After the earthquake in Turkey: “The health system no longer exists”

After the earthquake, the Darmstadt doctor Celik flew to Turkey and helped in a field hospital. In an interview, he reports on the conditions on site and the psychological effects – for those affected and doctors.

tagesschau.de: You were in Turkey in the last few days and helped there as a doctor. Why are you there?

Cihan Celik: I felt the same way as many other people, especially people with a Turkish migration background, who were very affected by this severe earthquake and were looking for a way to help. You could see that from the great willingness to donate.

And of course I wanted to contribute what I can contribute: medical help. And I first tried to do it officially by contacting aid organizations and the authorities. But then I realized: You have to do this with your own connections.

A certain fear of earthquakes was inherited from my family: My own family comes from south-eastern Turkey. In 1966 there was a big earthquake in Varto, my own mother was trapped under the rubble of her house for several hours as a child. So I was very moved and really wanted to help.

Privately organized field hospital

tagesschau.de: Where exactly did they go then?

Celik: I flew to Adana, which is on the edge of the earthquake zone. There I rented a car and drove to the epicenter of the destruction, to the port city of Iskenderun. There is a lot of coordination of the aid and a lot of aid arrives.

The city was also hit very hard and there was a field hospital that was organized privately. I had contacted his medical director beforehand. He was very happy to have specialist help and I immediately started a night shift.

Respiratory infections and not enough fresh water

tagesschau.de: What injuries, what diseases are there? What kind of patients did you meet there?

Celik: Regular health care is no longer available there. The entire healthcare system, from practices to pharmacies to hospitals and maximum care providers, no longer exists there. Therefore, the field hospitals must now cover all diseases.

Since people have been living in tents or under the open sky for two weeks, these are mainly respiratory infections. Above all, we have treated a large number of children – with infections of the upper and lower respiratory tract through to pneumonia.

But there are also gastrointestinal infections, diarrhea and vomiting. And there were still many patients with poorly cared for or infected wounds sustained in the earthquake. An amputation of a toe that had become infected was also necessary. It was also our job to procure medicines and provide them to people with chronic diseases.

“You have to treat everything”

tagesschau.de: You are a lung specialist, but then you suddenly had to disinfect wounds and you spoke of a toe. What happens to a medic?

Celik: Retreating to his specialist medical expertise is not possible there. There were nurses and specialists from all directions, also ophthalmologists and dentists, even veterinarians busy covering whatever problems people had.

We had very little diagnostic equipment – nowadays modern medicine is very dependent on laboratory and X-ray images and all other types of technical diagnostic equipment. All we had there was our hands, our common sense and expertise, and our stethoscope.

Disastrous hygiene

tagesschau.de: Let’s take a look at the clinical pictures. What are these conditions?

Celik: The framework conditions, both in terms of accommodation and hygiene, are of course catastrophic. Accordingly – also due to the cold at night – there are many respiratory infections and pneumonia. We couldn’t do Covid diagnostics, but it was assumed that there could also be many Covid cases among them.

Bronchitis was a common problem among the children and there were also many gastrointestinal infections with diarrhea. We had to initiate many intravenous therapies because many children were parched, let alone not fully awake. That was very devastating. And wounds that we saw were often not kept clean at all, so we often had to use antibiotics.

problems with medication

tagesschau.de: You said the water wasn’t cleaned in many places. What happens to a person if they don’t get clean water to drink?

Celik: Bottled water is currently being delivered. And the authorities have already warned against drinking water from the tap until it has been clearly approved. Experience from previous disasters shows that diarrheal diseases, including cholera, can occur if water hygiene is not guaranteed.

That’s something we’re very concerned about, because taking care of so many people with dehydration in the heat is a big challenge. The authorities must therefore ensure that this does not happen in the first place. And hygiene is the most important point.

Another problem is drugs for chronic diseases. Older people in particular have had heart attacks or cardiac arrhythmias, for example. It is very important that they take their regular medication for this. And many people don’t take any medication anymore because they say: I’m just glad to be alive.

Strong mental stress

tagesschau.de: Did the people also tell you something about their psychological situation?

Celik: The greatest psychological burden is grief. The suffering is unimaginable: Almost every patient has lost family members. That takes you away, because that’s the basic atmosphere there and no exception. And not only with the patients, but also with the team I worked with.

I was only there a week but there are people there who have been helping to pull people out of the rubble since day one and are still there now caring for sick patients. These are heroic stories: They continue to work with the greatest sacrifice and ensure that people are helped.

I have the greatest respect for this achievement and I just hope that the psychosocial care – including the helpers – will pick up speed at some point.