This article was updated on February 8, 2023
Following the two strong earthquakes, many buildings in northwest Syria collapsed, leaving thousands of people homeless. The search for survivors is ongoing, with the hospitals that remain functional treating the wounded. Many hospitals have been damaged, with some, such as the hospital in Jandaris, unable to carry on treating patients. Two MSF-supported maternity centres were evacuated due to the risk of the buildings collapsing. Our medical staff and the staff of other facilities have been working hard to treat patients since the first earthquake.
There was major destruction in large buildings in urban centres, more so than in places where people live in temporary shelters. The locality of South Afrin (Jandaris), Aleppo Governorate, might be the most affected area. The Displaced Affairs Office has opened reception centres and shelters to accommodate the impacted families in Idlib.
As of Feb 8:
According to the latest data available, more than 5,800 people have been killed in Türkiye and 1,800 in Syria. More than 20,000 injuries have been reported.The death toll is expected to rise in both Türkiye and Syria, as many people are still trapped under rubble.The MSF-supported health facilities in Aleppo and Idlib governorates received 3,465 injured people and 551 deaths.
Throughout the region, thousands of houses and buildings have been destroyed, leaving thousands of people homeless. To make matters worse, the temperatures are very cold, while people remain outside, with many sleeping in their cars due to the fear of further aftershocks that have continued until yesterday.
Northwest Syria is already going through a dire humanitarian situation due to many years of war, the economic situation, the pandemic and, more recently, a cholera outbreak. This earthquake makes the situation even more difficult while the medical and healthcare system continues to be fragile.
Following the powerful #earthquakes that hit the south of #Turkiye and northwest #Syria MSF has provided immediate support to 23 health facilities across Idlib and Aleppo governorates by donating emergency medical kits & supporting them with medical staff to reinforce their teams pic.twitter.com/pg2dhn4vQV— Doctors Without Borders (MSF) Southern Africa (@MSF_southafrica) February 7, 2023
What are the main needs we’re seeing?
SYRIA: In the aftermath of the earthquake, the needs are both medical support and relief assistance to the population. Accordingly, we have been treating injured people in northwest Syria and supporting health facilities.
Offering immediate relief support to people affected by the earthquakes, particularly those without shelter in this cold weather, will be a main priority. People need shelter, food, blankets, clothes, heating materials, hygiene kits, and medical assistance.
We are witnessing a lack of fuel, electricity and adequate water and sanitation. There is also a major challenge for people impacted by the earthquake to access mental health support, including our staff.
The region of northwest Syria has witnessed many years of ongoing humanitarian crises, with this earthquake causing yet more problems for the population.
We will continue to assess the needs and adapt our response accordingly.
What is MSF doing?
SYRIA: Since the first hours following the first earthquake, our Syrian colleagues have been working to provide help and care, even though their own personal situations were difficult. MSF has received wounded patients in the hospitals we run and support. We’ve treated more than 200 patients in the first hours. In addition, we started a mobile clinic in Kelly’s reception centre in Idlib governorate, and we’re also offering support to ambulances to facilitate the transfer of patients in need of emergency assistance.
MSF has activated an immediate response based on its emergency preparedness plan, supporting hospitals in Idlib and Aleppo with emergency kits, trauma kits, and surgical kits. We have supported hospitals with senior staff from our teams. We have also scaled up the bed capacities in our medical facilities by adding tents where needed and dressing points.
As an initial response, we’re distributing blankets, hygiene kits and food items to target 2,500 families in the Jindiris area, Afrin District of the Aleppo Governorate.
We also worked on increasing the capacity of the medical system by providing emergency medical items and kits to over 23 hospitals and clinics in northern Idlib. And we’re initiating psychological first aid activities in the facilities we’re supporting and across the mobile clinics.
Besides the emergency response, MSF continues to provide its regular medical assistance and activities in hospitals that have not been affected in order to support the population and ensure continuity of care for the most vulnerable, such as pregnant women, people with chronic diseases etc...
In northwest Syria, MSF is also working in partnership with two local NGOs, also extremely mobilized and with whom we work hand in hand.
