11 questions about Türkiye/Syria Earthquake (Updated on 15/2)
1) What is the situation in Northwest Syria?
Following the two strong earthquakes many buildings in northwest Syria collapsed leaving thousands of people homeless. The search for survivors is ongoing, with the hospitals that remain functional treating the wounded. Many hospitals have been damaged, with some, such as the hospital in Jandaris/Jindiris, unable to carry on treating patients. Two MSF-supported maternity centres were evacuated, due to the risk of the buildings collapsing. Our medical staff and the staff of other facilities have been working hard to treat patients since the first earthquake.
As per WHO, 48 heath facilities have been either damaged or destroyed, this had increased the pressure on the remaining facilities, as they were dealing with an influx of injured people. The burden on the remaining functional ones is unbearable. The health system is now extremely weak, this is the result of the reduction of humanitarian funds and limited support to health facilities in the last years.
Two MSF-supported maternity centres and one primary healthcare centre were evacuated, due to the risk of the buildings collapsing. Our medical staff and staff at other facilities worked hard to treat patients. WHO reported that around 48 health facilities have been damaged.
There has been major destruction in large buildings in urban centres. The district with the highest number of deaths and injuries is Harim, followed by Afrin and Jebel Saman.
Authorities reported that the number of destroyed buildings is currently estimated at 1,764 and the number of partially destroyed buildings was 5,771. The number of families affected from this earthquake is over 11,000 families who are now homeless.
The Displaced Affair Office has opened more than 20 reception centres and shelters to accommodate the impacted families in Idlib.
In addition, our team is reporting new arrivals to existing camps for internally displaced people, who were living already with limited resources. For instance, 702 people comprising 145 families affected by the earthquakes arrived at one camp in North Aleppo to share very limited space and resources with the people who were already there.
The searching and rescuing operations of those trapped under the rubble are now over. Local teams moved to the stage of recovering the bodies after almost losing hope of finding living people under the rubble. However, Civil Defense teams are still complaining about the scarcity of fuel and the loss of spare parts and maintenance for the vehicles, in addition to the urgent need to provide more heavy vehicles.
Prior to the earthquakes, northwest Syria was already facing a dire humanitarian situation due to many years of war, the pandemic and, more recently, a cholera outbreak. This earthquake makes the situation even more difficult while the medical and healthcare system continues to be fragile.
2) What are the main needs we’re seeing?
In the aftermath of the earthquake, the needs are both medical support and relief assistanceOffering immediate relief support to people affected by the earthquakes, particularly those without shelter in this cold weather, will be a main priority. People need shelter, food, blankets, clothes, heating materials, hygiene kits and medical assistance.
We are witnessing a lack of fuel, electricity and adequate water and sanitation. There is also a major challenge for people impacted by the earthquake to access mental health support, including our staff.
The needs are massive for a population who have huge needs, both for medical care and non-food items.
There will be even more displaced people in northwest Syria, where 2.8 million people, out of a population of 4 million people, were already displaced.
Critically injured patients need to be taken care of, either in Türkiye or in Northwest Syria, where the capacities are currently not available. Supporting hospitals and blood donation centres to save lives and treat the injured, providing medical supplies (surgical kits) for the clinics, providing mobile clinics, providing psychological support are all essential activities.
Mental health was already a high concern for Northwest Syria with increasing suicide rate over the last years due to the living condition, economic crisis, lack of perspective. We expect aggravation of chronic mental health conditions as well as other types of mental health disorders.
This earthquake adds a dramatic layer for the vulnerable people here who are still struggling after many years of war. The massive consequences of this disaster will require an equally massive international aid effort. International aid must reach northwest Syria as soon as possible to support the population.
We will continue to assess the needs and adapt our response accordingly.
3) What is MSF doing?
SYRIA: Since the first hours following the first earthquake, our Syrian colleagues have been working to provide help and care, even though their own personal situations were difficult. We’ve treated more than 200 patients in the first hours in MSF facilities, while MSF-supported facilities reported treating over 7,600 injured people and receiving around 1,000 deaths, between February 6 and 12.
In the two of the clinics and one hospital that we run in Idlib governorate, where we treated hundreds of patients in the first days after the earthquake, our teams have seen a decrease in the number of wounded arriving to the wards. We restarted our normal activities so we could treat patients seeking primary healthcare, as people still need it.
