Devastating earthquakes
On 6 February 2023, two massive magnitude 7.8 and 7.6 earthquakes struck southcentral Türkiye and northwest of neighboring Syria. Since then, over 22 thousand aftershocks have happened and continue happening.
People affected
More than 58,000 people have died, and millions have been affected following the earthquakes in both countries.
On 6 February 2023, between 4:17 and 4:30 a.m. local time magnitude 7.8 and 7.6 earthquakes struck southeast Türkiye and northwest of neighboring Syria. The initial earthquake which was centered near Gaziantep in south central Türkiye was the deadliest earthquake to hit the region in twenty years. Since then, over 22 thousand aftershocks have happened and continue happening, including smaller earthquakes that have caused again casualties and destruction.
More than 58,000 people have died, and millions have been affected following the earthquakes in both countries.
Two months after the earthquakes, more than 56,000 people have died, and millions have been affected following the earthquakes in both countries. The search and rescue phase are over. However, humanitarian needs remain acute.
The earthquakes wrought major devastation. Buildings are destroyed, infrastructures are damaged, and necessities such as fuel and electricity are not available.
TThere was major destruction in large buildings in urban centres. In Syria, around 10,600 buildings have been completely or partially destroyed. The most affected area is Jindires in south Afrin in the Aleppo governorate. The damage was also huge in Al Atrib and Afrin in northern Aleppo governorate as well as in Salqin, Harem and Bsenia in the Idlib governorate.
According to OCHA, 55 medical facilities have been damaged and several destroyed, hindering their capacity to respond. Two MSF-supported maternity centres in north Aleppo were evacuated, due to the risk of the buildings collapsing. Our services were relocated due to damage and deemed unsafe in three health facilities in Idlib.
At least 53000 families were displaced after the earthquake throughout Syria following the earthquake and need a form of shelter assistance.
People dig through the rubble of collapsed buildings following the effects of a strong earthquake in southern Türkiye. Idlib province, Syria, 6 February 2023. © Omar Haj Kadour
The disaster compounded an already desperate humanitarian situation. The 180,000 people that have been displaced by the earthquake adds to the two million people already living in difficult and precarious circumstances after being repeatedly displaced during 12 years of war. The displaced are left with no or little shelter, food, water or any form of access to necessities of livelihood. According to the Turkish government, some 60,000 Syrians have returned to Syria in the aftermath of the earthquake.
In March 2023, floods have been impacting northwest Syria. At least 50 displacement sites have been flooded and many of these camps had been set up to house families displaced by the earthquakes. More than 2,000 tents were destroyed or damaged during the floods.
Humanitarian aid and Search and Rescue materials and teams arriving in northwest Syria were limited and slow, particularly in the first two weeks after the earthquakes.
Bab Al-Hawa was the only authorized UN crossing point for life-saving medical supplies. However, on February 13, two more crossings - Bab Al-Salam and Al-Ra'ee - were opened from Turkey to northwest Syria (but not under the UNSCR). In addition, there are also commercial crossings for trade and local NGO supplies, such as Al Hammam and Jarablus. Non-medical convoys and authorized personnel can use these crossings through local partners.
While the Syria Earthquake Flash Appeal has secured over 98 per cent of the required funding, covering three months, more support is needed for the overarching humanitarian response, according to OCHA. The Syria Humanitarian Response Plan (HRP) for 2023 remains largely underfunded. Only $375 million has been received out of the $4.8 billion required (some 7.8 per cent), as of 28 April.
MSF supported 32 hospitals and hea
Syria remains the country with the biggest population of internally displaced people in the world. After 12 years of war, 15.3 million people require humanitarian aid in Syria.
The country has the world's largest population of internally displaced persons (IDPs), with 6.9 million, mainly women and children, who have been displaced multiple times and live in precarious conditions.
In northern Syria, camps lack humanitarian assistance, mental health support, and vaccination access. Many people suffer from skin conditions, including Scabies and Leishmaniasis, while others remain vulnerable to chronic conditions like diabetes and hypertension
lth facilities, through donations of emergency kits, trauma kits medical supplies, and blankets. This includes facilities in Idlib, Azaz, Afrin, Mare’, Bab El Hawa, among other towns. We also sent medical staff, including surgeons, to support hospitals dealing with the influx of wounded.
