YALE/TULANE ESF-8 PLANNING AND RESPONSE PROGRAM SPECIAL REPORT (EARTHQUAKE - TURKEY)

BACKGROUND TURKEY AFAD – Department of Earthquakes AFAD Turkish Catastrophic Insurance Pool Emergency Management General Directorate CURRENT SITUATION Ministry of Environment and Urban Planning Foundation for the Support of Women’s Work (FSWW) General Directorate of Disaster Affairs (GDDA), Turkey - gov Ministry of Interior DAMAGE ASSESSMENT Ministry of Health Ministry of National Education, Turkey - gov Ministry of Public Works and Settlement, Turkey - gov Prime Ministers Office, Turkey – gov INTERNATIONAL ASSISTANCE Turkish Red Crescent

INTERNATIONAL/REGIONAL RELIEFWEB RED CRESCENT UNICEF

UNITED STATES BLOOD US Embassy – Turkey The Department of State DIP NOTE U.S. Agency for International Development Chance of Chance of CIA World Fact Book Chance of Chance of Chance of HEALTH AND MEDICAL Precipitation Precipitation Precipitation Precipitation Precipitation USGS 0% 20% 20% 60% 20% Wednesday 2 NOV Thursday, 3 NOV Friday, 4 NOV Saturday, 4 NOV Saturday, 4 NOV HEALTH INFORMATION

HEALTH THREATS CDC - Earthquake WHO- Earthquake

46 | 30°F 50 | 36°F 46| 34°F 50 | 32°F 39 | 28°F PORTALS AND RESOURCES SHELTER CIA Facebook – Turkey Partly Cloudy Chance of Rain Partly Cloudy Rain Partly Cloudy Prevention Web Yale-Tulane ESF-8 Planning and Response Program Humanitarian Early Warning Service - Seismic APAN Earthquake Report IRIS MCEER 2 NOVEMBER 2011 Library of Congress Country Study – Turkey EMSC Kandilli Observatory and Earthquake Research Institute Underground Weather

NEWS AND MEDIA AlertNet BBC

MAPS Turkey - USGS

BACKGROUND

• A magnitude-7.2 earthquake struck 12 miles northeast of the city of Van in eastern Turkey on Sunday, October 23, 2011, at 1:41 p.m. local time at the epicenter (time in other time zones). The earthquake occurred at a depth of 12.4 miles and causing strong shaking throughout a broad area, and significant damage to Van and neighboring towns.

• The epicenter of the quake was in the village of Tabanli at Ercis district in the eastern province of Van. The province borders Iran on the east. The earthquake was also felt in the Van province city center as well as the neighboring 11 provinces including Ağrı, Batman, Igdir, Muş, Bingöl, Tunceli, Diyarbakır, Siirt, Sirnak, Mardin, and Erzurum.

• The HDI (Human Development Index) in the affected region (Van, Hakkari, Bitlis, Mus) is among the lowest in Turkey. The HDI is a combination of literacy rate, life expectancy An earthquake of magnitude 7.2 struck the eastern city and GDP (per capita). In the Van area (0.630), the HDI is equivalent to Bhutan, Solomon of Van in Turkey killing hundreds and injuring 350 on Islands, India or Congo, as compared to the average HDI of Turkey which is 0.810. The Sunday afternoon. The epicenter of the quake is development of the region poses many problems for health issues. reportedly located in the village of Tabanli in Van province bordering Iran. Source: Reuters • Van Province has a population of 1.035 million The average household size is between 7 and 8 persons. It has 539,619 residents living in cities, and a village population of 495,799.

• The current version of the USGS Prompt Assessment of Global Earthquakes for Response (PAGER) estimate is that economic losses are most likely to be in the $1–10 billion range, and fatalities are likely to be in the 100–1,000 range.

• Turkey is a tectonically active country that experiences frequent destructive earthquakes. Quakes in this region are controlled by the Arabian and Eurasian tectonic plates. The Arabian plate converges with Eurasia in a northerly direction at a rate of approximately 24 millimeters per year in this area.