In addition, MSF has activated an immediate response based on its emergency preparedness plan, supporting around 30 hospitals in Idlib and Aleppo with emergency kits, trauma kits, surgical kits, to increase the capacity of the medical system. We have supported hospitals with senior staff from our teams. We have also scaled up the bed capacities in our medical facilities by adding tents where needed, and dressing points for treating wounds. We also offered support to ambulances - with fuel to facilitate the transfer of patients in need of emergency assistance.
Hospitals and health facilities are lacking the most essential items. In Idlib governorate, we offered 6,100 blankets to 13 hospitals, and we’re supporting the production of oxygen for 8 health facilities. We also donated fuel to two hospitals so they can continue running their activities.
In Idlib governorate, we’re also running 4 mobile clinics in 3 reception centres offering general consultations, dressing, reproductive health services, and mental health consultations, to people affected by the earthquakes. As of Feb 13, we performed 2,134 consultations.
In Aleppo governorate, we started a mobile clinic in Jindires, on February 13 to serve the displaced communities. In the first day we treated 119 patients including children, pregnant women and people with injuries, in addition to mental health consultations.
As for relief assistance:
- In Idlib governorate and Afrin district in Aleppo, we distributed with our local partners more than 700 family kits including blankets, mattresses, and arrival kit. In addition to 7,700 individual blankets, 1,100 hygiene kits, 50 tents, and 550 additional mattresses in reception centres.
- Similarly, in collaboration with local partners, we distributed more than 515 full NFI kits, including hygiene items, kitchen kits, winter kits and blankets, to affected people in Jindires, one of the most affected cities, and families in reception centres in Azaz and Mare’a and surrounding villages.
- In the west of Idlib city, we distributed blankets, plastic sheeting, and winter kits to families.
Besides the emergency response, MSF continues to provide its regular medical assistance and activities in hospitals that have not been affected, in order to support the population and ensure continuity of care for the most vulnerable, including pregnant women and people with chronic diseases. With an already high prevalence in the population, these diseases can be deadly if left untreated because of lack of supplies and drugs.
In northwest Syria, MSF is also working in partnership with two local NGOs.
4) What is the situation in southern Türkiye /what are the main needs?
Well over 100,000 people in Türkiye have been left homeless by the earthquake and its aftershocks, which caused about 6,000 buildings to collapse, according to the International Federation of the Red Cross.
The authorities are requisitioning schools for future shelters and their mobile teams are deployed so that people can donate blood. They have declared alarm level 4 and a three-month state of emergency in the 10 hardest-hit provinces.
The authorities have said that the immediate needs identified are for shelters, NFI distribution activities and food distribution. While we do not have much visibility on medical needs, 145,000 Turkish health staff have been dispatched to the affected areas and 22 field hospitals are being deployed.
MSF emergency teams are assessing the needs in the most affected areas of southern Türkiye. Hatay, Kahramanmars, Adiyaman, Gaziantep and Diyarbakir seem to be very affected by the earthquake.
5) What is MSF’s plan to respond in Türkiye? What is the response of the Turkish authorities to MSF’s offer of assistance?
The model and scale of our response depends on the results of our assessment of the situation and on the space that we must implement an effective response.
Following the earthquakes, we have submitted two proposals on 6 and 7 February to the Ministry of Foreign Affairs to assist the population of Türkiye with medical teams and field hospitals. We received an answer from the authorities on Friday, 10 February. For the time being, they proposed that MSF support is best offered through donations of medical items and other materials.
Since 8 February, in partnership with the Turkish NGO IBC, MSF has provided food and first aid distributions in several shelters in Kilis, a border area in the south-west of Gaziantep.
6) Are the staff impacted in NWS?
We received the tragic news of the death of two of our colleagues who were found under the rubble. Many of our staff, who are living in northwest Syria, have been impacted, whether directly or indirectly, by the earthquakes. Some have lost their houses or their loved ones too.
To ensure they have the support they need, we are in close touch with our colleagues inside northwest Syria, providing them with the psychological support and other support we can offer, including temporary shelters, financial assistance and mental health consultations to team members and their families.
7) What are the next steps for the MSF response?
