Tıp fakültesi öğrencisinden Soner Yalçın’a mektup

medikritik Pt, 25/11/2019 - 06:49

Sayın Soner
Yalçın,

Uzun
yıllardır kitaplarınızı okurum. Son çıkan “Kara Kutu” kitabınızı da tıp
fakültesi okumam sebebiyle büyük bir ilgiyle derhal alıp okumaya başladım.
Kitabın sayfalarını çevirdikçe şaşkınlık içerisine girmeye başladım.

AŞI VE OTİZM İLİŞKİSİZLİĞİ

Aşının otizm
ile ilişkili olduğunu dillendirerek vatandaşı “aşı yaparken iki kere düşünün”
diye ürkütmeniz ilginç. Keşke aşı ve otizm konusunda kitabınızda kaynak
gösterdiğiniz Wakefield’in akıbetini de araştırsaydınız.

Yıl: 1998

Yer:
İngiltere

Gastroenterolog Andrew Wakefield ve arkadaşları
Lancet’te kızamık-kızamıkçık-kabakulak (KKK) aşısı yapıldıktan 1 ay sonra 8
çocukta otizm belirtilerinin başladığını bildiriyorlar.

Wakefield, KKK aşısının bağırsak enflamasyonuna
neden olduğunu, bunun sonucunda peptitlerin önce kan dolaşımına, ardından da
beyne geçmesiyle otizmin geliştiğini ileri sürüyor.

Çeşitli ülkelerde farklı araştırmacılarca yapılan
20 epidemiyolojik çalışmada, KKK aşıları ve aşılarda kullanılan thimerosal ile
otizm arasında ilişkiyi destekleyen hiçbir veri elde edilemiyor; ileri sürülen
biyolojik mekanizmanın bilimsel bir temelinin olmadığı ortaya konuyor.

Sonraki yıllarda, Wakefield’in aşı üreticelerine
dava açan avukatlarla para ilişkisi içinde olduğu, bazı araştırmalarının bu
davalarda yer alan avukatlar tarafından finanse edildiği anlaşılıyor.

İngiltere’de Ocak 2010’da Genel Tıp Konseyi (GTK)
Wakefield’i sahtecilik, araştırma tıbbının temel ilkelerini tekrarlayarak ihlal
etme gibi başlıklarda suçlu buluyor.Şubat 2010’da Lancet dergisi makaleyi geri
çekiyor.Mayıs 2010’da GTK Wakefield’in hekimlik yetkisini iptal ediyor.

Çok değil,
30 yıl önceyi düşündüğümüzde yakınlarımızın kaç aşıyla önlenebilir ölüm, kalıcı
engellilik ya da hastalıkla boğuştuğunu, kaçının sağlıklı ve uzun bir yaşam
sürmekten mahrum kaldığını hatırlamak güç değildir. Bu hastalıklardan ne
difteri kayboldu yeryüzünden ne kızamık, ne çocuk felci ne de boğmaca. Artık bu
hastalıkları çok az görmemizin nedeni 1980’li yıllardan itibaren sürdürdüğümüz
yüksek bağışıklama oranlarıdır. Dolayısıyla aşı reddi oranları arttıkça,
bu hastalıkların yeniden ve çok üzücü bir şekilde tüm halkımızın sağlığını
tehdit edeceği açıktır. Çocuklarımızın sağlıklı yaşam hakkının en temel bileşenlerinden
biri olan aşıların yerini alabilecek alternatif bir uygulama yoktur.

Sağlık
Bakanlığı verilerine göre;

19 yıldır
Türkiye’de çocuk felci, 2004’ten bu yana difteri vakası yok.

2001’de 30
bin olan kızamık vakası 2016’da sadece 9’a indi. Aşı karşıtlığı yüzünden
2019’da tekrar 2 bin 391 vaka bilirildi.

Çünkü
aşılanmayan kişi sadece kendine değil, bulaşıcılık açısından çevresindeki
kişiler için de risk oluşturur.

Aşı karşıtlığı toplum sağlığı sorunudur.

 Toplumda aşı karşıtlığının artmasını bildiğiniz halde tarafınızı koruyucu hekimliğin direği olan aşılardan değil aşı yapmamaktan yana alarak halk sağlığı sorununa ortak oluyorsunuz. Evet, aşıları üreten ilaç endüstrisinin herkes farkında ve bundan şikayetçi. Ancak bu sorunun çözümü aşıyı reddetmek olamaz. Yerli aşı üretimiyle bu sorun çözülmelidir.

ÇÖZÜM YERLİ AŞI ÜRETİMİ

İlaç
endüstrisi ile o ilaçları kullanmayarak mı mücadele edilir? Siz ve sizinle aynı
düşünen bir grup hastanın ilaçlarınızı bırakarak bu düzene tavır(!) aldığını
düşünelim. İlerleyen zamanda hastalığınızın oluşturduğu komplikasyonlar neyle
tedavi edilecek? Yine ilaçla. Yani koskoca ilaç endüstrisine karşı kişisel bir
tavırla mücadele edilemez. Devlet düzeyinde mücadele edilir.

