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Eastern Turkey - Health and safety
With Dr Felicity Nicholson
With a few sensible precautions most health problems can be avoided, and most people only experience a few minor things which can be easily treated with medicines you can carry with you. Sunstroke is the most likely thing to strike if you are travelling in the summer months, so make sure you always have your head covered with a proper rimmed hat and keep well hydrated. Use copious amounts of a broad-spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher to avoid burning. Stomach upsets are difficult to avoid in eastern Turkey so you should be careful about everything you eat and drink. Lomotil and antibiotics can be bought over the counter from the chemists’ shops (eczane) in all towns, but it is wise to consult a doctor before you go to check what is appropriate for you and buy before you travel. Always carry a few sachets of oral rehydration salts with you. In central Anatolia and Cappadocia standards of hygiene are higher so you are less likely to pick anything up until you hit the east proper, ie: Adıyaman and eastwards. In the summer months the dust can cause much discomfort to the eyes, with aggravated catarrh in the nose and sore throats. It is a good idea therefore to take eye drops and throat lozenges. Protect yourself from mosquito bites by using a DEET-based repellent, ideally containinig 50-55% as the optimum. This should be used during the day to prevent the risk of dengue fever and again at night to protect against malaria and to ensure a good night’s sleep. The most likely serious incident requiring medical help is a road accident, though the emergency services are good even in rural areas.
There are no certificate requirements for entry into Turkey, however some vaccinations are recommended to protect against certain diseases. It is wise to be up to date with diphtheria, tetanus and polio, which comes as an all-in-one vaccination: Revaxis. There is also a moderate to high risk of hepatitis A and therefore vaccination against this is also recommended for most travellers. There is a low risk of typhoid, but vaccination may be recommended to longer-term travellers in more rural areas. Turkey is classified as an intermediate risk for hepatitis B. Vaccination would be recommended for longer term or frequent travellers, children and those working with children, people working in medical settings and those playing contact sport or other risky sports. Turkey is classified as high risk for rabies and vaccination should be considered for all travellers if budget allows, as getting treatment is not always easy if you have not had the rabies pre-exposure vaccine before you go. Those handling animals are at highest risk, as are those who are in more remote parts of the country or who are travelling for a month or more. Hepatitis B and rabies courses consist of three vaccines given over a minimum of three weeks, so it wise to seek advice well in advance of your trip.
Travel clinics and health information
A full list of current travel clinic websites worldwide is available on www.istm.org. For other journey preparation information, consult www.travelhealthpro.org.uk (UK) or http://wwwnc.cdc.gov/travel/ (US). Information about various medications may be found on www.netdoctor.co.uk/travel. All advice found online should be used in conjunction with expert advice received prior to or during travel.
Eastern Turkey used to suffer from political instability due to problems with Kurdish insurgents but thankfully these problems have essentially been resolved and so travel in the region is now safe and easy. Everywhere is accessible and can be visited without restriction. Petty crime rates for such things as pickpocketing and car theft are very low, and there are too few tourists for the habit of overcharging foreigners to have caught on. However, the region has had a history of violence between its various ethnic groups, which resulted in martial law being imposed by the Turkish government throughout the 1980s and 1990s. Very few foreigners get caught up in violent incidents, and if they do, it tends to be by accident. In July 2008 three German tourists were kidnapped by the PKK, a Kurdish separatist group, on the slopes of Mount Ararat, and released unharmed a few days later, an act of protest against the German government for its closure of PKK offices in Germany. Two people, both Turkish nationals, were killed in the Gezi Park protests.
Bus or long-distance coach is the best and safest way for solo women to travel round the country. Women travelling on their own should keep away from traditional male enclaves like the meyhane (wine house) and birahane (beer house), as their presence there drinking will be taken as an invitation for sexual attention. In cities where there is a university and therefore a student population there may be some Western-style barlar (bars) where it is acceptable for women to go for a drink if other female students are present. Otherwise, you should bear in mind that gender segregation is much more prevalent in eastern Turkey than in the western parts of the country, and foreign women who drink too much in public will be regarded as conforming to stereotype and only after one thing. In Turkish baths, hammams, there are always separate times for men and women. Etiquette varies from hammam to hammam about whether or not you remove your underwear under your pestemal (short cotton sarong you are given), while men keep theirs on at all times. Carry a scarf to cover your head and shoulders on visiting a mosque and always dress modestly so as not to invite unwanted attention. Body language is very important, especially eye contact. If you make too much direct eye contact with a male stranger it is seen as very forward and again, inviting attention. Try to learn therefore to make only as much eye contact as is necessary when buying tickets, food, etc, so that it is clear you are only interested in carrying out the task. Watch how Turkish women behave and interact with other men in public. Whether or not you get hassled as a female in Turkey (or any Muslim country) has nothing to do with how attractive you are. A blond blue-eyed woman for example will not get hassled if she behaves modestly and dresses and carries herself demurely, because her whole body language is conveying she is not available. It is best to be polite but distant. Dress is important in the eastern provinces, and you should always make sure you are not scantily clad. Tight shorts and low-cut T-shirts are not at all appropriate and will cause offence. If you are decently dressed, covering bare flesh above the elbows and knees, and behave sensibly and discreetly, you will cause no offence but will simply be regarded with great curiosity by men and women alike.
Travelling with children
The family is very important to Turkish people and children of all ages are welcomed everywhere. This does not mean that society is child-centred, as nowhere will you find child menus or toys supplied. It is simply that they are accepted as a normal part of life, so adults can relax and enjoy themselves. Even very young children are taken out to eat in restaurants in the evening with their parents and amuse themselves happily with the forks and spoons on the table, eating small amounts of their parents’ food. High chairs are a rarity, as young children either sit on an adult’s knee or are big enough to have their own chair. Formula milk and nappies are available now in the eastern regions, either at the budding supermarkets or at the pharmacies. Baby food in jars is not always easy to find, however, but restaurants and hotels will usually be happy to purée food for you. UHT milk is widely available in small cartons with a straw. Some hotels can provide cots if these are requested in advance, but standards vary quite widely, and sides can be lower than those common in the UK for example, making them fine for a baby but less suitable for a mobile toddler. Child car seats are not regarded as standard, so you should check with the car hire firm whether they can provide these on request.
Homosexuality is illegal in Turkey (as it is in most countries where Islam is the predominant religion), and whilst it is tolerated in big cities like İstanbul and Ankara, and there are even a few gay bars, in eastern Turkey it is a different story and you will need to be very careful in public, as there is still strong prejudice against both gays and lesbians. There are now a couple of gay-friendly travel agents such as Absolute Sultans and Pride Travel.
Travelling with a disability
In Turkey’s eastern regions, many Turkish cities, hotels and tourist sites have no wheelchair access, though Turks will always try their best to improvise and be helpful. A visit to eastern Turkey will therefore be very challenging to travellers with mobility problems, with virtually no adapted toilets, ramps or wide doorways. Turkish Airlines does, however, give a 25% discount to travellers with minimum 40% disability and their accompanying carer(s), but you need a doctor’s letter as proof at the time of booking. Ankara and Cappadocia do have better facilities, but it is best to check in advance via a tour operator. There is one tour operator, Mephisto Voyage based at the İn Pension in Çavuşin, which can arrange special tours of Cappadocia for mobility-impaired people, using the Joelette system, a comfortable wheelchair on one wheel with adjustable treadle, head- and foot-rest.