In 4 health facilities (hospitals and clinics) in Idlib governorate, we treated injured patients, and we increased the capacity of the hospitals we’re working in by adding triage tents in the outside wards.
In addition, we deployed our ambulances and we’re supporting 90 ambulances to facilitate the transfer of patients in need of emergency assistance to the closest health facilities.
Two weeks after we have scaled up efforts deploying mobile clinics and distributing relief items to affected populations.
We set up mobile clinics that were deployed in three reception centers, and eleven different camps in northwest Syria. The aim is to offer essential medical services to people affected by the earthquakes.
Our teams launched a mental health hotline that is accessible to people, that is being communicated in the community through our health promoters and mental health specialists.
In Aleppo governorate, with our local partners, we distributed food and blankets to more than 500 families in the reception centers in Afrin.
Similarly, we distributed more than 800 kits, including hygiene items, kitchen kits, winter kits and blankets, to affected people in Jindires, one of the most affected cities, and families in reception centers in Azaz and Mare’ and surrounding villages.
A total of 19,594 blankets have been distributed in northwest Syria.
Offering immediate relief support to people affected by the earthquakes, particularly those without shelter in this cold weather, will remain a priority for our team. We will continue to assess the needs and adapt our response accordingly.
In an effort to continue our support.
On Sunday, February 26th 2023, MSF has brought in a convoy of 15 trucks including 1234 tents and winter kits to be distributed in the following days.
In addition, 24 tons of medical items have been imported in preparation for scaling up of activities.
Access to healthcare in Syria has been affected by conflict and attacks on facilities. Functioning facilities struggle with limited supplies, staff, and funding. The deteriorating economy also reduces access to medical care. People prioritize basic needs over medical needs, unable to pay for transportation or treatment. Medical referrals to Turkey have been suspended or restricted since the earthquake, which is particularly critical for cardiology and oncology patients.
Before the earthquake, 4 million people monthly benefited from cross-border aid through Bab Al-Hawa, the only remaining crossing point into Syria.
In September 2022, a cholera outbreak has been declared in Syria, including in the north of the country, where MSF works.
This outbreak has been linked to people drinking contaminated water from the Euphrates River in northeast Syria. It was further exacerbated by the acute water shortage and weak water and sanitation infrastructure severely affected by years of armed conflict and the decreasing humanitarian funding. However, currently all MSF activities in that regard has been put on standby as no patients have presented themselves to our facilities and cases who did suffer from mild symptoms, however MSF is ready to relaunch activities depending on the evolution of the situation.
MSF has been present in northwest and northeast Syria for many years, making a swift response possible in the most affected areas, mainly in NWS, while NES was much less affected.
MSF teams are adapting their response in Syria to offer immediate relief and medical support. The pillars of the first few days of the response are supporting medical facilities to treat patients with material and HR support, facilitating transport of patients by supporting ambulances, and providing immediate relief items to people affected.
Today, MSF has scaled its efforts deploying mobile clinics, distributing relief items, implementing water and sanitation and logistics activities, and offering psychological first aid.
As an initial response following the earthquakes, MSF supported 36 hospitals and health facilities, through donations of emergency kits, trauma kits medical supplies, and blankets. This includes facilities in Idlib, Atmeh, Azaz, Afrin, Mare’, Bab El-Hawa, among other towns. We also sent medical staff, including surgeons, to support hospitals dealing with the influx of wounded.
In 4 health facilities (hospitals and clinics) in Idlib governorate, we treated injured patients, and we increased the capacity of the hospitals we’re working in by adding triage tents in the outside wards.
In addition, we deployed our ambulances, and we supported 90 ambulances to facilitate the transfer of patients in need of emergency assistance to the closest health facilities. Two weeks after we have scaled up efforts deploying mobile clinics and distributing relief items to affected populations.