Çiçek
aşısını 19. Yüzyılda Avrupalılara öğreten Kurtuluş Savaşı’nın zor dönemlerinde
aşı üreten Türkiye’de, 12 Mart 1971 askeri darbesiyle tifüs aşısı üretimine ve
12 Eylül 1980 askeri darbesiyle çiçek aşısı üretimine son verildi. AB “uyum”
sürecinin ilk adımı Gümrük Birliği’ne girerek 1996’da kuduz aşısı, 1997’de BCG
aşısı ve 1998’de toptan aşı üretimine son verildi. Aşılar ülkemizde sadece
ithalat yoluyla temin edilmeye başlandı.

İlaç
endüstrisiyle ilaca ve aşıya karşı çıkarak değil, kendi aşımızı ve ilacımızı
üreterek karşı çıkabiliriz.

Hastalar popülizmin kurbanı oluyor

“Modern
Tıp”a aykırı söylemlerde bulunan doktorların ekranlara çıkarılmadığını
söylüyorsunuz. İnsaf!

Bugün en çok ekranlara çıkan doktor Canan Karatay değil mi?

Siz de kanal
kanal gezip modern tıp ve aşı karşıtlığınızı anlatmadınız mı?

Bugün
basında ve medyada en çok yer alan doktorlar sizin kitabınızda referans
gösterdiğiniz kişilerdir.

Aksine
bilimsel tezleri savunan kişiler ekranlardan esirgeniyor, hastalar popüler
söylemlerin kurbanı oluyor.

Sizin ilaç
endüstrisine kafa tutan(!) ve halkın yanında dediğiniz Canan Karatay, Ahmet
Rasit Küçükusta gibi kişilerin özel muayenehane randevusu 700 TL’den başlıyor
ve 6 aydan önce sıra gelmiyor. Acaba bu popülerlikte ekranların etkisi var
mıdır?

Sağlığın
ekonomi-politiğini incelerken bu durumu da hesaba kattınız mı?

 Bir örnek vereyim:

Çocuk acil
polikliniğinde nöbetçi olduğum bir gün içeri bebeğiyle bir anne girdi. Bebeğin
yüzü gözü şişmiş ve kızarıktı, zor nefes alıyordu. Anne ağlıyordu. Ne olduğunu
sorduğumuzda “çörekotu yağı içirdim, televizyonda söylediler.” dedi. Çocuğun
tanısı anafilaksiydi.  Anafilaksi ciddi
bir alerjik reaksiyondur. Allerjene maruz kalmanın ilk dakikaları içerisinde
vücudun bütünü etkilenir. Baş etkeni de içeriği bilinmeden alınan ölçüsüz
gıdalardır.

O çocuk
yaşıyor, ancak her gün yüzlerce çocuk denetimsiz kullanılan bitkisel ürünlere
bağlı allerji ve anafilaksi sebebiyle acillerimize geliyor.

Televizyonda
sürekli halka alternatif tıp adı altında önerilen ve internet dahil her ortamda
satışı yapılan bu ürünlerin denetimi var mı? Yok.

İlaç ve
aşıların ekonomi-politiğinden bahsedelim demişsiniz. Haklısınız, bahsedelim.

Alternatif tıp şarlatanlarının 2018 küresel pazarı yaklaşık 60 milyar dolar, 2026’da 210 milyar dolar olması bekleniyor. Aşı karşıtlığının da bir ekonomi-politiği var Soner Bey. Bugün bitkisel tedavi(!) ürünleri satan İbrahim Saraçoğlu Cumhurbaşkanı Başdanışmanlığı koltuğunda oturmaktadır.

Kitabınızda
Canan Karatay’ı cansiperane savunuyorsunuz. Tercihinizdir. Ancak şu cümlenize
anlam veremiyorum:

Gebelere
yaptığımız “şeker yükleme testi” hakkında demişsiniz ki “75-100 gram glikoz
vererek yapılan ölçümde anne karnındaki 300 gram bebek bundan nasıl
etkileniyor?”

Bu cümleyi
kurmak konuya yabancı olduğunuzu açıkça gösteriyor.

Soner Bey,
gebe bir kadın bir dilim pasta ya da tatlı yediği takdirde bile neredeyse şeker
yükleme testindeki ile aynı miktarda şeker vücuduna girmektedir. Bu şekerin
kandaki ve bebeğe geçen miktarını belirleyen şey insülin hormonudur. Karşı
çıktığınız test anne adayı ve bebek için hayati önem taşımaktadır. Gebeliğince
diyabeti kontrol altında olmayan annelerin bebekleri ciddi zararlar görüyor. Bu
zararları konuşmak ise başka bir yazı konusudur.

Karatay’ın
açıklamasından sonra şeker yükleme testi yaptırmak istemeyen bir çok gebe
kadının bebeği ciddi risk altında kalmıştır. Üstelik Karatay’ın böyle bir
açıklaması varsa, ispatlayıp neden bilim camiasına sunmuyor?

