Turkey Earthquake Relief
MSF Sets Up Clinics, Focus is Treatment of "Crush Syndrome"
August 23, 1999
Doctors Without Borders/Médecins Sans Frontières (MSF) is now active in four major urban areas - Izmit, Bursat, Ankara, and Gölcük - hard hit by last week's 7.4-magnitude earthquake in northwestern Turkey. Four MSF medical teams are currently assisting in the relief effort. All teams consist of a combination of MSF international medical volunteers and Turkish doctors and nurses. Thirty metric tons of medical supplies, surgical materials, tents, hospital tents, blankets, and materials for safe water supply and sanitation arrived in Istanbul by cargo plane.
In Izmit, the city at the epicenter of the earthquake, MSF has set up a clinic to serve a population of approximately 10,000 people living in the area. A medical team has treated patients mainly for burns and earthquake-related injuries, as well as for diarrhea, dysentery, and other ailments associated with unhygienic living conditions. MSF is working to increase clinic capacity to twice the current size.
In Gölcük, a city located between the seaside and the mountains near the epicenter of the earthquake, destruction of roadways and the lack of electricity are making relief efforts difficult. MSF teams in Goluck report that the area has been devastated by the earthquake and thousands of people are estimated to be trapped under the rubble. There is almost no sign of life inside the city as survivors have chosen to live in the nearby hills or with family in neighboring districts. MSF has set up a clinic in the city to treat burns and other earthquake-related injuries, as well as to provide some basic mental health care. Seriously wounded are being evacuated to Istanbul.
MSF has also sent in a nephrologist (kidney specialist), who has started working with a Turkish colleague and five nurses specialized in dialysis. Experience treating earthquake victims shows that kidney failure is a major cause of death among those who survive their initial injuries. In an affliction known as "crush syndrome," muscle tissue damaged after severe internal injury can release massive quantities of toxins into the bloodstream and lead to kidney failure. Left untreated, crush syndrome can be fatal.
As of August 22, over 250 people had been treated by MSF volunteers specializing in kidney disorders and dialysis treatment. In Istanbul, MSF visited all of the functioning hospitals to assess needs and installed five kidney dialysis machines in Marmara University Hospital. Five renal nurses began working in the hospital on August 20 and have provided dialysis treatment to over 110 patients in the past two days. In Bursat, 72 patients have already received dialysis treatment. MSF is transporting 12 metric tons of salt concentrate, used in kidney dialysis, to the region.
In Adapazari, MSF is pursuing new actions to aid the relief effort. More details to come.
The MSF teams in Turkey report that the most crucial problem facing the earthquake relief effort right now is coordination of the assistance pouring into the affected region. Damage to roads and highways has seriously impeded travel, and disruption of electric and telephone services is also adding to delays. The most severe surgical cases are being transported to Istanbul and Ankara by plane, helicopter, and ambulance.
Water and sanitation also remains a serious concern. The large numbers of people still living in open areas in unhygienic conditions raises the possibility of epidemic outbreaks. MSF is building latrines and providing water and sanitation support in all the regions in which it is working. MSF continues to monitor the risk of epidemics, but, as of yet, the teams report no signs of epidemics.