Abstract
The earthquakes in south-east Turkey in February 2023 directly affected 9.1 million people in Turkey [[1]] and 8.8 million people in government-controlled areas of Syria [[2]]. There were more than 54,000 deaths; more than 3.2 million people were displaced [[1]]; and more than 130,000 people were injured [[1]], either directly by collapsing structures, or indirectly while extracting themselves, or rescuing loved ones and possessions, from beneath the rubble. The severity of earthquake-induced injuries ranged from minor soft tissue injuries to significant head, chest, abdominal, crush and amputation injuries. The importance of early, high-quality, long-term rehabilitation services to promote functional recovery, shorten hospital stays, and reduce complications or disability is well recognised [3, 4], and these services are required urgently in south-east Turkey to minimise the impact on physical health, psychological well-being, social functioning and economic prosperity of those affected by the earthquakes [[5]]. The following front-line insights reflect the primary care physiotherapy care needs of a heavily affected town close to the epicentre of the first earthquake in Kahramanmaraş Province, southeast Turkey (60 km from Gaziantep), encountered in an emergency medical team field hospital 4–6 weeks post-disaster.
All age groups, from young children to elderly individuals, presented with injuries. Approximately 25% of presentations were related directly to the earthquakes, and included: delayed presentations of impact injuries, strains and falls.
Fifty percent of presentations were related indirectly to the earthquakes, and included: injuries due to falls over rubble; overuse injuries of the back or upper limbs sustained while rescuing people, retrieving possessions or partaking in clean-up efforts; acute exacerbations of chronic musculoskeletal conditions, such as osteoarthritis, secondary to cold and uncomfortable sleeping arrangements (75% of patients were residing in tents temporarily following destruction of their homes); and the inability to access planned clinical reviews following surgical interventions that took place prior to the earthquakes (due to the destruction of healthcare facilities or inability to access them).
The remaining 25% of presentations were not related to the earthquakes, and constituted the range of presentations usually encountered in daily physiotherapeutic practice.
Approximately 75% of patients were managed in a musculoskeletal triage/first contact practitioner format using clinical assessment (through Turkish/Arabic-English interpreters) and targeted care including x-ray imaging, strapping, plaster of Paris, analgesia and exercise. The remaining 25% of patients were rehabilitation cases, such as delayed shaft of humerus fractures with secondary radial nerve palsy, complex regional pain syndrome following fracture, crush injuries, and rehabilitation from pre-disaster surgical interventions. Approximately 5% of patients required onward referral to secondary care, although only one of these patients was an earthquake-related case.
Transparency declarations
We declare no competing interests.
Ethical approval
Not required.