SOURCE: OCHA SITREP Turkish soldier stands near collapsed building in Ercis, near USGS the eastern Turkish city of Van. REUTERS/Baz Ratner NYT

TURKEY EARTHQUAKE AND AFTERSHOCKS HIGH DEFINITION SITUATION

As of 30 OCT 2011: The death toll is at 601 , the number of injured 4,152, UTILITIES : Electricity and telecommunications services have been disrupted the number pulled from rubble alive 188. (AFAD) in the city of Van and the nearby town of Erciş (Van). Damage to buildings has also occurred in parts of the neighboring Bitlis and Hakkari Provinces. AFTERSHOCKS There have been 1,769 aftershocks since the earthquake occurred: DEPLOYED ASSETS • 637 aftershocks with magnitudes 2-3 • Search and rescue, medical and first aid personnel from 48 different • 850 aftershocks with magnitudes 3-4 provinces and 39 different institutions have been deployed to the region. • 108 aftershocks with magnitudes 4-5 • 7 aftershocks with magnitudes 5-6 • In total, 4.446 search-rescue personnel, 1,796 medical personnel, 18 search dogs, 653 construction vehicles, 173 ambulances (7 of them air DAMAGE ASSESSMENT: ambulances), 11 mobile hospitals (6 of them in service), 143 generators, • A technical committee of 20 personnel from the government and 200 77 reflectors, 141 WC-shower bath containers, 44,164 tents (9,436 of technical personnel from different provinces have started preliminary them from abroad), 109 tents for general usage, 60 prefabricated houses, damage assessment. 15 house containers, 2,310 Mevlana type prefabricated houses, 165,531 blankets, 1,179 quilts, 37 portable kitchens, 3,051 kitchen sets, 6,915 DAMAGE NUMBERS catalytic stoves, 5,792 sleeping bags, 1,000 folding beds and 1 mobile oven have been delivered to the region. Collapsed buildings 2,309 Severely damaged 11,847 FOOD • Food items have been sent by different sources, including from provinces neighboring Van. Moderately damaged 17,923 • Red Crescent is continuing to distribute hot meals three times a day to the affected population. • All disaster and emergency centers of related ministries operating 24/7. WATER: People in the earthquake area have been warned by the Ministry of • On 24 OCT 2011 the Ministry of Education indicated many schools in the Health to drink only bottled water. Many cases of diarrhea have been area collapsed or were seriously damaged. With the possible exception of reported locally. boarding schools, they were all empty and resulted in no casualties LIVESTOCK • Farmers and livestock breeders will need support to resume their SOURCE: OCHA SITREP No#7 activities. VAN EARTHQUAKE PRESS RELEASE (31 OCTOBER 2011,12:00 PM) VAN EARTHQUAKE PRESS RELEASE (30 OCTOBER 2011,06:00 PM) • The earthquake had a very high toll on livestock, – cattle and sheep – VAN EARTHQUAKE PRESS RELEASE (28 OCTOBER 2011, 15:30 PM) which is the main economy in the rural areas. VAN EARTHQUAKE PRESS RELEASE (27 OCTOBER 2011, 11:45 AM IFRC Info Bulletin 1 IFRC Info Bulletin 2 World Bulletin USGS Earthquake Report .com

DAMAGE ASSESSMENT - ERCIS HIGH DEFINITION

DAMAGE ASSESSMENT - BITLIS HIGH DEFINITION

INTERNATIONAL ASSITANCE

• The Government of Turkey has called for international assistance only in terms of tents, prefabricated houses and containers. In that regard, on 31 AID-IN-KIND THAT HAS BEEN DELIVERED TO TURKEY October, at the Ministry for EU Affairs, the EU and the Turkish Red Crescent signed a grant agreement for the supply of some 1,200 temporary housing units accommodating 6,000 persons that were rendered homeless after the Van earthquake. These housing units, made of steel and fully insulated, include two rooms, a kitchenette and a bathroom and toilet, which will be connected to electricity, water and sewage.

• This EU operation comes in addition of the supply, currently under way, of some 6,600 family tents accommodating approximately 35,000 persons. The tents have been provided through grants from some 18 EU Member States1, while part of the air transport costs and the coordination are provided by the European Commission's Humanitarian Assistance and Civil Protection unit, ECHO. Most tents consignments have already been delivered to Erzurum airport.

• UNHCR has donated a total of 4,000 tents, 50,000 blankets, and 10,000 sleeping mats, out of which 500 tents and 1,000 blankets have been received by the Government in the meantime (AFAD).

• For the reception of international assistance coming by air, Erzurum is determined to be logistics center and Erzurum Governorship is assigned to establish this center and transfer the aids to Van. – In the case that the Erzurum Airports capacity is exceeded, the Military Airport will be used and an alternative.

