact and outreach of TB intervention among irregular migrant communities through involvement of multiple stakeholders (2) Increasing TB awareness through a community targeted approach (3) Increasing TB contact tracing and treatment success among infected irregular migrants, and, (4) Improving overall health seeking behavior of irregular migrants through empowerment and trust. Given these particularities we list our policy suggestions for revision of regulations regarding TB control and healthcare needs of irregular migrant populations.

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Notes

  1. The main reason for ITAP’s discontinuation was an inability to institutionalize the program despite several efforts made in this direction. Under Turkish legislation the condition for a civil society initiative to receive foreign funding is that it must be implemented through an existing Turkish institution. Program coordinators did approach three different organizations on this matter, however each of them remained reserved about taking up such a program because it involved working with irregular migrants, which was seen as a “tricky” issue that could upset state authorities. Consequently, a formal bank account could not be obtained for ITAP, funding resources obtained from abroad could not be transferred to Turkey and efforts to raise additional funds had to remain limited to the charitable contributions of immediate social circles in Turkey.

  2. The International Organization for Migration defines an irregular migrant as “A person who, owing to unauthorized entry, breach of a condition of entry, or the expiry of his or her visa, lacks legal status in a transit or host country. The definition covers inter alia those persons who have entered a transit or host country lawfully but have stayed for a longer period than authorized or subsequently taken up unauthorized employment (also called clandestine/undocumented migrant or migrant in an irregular situation). The term ‘irregular’ is preferable to ‘illegal’ because the latter carries a criminal connotation and is seen as denying migrants' humanity [8].”

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Acknowledgments

We would like to express our gratitude to Prof. Dr. Zeki Kilicaslan, who was key in securing the collaboration of IVSD in every stage of ITAP, for his equally generous support in the preparation of this manuscript. We are also thankful too all participants in this study for sharing their valuable experiences with us.

Ethical Standard

This study was originally presented at the Mobility and Health Panel of the Annual Meeting of Reproductive Health Working Group (Oman on 27–29 January 2014). Following the high interest and encouraging comments of panel participants, authors were convinced by the relevance and timeliness to more thoroughly analyze and internationally publish on these experiences. As this idea developed after research and writing of the original paper had already been completed, review and approval by an Ethics Committee was not sought.

Author information

Authors and Affiliations

  1. Department of Public Health, School of Medicine, Acibadem University, Istanbul, Turkey

    Yesim Yasin

  2. Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK

    Kristen Biehl

  3. Humanities and Social Sciences Department, Isik University, Istanbul, Turkey

    Maral Erol

Authors
  1. Yesim Yasin
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  2. Kristen Biehl
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  3. Maral Erol
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Corresponding author

Correspondence to Yesim Yasin.

Appendix

Appendix

List of interviewees with pseudonyms:

  1. 1.

    Ziya, male, 57, medical doctor.

  2. 2.

    Bahar, female, 46, medical doctor.

  3. 3.

    Bernard, male, 52, CHW/interpreter.

  4. 4.

    Jamal male, 41, CHW/interpreter.

  5. 5.

    Samuel, male, 42, CHW/interpreter.

  6. 6.

    Lisa female, 63, director of a faith-based organization.

  7. 7.

    Ali, male, 45, medical doctor.

  8. 8.

    Nese, female, 45, program co-coordinator.

  9. 9.

    Mahmoud, male, 44, Dr./program advisor.

  10. 10.

    Rob, male, 38, CHW/interpreter.

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Yasin, Y., Biehl, K. & Erol, M. Infection of the Invisible: Impressions of a Tuberculosis Intervention Program for Migrants in Istanbul. J Immigrant Minority Health 17, 1481–1486 (2015). https://doi.org/10.1007/s10903-014-0115-7

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