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Post-Earthquake Health Problems

In addition to the many victims after the earthquake disaster that caused great destruction in our country on 6 February 2023, the health problems that the people in the region may experience and the precautions to be taken.

Earthquakes have caused the death of 780,000 people in the last century. In addition, the tsunami disaster took 200,000 lives in the last century. Apart from direct deaths from disasters, deaths from other health causes account for a significant 1:3 ratio. These include acute liver damage and diseases, splenic damage, pelvic damage, subdural (brain) damage and haemorrhages, sepsis, multiorgan damage, wound infections that manifest themselves within days to weeks after the earthquake. In addition, earthquake victims with chronic diseases such as diabetes, heart failure, kidney failure are in danger of death as their medical treatment cannot continue. Among those who stayed under the rubble for a long time, 14-18 per cent were rescued with kidney failure. At this stage, sodium potassium electrolyte levels are dangerous and even if they are normal, fluid resutation (support) should be applied rapidly, and the content of this fluid should not contain potassium and calcium since the ion levels of the person are already elevated. Tetanus also accounts for a significant proportion of these problems. In people with injuries, necrotic tissue and damaged skin create an environment for bacteria because there is no nutrition. All these health problems are called Crush Syndrome.

People with problems such as bruises and fractures have a high rate of abnormally elevated coagulation problems (Disseminated Intravascular Coagulation, DIC), sepsis, adult respiratory distress syndrome.

In addition, heart attack, arrhythmia, systolic and diastolic blood pressure increases are observed in approximately 35% of cases.

Post-traumatic stress, mental problems, depression, and suicidal tendencies are also seen among survivors.

Children experience more injuries and other health problems than adults.

Health problems in earthquake can be divided into three phases.

Phase I health problems:

Sepsis: Sepsis is a severe response of the immune system to an infection. It is characterised by high fever, accelerated heartbeat, breathing difficulties and convusion. It is more likely to occur in children, the elderly, and people with weak immunity. If the bacteria causing sepsis is in the blood, the reaction is more severe and is called septicaemia. As sepsis progresses, a condition called septic shock develops. In this case, the person should be given oxygen immediately, breathing should be facilitated, the damaged tissue should be surgically removed, and high doses of antibiotics should be given if it is thought to be a bacterial shock.

Bone fractures: It is a serious body damage during an earthquake. Bone can be broken in two ways. These can be divided into complete or partial fracture. In addition, if the broken bone damages the tissue or skin, it can be considered as combined damage, and if it only breaks and does not damage the tissue, this can be considered as closed fracture. Combined damage is the most dangerous here.

Heart attack (MI): Heart attack, unlike cardiac arrest, manifests itself with symptoms such as a feeling of pressure in the chest spreading towards the arms and pain, nausea, vomiting, sweating. Cardiac arrest is when the heart stops. Cardiac arrest can occur suddenly without symptoms. The patient has no reaction and cannot breathe. Cardiopulmonary resuscitation (CPR) should be performed immediately. If the patient is not breathing but is trying to breathe, CPR is started with the CPR procedure (fingers are interlocked with the hands overlapping and pressed into the centre of the chest from a height of at least 5 cm at an average of 100 times per minute. The chest should be allowed to normalise before each press). This should be continued for a while even if the patient starts breathing. A defibrillator should be used when medical help arrives.

Phase II Health problems:

The greatest risk after an earthquake is to protect survivors from various infections. These first days are the period from 4 days to 4 weeks after emergency medical assistance to take precautions against contamination caused by earthquake damage. These are airborne, food and waterborne infections.

Phase III Health Problems:

This is the period 4 weeks after the earthquake. This is the period of clinical emergence and contagiousness of infections with a long incubation period. These are manifested in various ways

a- Diarrhoeal diseases: These are usually water-borne. Such problems now account for 40 per cent of those living in camps. Contamination of water during transport, faecally contaminated water and the sharing of such water can lead to serious epidemic problems. Leptospirosis infection is the most serious of these.

b- Infectious diseases that can be transmitted from the bodies of deceased persons: These are not as serious as water-borne infections, as the invading organisms can no longer survive once decomposition has begun. Cholera, typhoid, and haemorrhagic febrile disease epidemics are exceptions. Therefore, survivors should not stay for a long time after burying their relatives in the environment where their relatives are buried.

c- Infectious diseases that may occur through the respiratory tract (Acute Respiratory System Diseases): These can be Influenza, Covid, Meningitis, Tuberculosis and Scabies (scabies), Measles, Malaria, AIDS diseases. These diseases can be caused by the fact that many people breathe the same air and use the same beds in closed environments.

As a precaution, distance between tents, proper storage of food, proper disposal of garbage, vaccination, control of drinking and utility water, raising public awareness are important steps in preventing the health problems that may occur above.

The table below summarises possible health problems and preventive measures (taken from Source 2).

Clean Water

Diarrhoeal diseases, typhoid, Guinea worm

Good sanitation

Diarrhoeal diseases, Carrier-borne diseases, Scabies


Tuberculosis, Measles, Acute respiratory infections


Measles, Meningitis, Yellow Fever, Japanese Encephalitis, Diphtheria

Carrier control

Malaria, Oriental Boils (Leishmaniasis), Dengue Fever, Japanese Encephalitis, Yellow fever, other haemorrhagic febrile diseases

Personal protection, Malaria, leishmaniasis

Malaria, Dengue Fever, Oriental Boils (mosquito net used with insecticide)

Personal hygiene

Bit-borne diseases: Typhoid fever, Depressic Fever, Trench Fever

Health Education

Sexually transmitted diseases, HIV/AIDS, Diarrhoeal diseases

Isolation of epidemic diseases

Cholera, Dysentery, Tuberculosis, Acute respiratory infections, Malaria, Fever, Haemorrhagic fever, Meningitis, Typhoid fever

WHO: Communicable Disease Control in Emergencies: A Field Manual: ISBN 92 4 154616 6.,WHO /CDS/2005

Connolly MA, Gayer M, Ryan MJ, et al. Communicable diseases in complex emergencies: impact and challenges. Lancet, 2004;364:1974-1983

Kouadio Koffi Isidore, Syed Aljunid, Taro Kamigaki, Karen Hammad and Hitoshi Oshitani: Preventing and controlling infectious diseases after natural disasters. United Nations University Articles.13 March,2012.