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Turkish earthquake: The health impact

While some rescue groups and the Turkish authorities fear the threat of major epidemics, the World Health Organization (WHO) says the main long-term risk is to impoverished and vulnerable populations, such as women and unemployed people.

Some of these might have been displaced by the earthquake or may face difficulty accessing medical services which have been disrupted because of the crisis.

Dr Michel Thieren, medical officer for the WHO's humanitarian assistance programme, compared the situation to that following Hurricane Mitch in Central America.

"Vulnerable groups such as single women who cannot afford the additional burden and losses caused by a natural disaster could be at risk," he said.

"They will need public health services, such as immunisation and reproductive health programmes, long after the press has forgotten about the earthquake."

The Panamerican Health Organisation says the main ongoing health risk of Hurricane Mitch is to the poor and that it has served to emphasise and deepen existing problems in access to healthcare.

First 24 hours

Dr Thieren said the main health problems in Turkey, caused by crush and other injuries, were usually dealt with within 24 hours.

"People are either dead or treated by then, although there may be a second wave of need caused by aftershocks or people taking time to reach medical services," he said.

The main role of international agencies in the immediate aftermath is to replenish and replace medical and surgical supplies caused by the rush on hospitals.

The WHO believes it is highly unlikely that there will be any epidemics following the earthquake, although Dr Thieren says there is "a theoretical risk" caused by damage to the water sanitation system and disruption of health services.

"The transmission of diseases which are prevalent in a place like Turkey could be destabilised and they could become more prevalent, but this is unlikely."

And, although there had been some unconfirmed reports that cholera may have broken out in some areas, he said this was unlikely as the disease had not previously existed in Turkey.

Food shortages could also be a problem in some areas.

Dr Thieren added that there was a myth that the presence of lots of corpses could create epidemics.

Burial 'less important'

But he said that, from a public health perspective, disposal of corpses was not as great a priority as dealing with survivors.

"Disposal takes up a lot of resources and there is no real need to take it as a priority, jeopardising the overall health operation.

"This is a very important message."

However, the Turkish authorities are encouraging citizens to conform to the Muslim practice of burying the dead within 24 hours if possible, as they fear the spread of disease from bodies decomposing in the extreme summer heat.

To this end, gravediggers have worked in shifts, night and day.

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