MSF teams are adapting their response in northwest Syria to offer immediate relief and medical support. The pillars of the first few days of the response are supporting medical facilities to treat patients, facilitating transport of patients by supporting ambulances, and providing immediate relief items to people affected. Our teams have now set up mobile clinics in shelter/reception camps and are offering psychological first aid, as the mental health needs are huge. We’re also doing our best to maintain our regular activities, to ensure continuity of care to the people who need it the most such as children, pregnant women and patients with chronic health conditions.
Meanwhile, with our partners, we continue to assess the situation and the needs in Idlib and northern Aleppo in Syria, and in southern Türkiye, to scale up our response.
In collaboration with local partners, MSF is providing some assistance in Türkiye, and is ready to mobilize further emergency capacities if needed. We should note that this is a really complex operation that needs to be phased very carefully, and we also need to start thinking about the longer term, including the secondary effects of the earthquake including potential challenges like disease outbreaks.
The massive consequences of this disaster will require an increased international aid effort that is up to the scale especially in Northern Syria. In order to be able to address some of the immediate needs, including medical, shelter and food, humanitarian agencies need access through all available border points. We are witnessing a lack of fuel, electricity and adequate water and sanitation. There is also a major challenge for people impacted by the earthquake to access mental health support, including our staff.
8) How is humanitarian aid coming inside northwest Syria?
Bab Al-Hawa is the main UN supported humanitarian crossing between Türkiye and northwest Syria, from which essential life-saving medical supplies can enter northwest Syria. On February 13, two additional crossing points of Bab Al-Salam and Al Ra’ee from Türkiye to northwest Syria were announced open for an initial period of three months. We hope this will help ensuring a timely and effective delivery of the humanitarian aid.
We support the call for more access points to be made available for humanitarian help to enter northwest Syria.
The biggest challenge would be a potential delay in the importation of humanitarian and medical aid into Syria.
In order to be able to address some of the immediate needs, what we do know is that humanitarian agencies need access through all available border points.
It’s clear that the current response is not covering the huge needs of the population in northwest Syria. Humanitarian response should be scaled up immediately and directed much closer to the communities who are in dire need of shelter, food, heating material and medical care.
9) What are the challenges you’re facing while responding to the current emergency?
We are expecting a lot of pressure on local supply markets. As a consequence, we are expecting the prices to rise and shortages to happen. Fuel might become an issue as well.
We are also expecting some challenges to bring big volume of humanitarian aid inside Syria, as the access points remain limited and there is a risk of a bottleneck impeding the flow.
We have also used our emergency stocks to respond in recent days, and we will need to replace them as soon as possible.
10) What are the main challenges for the provision of healthcare in Syria?
Generally speaking, following 12 years of war, a record 14.6 million people need humanitarian assistance in Syria. It is the country with the largest number of internally displaced people (IDPs) in the world, with 6.9 million IDPs, most of whom are women and children. Many have been displaced repeatedly and live in precarious conditions.
Even before the earthquakes, the continued conflict in Syria had shattered the health system. Hundreds of health facilities have been damaged or destroyed by the war. Many doctors fled the war or were killed. Human resources in the health sector were extremely limited in both northwest and northeast Syria. Hospitals often ‘share’ medical personnel to remain functional. Most facilities continue to face regular shortages of essential medicine and medical supplies. And this earthquake is causing yet more problems for the health structures.
In areas where access could be negotiated, such as northwest and northeast Syria, we run and support hospitals and health centres, and we provide healthcare through mobile clinics.
11) Specifically, what areas in Syria is MSF providing healthcare?
In northwest Syria, prior to the earthquake, MSF was supporting 7 hospitals including 1 burn unit, in addition to 12 Primary Health Care centres (PHCs) and 3 ambulances for referrals. In addition, MSF supports 11 mobile clinics serving Internally Displaced People (IDP) camps. MSF is also running Water, Sanitation and Hygiene (WASH) activities in close to 100 IDP camps across the northwest.
In northeast Syria, we run a primary healthcare clinic, NCDs programmes, mobile wound care, and a reverse osmosis plant to provide safe drinking water in Al-Hol camp. MSF also supports a hospital, as well as an outpatient department (OPD), ER, and nutrition programming, and currently have a team engaged in a short-term influenza B intervention in response to high child mortality.
In addition, since the announcement of the Cholera outbreak, MSF has been responding by conducting community-based health promotion activities as well as training for relevant healthcare workers. We’re also supporting cholera treatment units, and oral rehydration points in the affected areas in Northwest, and Northeast Syria.