Out of Insulin in Turkey
Being a person with type 1 diabetes (T1D) is the same as breathing. I was diagnosed when I was 22 months old and do not remember a life of being “diabetic free.” The week before school all my teachers would be informed, coaches would be told before practices started and friends’ parents would be notified prior to any overnight functions. I say this to say that I never once wished for anything different. I have T1D and that is life. One day I may see type 1 as type none, but until then I have just accepted and life continues.
That was, until I was into my sixth month of living in the exquisite country of Turkey. What started out as a vacation with a friend, turned into a solo vacation and eventually turned into a solo move. I am a spontaneous, play-it-by-ear type of traveler. I set an overall plan, add one or two details and then flow with the wind the rest of the way.
My decision to gallivant around Turkey, was not the same as a two-week mission trip to South America, a weekend getaway to Canada, or a five-month whirlwind across the USA. I started gathering my insulin pump supplies I had on hand and began hours of research and phone calls concerning policies, shipping restrictions and the rest of the mundane but important work of making sure I would stay alive in a foreign land.
Through hours of searching the World Wide Web, countless phone calls with the American embassy, and getting in touch with some local Turks, I learned that Turkey was not too keen on accepting packages from the USA. I personally think this is an ego issue, but you take things like that in stride because they are not up for debate. I also learned that if a package contains medication from the USA then a certified letter from the doctor has to be included.
My next step was a quick visit over to my doctor. He wasn’t too keen on the fact that I was going to Turkey or the fact that I was going by myself, but at that point no one was. He went ahead and wrote out a letter and saved it on his computer. He knew that my friend would be calling him around month four or five of my stay over there and he knew to just e-mail her the letter so she could include it with my supplies. Next he contacted my insurance and petitioned for me to have a three-month supply advancement on pump related items as well as insulin. It took some back and forth discussion and after being convinced that I would not misuse my medication the insurance company relented and shipped me my supplies. To me this meant that all was set. I had done my research, talked to the right people and had a system set in place.
With my personal items in storage and my suitcases loaded in the back of my friend’s vehicle I headed to the airport. My soul was more open than it ever had been and I was excited to see what awaited me. Turkey was an intriguing mystery to me. This was a country where negative news derived from, which had in return made this country all that more fascinating to me.
(I could tell you about my day in and day out experience but that would consist of pages upon pages. If an opportunity is ever presented to live in another country—DO NOT hesitate to go. What one can learn from the people, the land and the traditions is worth every minute and every struggle you may encounter. Turkey has a place in my heart and will always be considered a bit like home to me. The rest of this story is going to hit on the struggles of being a person with diabetes living in a country that is not your native home, but I want everyone to realize that even through the hard times it is doable and completely worth it.)
Three months into my adventure, I contacted my friend and had her send over the trial run package—I may be spontaneous but I’m still a planner to an extent. My friend messaged me that she had mailed my package and sent it express delivery because that’s what I would have to choose when I shipped my insulin. I shuddered at the price she warned me that would appear on my credit card.
By the end of the week I had received my package. It was a little worn out and missing a bag of starburst, which I assume the men at customs deemed “hazardous” and kept for themselves. Going back over the pre-planning I had done a few months prior in the states and the success of the delivery, any worries I had quickly vanished from my thoughts. I went about enjoying the life of being the only American resident in my village and the only American resident in the closest city to me. I felt like a queen and in some aspects—after the people warmed up to me, I was even treated a little bit like royalty.
A little over five months into my new and exhilarating life, I called my friend and told her I had about a month of supplies and insulin left and if she could ship out the necessary items sometime that week I would really appreciate it. She contacted my doctor to include the appropriate letters and shipped it off. She called me the day after she shipped it and according to the first run I should have it in about a week.
A week later, I received a notified letter from customs, no package, just a letter with Turkish vocabulary upon Turkish vocabulary flowing across the pages. I had no clue what it said and my limited Turkish was absolutely useless. By this point, I had found a job teaching English and took it to one of my co-teachers and a girl who had become one of my closest life friends.
She called them, spoke some very harsh words and then hung up. She told me that they were going to release it immediately. A few days come and go and nothing. She called again and they informed her they needed letters from my doctor. My boss then intercepted the call and explained the letters were included but to appease the men at customs I contacted my doctor and had him e-mail another copy. A few more days pass and I still had not received my package. By this point I started to slightly worry. I was doing everything they were asking and they still would not release it.
Time is quickly passing at this point and to conserve my insulin, I only ate when my blood sugar was low. (I don’t recommend this but even with all my preparation, I was not prepared to be completely out of insulin.) I was on the phone with customs daily. They continually claimed to need this documentation. On day 29 of my package having been sitting in customs, my boss finally gets ahold of another individual and they say that even though they have continuously stated that they need a letter from my doctor (presumably “my doctor” in the U.S.); instead what they meant to say was that they needed a letter from a Turkish doctor.
If you have never been to a hospital in a foreign country, I recommend it. It will make you appreciate the hospitals here and will eliminate any complaining that may arise. With no one at my job available to accompany me to the hospital, I boarded the bus with Google translate in hand. Trying to explain what T1D is to people in the USA is often challenging, but I never imagined how hard it would be to explain what T1D is in a language I was not fluent in.
I explained my dilemma as best as I could, pleaded with her to write me a prescription, for a drug she knew nothing about in order to retrieve my package that was still being held hostage in customs. I also asked her to write me a prescription for their version of insulin so I could go purchase a vial in case this ordeal prolonged any further.
I e-mailed customs my prescription written by a Turkish doctor and 34 days after my package arrived in Istanbul, I finally had it in my possession—dented, soggy from the gel packs being punctured and with a few things missing. Looking back, the experience was difficult, but I learned to never let the bad experiences outweigh the phenomenal moments. And this may have been an issue but I learned to overcome it and I am ready to conquer another country.