Two weeks after the earthquakes, MSF scaled up their efforts by deploying up to 14 additional mobile clinics in several reception centers and different camps across northwest Syria. The aim was to offer essential medical services to people affected and displaced by the earthquakes.
Our teams launched a mental health hotline that is accessible to people, that is being communicated in the community through our health promoters and mental health specialists.
In addition, we offered mental health services in the mobile clinics and health centres we support, and set up safe spaces for social and recreational activities for women and children. We also created a Psycho-social Care Unit strategy to support our staff, which were affected by the disaster.
In Northwest Syria, MSF, along with local partners, distributed more than 110,800 relief items including heating kits, hygiene kits, kitchen kits and including more than 6000 tents and 37000 blankets. MSF also supported bakeries to provide more than 367000 bread to the affected people.
Hundreds of thousands of people lost their homes due to the earthquakes and were left without access to their essential needs. Therefore, MSF was donating tents and started coordinating more with other organizations to organize shelter for newly displaced people.
Due to the huge destruction of health facilities in the Afrin area, MSF has supported the Afrin hospital managed by a local partner and continued running mobile clinics in camps of newly displaced people. MSF shifted at this stage from the first aid psychological support to a more advanced mental health support to the affected people. Our team has also set up a mother and child space to provide privacy for lactating mothers in camps. In the Idlib governorate, MSF supports the referral of cold cases, supports 2 hospitals which have ICU and dialysis and a blood bank.
Following the destruction of the maternity centre supported by MSF in Jindires, MSF is currently in the process of building a new maternity centre which will provide a safe and convenient space for pregnant women and new-borns, which will address the gap in maternal healthcare services in the area. In Idlib governorate, MSF is also rehabilitating three hospitals and PHCs, which it already supports in Salqin, Al-Maland and Heyr Jamous, after it was partially destroyed by the earthquakes.
In Idlib governorate, MSF provided water and sanitation activities in 18 camps for the newly displaced people. This included rehabilitating latrines, providing water trucking, installing water tanks, and supporting waste collection services. MSF also provided mobile latrines and water and sanitation support to camps receiving new IDPs. In Aleppo governorate, MSF collaborated with local partners to install latrines and water tanks, provided chemicals to a water treatment plant in Afrin city and provided clean water to people.
To continue our support, since the earthquakes, MSF brought in a convoy of 53 trucks including tents, winter kits and other essential items and distributed them to those who were affected by the earthquakes. In addition, 35 tons of medical items have been imported in preparation for scaling up of activities.
MSF is currently providing recreational activities and psychological aid to people, particularly children, who are residing in collective shelters in Aleppo governorate. The recreational activities provided by MSF are aimed at improving the mental health and wellbeing of the people living in these shelters. This can include activities such as games, sports, arts and crafts, and storytelling. These activities provide a much-needed distraction from the stressful and uncertain environment of the shelters and can help to build social connections and a sense of community.
Thousands of people got injured during the earthquakes and due to the severity of their injuries, emergency surgeries were performed to stabilize their condition. However, emergency surgeries typically prioritize saving the patient's life rather than focusing on cosmetic or mobility concerns. This means that many of the patients who underwent emergency surgeries may require follow-up and reconstructive surgeries to prevent scarring and mobility issues in the future. To address this need, MSF is currently supporting a hospital in Idlib governorate to provide follow-up and reconstructive surgeries to the affected people to help minimize the long-term physical effects of the injuries
There was no major damage or injuries reported at or near our projects in northeast Syria as a result of the recent earthquakes. However, the team is actively utilising any opportunities to provide support to earthquake affected areas elsewhere in Syria.
In northwest Syria, MSF is 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, Non-Communicable Diseases (NCD’s) program, 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 in NES. In addition, MSF teams in northeast Syria frequently respond to additional medical needs as they arise including a now completed measles intervention and a recent short-term influenza B intervention in response to high child mortality starting in December 2022. The project was finalized in April, after a significant drop in the number of cases.