• For the reception of international assistance coming by land, Logistics Reception Center has been established by Van Governorship.

• European Union granted 10 million TL to Turkish Red Crescent in order to provide temporary housing units for homeless

SOURCE: OCHA SITREP#9 VAN EARTHQUAKE PRESS RELEASE (31 OCTOBER 2011,05:00 PM) VAN EARTHQUAKE PRESS RELEASE (31 OCTOBER 2011,12:00 PM) VAN EARTHQUAKE PRESS RELEASE (30 OCTOBER 2011,06:00 PM)

TURKISH RED CRESCENT

THE TRC CRISIS MANAGEMENT DESKS

• The TRCS Crisis Management Desks in the Disaster Management Center (HQ) (Ankara), the Northern Anatolia (Erzurum), the South- eastern Anatolia (Elazığ), the Eastern Anatolia (Muş), and the Mediterranean (Adana) Regional Disaster Management Centers and Sivas and Diyarbakir Local Disaster Management Centers are currently staffed. There are also 5 staff from Elazığ Regional Disaster Center.

DAMAGE ASSESSMENTS • 2 staff from Muş Disaster Management Center and 3 staff from Erzurum Regional Disaster Management Center have been deployed to the Van Province to conduct needs assessments. • Damage assessment is being conducted through the Turkish Red Crescent Branch Offices, District Governorates, Gendarmerie Commands, Security Departments in the town and cities, and is being coordinated from the Disaster Management Center (HQ).

COMMUNITY SUPPORT • The TRCS alerted all its units in Turkey in order to meet the urgent shelter and food needs of the victims, and dispatched the relief items from Ankara, Elazığ, Erzurum, Adana, Muş and Manisa Children play near relief tents for people left homeless by the Regional Disaster earthquake in Ercis, near the eastern Turkish city of Van. • Management Centers and also deployed 167 disaster specialists SOURCE: Source: REUTERS/Baz Ratner (including 30 volunteers), 37 vehicles. TRCS also deployed volunteers, composed of mukhtars, clergies, police forces and teachers that were trained within the framework of the project on “Organizing Community Leaders” for this kind of disaster situations. • Tent camps have been established and delivery of tents to affected families has also started.

SOURCE: TRCS OPS UPDATE – 9

TRCS OPS UPDATE – 8

BLOOD SUPPORT

• Following devastating earthquake, TRC’s Regional Blood Center based in Van communicated immediately with hospitals in the affected area and created additional stocks of blood in the Hospitals.

• Level of blood stocks was heightened with the transportation of 350 units of blood, especially of negative blood group from Erzurum Regional Blood Center one hour after the earthquake.

• After the re-opening of the airport, a total stock of 18,000 units of erythrocyte suspension was sent to Van from other regional blood centers for the purpose of stock replenishment.

• Stocks of blood have been continuously replenished when they fall below 800 units. Erzurum and Ankara Regional Blood Centers are also creating additional blood stocks for the replenishment of stocks in the affected areas in case of need.

• Turkish Red Crescent is self-sufficient to cover the blood requirements of the health institutions upon their request. The quantity of blood which has been sent to hospitals in the region and blood usage in the period between 23 October 2011 and 31 October 2011 (See Chart).

SOURCE: TRCS OPS UPDATE – 10 TRCS OPS UPDATE – 9 TRCS OPS UPDATE – 8

HEALTH AND MEDICAL

PSYCHO-SOCIAL SUPPORT • Psychological support divisions in hospitals were assessed with the • Psychologists and social service specialists were assigned to the Health Directorate and State Hospital’s Head Physician to estimate disaster affected regions to provide psycho-social support for the needs for long-term referral systems. victims who have lost family members and for victims who have experienced post-traumatic stress due to the quake. • Schools will open on November 18; psycho-social support and consultation programs have been arranged. • 18 psych-social workers from various cities are working in Van and Erciş. Turkish Psychological Association, Turkish Association • Erciş District Governorship was informed of the current situation and of Social Workers, Turkish Psychiatry Association, Turkish was asked for a suitable area for psycho-social support activities. Psychological Counseling and Guidance Association and Association of Child and Adolescent Psychiatry are providing • 1 child psychiatrist, 2 psychiatrists, 4 psychologists, 4 social service psycho-social support in the disaster area. specialists started to work in the Erciş Tent City. Individual interviews, needs assessments, and planning are being carried out, especially for

children and women. • In order to provide psycho-social and social support services, qualified staff have been assigned to the Van Provincial • WHO/UNICEF/IOM are coordinating tools with their related ministries Governorate. 30 field tents have been set up to deliver these for psychological support to affected populations. services.

