FISEK INSTITUTE

Mission Statement: The Fisek Institute is a non-governmental organization acting in the field of occupational health and safety at the national level. It focuses on the continuation and enrichment of the community medicine philosophy by its applications especially for small and medium scale enterprises and working children.

Words for Identity:

• Occupational Health
• Occupational Safety
• Occupational Hygiene
• Child Labor
• Social Policy
• Women
• Community Medicine

Objective: It aims at making use of medicine to protect and improve the community's health, at making use of social sciences to protect and improve the people's social lives, at making use of engineering sciences to purify living and working conditions from hazards and to combine all of these to implement theoretical and practical studies. At the same time, it aims to raise the consciousness of the public in order to remove the reasons forcing children to work; to eliminate the factors that are dangerous for their health and safety at work; to ensure improvement of health, identity and self-esteem of the working children.

FISEK INSTITUTE

Foundation's Administrative Organization: Founder's Council, Executive Board, Foundation General Management, Auditing Council.

Service Approach: The Institute regards health as one's well-being not only physically and mentally, but also socially. It has a multi-science approach (medicine, engineering, social sciences) regarding occupational health and safety (Institute's expertness field) and uses team-work in its activities. It unites preventive-protective services with treatment services in line with the community medicine approach. So as for the workers receiving occupational health and safety education in order to adopt the information to apply it, education is implemented interactively and by application. It is also important to strengthen the communication and confidence with the employee and the employer so as to give occupational health and safety services effectively. For that reason, independence from both the employer and the employee is essential. The obligation of the employers to provide a healthy and safe working environment for his/her employees is the fundamental basis for the Institute's activities. However, its practices are not based on using legal force, but rather on the art of convincing, in other words, it uses smiling discourse.

Limitations: It is impossible for the Fisek Institute to spread the Fisek Model throughout the country on its own. The Fisek Institute can only implement and develop model studies. Therefore, it considers priorities within these studies and gives service to industry (especially to the small and medium scale enterprises).

It is the Fisek Institute's assertion that a widespread organization at the national level requires a central planning mechanism that would not seek profit, in other words, a social state. Similar to this, the elimination of child labor is possible if and only if a long term program for the struggle against poverty succeeds.

One limitation of the Institute itself is due to the sustainability of the model depending on only the contributions of employers in small industries. Sometimes, economic fluctuations affect those employers' financial capacities, thus their desire to implement legal obligations is hindered. These payment difficulties may create problems for the Institute's services, as well.

Institute's Memory: Traces of its past can be seen in the Institute's periodical 'Working Environment' ('al''ma Ortam'), legal documents, correspondence, project documents, web site, introductory videotape and analysis of application centers.

The Fisek Institute was founded in November 1982, through health services for small scale jobsites in Ankara (city)-Atasanayi (an industrial region that was given priority as to the Institute's work which shifted its priority to Ostim afterwards). The studies that began as pre-employment health examinations and periodical health checks were only given to five jobsites in 1982 which later grew into 156 jobsites in 1986. These jobsites were visited at certain time intervals and health files were arranged after the examinations were done every six months. The confidence and positive communication created with both the employees and the employers allowed the scientific research to be carried out. The Institute's founders had carried out a project named 'Medical-Social Problems of Working Children' (in four cities with the primary focus in Ankara, supported by Population Council/MEAwards) in 1984-1986, while in 1985-1986 they implemented a project named 'Special Risk Factors of Children at Work' supported by World Health Organization (in Ankara; various other cities were also included due to the project examining the past experiences of those children).

As employers' contributions increased, the studies developed into a revolving fund. At the same time, expectations from the scientific research done and work performed increased as well as some financial obligations that came into being (e.g. bills, taxes etc.). All of these factors made it necessary to be organized in a company form, thus in 1986, 'Fisek Private Heath Services and Research Institute Ltd. Co.' was established.

Since 1994, the Institute's branch in Istanbul(city)-Yenibosna(industrial region) started to implement 'group jobsite physician' services as a part of SSK services (Social Security Association's heath services). The same practice began to be implemented in Ankara in 1996.

Contact with the Turkish Representative of International Labor Organization (ILO) has been an important developing factor for Fisek Institute. ILO's concern for the heath services model study at small and medium scaled jobsites was very important. Their request for a report led to a study named 'Proposal for a Feasible Measure That Can Be Taken for the Improvement of Working Conditions in Small Enterprises' in July, 1986. Another important contribution by ILO is their support for the first six issues of the periodical 'Working Environment' ('al''ma Ortam') in 1992. 'Working Environment', still being published bi-monthly, has been the single, most long-lasting periodical of its kind. ILO's International Programme on the Elimination of Child Labor (IPEC) that was started in November 1992 in six developing countries (Turkey being one), and later included more countries, has accelerated Fisek's studies and has contributed much to its model-formation process. ILO's support of equipment, personnel and its encouragement played an important role in Fisek Model giving health and social service to working children.

