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The Social Policy of the AKP toward the Kurds

Healthcare Provision in Hakkâri (2003–2014)

by İlker Cörüt (Author)
©2023 Monographs XXVIII, 324 Pages

Summary

This research focuses on the period 2003 to 2014, which was exceptional in the history of the Turkish Republic for its radical shift in the official stance adopted towards Kurds. The overall Kurdish policy of the AKP in 2003–14 was part of a wider agenda of refashioning the nation on an anti-Kemalist, anti-elitist, and essentially pro-Muslim basis. This reconstruction of the nation was built on the populist claim to be ending the varying levels of social and cultural exclusion that the religious masses, Kurds, informal employees, and poorly educated rural masses had been subject to as subaltern groups of the Republic. This policy did not work. The AKP failed to establish Turkish hegemony over Kurds and could not suppress the Kurdish national movement. This book looks for an explanation of the failure of the Kurdish policy of the AKP by considering the limits of its social policy in instituting a compliant, cooperative, submissive Kurdish subjectivity. To do this, it focuses on the persistence of patient dissatisfaction in Hakkâri, a small Kurdish province, during the period despite the very considerable improvements to healthcare provision achieved in these years. The empirical findings of this study show that the persistence of patient dissatisfaction in Hakkâri as a mass phenomenon was essentially a daily symptom of an ethnopolitical resistance to being interpellated by the AKP as citizens-in-the-making who would compare past and present, realize the progress, and thus appreciate the current quality of healthcare provision by tolerating any shortcomings as a minor price to pay for relative material comfort. In short, the limit of the AKP strategy was reached in an attempt to carry out a sort of politics of redistribution that tried to convince Hakkârians to be content with a situation that fell short of full respect to their identity and bodies.

Table Of Contents

  • Cover
  • Title
  • Copyright
  • About the author
  • About the book
  • This eBook can be cited
  • Table of Contents
  • List of Figures
  • List of Tables
  • Preface
  • Acknowledgements
  • List of Abbreviations
  • 1 Introduction
  • 1.1 Research Objective
  • 1.2 Theoretical Framework
  • 1.3 Fieldwork: Field and Methodology
  • 1.4 Overview
  • 2 The Kurdish Question, Sovereign Violence, and Hakkâri
  • 2.1 Historical Background of the Kurdish Question
  • 2.2 Sovereign Violence and State Incapacity
  • 2.3 Dehumanization: Sovereign Violence and the Official Discourse on Kurds
  • 2.4 Sovereign Violence in Hakkâri
  • 2.5 Privatization of Sovereignty in Hakkâri
  • 2.6 Conclusion
  • 3 Indirect State Racism, Healthcare Provision, and Hakkâri
  • 3.1 Indirect State Racism
  • 3.2 Indirect State Racism toward Hakkâri: Not an Ethnic Phenomenon?
  • 3.3 Poverty of Healthcare Provision as Indirect State Racism toward Hakkâri
  • 3.4 Conclusion
  • 4 Turkish Nationalism, the Kurdish Question, and Hakkâri: Discourses and Practices, 2003–2014
  • 4.1 The AKP: From Conservative Democracy to Authoritarian Conservatism
  • 4.2 The AKP and the Kurdish Question
  • 4.3 The AKP’s Turkish Nationalism
  • 4.4 The AKP’s Turkish Nationalism and Hakkâri
  • 4.5 The Limits of the AKP’s Turkish Nationalism in Hakkâri
  • 4.6 Conclusion
  • 5 The Persistence of Patient Dissatisfaction as a Mass Phenomenon
  • 5.1 Dissatisfaction with Healthcare Provision in Hakkâri: A Mass Phenomenon
  • 5.2 An Analysis of Dissatisfaction with Healthcare Provision in Hakkâri
  • 5.3 Conclusion: Dissatisfaction as Citizenship versus Turkishness
  • 6 The Compulsory Public Service of Doctors (CPSD) in Hakkâri
  • 6.1 CPSD, the Production of National Space, and the Kurdish Question
  • 6.2 Unitary Theory of Space as a Key to Understanding Doctors in Hakkâri
  • 6.3 Production of Space as Endurance: Nothing to Be Discovered, but a Bundle of Problems to Be Passively Managed
  • 6.4 The Production of Hakkâri as Endurance as the Outcome of a Trialectical Relationship
  • 6.5 Essentialist and Discriminatory Discourses and Practices of the Doctors
  • 6.6 An Exception: Nursing and Midwifery Professionals
  • 6.7 Conclusion
  • 7 Discussion
  • 7.1 Patient Dissatisfaction and Essentialist Discourses as Limits of Turkish State-Nationalism
  • 7.2 The Issue of the Rationality of Ethnopolitical Challenges: Gains and Losses
  • Appendix
  • Bibliography
  • Index

