2A-S1-1

NATURAL DISASTER OF TURKEY: MARMARA EARTHQUAKE AUGUST 17, 1999 IN THE FIELD OF CHILD HEALTH CARE

Munevver Bertan, Turkey

Turkey has experienced several types of disasters in the last century. Over the past 55 years, 61% of all natural disasters experienced in Turkey were earthquakes, Whereas 15% were landslides, 14% were floods, and the rest were other types of disasters.

Sudden impact disasters like earthquakes account for rising morbidity and mortality worldwide: the death toll gets higher as the population density in seismically active regions of the world is increasing. Turkey has unfortunately experienced 34 earthquakes of magnitude 6.5 and over between years 1900 and 1999. Among these, Erzincan (27 December 1939, Ms =7.9), Ladik (27 November 1934, Ms=7.2), Gerede (01 February 1943) and Van (24 November 1976, Ms=7.2), Gerede (01 February 1943) and van (24 November 1976,Ms=7.5) earthquakes were of significant impact in terms of destruction/damage to property and loss/damage to human life.

Recently, Turkey has Experienced two high impact earthquakes, namely Marmara earthquake on August 1.7,1999 (Ms=7.4) and Bolu�Cduzce earthquake on November 1.2,1999 (Ms=7.2) According to the Ministry of Health Statistics, the death toll of the Marmara earthquake reached to 15,082 as pf September 5,1999with 23,983 injured individuals and a total of 112,813\damaged/collapsed properties (1), Despite all efforts of several national and individuals have still experienced various environmental and health-related problems.

Special groups of individuals such as women of childbearing age, elderly, and children are much more vulnerable to most adverse effects of earthquakes. Nearly half of the deaths are children and adolescents in earthquakes. Children are more prone to diseases (infectious diseases, in particular) Difficulties in child birth and provision 0f breast-feeding, and limited access to medical care in case of diseases is a common situation in earthquake affected regions and makes children vulnerable to diseases and death. Responses of the children are different for different age groups, but changes in eating and sleeping behaviours are experienced in all age group. Usually a child�@s emotional response to a disaster will not last long but some problems may be present or recur many months afterward, making a consistent and long-term counseling necessary. It is important to investigate the most common health problems and associated health needs of children in cases of emergency, and provide a well-established health system to adequately manage emergency health situations and to improve the quality of life afterwards.

In effort to understand the characteristics and health problems of earthquake victims of the Marmara Earthquake, the Hacetttepe University conducted several studies in the affected region. In two tent cities established in Golyaka after the Marmara Earthquake, Dr. Yardim conducted a health study and found that 46.0% of these two tent city populations were aged 0-19 years, 54%of who were males. Among 0-19 year-old residents of these two tent cities, the most common heath complaints were common cold/running nose/sore throat (19.3%), followed by cough/difficulty in breathing (168%), and fever (16.0%), (Yardim, 1999 - unpublished data).The most of the children reported to have more than one of these symptoms. Almost all of these children (except 1 out of 98) seeked medical help for these symptoms and local health center was the most commonly visited heath unit.

In another study conducted by Hacettepe University, Dr, Uner studied the characteristics and health problems of residents in two tent cities in Sakarya Province (Uner, 1999-unpublished data). Among those aged 0-4 years old. In the study population about 40% reported that they did not seek any medical help for their complaints, mainly because ��it was not important ��(48%), ��because of financial problems��(24%) ��the waiting time was long ��(20%) and ��has no health insurance��.