Rasha Kaloti
Health Policies Researcher at ImpACT International
On 6 February 2023, a powerful earthquake of 7.8 magnitude hit southeast Turkey and northwest Syria. The earthquake and a series of aftershocks have devastated these areas, with a death toll of over 37,000 people as of 14 February. Additional tens of thousands of people have been injured and hundreds of thousands of people are displaced, in a region already deeply affected by conflict and displacement. The healthcare system in Northwest Syria is particularly at a great risk of further collapse as a result of this disaster which has been described as the biggest disaster of the last century.
Healthcare facilities will face a further challenge if the Cholera outbreak spreads further in this region as predicted.
Situation in Northwest Syria Pre-Earthquake
After 12 years of a devastating civil war in Syria, the country has become deeply divided with limited development and political progress. Approximately 4.6 million people live in northwest Syria, 63% of which (2.9 million) are internally displaced persons from Syria. According to the United Nations (UN). The vast majority of residents in northwest Syria (4.2 million) rely on humanitarian assistance to meet their basic needs. The ongoing war and economic crisis mean there are very few work opportunities for people living there.
By the end of 2022, all United Nations Office for the Coordination of Humanitarian Affairs (UN-OCHA) clusters were underfunded in Syria, with 48% gap in humanitarian response to northwest Syria amidst a cold winter and a cholera outbreak.
Earthquake Impact on Healthcare
- Direct Casualties & Displacement
The earthquake has resulted in 4,400 deaths and 8,500 injuries in northwest Syria as of 12 February. Death numbers are increasing by the day as a significant number of people remain trapped in the debris of collapsed buildings. This is causing a heavy demand on healthcare facilities and health workers to cope with these numbers, while being already fragmented and under-resourced prior to the current disaster.
According to the UN-OCHA, there are records of 1,700 totally destroyed buildings, and 6,300 partially destroyed buildings in 19 districts in northwest Syria as of 12 February. More than 30,000 displacement movements were recorded in northwest Syria between 6 February and 8 February, and 11,000 families are now estimated to be homeless. This will result in an increased risk of deteriorating physical and emotional wellbeing due to the poor living conditions faced by these displaced groups.
- Healthcare Facilities
According to the latest UN OCHA flash update, the high number of injuries and casualties is overwhelming healthcare facilities. In addition to the clinics and hospitals that have been directly affected as a result of the earthquake; it is estimated that at least 31 healthcare facilities in northwest Syria are partially or fully non-functional. Even though non-governmental organisations are providing essential kits, medical supplies and fuel, these are still inadequate to meet the needs, especially in the more densely populated areas of Idlib and Aleppo. Especially that the healthcare sector had already been underfunded prior to the earthquake, and suffered from resource shortages, attacks on healthcare and a lack of a central governance system to coordinate interventions.
Healthcare facilities will face a further challenge if the Cholera outbreak spreads further in this region as predicted. The direct damage on water sources and consequently water availability and quality is putting disaster-affected people at a higher risk of cholera infections and other water-borne diseases.
- Mental Health Concerns
This earthquake and its aftermath are likely to have caused further distress, anxiety and depression for Syrians in this region. Local UN sources indicated that many civilians are now experiencing panic attacks and nervous breakdowns amidst this disaster.
Half of those living in northwest Syria are children, most of whom suffer symptoms of traumatic disorders after being born and raised in conflict. An estimated 75% of already vulnerable people living with mental health conditions receive no treatment at all. Anxiety and depression are the main mental health conditions impacting women in northwest Syria, studies have shown that women who experience conflict and displacement are more likely to experience depression and anxiety than men.
What Next?
Multiplied emergency relief efforts are required to support the affected communities in northwest Syria, with the urgent prioritisation of saving lives and providing medical care for those injured. This requires local and international governments to ease humanitarian logistical missions to the northwest area, and remove sanctions on Syria, in order to facilitate the required relief aid in time. Simultaneously, collaborative efforts of local and international organisations and actors to coordinate a healthcare development response are urgently needed. This response should assess the existing gaps in healthcare resources, health workers and medical supplies and how these can be covered in the short and long terms. In addition to setting plans for re-establishing healthcare facilities and working alongside other operating sectors such as the education, water and sanitation, and economic sectors.