This article was originally published in the European Voice.
Many tensions have bedeviled NATO's military operations in Libya—tensions between France and NATO, between Germany and its allies, and between active and less active partners in the coalition. But it is the clash between Turkey and France that should most worry the EU.
This is more serious than their difference of approach on military intervention to Muslim countries. A strategic rivalry is emerging that is compromising the ability of the West to respond cohesively and effectively to emerging threats. And this rivalry is damaging the EU's relationship with Turkey at a moment when both have much to gain by working together in the southern Mediterranean.
The relationship between Paris and Ankara has long been poor, but it has rarely been worse. Turkey was conspicuously absent from the meeting of leaders in Paris that, on 19 March, established the ad hoc coalition to enforce the no-fly zone over Libya. French President Nicolas Sarkozy's decision not to invite Turkey showed how deep the rift between Paris and Ankara has grown.
Usually, acrimony in bilateral relations can be addressed through political dialogue and direct contacts between leaders, but reconciliation looks far away. Sarkozy's visit to Turkey in March added insult to several years of injury, by repeating his opposition to Turkey's bid to the join the EU. Turkish Prime Minister Recep Tayyip Erdogan was furious about being frozen out of the Paris summit.
The strategic rivalry could extend beyond Libya. France is actively looking for new interlocutors in north Africa, a region in which it has huge political, economic and energy interests as well as a long history. Paris is seeking not only to establish ties with the emerging leaders in Tunisia and Egypt, as well as looking for new allies in Algeria and Morocco.
But, while France may have aspirations, the emerging political constituencies in Tunisia and Egypt find Turkey a more interesting model and more appealing partner for their transition processes.
Like France, Turkey has a difficult imperial legacy in the region, but it offers a successful combination of Muslim traditions, democracy and rising prosperity. And, in Arab eyes, the dynamism of its economic growth compares favorably with crisis-ridden Europe's sluggishness.
In recent years, as its membership talks with the EU have slowed down, Turkey has focused on being a big power in its neighborhood. In the process, it has regained self-confidence.
However, the Arab transitions pose Turkey a challenge that it cannot manage alone—and neither can the EU. The region needs what both have to offer. For example, the EU can offer money but not guidance on combining political Islam with democracy. For its part, Turkey has trade and investments but lacks the EU's capacity for technology transfer and market size to help north Africa's developing economies.
Both Turkey and the EU have much to gain from dovetailing their neighborhood policies to form a common strategy for the southern Mediterranean.
For that to happen, Turkey and the EU would need a high-level political dialogue on foreign policy. That is missing at the moment because Turkey's accession process is nearly at a standstill. Negotiators have no reason to meet to discuss foreign, security and external policies because those chapters are blocked.
The EU should therefore establish a foreign-policy dialogue that allows Turkey to work in concert with the Union regardless of the progress of accession talks. This dialogue would be a forum for regular, institutionalized discussions about the aid, technical assistance, political support and economic opportunities that are needed to facilitate the Arab transitions.
Strategic dialogue between the EU and Turkey needs to replace the emerging strategic rivalry between France and Turkey, to establish a smoother and more reliable regional security order led by NATO, and prevent a repeat of the debacles in the Libya crisis.
THE UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER RECEIVES STATEWIDE AWARD FOR QUALITY.
States News Service February 1, 2011 AUSTIN, TX -- The following information was released by the Texas Hospital Association (THA):
For its efforts to reduce the incidence of ventilator-associated pneumonia in the ICU to zero, the Texas Hospital Association has honored The University of Texas MD Anderson Cancer Center with the inaugural Bill Aston Award for Quality. Established in 2010, the award recognizes a hospital's measurable success in improving quality and patient outcomes through the sustained implementation of a national and/or state evidence-based patient care initiative. It will be presented Feb. 3 at the THA Annual Conference in Austin.
When Joseph L. Nates, M.D., joined MD Anderson Cancer Center in Houston in 2002, he learned that the intensive care unit ventilator-associated pneumonia rate was 34.2 cases per 1,000 ventilator days, double the national average for trauma ICUs (used as the benchmark).
Nates was concerned; VAP increases ICU stay by up to 22 days and hospital stay by up to 25 days, and it has the highest mortality of health care-associated infections. The following year, Nates and his colleagues implemented aggressive multidisciplinary strategies to reduce the VAP rate. By 2009 that rate had dropped to zero, and it has stayed at zero for the past year. web site md anderson cancer center
"When we started, a lot of people were skeptical that we could reduce that rate. Our ventilated cancer patients are very sick, and many of them are immunosuppressed from chemotherapy," said Nates, who serves as medical director of the ICU.
"Many of the techniques we are using today had not even been published when we started eight years ago. That's why you have to keep learning and working on the problem. We haven't eliminated the causes. If we don't continue to work on the factors that lead to VAP, the infections will come back," Nates said. "The main reason for achieving a rate of zero VAPs for the past year is that we have been persistent. We have a cohesive and aggressive multidisciplinary team that consists of physicians, nurses, respiratory therapists and infection control specialists who work together toward this common goal." Thomas Burke, M.D., executive vice president and physician-in-chief at MD Anderson, points to the impassioned leadership Nates provided.
"Quality projects require a champion, and he's the guy that drove this team," Burke said. "To be successful, you have to be relentless." Another important driver of success was the impact on patient lives. VAP is a deadly complication. In 2005, the American Thoracic Society published data that showed a 30-40 percent death rate for VAP cases occurring in the general population. Other more conservative estimates put the death rate at 25 percent of all VAP patients. For the MD Anderson ICU, which averaged more than six cases per month in 2002, a drop to zero represents dozens of lives saved during the past eight years. website md anderson cancer center
The drop in VAP rates also saves an enormous amount of money and helps patients recover more quickly and leave the hospital sooner, freeing up critically needed hospital beds. The average cost of treating a VAP infection is about $57,000. With at least six cases per month, MD Anderson's cost for treating VAPs in 2002 was more than $4.1 million per year.
Burke said the ICU team has inspired the work of other quality improvement projects at MD Anderson.
"This is a classic quality improvement project," he said. "There isn't one thing that made all the difference -- there was a series of things that got the team members part-way there. They didn't abandon their gains, and they didn't settle for their initial gains. They kept working." *** About MD Anderson The University of Texas MD Anderson Cancer Center in Houston ranks as one of the world's most respected centers focused on cancer patient care, research, education and prevention. MD Anderson is one of only 40 comprehensive cancer centers designated by the National Cancer Institute. For seven of the past nine years, including 2010, MD Anderson has ranked No. 1 in cancer care in "America's Best Hospitals," a survey published annually in U.S. News and World Report.
About Texas Hospital Association The Bill Aston Award for Quality In 2010, the Texas Hospital Association established the Bill Aston Award for Quality through an endowment of the Baylor Health Care System. The award is named for the late Baylor Health Care System Board Member and Texas Healthcare Trustees Chairman Bill Aston, a longtime leader in and champion for quality and patient safety. All THA active institutional members are eligible for the award. Nominated projects must demonstrate improved outcomes in patient care and be related to a national or state standard for improved patient care.
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