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Turkey earthquake: Infectious diseases pose acute danger

Burcu Karakas in Hatay province, Turkey
February 18, 2023

Survivors of Turkey's devastating earthquake are criticizing the government for a lack of sanitary facilities in the affected region. Emergency services have said infectious diseases are on the rise.

A family stands beside a car covered in blankets
Survivors are forced to live in tentsImage: Burcu Karakas/DW

Yasemin Astan, her husband, Hasan and their five children just managed to escape their home in Antakya, in southern Turkey's Hatay province, before it was destroyed in the February 6 earthquake. Now, the Astan family lives in a tent.

Two days after the natural disaster struck Turkey and Syria, many such tents were set up for people in need. The Astans and others who have found temporary shelter in Antakya are reporting unhygienic conditions.

"They set up a Portaloo on the other side of the street," Yasemin Astan told DW, gesturing across the road. "But it's almost impossible to see anything at night, and it is very difficult to walk — how can I leave my children behind and walk all this distance in the dark when I need to use the toilet?"

The Astan family shares a tent with several other people. In total, 13 people live here, including nine children. "This tent just isn't large enough for 13 people," Astan said.

A young person is seen inside a tent, with blankets on the ground
This tent currently houses 13 peopleImage: Burcu Karakas/DW

'Acute danger of infectious diseases spreading'

In addition to the criticism of official efforts to prepare for earthquakes, people across Turkey are calling the government's response inadequate. Many survivors have had to forgo showers since the quake hit on February 6. But that isn't their biggest problem: worst of all, residents say, is the lack of proper toilets.

And there is refuse everywhere. A representative of the Family and Social Services Ministry in the camp told DW that he called faraway cities such as Nevsehir and Konya to ask for help.

"I told them: At least send us a rubbish container so refuse won't pile up where people walk," the representative said. "And, of course, there is the acute danger of infectious diseases spreading."

The representative pointed to a portable building containing a toilet, which he said was at capacity and leaking into the camp. "Everything from this toilet ends up seeping down," he said. "It is the only toilet in the entire area, even though we asked the authorities for at least 25."

Antakya residents grieve for loved ones, for their city

An empty Antakya

At night, the once-bustling multicultural city is deserted except for soldiers patrolling districts flattened by the earthquake. One aid agency volunteer told DW that "there are those who have been evacuated from the city, and there are those who are still in Hatay — they are either waiting for burials, or have nowhere to go."

Though some people are still being found alive under the rubble after all this time, officials have now switched their focus to clearing the debris. With the cleanup operation underway, streets are engulfed in dust and dirt. People should be donning masks, though hardly anyone here in the streets is seen wearing one. A volunteer from Sakarya province said these unhygienic conditions make it almost impossible for anyone to recuperate.

The Turkish Medical Association has set up a container in the nearby town of Defne to treat survivors and offer clothing and medicine. "I have been here for six days," said a doctor who asked that their name not be used. "We wash ourselves using wet wipes because there is no possibility to shower."

Survivors gather around an oven to keep warm
Cold temperatures are a serious danger for survivors of the earthquake who are now living in tentsImage: Burcu Karakas/DW

Another doctor said sewage was directed straight into the Asi River, posing a public health risk. The doctor said this must be addressed immediately. "There are toilets, but they are not clean and are therefore a potential source of infection," the doctor said. "Slowly, we will see what we all have been fearing: infections, diarrheal diseases and fever breaking out," he added. "Water in the area needs to be treated soon."

The doctor said more than 100 people of the at least 250 he had treated so far had contracted infectious diseases. "We observed that gynecological diseases are on the rise: women who have vaginal infections, itching sensations, fungal infections," the doctor said. "The reason is that nobody here has access to showers."

He added that children are suffering from diarrhea, and rashes are breaking out. "There are people who have been forced to wear the same clothes for days," the doctor said, "and as they sweat skin rashes have been the result." Cancer patients who have sought help have been turned away as doctors lack the proper medicine to treat them.

Workers amid the rubble of a collapsed building in the aftermath of the deadly earthquake
The earthquake brought tremendous destruction to Hatay province Image: Clodagh Kilcoyne/REUTERS

Cold is killing people

Patients have also died of hypothermia, said a doctor who was working in the pediatric emergency room of the Mustafa Kemal University Hospital on the day of the earthquake.

"There were two soldiers with broken legs, but the orthopedic unit was a bit further away and we had no stretcher to take them to the hospital building," the doctor said. "I ripped a curtain from a window and covered them both, entered the building to retrieve something and ran back — by then, the two had died of hypothermia."

Members of a group cooperating with Turkey's Red Crescent have headed to villages near Kirikhan. Though they have found little structural damage in the villages, they are encountering great demand for food and medicine — especially for children. "Even if we had medicine, we would need help distributing it," a member of the Red Crescent's contingent told DW. "We are faced with a serious organizational problem. More could have been achieved in eight days."

A mound of litter is seen with a tent in the background
Garbage has been piling up near the tentsImage: Burcu Karakas/DW

Turkish Health Minister Fahrettin Koca recently said mobile pharmacies were now operating in the disaster zone and villages still had access to health care. He said public health coordination centers had been set up as well.

"Necessary measures are being taken to prevent infections that can spread after earthquakes: Rabies and tetanus vaccines were sent to the region," Koca said. "Our health centers are helping supply sanitation products. I want to stress once more that the health care system in the disaster zone is working."

This article was translated from German.