Ayrıca çok
merak ettiğim bir husus var. Siz ve Canan Karatay, neden bu konularda uzman
olan kişilerle aynı programa katılmıyorsunuz?

Türk Diyabet
Vakfı Başkanı Prof. Dr. Temel Yılmaz, Canan Karatay’ı söylediklerini tartışmak
için açıktan davet etti. Kendisi neden sağlık camiasına mensup hiç kimseyle bu
konuları tartışmadı?[1]

Bazı yanlışlar tüm doğruları götürür

Kitabınızda
“bilinçli hasta” kavramını kullanmışsınız çok doğru. Eskiden baba modeli
doktorluk esastı. Doktor tek otoriteydi, hasta her dediğini yapmak zorundaydı
ve doktorun hastaya bilgi verme zorunluluğu yoktu. Oysa şimdi arkadaş modeli
hekimliğe geçiliyor. Yani doktor hastayı bilgilendiriyor ve tedaviyi işbirliği
halinde yapıyorlar.

Türkiye’de
sağlık okuryazarlığı artırılmalı. Basın ve medyada zorunlu klipler
döndürülmeli. Hastane bekleme salonlarında sıradan TV kanalları değil, bu
klipler dönmeli. Memesinde kitle saptayan hasta göğüs hastalıklarına gelmemeli,
genel cerrahiye gideceğini bilmeli.

Tıp eğitimi
yenilenmeli, çok haklısınız. Batı’ya endeksli bir eğitim modeli ile Türk
halkına uyumlu bir sağlık hizmeti vermek ve Türk tıbbını dünyadaki gerçek
konumuna ulaştırmak oldukça zor.

Tıp
öğretiminin “hastalık yok,
hasta var” sözlerinde
anlam kazanan temel ilkesi uygulamada karşılığını bulmuyor. Sağlık sistemi
hakkındaki eleştirilerde haklısınız; fazlası var, eksiği yok.

Soner Bey, “Kara Kutu”da Modern Tıp anlayışının yanlışlarından yola çıkarak Modern Tıp’ı bütünüyle zan altında bırakma hatasına düşmüşsünüz. Hele ki aşılar hakkındaki söyledikleriniz haklı olduğunuz birçok konunun önüne geçiyor.

SONUÇ

Yukarıda
bahsettiğim yanlışları öne sürerek bireysel tavırlarla bu şartlara karşı çıkmak
daha büyük bir yanlıştır. İlaç ve aşı, tekelleşme ve kapitalizme bağlı olarak
yanlış güçlerin elinde de olabilir, ancak insanlığın en büyük mucizeleridir.
Yerli ve milli üretim atağını ilaç ve aşı alanında geliştirmek halk sağlığımız
ve ekonomimiz için yapılacak en doğru iş olacaktır.

Kabul ediyoruz, günümüzde, tıp hizmetinin son derece kâr odaklı olması, doktor hasta ilişkisinin gitgide mekanikleşmesi ve ilaç firmalarının etik olmayan uygulamaları nedeniyle insanların modern tıbba olan güvenleri azalmış durumda. Pek çok doktor muayenesi son derece kısa sürüyor ve hastalar sıklıkla geçiştirildikleri hissine kapılıyorlar. Muayene sırasında yüzlerine bile bakamayan ve bir sonraki hastaya yetişme kaygısı ile hastanın kendini ifade etmesine imkan veremeden reçete yazıp hastanın eline tutuşturan doktorlar nedeniyle hastalar kendilerini uzun uzadıya dinleyecek alternatif tıpçıları tercih ediyorlar. Benzer şekilde ciddi yan etkileri olan bilinen ilaçların bu etkilerinin tam olarak açıklanmadan hastalara verilmesi nedeniyle hastalarda hekimlerinin verdiği ilaçlara genel bir güvensizlik oluşmuş durumda.

Kitabınızda
anti-kapitalizm ile bilim düşmanlığı arasındaki farkı silikleştiriyorsunuz.
İlaç endüstrisindeki  parasal akıştan namuslu
her biliminsanı ve duyarlı hekim eleştirmelidir. Ama bunu aşılar konusunda kuşku
yaratmaya kadar götürürerek anti-kapitalizm değil, üzülerek söylemek zorundayım
bilim ve toplum düşmanlığı yapmış olursunuz.

Emin olun,
ilaç endüstrisini en çok sağlık camiasında eleştiriliyor. Ancak yerine önerilen
bir sistem olmayınca yaptığınız eleştiriler yine ilaç endüstrisini beslemekten
öte gitmiyor.

Saygılarımla

Eren ÖZTÜRK
İntörn Doktor

http://www.medikritik.com/haberler/genc-hekimin-soner-yalcina-mektubu-u…

[1]

https://www.haberturk.com/prof-dr-temel-yilmaz-dan-canan-karatay-a-teme…

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