Türkiye earthquake: external situation report no.1: 13–19 February 2023

1. EVENT OVERVIEW Priority concerns The priority concerns in the earthquake affected areas are: • ensuring access to the most vulnerable and affected populations; • immediate trauma care for injured persons and post-trauma rehabilitative care; • provision of essential medicines, emergency kits and supplies to address urgent needs; • prevention and control of disease outbreaks, including through strengthening disease surveillance; • access to mental health and psychosocial support; • ensuring access to essential health services, particularly for women, children, the elderly and those living with noncommunicable diseases. WHO Actions • In Türkiye, WHO is supporting the Government-led response and working in close coordination with the Türkiye Ministry of Health (MoH) and the Disaster and Emergency Management Authority (AFAD). • In close collaboration with the MoH, WHO continues to coordinate the deployment of emergency medical teams (EMTs). As of 19 February the EMT Coordination Cell (EMTCC) in Türkiye has overseen the work of 29 approved international EMTs from over 20 countries, representing the largest deployment of EMTs in the WHO European Region in its 75-year history. • WHO has mobilized 78 tonnes of supplies into Türkiye for the response, with 19 tonnes in the pipeline. • Alongside the MoH, WHO developed post-earthquake public health advice in the form of a questions and answers document translated into Turkish, which covers relevant health topics. • WHO has released a flash appeal for immediate funding totalling US$ 84.5 million, of which US$ 50.8 million have been requested for Türkiye. Türkiye earthquake external situation report no.1: 13 – 19 February 2023 430K 9.1M 40K 108K 2 External situation report no.1 2. SITUATION UPDATE On 6 February 2023 a 7.8 magnitude earthquake struck at 04:17 local time with its epicentre located in the Pazarcık district in Kahramanmaraş province, Türkiye. This is the highest magnitude earthquake recorded in Türkiye since 1939 and was followed by around 5700 aftershocks. Combined, the earthquakes have affected an area of about 400 km2 including the large Turkish industrial cities of Adana and Gaziantep and the surrounding cities of Adıyaman, Diyarbakır, Kilis and Malatya. The earthquakes have directly affected 11 provinces within Türkiye in all; Adana, Adıyaman, Diyarbakır, Elazığ, Gaziantep, Hatay, Kahramanmaraş, Kilis, Malatya, Osmaniye, and Şanlıurfa – 10 of which have declared a state of emergency. Approximately 15 million people (according to the 2021 census) live in these provinces, including over 1.7 million Syrian refugees and around 4.6 million children. More than 40 642 people have been reported to have been killed across Türkiye as of 19 February 2023 with more than 108 000 injured. Overall, the United Nations (UN) Office for the Coordination of Humanitarian Affairs has reported that potentially 9.1 million people have been affected by the earthquakes. More than 345 000 individual units in 90 609 buildings either collapsed or were heavily damaged in Türkiye, including at least 15 hospitals. The runway of Hatay airport was split and uplifted. Heavy snow in the region is further exacerbating the situation, in addition to heavy rains, making it harder for those who are displaced from their homes due to damage and/or safety concerns as well as for refugees and internally displaced persons residing in tents. In Türkiye, an estimated 1 million people have lost their homes as a result of the earthquakes and are living in temporary shelters. The Government of Türkiye has declared a level four alert to appeal for international aid, in addition to a state of emergency for three months in the 10 most affected provinces. Emergency services in Türkiye have rushed to search for survivors trapped under many collapsed buildings and search and rescue efforts are continuing in around 200 locations within Adıyaman, Diyarbakır, Hatay, and Kahramanmaraş provinces. Fig. 1. Türkiye: Population exposure estimation in the highest affected provinces by the earthquake on 6 February, 2023 3 External situation report no.1 Despite the extent of the damage, disease surveillance systems remain in place at least to some extent; with a case of chickenpox reported among the affected population on 19 February by the Government. The MoH also reported an increase in acute intestinal infections, although few patients are hospitalized. The AFAD Coordination Center in the southern province of Hatay said that a total of 6 447 babies have been born in the earthquake region since the first day of the disaster. 3. WHO ACTIONS TO DATE Leadership and coordination • On 7 February 2023 WHO classified the earthquake in Türkiye as a grade 3 emergency, putting in place a three-level response coordination and the mobilization of Organization-wide assets. • WHO is supporting the government-led response and working in close coordination with the MoH and AFAD. • WHO is acting as lead in the health and nutrition sector within the UN activated coordination cell. Health Operations • Online training modules have been provided by WHO including on Early Childhood Development and other topics, which have been activated under the distance learning platform for the MoH to use. • WHO has supported the Government of Türkiye to carry out a rapid health services and needs assessment in the affected provinces between 12–22 February 2023. • A collaboration between WHO and UNICEF for the procurement of tetanus and rabies vaccines is ongoing. The EMT Coordination hub in Adana province, Türkiye ©WHO 4 External situation