←xii | xiii→



List of Tables

Table 1. Healthcare Provision in Hakkâri, 2002 and 2010

Table 2. Population of Hakkâri Districts and Province in 1891 by Religious Belonging

Table 3. Illiteracy Rate in Southeastern Anatolia Region and Hakkâri, 1950–1990 (%)

Table 4. Proportion of Kurdish Population in Kurdish Provinces, 1935–1990 (%)

Table 5. Provincial Proportions of Villages with Electricity, Telephone, and Road and of Rural Population in Kurdish Provinces at the end of 1983 (%)

Table 6. Number of Banned Uplands and Meadows in Hakkâri

Table 7. Health Workforce in Hakkâri (Numbers of State Professionals Employed, Five-Yearly), 1955–2005

Table 8. Performance of Hakkâri Health Center, 1956–1967

Table 9. Performance of Hakkâri Public Hospital, 1968–1980

Table 10. Performance of Hakkâri Public Hospital, 1981–2002

Table 11. TT Vaccination Coverage for Hakkâri and Turkey (%), 1996–1999

Table 12. Measles Vaccination Coverage for Hakkâri and Turkey (%), 1997–2002

Table 13. Progressive Rates of Increase in Nominal Public Investment in the Kurdish Provinces and the Rest of the Country in 2003–13 (index: 2003=100)

Table 14. PKK Guerillas Killed Yearly in Military Operations, 2003–2016

Table 15. Progressive Rates of Increase in Nominal Public Investment in Hakkâri, Kurdish Provinces, and the Rest of the Country (index: 2003=100), 2003–2013

Table 16. Surgical Operations Performed in Hakkâri Public Hospital (by category), between 1995 and 2013

Table 17. Performance of Hakkâri Public Hospital, 1995–2013

Table 18. Maternal and Child Health Services in Hakkâri, 1996–2014

Table 19. Immunization Rates in Hakkâri and Turkey, 1996–2012

Table 20. Hakkârian PKK Guerillas Killed, 2003–2014

Table 21. Gender and Age Composition of the Sample and Hakkâri City (%)

Table 22. Educational Background of the Sample and Hakkâri City (%)

Table 23. The Level of Out-Patient Satisfaction with Hakkâri Public Hospital, March 2013

←xiv | xv→



Preface

This research focuses on the period 2003–14, which was exceptional in the history of the Turkish Republic for its radical shift in the official, government stance adopted toward Kurds and the “Kurdish problem” (Kürt sorunu). What made this radical shift possible was the election and coming to power of an Islamist-oriented party, the Justice and Development Party (Adalet ve Kalkınma Partisi, AKP), which opened the gates to a new era in Turkish politics, reshaping its norms and institutions and the composition of leading cadres.

The pre-AKP period of the Republic—or “Kemalist Turkey”—had been characterized by a normative allegiance to bourgeois-secular civilization, privileged place of the military as the guardian of the political system, and intolerance for Kurdish ethnic claims. Thus, other than during partial exceptions in the early and late 1990s prompted by the European Union (EU) membership process, Turkish governments had never really had a Kurdish policy. Rather, they had addressed the Kurdish problem as an issue of public order, security, and state sovereignty.

Recently, the post-2014 period of the AKP has seen a return and replication of Kemalist norms in another reduction of Turkey’s Kurdish issue to counter- insurgency, now with a highly developed military and surveillance capacity. From the point of view of the AKP today, the ethnic and social rights of Kurds have ←xv | xvi→been restored—by the AKP governments—so there is no longer any Kurdish question worth mentioning.

The 2003–14 period is thus specified here by the AKP’s governance and approach to the Kurdish issue. It includes and extends the AKP’s early “golden period” to the time when it entered into and then backed away from its “Kurdish Opening,” diluted and renamed a “Democratic Opening.” Despite all the policy fluctuations, the hopes and tragedies and missed opportunities—from the original foregrounding of civil rights in the EU-accession process to the Roboski massacre and siege of Kobanê (when Ankara favored the attacking Islamic State over the PKK-linked Kurdish resistance), and through it all the ground-breaking, mostly secret negotiations with Kurdistan Workers’ Party (Partiya Karkerên Kurdistanê, PKK) representatives in Oslo culminating in the “Peace” or “Solution Process” (Çözüm Süreci) and open talks with jailed PKK leader Abdullah Öcalan—this period represented a real divergence from the past (as well as from what came after, the post-2014 violence).