Map of the earthquake in Syria and Turkey with MSF response. © MSF
According to the Disaster and Emergency Management Presidency (AFAD), as of 22nd of April, more than 51,768 people have died following the earthquakes in Türkiye. According to the same source, there have been more than 28,000 aftershocks in the affected region since the February 6 earthquakes, 48 of them higher than magnitude 5 on the Richter scale. As of the 3rd of April, the disaster area has expanded. AFAD declared that areas where buildings were damaged in Bingöl, Kayseri, Mardin, Tunceli, Niğde, and Batman were given the status of "General Disaster Areas", meaning they are partial disaster zones.
According to the UN (OCHA), more than 3 million have been displaced and more than 1.6 million have been living in formal and informal settlements across earthquake affected areas. According to the Turkish Ministry of Interior, as of April 3rd, there are over 650 thousand tents and over 50 thousand containers sheltering people. The official state of emergency has been declared until May 2023.
National Search and Rescue (SAR) concluded activities in the first week of March in earthquake affected areas, such as Malatya, Adıyaman and Gaziantep. Bulldozers are still removing tons of rubble and authorities are still inspecting the buildings that are standing to conclude if they should be destroyed or not.
Across the most affected cities, thousands of buildings have been damaged: 56,426 buildings are either collapsed or urgently need to be demolished, 206,452 buildings have suffered severe damage, 48,984 buildings have moderate damage, and 516,352 buildings have minor damage, according to the Turkish Ministry of Environment and Climate Change. Moreover, many of the standing buildings have cracks and other issues so the authorities are inspecting them: 1.25 million have been inspected, according to the authorities.
People are very afraid of going back to their homes because there are still aftershocks daily. Also, economic activities (banks, shops, etc) and some basic services have been disrupted, converting many cities into ghost towns.
Many families have been affected by the earthquake and are living in tents like this one in a village of the rural areas of Elbistan district, in southern Türkiye. © Igor Barbero/MSF
Many informal camps are in place with tents and containers scattered across every corner of each city, away from tall buildings but not too far from the survivors’ homes. Heavy rains have also generated flooding, adding further difficulties, such as issues regarding appropriate shelter and water and sanitation conditions. Floods have killed 21 persons in total (17 deaths in Şanlıurfa and 4 in Adıyaman), flooded some camps, contaminated water, and partially damaged the irrigation systems for some farmers. Rough weather continued to adversely impact the survivors as a tornado passed through the epicentre of the first destructive earthquake on April 20th. The tornado killed one person, injured 50 and destroyed the tents of the earthquakes’ survivors.
In rural areas, while most of the families have lost at least one person and are trying to rebuild their livelihood and communities, they are also having to host relatives coming from other locations. People coming from the cities often feel like urban spaces are too dangerous and resort to the countryside. Although some of the houses have not been destroyed in rural areas, most of them are still deemed unsafe and people are extremely fearful and resort to them just for quick tasks during the day, and share a tent at night between, at times, up to 10 people.
According to the Ministry of Environment, Urbanization and Climate Change, construction to build residences and country houses (for villages) to host 270,000 families have already begun. According to the ministry, 650k buildings will be constructed within a year and 46,327 of them are already being built.
All MSF relief activities in Türkiye are carried out in collaboration with local partners. MSF is not registered in Turkiye so this is the model we have to use to help people affected. Although this limits our capacity we want to keep the focus on the people and not ourselves, please bear in mind that our activities in Turkiye are not huge given the scale of this disaster.
MSF is supporting various local NGOs in Türkiye to provide humanitarian relief to people affected by the earthquakes, including psychosocial interventions, water and sanitation improvements and relief items distributions and donations, as the humanitarian emergency evolves.
Psychosocial activities for the affected population and volunteers include individual and group sessions, as well as donating pedagogical material for psycho-social workshops. In places like Adıyaman and Malatya, we are supporting local organisations in setting up clean, safe and warm spaces where they can find psychosocial support, showers and toilets, laundry machinery, charging docs, amongst other services.
MSF has also supported and continues to support with donation and distribution of medical materials, food, water and logistical supplies, as well as tens of thousands of relief items, such as hygiene kits blankets, stoves and underwear. We also address the immense needs in water and sanitation with the constructions of showers and toilets and setting up and refilling water tanks in makeshift camps.
