In Puerto Rico after Hurricane Maria in 2017, the immediate official count of 64 fatalities was adjusted to nearly 3,000 in the following six months. This tragic increase was attributed to deteriorating health conditions driven by the loss of infrastructure and basic services.
In northwest Syria, conflict spanning more than a decade has left infrastructure in tatters. The World Bank estimated in 2017 that more than a third of Syria’s housing stock had been damaged or destroyed in the conflict.
In a sign of the precarious state of buildings before the earthquake, a five-storey building collapsed last month, killing 16 people. Many blast-damaged buildings present an ongoing risk now that the quake has further destabilised them.
The earthquakes also come against the backdrop of a cholera outbreak. The disease was already affecting parts of Syria, but had received little attention.
After the 2010 Haiti earthquake, a cholera outbreak brought in by humanitarian workers took almost a decade to stamp out. There were more than 820,000 cases and nearly 10,000 lives lost.
Last week’s earthquake has also occurred amid freezing winter conditions. Many displaced families are out in the cold after losing their homes. Temperatures in Kahramanmaraş – the epicentre of the magnitude 7.8 earthquake – and across quake-affected regions are plunging to -5°C at night.
Erecting adequate shelter to protect people from the cold must be a central focus of the evolving humanitarian response.