Achieved dimensions in child labor studies and the extent of experience accumulated made it necessary to develop an expert institution under the frame of Institute, thus the 'Fisek Institute Science & Action Foundation for Child Labor' was established in 1997.

1982 A health unit is established in Ankara-Ostim

1982-1986 Periodical health checks and pre-employment medical examinations in Atasanayi, Ostim, Siteler and Otosanayi industrial regions were given

1984-1986 Report of Medical-Social Problems of Child Labor (in Ankara, K'z'lcahamam, Bursa, Eski'ehir) supported by the Population Council/MEAwads

1985-1986 Report on 'Special Risk Factors of Children At Work' (in Ankara; also many other cities included) supported by WHO

1986 Establishment of the Fisek Institute Private Health and Research Services Ltd. Co.

1986 Proposal for a Feasible Measure That Can Be Taken for the Improvement of Working Conditions in Small Enterprises (for ILO)

1992-1994 Project of 'Health Services for Children Working in Small Scale Enterprises' (in Ankara, Istanbul, Denizli) supported by ILO/IPEC

1992 Mobile clinic is purchased and services are provided for Ankara

1992 'Working Environment' ('al''ma Ortam') is published and 'Readers Seminars' begin

1994 A health unit is established and mobile clinic is bought in Istanbul-Yenibosna

1995 Project of 'Improvement of Working Conditions at Small Scale Enterprises Employing Child Labor and Occupational Safety Exhibitionhouse' (in Ankara, Istanbul, Denizli) supported by ILO/IPEC

1995 A health unit is established in Ankara-Sincan; a health unit is established and a mobile clinic is bought in Denizli; a mobile clinic is bought, thus mobile dentist clinic practice starts in Izmir

1997 The mobile clinic in Izmir is shifted to Ankara

1997 'Fisek Institute Science & Action Foundation for Child Labor' is established

1998 A health unit is established in Ankara-Uyumlu industrial region

EVALUATION OF INSTITUTIONAL PRODUCTION

Priorities: Social risk groups are given priority in line with the community medicine philosophy. That is why, it takes occupational health and safety as the basis of its activities. Workers are at all a social risk group due to their poor working and living conditions. Enterprises employing less than 50 workers do not have to constitute an occupational health and safety council or employ an occupational physician, nurse and occupational safety expert, so, their working conditions are relatively poor. Limited capital, underdeveloped technology, weakness of workers' pressure are additional negative points of the small and medium scale enterprises. For that reason, the Institute gives priority to and develops the model with these enterprises being in core. In society, children naturally constitute a risk group. Therefore, a working child is even more fragile due to social, mental and physical health hazards. As for the working girls, this risk doubles due to their female identity additional to them both being a child and a worker. As regards; the working children -especially the working girls- are given priority in the organization of Institute's activities.

Firsts: Inclusive research about child labor in Turkey was first carried out by the Fisek Institute (1984-1986). It was again Fisek that had the first initiative to gather small scale enterprises around one focus in order to give health services. As the small enterprises are generally dispersed in the industrial regions, a dual study has been executed: On the one hand, there is the center named 'Health Center in Industry' where activities such as medical examinations in the case of emergency, communication etc. are carried out. On the other hand, there is the 'Mobile Clinic' visiting the jobsites. Giving free health examinations for the working children in industry by a non-governmental organization (and giving them with a professional team in the field of occupational health and safety), school health studies in the Workers' Schools (Apprenticeship Education Centers) are once again firsts. As for the periodical 'Working Environment', its longevity as a periodical in occupational health and safety with a multi-science approach is likened none.

Originalities: We may summarize the originalities of Fisek Model as stated below:

• It adopts the community medicine approach; it gives emphasize on preventive medicine and it recognizes the individual within his/her social environment (See the table at the end of this section so as to compare community medicine approach and Fisek Institute's approach)
• Its basic target is working children and youth. It gives a special importance to the working girls.
• It focuses on occupational health and safety.
• Its main financial resource is the payments of small industry employers in return to services given.
• It has a modular structure organized around one focus.
• It has provided its sustainability.
• It connects development (renewability) to participation.
• Means used in supplying services are such:
• Mobile Clinic
• School Health Unit in the Workers' Schools
• Health Center in Industry
• Exhibitionhouse
• The services stated above are given by an organization independent from the government and other special interest groups.
• It has an academic , ethical and artistic care.
• 'Smiling Discourse' is adopted.
• It has been implementing what is original and challenging.