What is the situation in southern Türkiye /what are the main needs?
TÜRKIYE: At least 150,000 people in Türkiye have been left homeless by the earthquake and its aftershocks, which caused about 6,000 buildings to collapse, according to the International Federation of the Red Cross.
The authorities are requisitioning schools for future shelters, and their mobile teams are deployed so that people can donate blood. They have declared alarm level 4 and a three-month state of emergency in the 10 hardest-hit provinces.
The authorities have said that the immediate needs identified are for shelters, NFI distribution activities and food distribution. We do not have much visibility on medical needs yet.
MSF emergency teams are assessing the needs in the most affected areas of southern Türkiye. Hatay, Gaziantep and Diyarbakir seem to be very affected by the earthquake. The city of Hatay is now closed because buildings are still collapsing. The assistance will be provided on the outskirts of the city.
MSF is ready to provide assistance in Türkiye, and to mobilize its emergency capacities, as we were not working inside Türkiye before the earthquake. Discussions are ongoing with the authorities and local partners regarding the frame of our support.
What needs to be done?
SYRIA: The needs will be massive for a population who have huge needs, both for medical care and non-food items (blankets, heating materials).
There will be even more displaced people in a region where 2.8 million people, out of a population of 4 million people, were already displaced.This earthquake adds a dramatic layer for the vulnerable people here who are still struggling after many years of war.
The massive consequences of this disaster will require an equally massive international aid effort. International aid must reach northwest Syria as soon as possible to support the population.
We remain in close contact with the local health authorities in northwest Syria to extend our support where it’s needed.
TÜRKIYE: first, support must be provided to the population gathered in shelters. Then medical aid will be needed.
How is humanitarian aid coming inside northwest Syria?
Bab Al-Hawa remains the only humanitarian crossing between Turkey and northwest Syria, from which essential life-saving medical supplies can enter northwest Syria. However, it’s not as functional as it should be, and the roads leading to the border have been damaged. We are supporting the call to make sure that Bab Al Hawa remains open and more access points are available for humanitarian help to enter northwest Syria.
The biggest challenge would be a potential delay in the importation of humanitarian and medical aid into Syria since almost all organizations and actors rely on this crossing for their activities.
What are the challenges you’re facing while responding to the current emergency?
We are expecting a lot of pressure on local supply markets. In consequence, we are expecting the prices to rise and shortages to happen. Fuel might become an issue as well. We are also expecting some challenges to bring a big volume of humanitarian aid inside Syria, as the access points remain limited (cf. our previous Comms on cross-border), and there is a risk of a bottleneck impeding the flow. We have also used our emergency stocks to respond in recent days, and we will need to replace them as soon as possible.
What are the main challenges for the provision of healthcare in Syria?
Generally speaking, following 12 years of war, a record 14.6 million people need humanitarian assistance in Syria. It is the country with the largest number of internally displaced people (IDPs) in the world, with 6.9 million IDPs, most of whom are women and children. Many have been displaced repeatedly and live in precarious conditions. MSF operates in Syria where we can, but ongoing insecurity and access constraints continue to severely limit our ability to provide humanitarian assistance that matches the scale of the needs. Our repeated requests for permission to operate in areas controlled by the Syrian Government have not been granted. In areas where access could be negotiated, such as northwest and northeast Syria, we run and support hospitals and health centers, and we provide healthcare through mobile clinics.
Specifically, in what areas in Syria is MSF providing healthcare?
In northwest Syria, MSF is currently supporting 7 hospitals, including 1 burn unit, in addition to 12 Primary Health Care centres (PHCs) and 3 ambulances for referrals. In addition, MSF supports 11 mobile clinics serving Internally Displaced People (IDP) camps. MSF is also running Water, Sanitation and Hygiene (WASH) activities in close to 100 IDP camps across the northwest.
In northeast Syria, we run a primary healthcare clinic, NCDs programmes, mobile wound care, and a reverse osmosis plant to provide safe drinking water in Al-Hol camp. MSF also supports a hospital, as well as an outpatient department (OPD), ER, and nutrition programming, and currently have a team engaged in a short-term influenza B intervention in response to high child mortality.