ACTIVITIES: • Provincial Disaster and Emergency Directorate and Ministry of Social and Family Affairs were contacted to establish a psycho- social support center in Van and Erciş and to plan long term activities. National Theatre in central Van will be used as the psycho-social support center as soon as the damage assessment is over. Psycho-social support activities will also start when the 4 tents in central Van are pitched in Erciş.

SOURCE: TRCS OPS UPDATE – 10 OCHA Report #7 TRCS OPS UPDATE – 9 TRCS OPS UPDATE – 8

HEALTH AND MEDICAL

• The hospital in Ercis was badly damaged in the earthquake according to reports from earthquake-report.com; medical tents have been deployed to replace the hospital. There were 179 hospital beds per 100,000 population in Van Province as of 2007 (1851 total beds in the province), so most hospital beds were occupied at the time of the quake. Over 1300 people were injured. Patients have already been moved to Ankara and Erzurum.

• As part of the overall coordination provided by the Prime Ministry Disaster and Emergency Management Presidency, the Turkish Ministry of Health - Disaster and Emergency Coordination Centre (SAKOM) is coordinating the health response and has deployed 6 helicopter ambulances, 4 plane ambulances and 201 land ambulances to the Van province.

• The Ministry of Health has prepared 1,700 hospital beds in Ağrı, Erzurum, Bitlis, Diyarbakır, Muş, Iğdır and Ankara for further medical evacuations. An earthquake survivor rests in a field hospital in the eastern Turkish town of Ercis on Oct. 26. SOURCE: REUTERS/Osman Orsal • Air ambulances are transporting medical rescue teams to the earthquake- affected area and are evacuating patients. • Ministry of Health is continuing rapid public health assessment of affected populations living in camps and assessment of • Temporary tent hospitals have been established in Van and in Erciş to related services. provide additional health services in the affected areas.

SOURCE: CHA Report #7 TRCS OPS UPDATE – 9 TRCS OPS UPDATE – 8 WHO - Information Bulletin: Earthquake in eastern Turkey (Van Region) CEDIM Forensic Earthquake Analysis Group IFRC Info Bulletin 1 IFRC Info Bulletin 2

HEALTH RISKS - EARTHQUAKE

IMMEDIATE RISKS EARTHQUAKE AND COMMUNICABLE DISEASES Earthquakes cause high mortality resulting from trauma, asphyxia, dust inhalation (acute respiratory distress), or exposure to the environment (e.g., Earthquakes may increase the transmission of the following : hypothermia). • Water/Sanitation/Hygiene-related and Foodborne Diseases • Wounds and Injuries will be numerous due to the initial impact of the – Displaced populations are at high risk from outbreaks of water, earthquake and subsequent rescue and clean-up activities. sanitation, and hygiene and foodborne-related diseases due to reduced access to safe water and sanitation systems. – Crush injury is defined as compression of extremities or other parts of the body that causes muscle swelling and/or neurological disturbances in the – Disruption of usual water sources and contamination of water by affected areas of the body. Typically affected areas of the body include lower extremities (74%), upper extremities (10%), and trunk (9%). damaged sewage infrastructure may result in unsafe drinking water

– Crush syndrome is localized crush injury with systemic manifestations. • Diseases Associated With Crowding These systemic effects are caused by a traumatic rhabdomyolysis (muscle breakdown) and the release of potentially toxic muscle cell components – Population displacement can result in overcrowding in resettlement and electrolytes into the circulatory system. Crush syndrome can cause areas, raising the risk of transmission of certain communicable diseases local tissue injury, organ dysfunction, and metabolic abnormalities, that are spread from person to person through respiratory droplets such including acidosis, hyperkalemia, and hypocalcemia. as measles, diphtheria and pertussis (see section below on vaccine- preventable diseases), and acute respiratory infections or ARI. This risk – Risk of wound infection and tetanus are high due to the difficulties with immediate access to health facilities and delayed presentation of acute is increased with inadequate ventilation. injuries. – Overcrowding can also increase the likelihood of transmission of meningitis, waterborne and vector-borne diseases in the weeks and – Gangrene is a complication of wound contamination and prompt wound months following the earthquake. treatment is critical for its prevention. Gangrenous wounds should be managed aggressively, with surgical removal of gangrenous tissue. There is no risk of transmission of gangrene to unaffected persons.

