The World Health Organization (WHO) triggered its “no regrets” policy at an emergency meeting on Tuesday in response to the earthquakes that devastated Turkey and Syria this week, while promising long-term aid to the affected regions after the period of emergency response ends.

The policy – which says that in unpredictable crises, WHO should err on the side of caution by over-resourcing disaster response efforts rather than risk under-funding them at a cost later paid in lives – immediately frees up all of the organization’s financial resources and personnel to attack the crisis.

Director General Dr Tedros Adhanom Ghebreyesus announced that WHO had mobilized its network of emergency medical teams – over 20,000 pre-qualified emergency responders, medics and nurses from its member states – to provide essential health care for the injured, with a focus on immediate trauma care.

In addition, three chartered flights carrying surgical trauma kits and other key medical supplies are on route to Turkey and Syria from WHO’s logistics hub in Dubai. The flights are estimated to arrive sometime between Tuesday evening and Wednesday morning.

As aftershocks continued into their third day, the official death toll rose to 5,102, with another 22,000 injured across Turkey and Syria. Over 5,700 buildings were destroyed in Turkey alone, including 15 hospitals. Exact numbers for the destruction of infrastructure in Syria are not known. 

Officials said casualties will continue to rise as rescuers frantically search the rubble for survivors in sub-zero temperatures. The last earthquake of a similar magnitude in Turkey, which shook the north west of the country in 1999, killed over 18,000 people. 

“It’s now a race against time,” Tedros said. “Every minute, every hour that passes the chances of finding survivors alive diminishes.”

A story split by the border

By Tuesday morning, Turkish officials said around 1,000 ambulances, 4,500 health personnel and 240 national emergency medical teams had been deployed to the disaster zones. The arrival of national and international personnel would reinforce this response. Crisis units have also been set up in all affected provinces under the coordination of the national disaster response agency.

In Syria, meanwhile, just 28 ambulances and seven mobile clinics had been dispatched by the government to affected areas in Aleppo and Latakia, just two of the five cities hit by the quakes. 

The stark difference in response illustrates the contrasting realities for survivors on either side of the Turko-Syrian border.

Turkey, despite its recent economic troubles, remains the world’s 19th largest economy, with a vast network of allies across the globe. It has a functional state that is aware the country sits on a dangerous fault-line and is at tremendous earthquake risk, with national plans and designated government agencies to respond to emergencies.

But across the border, a deadly mixture of war, displacement, climate shocks, inflation, economic decay, crumbling infrastructure and a recent cholera outbreak has trapped Syrians in what the WHO calls a “super crisis”. 

Impacts from the earthquake are expected to further compound these crises, making the vulnerable even more vulnerable.

Rebels, poor roads and makeshift houses

The last rebel enclave in northwestern Syria – a place close to three million people who fled the fighting in Syria call home – was the hardest hit by the earthquakes. Rebels govern the region with very few resources, and many people live in temporary housing, tents, or unfinished, poorly built apartment blocks.

Areas of the country under government control do not fare any better. Prior to the quakes, the UN estimated 90% of Syria’s population of 18 million live in poverty, while 70% are in need of humanitarian assistance, the largest number since the conflict began 12 years ago. 

Barely a week before the earthquakes hit, the World Food Programme warned that food insecurity in Syria had reached a 12-year high, with an estimated 2.9 million people at risk of sliding into hunger and a further 12 million do not know where their next meal will come from. This means 70% of the Syrian population may soon be unable to provide food for their families, the UN agency said.  

“If we don’t address this humanitarian crisis in Syria, things are going to get worse than we can possibly imagine,” WFP Director David Beasley said from Damascus on January 27. 

‘Every minute, we lose a life’

As the Syrian conflict reaches its 12th anniversary next month, humanitarian aid has dwindled. In 2022, the United Nations (UN) received less than half of its $4.4 billion target to meet the needs of the people caught in the crossfire of a never-ending stream of crises beyond their control. 

With so many people in need of humanitarian assistance in Syria, the destruction of roads used to deliver aid is another major concern, UN and WHO officials said. 

“The movement of aid through the border into northwest Syria is likely to be or is already disrupted due to the damage caused by the earthquake,” said WHO Senior Emergency Officer Adelheid Marschang. “This, in itself, would be a huge crisis.”

Statements from Médecins Sans Frontiéres (MSF) and the Syrian Civil Defense – an organization better known as the White Helmets – backup Marschang’s concerns in grim detail. 

“Health facilities are impacted and overwhelmed. Medical personnel in northern Syria are working around the clock to respond to the huge numbers of wounded arriving at facilities,” said Sebastien Gay, MSF’s Head of Mission in Syria. 

In a message sent out over WhatsApp, the White Helmets said harsh weather was impeding their rescue efforts, and leaving thousands stranded in the cold. With medical supplies and manpower already stretched thin before the earthquake, the group pleaded for help from the international community. 

“Tens of thousands of civilians are homeless,” the statement said. “The medical situation is abysmal. Tens of thousands of buildings are now cracked. There’s a snowstorm. There’s predictions of flooding in the area. The humanitarian situation is disastrous, with every meaning of the word.

“Every minute, we lose a life. We are now racing with time.” 

Image Credits: Engin Akyurt/ Unsplash, Mercy Corps, Mahmoud Sulaiman/ Unsplash.