The medical problems of the Turkey and Syria earthquake survivors are just beginning

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As international medical teams pour into quake-ravaged areas of Turkey and Syria, the injuries they encounter are horrific but not surprising: broken bones, arms and legs shattered by collapsed buildings, infected wounds.

But this is only the beginning for doctors and paramedics working hard to save lives in a disaster that has already claimed more than 20,000 lives, experts say.

In the coming weeks, as search efforts turn to the grim task of recovering bodies, countless survivors will need medications for high blood pressure, diabetes and asthma left in the rubble. Pregnant women give birth in temporary shelters and refugee camps. Cancer patients will go away without treatment.

Freezing temperatures mean that survivors in frozen shelters face hypothermia or frostbite. Closed spaces in shelters can also spread coronavirus and other respiratory viruses.

Another danger looms: waterborne diseases such as cholera, which have already appeared in the war-affected region of northwest Syria due to the poor quality of water and sanitation.

“It’s a horrible situation. You can’t do everything you want to do and you have to adapt to a completely different way of treating people. It’s a stressful situation,” said Thomas Kirsch, a professor of emergency medicine at George Washington University’s College of Medicine and Health Sciences, of the challenges ahead for medical workers. mentally and morally.

The time period after the search and rescue effort will be crucial, though less dramatic, said Paul Spiegel, director of the Center for Human Health at the Johns Hopkins Bloomberg School of Public Health.

“You could potentially save a lot of lives by ensuring monitoring and consideration that care and supplies continue,” he said.

The effort is being led by the Turkish government, the World Health Organization and other aid groups, which regularly send emergency teams to quake zones.

The challenges of providing medical care are particularly formidable in Turkey and Syria, which were rocked by a 7.8-magnitude earthquake early Monday morning, the second an hour later it was recorded at 7.5.

The disaster destroyed hospitals and other medical facilities that would have been crucial in treating those injured in the building collapses, not to mention other illnesses. Kirsch, who has worked extensively in disaster areas, including Haiti after it was devastated by an earthquake in 2010, said winding and impassable roads wouldn’t make it any easier for medical organizations.

“The logistics and coordination of the healthcare response is a real problem,” he said.

Syria is of particular concern due to the destruction of healthcare infrastructure after years of civil war, the World Health Organization representative in Syria, Iman Al-Shankaiti, told reporters Wednesday.

“Certainly, the health needs are enormous. It is important to note that the health system has suffered for the past 12 years, and continues to suffer and be strained by the ongoing emergencies, the most recent of which is this earthquake,” Al Shankiti said.

The World Health Organization said it would send three flights carrying medical supplies to both countries, including trauma kits, from a logistics hub in Dubai. It also released $3 million in financing.

The Israeli army said it was setting up a field hospital in Turkey.

Non-governmental groups will also be key. MSF, which was already present in northwest Syria, said it continues to support seven hospitals, healthcare centers and a burns unit in the area.

Americaris, a health-focused relief group based in Connecticut, has already sent shipments of hygiene kits, IV fluids, and some chronic disease medications. A team of four people is already on the ground in southern Turkey.

“In the coming days, there will be an enormous need for those chronically ill medicines,” said Julie Faroghese, the organization’s chief medical officer.

Project Hope, a global health and humanitarian aid organization, is also present in Gaziantep, Turkey, a city hit hard by the earthquakes. Like many medical relief organizations, it is assessing what assistance each area will need with short- and long-term health care, as search and rescue operations continue to search for survivors.

The organization’s Humanitarian Health Adviser, Pranav Shetty, fears that doctors will witness in the coming days many of the same medical cases that unfolded in Haiti after the devastating earthquake that hit it in 2010.

He said doctors would need to work quickly to remove dead tissue from the wounds, lest it lead to serious infections.

Another concern is what is known as “crush syndrome,” which occurs when survivors are pulled from rubble, putting pressure on muscles and releasing toxins from damaged tissues. This can wreak havoc on survivors’ kidneys, requiring dialysis – not easy to provide when hospitals are destroyed.

“This is a very powerful intervention that requires a lot of resources,” Shetty said.

However, everyday ailments may end up becoming a bigger problem as the months go by.

Foreign medical assistance will be needed to help with everyday conditions such as diabetes, heart attacks and strokes, said Kirsch, of George Washington University.

“Turkey has a very strong healthcare system, so its recovery will be better than many countries that are less economically strong,” he said.

And both countries will need to pour resources into mental health treatment, not just for survivors but for overworked medical workers providing services to those in need.

“Sometimes you make life-and-death decisions that you wouldn’t have to make in other situations,” Kirsch said of the medical staff in the quake zones. “This is an early conflict.”

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