NOTES: previous experience with earthquakes that caused major structural damage has demonstrated that the incidence of crush syndrome is 2- 15% with approximately 50% of those with crush syndrome developing acute renal failure and over 50% needing fasciotomy. Of those with renal failure, 50% need dialysis.

SOURCE: CDC| WHO| CDC- CRUSH INJURIES| WHO - PUBLIC HEALTH RISK ASSESSMENT AND INTERVENTIONS HYPOTHERMIA

WHAT IS HYPOTHERMIA? BODY TEMPERATURE • A medical emergency that occurs when body heat is lost faster than it DESCRIPTION SYMPTOMS is metabolically produced. CELSIUS FAHRENHEIT • Medical definition: Hypothermia is defined as core body temperature 37 98.6 No hypothermia No hypothermia below 95 F (35 C). Definition of • Left untreated, hypothermia can be fatal Below 35 95 N/A hypothermia Shivering Mild 32 to 35 89.6 to 95 Lethargy, apathy, confusion hypothermia Rapid heart rate

Shivering stops Moderate 28 to 32 82.4 to 89.6 Increased confusion or delirium hypothermia Slowing heart rate; may become irregular

Coma Severe Below 28 Below 82.4 Ventricular fibrillation hypothermia May appear deceased 20 68 Brain activity stops

SYMPTOMS  Shivering FIRST AID  Lack of coordination  Slurred speech  Difficulty thinking • Severely hypothermic individuals should be handled carefully as vigorous  Drowsiness or low energy movements can trigger cardiac arrhythmias including fatal ventricular  Progressive loss of consciousness fibrillation  Apathy • Move hypothermic persons from the cold, remove any wet clothing, and  Weak Pulse cover with blankets  Slow, shallow breathing • Provide warm beverages if the person is able to swallow • Apply warm dry compress to the neck, chest wall, or groin • Do not apply any direct heat WHAT CAUSES HYPOTHERMIA? Hypothermia occurs when your body • Monitor breathing and pulse. Assist ventilations and perform CPR if loses heat faster than it produces it. The most common causes of necessary. hypothermia are exposure to cold-weather conditions or cold water. But prolonged exposure to any environment colder than your body can lead to hypothermia if you aren't dressed appropriately or can't control the conditions. SOURCE: THE MAYO CLINIC OUTDOOR ACTION GUIDE HEALTHSHELTER AND MEDICAL

• Sheltering Activities: Tents, blankets, sleeping bags and heaters have been dispatched and distributed in the disaster-affected area to cover the need for emergency shelter.

• Turkish Red Crescent disaster response teams established three tent camps in the Erçis District of Van • The Government has ordered TOKI (governmental agency on construction) to construct houses for the affected population as quickly as possible. • For temporary shelter purposes containers are being manufactured and will be dispatched to the earthquake as soon as possible. – The Government has allocated 600.000 TL ($322.580,00) to the Batman Governorship for the repair and maintenance of 260 containers in its possession and delivered to the affected areas in Van. • Two Mevlana House Camps (278 Mevlana pre-fabricated houses) are being – Another 100 containers manufactured under the established both in Van Central Province and Ercis District. 1,968 Prefabricated management of Kocaeli Governorship will be delivered to the Mevlana Houses have already been distributed to 48 villages which are located affected area on 3 November. in higher altitude and colder areas. • The Ministry for EU Affairs, the EU and the Turkish Red Crescent are signing a grant agreement for the supply of some 1,200 temporary housing units accommodating 6,000.

Due to the present weather conditions and presuming that it becomes worse in the coming weeks the provision of winterized tents and prefabricated houses would be the best solution in order to meet the needs of the affected population. Many people are afraid to return to their houses due to the frequent aftershocks that mean the increased SOURCE: TRCS OPS UPDATE – 10 | IFRC EMERGENCY APPEAL OPERATION UPDATE, TURKEY: VAN EARTHQUAKE request for tents. :TURKISH RED CRESCENT DISASTER OPERATIONS UPDATE – 8| OCHA SITREP NO#7 | EUROPEAN COMMISSION HUMANITARIAN AID DEPARTMENT