Turkey Earthquake Relief
August 30, 1999
Doctors Without Borders/Médecins Sans Frontières (MSF) remains active in four urban areas—Izmit, Gölcük, Bursa, and Istanbul—hard hit by the 7.4-magnitude earthquake that devastated northwestern Turkey on August 17. Twenty-two MSF international volunteers, including two teams of kidney specialists, are working together with 46 local staff members and TOSAV (Toplum Saglik Vakfi), a Turkish medical organization, to assist in the relief effort.
MSF has now set up and staffed 5 medical clinics (2 in Izmit and 3 in Gölcük) to provide basic consultation, referral services, immunizations, medicines, and wound dressings to victims of the earthquake. Total consultations for all clinics are averaging 600 to 700 per day, and the goal has been to reach 10,000 consultations per week within two weeks.
MSF and its local partners have also installed 10 water bladders (3 in Adapazari, 3 in Izmit, and 4 in Gölcük), each of which is capable of providing water for approximately 1,500 people; distributed plastic sheeting for 6,000 families (2,000 in Izmit and 4,000 in Gölcük); and rotated two teams of international nephrology specialists along with 5 dialysis machines to Marmara University Hospital in Istanbul. A third team of specialists will rotate into Marmara University tomorrow, and another team will be sent to Bursa for assistance in dialysis treatment there.
Search and rescue efforts were definitively terminated on Thursday, August 26. Government efforts in reconstruction and aid to victims has increased greatly in the last days. There are tent cities being set up throughout the affected region, and they are slowly filling up with people. MSF teams report that the camp situation is extremely fluid at the moment, as families come and go while trying to figure out their next steps. Some have people lost everything, while others can still enter their damaged buildings, and still others have suffered no direct damage but sleep outside because they do not trust the safety of their buildings. Some families are planning to leave, while others are waiting for the government to help them find housing in the same region.
In Izmit, the city at the epicenter of the earthquake, an MSF clinic was set up in an old military park area. The clinic is targeting a population of 10,000 who are living in temporary, impromptu camps in the immediate area. This has been the busiest clinic so far, with an average of 300 consultations per day. Thirty percent of the consultations have recently been for upper respiratory tract infection and ten percent for diarrhea. The clinic is housed in 4 dispensary tents and staffed by 3 doctors, 3 nurses, 4 registrars, and 6 community health workers. An MSF water bladder has been installed nearby, and plastic sheeting for 2,000 families has been distributed.
On August 27, MSF set up a clinic staffed by 2 doctors and 2 nurses in the municipality of Derince, near Izmit. The clinic is serving the inhabitants of an extremely large camp nearby where 1,000 tents have already been set up and 2,000 more are planned to provide temporary shelter for a total population of 10,000. There are currently 1,500 inhabitants in the camp, but this number is expected to grow quickly.
In Gölcük, a city located between the seaside and the mountains near the epicenter of the earthquake, MSF has set up a clinic and water bladder in the Gozlemetepe camp with a 3,000 person capacity. The clinic has 6 tents, 1 doctor, and 2 nurses. They are averaging 100 consultations per day.
Last week, MSF set up a clinic and water bladder in Yeni Mahalle camp in Gölcük as well as a clinic in a nearby urban neighborhood dotted with smaller tent camps. The clinic has provided approximately 60 to 70 consultations a day, down from 200 per day last week before other medical services were established nearby.
The Yenikoy clinic in Gölcük was initially started by French medical students and turned over to MSF last week. It is situated in a primary school in semi-rural Yenikoy, which had a population of 6,000 before the quake and suffered 400 deaths. There is a small tent camp in a soccer stadium nearby, but much of the target population still live in their homes. The clinic has been averaging 80-100 consultations per day, treating mostly upper respiratory tract infections and a small number of diarrhea cases suffered by those who spent the past week outdoors in the rain. The MSF staff reported a need for clean water in the area and gave chlorine tablets to the local authorities, who were able to treat 200 metric tons of water with it.
Teams of MSF volunteer nephrologists and renal nurses continue to treat victims of an affliction known as "crush syndrome," in which muscle tissue damaged after severe internal injury releases massive quantities of toxins into the bloodstream that can lead to kidney failure. Left untreated, crush syndrome can be fatal. Since August 20, MSF has installed five kidney dialysis machines and rotated three international teams of kidney specialists to Istanbul's Marmara University Hospital. There have been a total of approximately 700 cases of "crush syndrome" throughout the region, 400 of them remain on dialysis and 300 have recovered. In Bursa, 72 patients have already received dialysis treatment and MSF has sent in a reinforcement team of kidney specialists and donated 12 metric tons of salt concentrate, used in kidney dialysis, to the hospital.
This week, MSF is sending in two cargoes of hygienic materials and medical supplies to be distributed in the earthquake-affected areas. A distribution of cooking pots, supplied through local purchase or local donation, will also take place.
MSF is also planning psychological assistance to earthquake survivors in an effort to prevent cases of Post-Traumatic Stress Disorder (PTSD). The teams are already cooperating with psychosocial teams in Gozlemetepe camp in Gölcük.