Between 2003 and 2014, that is, for first time in the history of the Republic, the Turkish government developed an approach to the Kurdish issue that went beyond oppression and nonengagement, state security considerations, and the dirty war of counterterrorism. Although there were continuing tensions, distrust, and military operations during these years—including lethal PKK attacks in Hakkâri in 2007 and a massive response from the Turkish military in 2008 with an incursion into Iraq to attack PKK bases there—the period overall was one of relative peace and progress. The PKK announced ceasefires and the government began to recognize Kurdish language and cultural rights and seemed to have public opinion more or less on its side, favoring the steps necessary for a resolution (or at least the party’s electoral support was strong enough for it to take a calculated political risk).

During this period, the AKP addressed Kurds as equal members of the nation (millet), essentially a Muslim one, whose ethnic and social rights had been systematically violated by the secular Kemalist elites alienated from the (Muslim) nation as a whole. The political calculus of the AKP approach was evident. The more the violated ethnic and social rights of Kurds were restored, the smaller would be the grounds for the exploitation of Kurds by the PKK and the more peaceful the state-Kurd relations, the AKP reasoned.

In other words, the overall Kurdish policy of the AKP in 2003–14 was part of a wider agenda of refashioning the nation on an anti-Kemalist, anti-elitist, and essentially pro-Muslim basis. This reconstruction of the nation and state was built on the populist claim to be ending the varying levels of social and cultural ←xvi | xvii→exclusion that the religious masses, Kurds, informal employees, and poorly educated rural masses had been subject to as subaltern groups of the Republic.

Although liberatory in many respects, the AKP’s Kurdish policy between 2003 and 2014 had many limitations. These account for how the government could so easily slide from a reformist stance (e.g., negotiating with the PKK over an amnesty for its fighters) into a complete counter-insurgency strategy, finally, thus, to make a full circle (with methods recalling the horrifying tactics of the 1990s as that era’s village evacuation was now replaced by the military destruction of city centers).

In fact, the AKP’s challenge to Kemalist Turkey bore the character of a “passive revolution.”1 It was a passive revolution both because it contained the subaltern opposition to social exclusion and reconciled this with structures of capitalism and also because it sought to satisfy Kurdish demands in order to weaken the Kurdish national movement and consciousness yet without any major concession on the constitutive principles of the Turkish nation-state. To put it in Ranajit Guha’s Gramscian terms, the AKP’s Kurdish policy between 2003 and 2014 reflected a shift rather than removal of Turkish “dominance” over Kurds, from one without “hegemony” to one with it; in fact, the change in state policy was rather more (just) a shift in its balance or makeup, from coercion outweighing persuasion to persuasion outweighing coercion.2

This policy did not work. The AKP failed to establish Turkish hegemony over Kurds and could not suppress the Kurdish national movement. On the contrary, the Kurdish movement reached the peak of its power, with its legal, political representation, the People’s Democratic Party (Halkların Demokratik Partisi, HDP) even capturing enough votes nationwide to pass the old 10 percent threshold maintained to keep Kurdish parties out of the parliament in Ankara. Why was this? How was it that even the barely functioning Hakkâri Public Hospital, which for decades had served little better than a large health post, could be upgraded to a fairly well staffed, modern facility as part of a national policy to remove inequities in health provisioning, and yet this seemed not to be appreciated by the local population and did not translate into the expected levels of votes?

This book looks for an explanation of the failure of the Kurdish policy of the AKP by considering the limits of its social policy in instituting a compliant, cooperative, submissive Kurdish subjectivity. To do this, it focuses on the persistence of patient dissatisfaction in Hakkâri, a small Kurdish province in the southeast corner of Turkey, as an example or case study of a widespread phenomenon during the period despite the very considerable improvements to healthcare provision achieved in these years.

←xvii | xviii→I look for the answer in social policy for two reasons. First, social policy was crucial to the AKP’s Kurdish strategy; it was effectively instrumentalized by the AKP government to win over the Kurds. In the first decade of AKP rule, one can observe a striking expression of the change in the “organic composition of power”3 of the state over Kurds. The relative weight of coercive and persuasive elements in the composition of state policy tools in the Kurdish region was shifted away from security measures and militarization and toward the deployment of a social policy, specifically in response to the Kurdish issue. Since the coercive elements had been employed in the securitization approach applied by the Kemalist state forces—the army, primarily—this was actually an entirely logical type of “democratizing” move for the new government. And indeed, the region had suffered from a lack of relevant social programs in Kemalist Turkey, as is evident in the statistics for public investment and social assistance presented in this work.

