2 months on from the Türkiye earthquakes: Going the last mile to provide continuing health services
Kahramanmaraş province – commonly referred to as Maraş – was the epicentre of the first earthquake to hit Türkiye on 6 February 2023. Thousands of people lost their lives, homes were destroyed, and infrastructure, including hospitals and other health facilities, were severely damaged. An estimated 3.3 million people in Türkiye have been displaced because of the disaster, many of them now living in temporary tent settlements while others have moved into container housing.
Here and in surrounding areas, many survivors continue to need access to primary health services for treatment and rehabilitation for existing conditions, to prevent future ill health through immunization and screening programmes, and to receive palliative care for terminal illnesses.
Yet, the disaster has severely disrupted these services, with health facilities damaged, the supply of medicines and medical equipment disrupted, and a shortage of health workers occurring at a time of increased demand.
But thanks to the determination and dedication of Turkish Ministry of Health staff, often working outside of their normal official duties, as well as volunteers and foreign humanitarian teams, solutions are being found to overcome some of these challenges.
A new medicines hub has been set up in the town of Pazarcık, staffed by Ministry of Health pharmacists and support staff.
A former restaurant, located within a recreational park, has now been repurposed into a busy operations and logistics centre where more than 45 doctors, nurses, pharmacists and volunteers gather daily to assess local medicine needs, source stock and ensure that medication is delivered to surrounding villages.
Volunteer doctors and nurses journey out to local communities on a daily basis to deliver medicines and provide vital childhood vaccinations.
A WHO team joined the health care staff on one of their outreach journeys to the village of Ulubahçe. The staff, who go out in groups of between 3 and 5, are determined to make sure that people who can’t move far from their homes, or who are living in temporary accommodation, get the medicines and medical services they need, when they are needed – in effect going the last mile.
Zeynep Sayrah is one of Ulubahçe’s residents that is benefiting from the services provided.
Zeynep Sayrah and her family have been greatly affected by the earthquakes. Currently, they are living in a woodstore, located in the garden of their damaged house. Their challenges are compounded by the fact that Zeynep's daughter is diabetic and relies on regular medication to manage her condition.
The health centre in Ulubahçe serves a population of 713 people.
The delivery of medicines to the village health centre has been a lifeline for Zeynep's daughter and many others like her. Home visits from the doctors have also meant people can get proper medical examinations to help detect any signs of ill health and receive appropriate treatments.
Münüre Andırınlı is another resident who has been able to get the medication she needs, thanks to deliveries to the village.
“Despite the slight damage to our home after the earthquake, we found ourselves living in a tent,” said Münüre. “But we weren't alone. Our village head and the health care workers were a godsend. The pharmacists delivered my medication right to us. I am so grateful to everyone who helped us during those tough times.”
Münüre Andırınlı also benefitted from the treatment provided by German doctors in nearby Pazarcık.
“When I had toothache, I headed to the temporary medical centre set up in the tent settlement of Pazarcık, and was very quickly treated by German doctors,” said Münüre. “They are true lifesavers!”
The doctors work for Humedica, an international nongovernmental organization that has been providing humanitarian relief in the wake of disasters for the last 45 years.
The outreach team has also been keen to make sure children continue to get vaccinations as part of their normal immunization schedules.
Efforts to provide emergency medical aid in the aftermath of the earthquake have resulted in the distribution, so far, of over 160 000 tetanus vaccine doses, 3 000 tetanus antiserum doses, and more than 10 000 rabies vaccine doses, along with childhood vaccinations for diseases such as measles, mumps, rubella, meningitis and chickenpox. However, further support is required for the transportation and storage of vaccines in the affected regions to support the roll-out of screening-prevention-vaccination programmes.
Much has been achieved, but more still needs to be done to enhance health care in the earthquake-affected areas.
Despite the huge efforts made by the Turkish Ministry of Health and others, there are still significant needs to be addressed both now and in the future. One such need is the provision of orthotics, prosthetics, and wheelchairs to cater to the many individuals who have been disabled through the disaster. Additionally, it is vital to bolster the capacity of physical medicine and rehabilitation hospitals to provide quality home health care services.
The Turkish Government also aims to increase access to medicine by providing mobile pharmacies. This will help ensure that people have access to medication and other medical supplies, regardless of their location.