Feedback Methods - Participation:

Social participation: Continuing communication with children, workers, employers of the jobsites where model is implemented and sensitivity to their proposals increase society's interest and contribution in the studies of the model. However, tests of ways to increase this participation are still continuing. On the other hand, the most powerful weapon against possible non-communication and insensitivity of implementers (i.e. personnel of the Institute) is the possibility of employers and trade unions ceasing from buying the services.

Initiative to the Institute personnel: Fisek Model aims to make good use the experiences of Institute personnel. Their past and current information and experience accumulation is being translated into practice quickly; restrictions are being avoided. At the same time, newnesses and contributions are being encouraged. It is also seen as a positive development for the personnel to develop their professional identities and strengthen their ties with their professional organization. As for the communication between the personnel, a picnic is organized by them every year. 'Fisek Personnel Assembly' practice has been added to the Institute's inside participation means in 1997, that is planned to be repeated every year.

Organization of volunteer and expert participation: Volunteer participation in the Readers' Seminars once every two months organized by the Institute's bi-monthly periodical Working Environment ('al''ma Ortam') plays an important role in its structure based on collective work and discussion. These seminars that are an action of community medicine and have widespread participation throughout the country have been gaining the characteristics of a school over time.

Level of Meeting Social Needs: The Fisek Institute is providing service to 400 jobsites in Ankara(city)-Ostim(industrial region), to 40 jobsites in Ankara-Sincan, to 140 jobsites in Istanbul, and to 45 jobsites in Denizli. School health studies are carried out in Workers' Schools in Ankara, Istanbul and Denizli (7400 apprentices have received health checks in those schools between 1993-1998) while at the jobsites 500-600 working children are provided health services yearly on the average. Other than these children, 150 more children have also been receiving health checks (that is planned to be provided two times a year, one has already been given in October 1998) in Pendik Industrial Region due to the contract signed with Turkish Employers' Union (TISK) in the framework of ILO/IPEC. Today, large scale enterprises (such as Mercedes Benz-T'rk A.'./ Aksaray, Pirelli A.'./ Kocaeli, Ar'elik A.'./ 'ay'rova, Ar'elik A.'./ Eski'ehir, Matsan/ Manisa, Matsan/ Istanbul) receive occupational health and safety educational programs, risk analysis and application studies. Those education programs and publication studies in that scope have also been carried out with Harb-I' (trade union of workers in the military sector in Turkey) in five big factories (in Ankara, Kocaeli, Istanbul) and are aimed at increasing the participation and sensitivity of ground members under the scope of Harb-I' 2000 Project.

The Fisek Institute has been improving its services in quality and variety while still limiting them at the micro-level as required by the 'model study'. The same effort is also observed when its historical development is examined. However, expectations from the Institute are increasingly diverse despite the expertness of the Institute with regard to occupational health and safety issues due to the lack general qualified health services offered by the state.

Financial Support: Payments from employers in return for occupational health and safety services provided for the workers on the basis of employers' legal obligations, money from occupational safety educational programs given to trade-unions, project supports, income from subscriptions to our bi-monthly periodical 'Working Environment', sale of postcards, handmade crafts and other items at fairs or bazaars, grants and donations to the 'Science & Action Foundation for Child Labor'.

Heartfelt Volunteer Cooperation Projects: 'New' and 'creative' studies of Fisek Institute in various fields have been reproduced by many organizations within the society due to sharing them (such as the 'common health centers for small scale jobsites' that didn't exist before Fisek's initiative in our country). This is only one example of Fisek performing its duty for the society. For, Fisek Institute has been performing activities in collaboration with many respected institutions in the society. These activities are combined under the umbrella title of 'heartfelt connection projects' by the Fisek Institute. In addition to the projects mentioned in the above paragraphs, the Foundation have also contributed in some education programs (such as supplying educational support in occupational health and safety issues to the MEKSA Foundation's 'Education Technical Seminars' and in child labor issues to the 'Workshop for Education Programs of Expert Groups in Trade-Unions' arranged by the 'Turkish Economic and Social History Foundation' and 'Frederich-Ebert Foundation' in 1998). It was again 1998 when the Institute made a competition between the primary school students to make them think, write or paint about child labor. As well as these, the Foundation's Representation Branch that is composed of deeply commited volunteers has been attending many bazaars and fairs so as to inform people about the Institute's goals. It is Fisek's heartfelt connection projects that combine the volunteer action with professional action and that attempts to increase social solidarity.