A second reason to look for the reason for the failure of the AKP social policy approach to win Kurdish “hearts and minds”—one that is mostly overlooked in Turkish and Kurdish studies—concerns the fact that processes of redistribution are intertwined with recognition.4 What occurs during a redistribution of resources involves a realignment of recognition. The relative positions of groups involved are altered, and new hierarchies are built, fortified, or challenged. In other words, an analysis of Turkish hegemonic attempts to incorporate Kurds into the Turkish national body and of Kurdish ethnopolitical resistance to being co-opted in a moment of redistribution needs to go well beyond an analysis of high politics. It must also pay close attention to how subjectivities are instituted and relative positions are taken in everyday processes that are not immediately political. In this respect, I should also acknowledge that one of my basic motivations in this research was my own critical distance from the dominant tendency in discussions in Turkish and Kurdish studies limiting the issue of the recognition of Kurdishness to that of cultural and political rights.

The main focus of this book, patient dissatisfaction in Hakkâri, was also not chosen without reason. My sense was that the nature of the social policy in the Kurdish strategy under the AKP, which comprised much more than a mere distribution of resources and directly pertained to the issues of recognition, subjectivities, and the (re)negotiation of the relative positions of the sides involved, could not be better revealed than through a research study in Hakkâri. This has been among the poorest and most stigmatized and marginalized of the Kurdish provinces throughout the history of the Republic; if social policy were only an issue of resource distribution, the AKP government would have been expected to weaken the Kurdish movement and emerge as the leading political power there, ←xviii | xix→given that the 2003–14 period saw armed combat and deadly incidents at their lowest levels overall since the first clashes between the PKK and the state in the province in the early 1980s.

It would not be an overstatement to argue that Hakkârians could now access a more or less adequate health service in Hakkâri for the first time ever, and this was directly due to the central government policies and investments introduced from 2003. And yet, the electoral base of the AKP in Hakkâri never did expand beyond a third of the electorate, and Hakkâri remained a bastion of the Kurdish national movement throughout the period.

The empirical findings of this study show a widespread persistence of patient dissatisfaction in Hakkâri even after a decade of material improvements that effected a complete major upgrade of the healthcare system. Interpreting this, we need to say that the issue for patients was more a matter of perspective and political subjectivity than of biomedical dissatisfaction. It was a daily symptom of an ethnopolitical resistance to being interpellated by the AKP as citizens-in-the-making who would compare past and present, realize the progress, and thus appreciate the current quality of healthcare provision by tolerating any shortcomings as a minor price to pay for relative material comfort.

This book thus reveals two factors that prevented Hakkârians from subscribing to the AKP transition narrative. One was the history of state-citizen relations in Hakkâri—that is, the firmly established conviction on the part of Hakkârians that their lives counted for little in the eyes of the Turkish state. The other was a strong, egalitarian insistence on the “here and now,” which reflects an anti- colonial intolerance of any promissory talk of something “in the making” that will fully manifest “later, not now.”

It was when I came to finishing the dissertation on which this book is based, in the middle of 2015, that the negotiation process between the PKK and the AKP finally ended. Thereafter, the Turkish state launched a full-fledged assault on the PKK and affiliated NGOs and political parties. This was quite different from the violent interruptions that had occurred between the different rounds of negotiations, for it signaled a strategic move by the AKP indicating and acknowledging that the party’s Kurdish policy had failed to weaken the hegemony of the Kurdish movement.

Details

Pages
XXVIII, 324
Year
2023
ISBN (PDF)
9781433195785
ISBN (ePUB)
9781433195792
ISBN (Hardcover)
9781433195761
DOI
10.3726/b19533
Language
English
Publication date
2023 (May)
Keywords
Social Policy Assimilation Citizenship Patient dissatisfaction in Hakkâri Ethno-political Challenge Uneven Geographical Distribution of Doctors PKK Kurdish nation-building Kurds Kurdish Question Healthcare Turkish Nationalism Kurdish policy of AKP
Published
New York, Bern, Berlin, Bruxelles, Oxford, Wien, 2023. XXVIII, 324 pp., 19 b/w ill., 7 color ill., 23 tables.

Biographical notes

İlker Cörüt (Author)

İlker Cörüt (PhD, Central European University) is a Post-Doctoral Researcher at the Centre for Citizenship, Social Pluralism, and Religious Diversity at Potsdam University in Germany. Dr. Cörüt was awarded the ASEN/Nations and Nationalism Essay Prize and received the Remarkable Work Award from the Turkish Academy of Sciences for a Turkish translation of Provincializing Europe.

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Title: The Social Policy of the AKP toward the Kurds
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