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Analysis of Disparities in the Initial Health Care Response to the February 2023 Earthquakes in Turkey and Syria

Published online by Cambridge University Press:  18 November 2024

Abeer Santarisi Open the ORCID record for Abeer Santarisi [Opens in a new window] ,
Attila J. Hertelendy Open the ORCID record for Attila J. Hertelendy [Opens in a new window] ,
Fadi Issa ,
Jeffrey Franc Open the ORCID record for Jeffrey Franc [Opens in a new window] ,
Christina Woodward Open the ORCID record for Christina Woodward [Opens in a new window] ,
Dana Mathew ,
Jacob Noel ,
Timothy J. Curtis Open the ORCID record for Timothy J. Curtis [Opens in a new window] ,
Eric D. Miller  and
Chinonso Agubosim
...Show all authors
Abeer Santarisi*
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA Center for Anesthesia Research Excellence (CARE), Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
Attila J. Hertelendy
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, USA
Fadi Issa
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Jeffrey Franc
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, CAN Department of Translational Medicine, Università del Piemonte Orientale, Vercelli, Piedmont, Italy
Christina Woodward
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Dana Mathew
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
Jacob Noel
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
Timothy J. Curtis
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
Eric D. Miller
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
Chinonso Agubosim
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Van Kenyon
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
Ryan Boasi
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
Eman AlShaikh
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA Emergency Medicine Department, Rashid Hospital, Dubai Health, Dubai, UAE
Amalia Voskanyan
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
Gregory R. Ciottone
Affiliation:
Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA
*
Corresponding author: Abeer Santarisi; Email: [email protected]
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Abstract

Objectives

This study analyzes disparities in initial health care responses in Turkey and Syria following the 2023 earthquakes.

Methods

Using Humanitarian Data Exchange, Crude Mortality Rates (CMR) and injury rates in both countries were calculated, and temporal trends of death tolls and injuries in the first month post- catastrophe were compared. World Health Organization (WHO) Flash Appeal estimated funding requirements, and ratios of humanitarian aid personnel in Urban Search and Rescue (USAR) teams per population from ReliefWeb and MAPACTION data were used to gauge disparities.

Results

56 051 096 individuals were exposed, with Turkey having 44 million vs 12 million in Syria. Turkey had higher CMR in affected areas (10.5 vs. 5.0 per 10,000), while Syria had higher CMR in intensely seismic regions (9.3 vs. 7.7 per 1,000). Turkey had higher injury rates (24.6 vs. 9.9 per 10 000). Death and injury rates plateaued in Syria after 3 days, but steadily rose in Turkey. Syria allocated more funding for all priorities per population except health care facilities’ rehabilitation. Turkey had 219 USAR teams compared to Syria’s 6, with significantly more humanitarian aid personnel (23 vs. 2/100,000).

Conclusions

Significant disparities in the initial health care response were observed between Turkey and Syria, highlighting the need for policymakers to enhance response capabilities in conflict-affected events to reduce the impact on affected populations.

Narrative Abstract

The 2023 Turkish-Syrian earthquakes, the most devastating in the region since 1939, heightened challenges in Syria’s health care system amid ongoing conflict, disrupting Gaziantep’s humanitarian aid supply route. The initial health care responses post-earthquakes in Turkey and Syria were analyzed through a descriptive study, where Crude Mortality Rates (CMR) and injury rates during the first week were calculated. The World Health Organization’s funding priorities and the ratio of humanitarian aid personnel in Urban Search and Rescue teams per population were assessed. Turkey had 4-fold higher earthquake exposure and experienced higher CMR and injuries per population, while Syria had higher CMR in intensely seismic regions. Temporal trends showed plateaued death and injury rates in Syria within 3 days, while Turkey’s continued to increase. Syria required more funding across nearly all priorities while Turkey had more humanitarian aid personnel per population. Significant health care response disparities were observed, emphasizing the imperative for policymakers to enhance initial responses in conflict-affected events.

Keywords

health care responseurban search and rescue teamSyrian-Turkish Earthquakesdeath tollsinjuriesinfrastructural damage
Type
Review Article
Information
Disaster Medicine and Public Health Preparedness , Volume 18 , 2024 , e270
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

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