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Epidemic fears after health care infrastructure shattered by Syria quake

Epidemic fears after health teams die in Syria quake
Rubble in Aleppo following the devastating earthquake. Credit: Sevim Turkmani/OCHA

Syria fears a resurgence of diseases such as polio and cholera, after scores of health centers were destroyed and medical staff killed in last week's earthquake, the country's health minister said.

Maram Al-Sheikh, minister of health in the Syrian Interim Government, said the earthquake had caused significant damage to the region's primary health care system.

"More than 59 health facilities have been completely or partially destroyed," Al-Sheikh told us. "More than 50 have been killed in the northern Syrian region."

The 7.8 magnitude earthquake that hit southern Turkey and northwest Syria in the early hours of 6 February, followed by hundreds of aftershocks, is known to have killed at least 41,000 people as entire streets were reduced to rubble.

UN agencies and NGOs have warned of a secondary health crisis if needs are not met, as the threat of infectious diseases such as cholera rises.

"We are facing a major challenge … of contagious diseases outbreaks," Al-Sheikh said, referring to measles, polio, cholera, and perhaps a new wave of COVID-19 and viral infections.

"We need … technical and from UN organizations, international donors, and local organizations, otherwise, we can't deal with outbreaks of diseases that were previously controlled."

His comments come as the UN called on Thursday (16 February) for US$1 billion over the next three months to help people in Turkey affected by the quake, on top of US$397 million requested for people in Syria on Tuesday.

The World Health Organization also said its appeal for US$43 million to respond to the devastating earthquake in Turkey and Syria is set to double, as agencies scramble to reach survivors with life-saving medical supplies.

"Survivors are now facing freezing conditions without adequate shelter, heating, food, , or medical care," WHO director-general Tedros Adhanom Ghebreyesus told a media briefing on Wednesday.

He said the WHO was providing care to injured survivors, as well as those with disabilities, hypothermia, mental health and psychosocial needs, and those at risk from infectious diseases.

"So far, we have shipped medicines and supplies to both affected countries to support care for more than half a million people, including for urgent surgery," he added.

However, aid has been slow to reach survivors, with the first UN convoy only crossing from Turkey's Bab al-Salameh on Tuesday, a day after the reopening of two border crossings.

Medecins Sans Frontieres (Doctors Without Borders/MSF), which has teams on the ground in northern Syria supporting hospitals with staff and medical equipment, said it had been drawing on emergency stocks while waiting for international supplies.

"Almost a week after the earthquakes, we still have not received any help from outside," said Moheeb Kaddour, director of an MSF hospital in Atmeh, northern Syria, earlier this week. "Support only came from other hospitals, local communities or organizations already present before the disaster."

He said doctors were still performing lifesaving surgery on crush syndrome victims, explaining: "This pathology, which results from a prolonged compression of the muscles, can be fatal ... The situation is indescribable and for now we are alone."

The Bab al-Salameh and al-Rai border crossings from Turkey into opposition-held territory in northern Syria were opened on 9 February, following UN negotiations with Syria's president Bashar al-Assad. More than 100 trucks loaded with UN aid have since crossed into Syria, carrying tents, blankets, heaters, food, medicines and cholera testing kits.

However, international NGOs working in Syria are calling for an urgent scale-up of the response in the region where 4.1 million people were already relying on humanitarian assistance to survive before the disaster—a result of 12 years of conflict.

"NGOs are extremely concerned that the current level of response reaching the affected areas of Syria is nowhere near what is needed in face of the devastation," said a release issued by 35 organizations.

They said due to the lack of additional equipment and capacity entering northwest Syria, local rescue teams could only search five percent of the affected areas, meaning that those trapped under the rubble in the remaining 95% could not be saved.

More than 8,900 buildings were completely or partially destroyed in northwest Syria, leaving at least 11,000 people homeless, according to UN figures.

Women and girls make up the majority of people taking refuge in shelters in north and northwest Syria, or those displaced, according to the UN Population Fund (UNFPA).

Laila Baker, UNFPA regional director for Arab States, said maternal health services and other programs for women and girls have had to "scale up massively" since the quake.

Disease risk rises

Aid agencies say humanitarian assistance is now urgently needed to avert a secondary health emergency in both countries, with thousands of people lacking safe drinking water and sanitation facilities, raising the risk of waterborne disease outbreaks such as cholera.

Syria was already in the midst of a cholera outbreak, with more than 14,000 suspected cases recorded in Idlib and over 11,000 in Aleppo since September.

The UN children's agency, UNICEF warned that cases of respiratory infections and hypothermia among young people in Turkey were also rising.

"Families with children are sleeping in streets, malls, mosques, schools, under bridges, staying out in the open for fear of returning to their homes," said UNICEF spokesman James Elder.

Randa Ghazy, regional media manager at Save the Children International, is in Antakya, one of the worst affected areas in Turkey. She said, "I spoke to parents in the areas around Antakya who are sleeping in cars and community centers, they told me that their children are vomiting, so there's a real concern that some children are already falling ill."

She said many hospitals had been destroyed and those remaining were overwhelmed with the number of injured. "Hospitals are also running short on medical supplies and fuel to operate. They won't be able to cope with a waterborne disease outbreak, and children will be in the greatest danger," she added.

The organization said it was sending a team of water sanitation and hygiene specialists to assess the needs on the ground and support the Turkish government.

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