report no.1 • WHO is working in collaboration with the MoH to support a cholera contingency and preparedness plan due to ongoing outbreaks in neighboring countries (Syria and Lebanon), which may pose a risk for onward transmission. • On 19 February WHO held a child psychological first aid training for 563 staff from the MoH psychosocial support teams. The training covered the importance of responding to children in an empathetic manner, the different reactions children may have according to their age and stage of development, adapting speech to communicate with children and their families and identifying children in need of support. Operational Partnerships • WHO’s EMT initiative has been activated to provide essential health care for the injured and the most vulnerable affected by the disaster, in response to a request for international assistance issued by the Government of Türkiye on 6 February 2023. • The EMT Coordination Cell (EMTCC) has scaled up, with additional surge mobilized from the EMT Secretariat and Turkiye Country Office staff under MoH leadership and using WHO capacity. As of 19 February the EMTCC in Türkiye has overseen the work of 29 approved international EMTs from over 20 countries, representing the largest deployment of international EMTs in the WHO European Region in its 75-year history. • The priority is to support the hospitals that have been damaged in the earthquakes, as well as those dealing with high numbers of trauma patients and catastrophic injuries. • WHO also provides support for the daily EMTCC coordination meetings with EMTs in the field and the MoH National Medical Rescue Team. • As of 13 February large numbers of severely injured patients were evacuated by national authorities to hospitals outside of the disaster zone, including 3135 patients by air and 328 by sea. Severely injured patients in need of post-acute care have also been transported to urban centres away from the disaster zone – in particular Ankara, Istanbul and Mersin. In addition, a total of 158 165 affected people have been evacuated. Risk communication • WHO is working closely with the AFAD and the MoH regarding risk communication and community engagement, sharing messages and other content. • Social listening has been put in place by WHO to better understand the needs of the affected population. • Alongside the MoH, WHO developed post-earthquake public health advice in the form of a questions and answers document translated into Turkish, which covers relevant health topics • UNICEF Türkiye and WHO are collaborating around developing messaging and using social listening and infodemic analysis to monitor social media channels to identify major perceptions, concerns and misinformation and feed messaging and interventions. • A social media campaign has been launched by WHO on hypothermia, water use, frostbite, child safety, breastfeeding and the use of information sources with posts on Facebook, Instagram and Twitter. Emergency communications • The WHO Regional Office for Europe’s Emergency Director, Dr Gerald Rockenschaub, talks about the massive mobilization of EMTs in Türkiye to save lives. The video can be watched here. • A WHO web story on how EMTs are supporting the health response to the Türkiye earthquakes can be found here and the accompanying video can be watched here. • The WHO Regional Director for Europe, Dr Hans Kluge, issued a statement on the Türkiye/Syria earthquakes which can be read here. 5 External situation report no.1 • Supplies arriving in Türkiye to support the response: a short video with Pierre Nabeth, Head of Office, WHO European Centre for Preparedness for Humanitarian and Health Emergencies in Istanbul, Türkiye, can be found here. Supplies and Logistics • WHO has mobilized 78 tonnes of supplies into Türkiye for the response, with 19 tonnes in the pipeline. Resource mobilization • WHO has released more than US$ 16 million from the Contingency Funding for Emergencies, including US$ 3 million within hours of the disaster. WHO has released a flash appeal for immediate funding totalling US$ 84.5 million, of which US$ 50.8 million have been requested for Türkiye. • The UN in Türkiye has also submitted a flash appeal for preliminary estimated funding requirement for immediate and urgent health needs, amounting to US$ 1 billion. The preliminary appeal includes the requirements of UN agencies and nongovernmental organizations. In the health sector an estimated US$ 118 million is required. WHO sends health supplies to reach people impacted by the earthquakes in Türkiye. ©WHO 6 External situation report no.1 4. KEY NEXT STEPS As part of the WHO Regional concept of operations, WHO will work to consolidate the response in the affected areas. This includes providing support to the MoH by: • leading the health and nutrition sector coordination in Türkiye; • carrying out in-depth health needs and health facility damage assessments; • supporting water hygiene and sanitation in affected areas and health facilities; • enhancing community engagement and listening to guide the response; • supporting the transition of EMT service delivery to disrupted health system support; • supporting health service provision to displaced populations to allow continuity of care especially for women, children, elderly people and those with noncommunicable diseases; • strengthening and extending mental health services; • reinforcing early warning and surveillance for infectious hazards. WHO visit to the Turkish town of Antakya ©WHO Document number: WHO/EURO:2023-7145-46911-68441 © World Health Organization 2023. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license