An Emerging Health Crisis in Turkey and Syria after the Earthquake Disaster on 6 February 2023: Risk Factors, Prevention and Management of Infectious Diseases

Autoimmune Diseases Following Environmental Disasters: A Narrative Review of the Literature

Environmental disasters are extreme environmental processes such as earthquakes, volcanic eruptions, landslides, tsunamis, floods, cyclones, storms, wildfires and droughts that are the consequences of the climate crisis due to human intervention in the environment. Their effects on human health have alarmed the global scientific community. Among them, autoimmune diseases, a heterogeneous group of disorders, have increased dramatically in many parts of the world, likely as a result of changes in our exposure to environmental factors. However, only a limited number of studies have attempted to discover and analyze the complex association between environmental disasters and autoimmune diseases. This narrative review has therefore tried to fill this gap. First of all, the activation pathways of autoimmunity after environmental disasters have been analyzed. It has also been shown that wildfires, earthquakes, desert dust storms and volcanic eruptions may damage human health and induce autoimmune responses to inhaled PM2.5, mainly through oxidative stress pathways, increased pro-inflammatory cytokines and epithelial barrier damage. In addition, it has been shown that heat stress, in addition to increasing pro-inflammatory cytokines, may also disrupt the intestinal barrier, thereby increasing its permeability to toxins and pathogens or inducing epigenetic changes. In addition, toxic volcanic elements may accelerate the progressive destruction of myelin, which may potentially trigger multiple sclerosis. The complex and diverse mechanisms by which vector-borne, water-, food-, and rodent-borne diseases that often follow environmental diseases may also trigger autoimmune responses have also been described. In addition, the association between post-disaster stress and the onset or worsening of autoimmune disease has been demonstrated. Given all of the above, the rapid restoration of post-disaster health services to mitigate the flare-up of autoimmune conditions is critical.

Establishment of a post-disaster healthcare information booklet for the Turkey-Syrian earthquake, based on past disasters

The scientific evidence based on experiences with past disasters points to the possibility of the occurrence of future mental health issues among those who were affected by the recent Turkey-Syria earthquake. However, post-disaster care information on factors that could give rise to mental health issues among those affected have yet to be provided. In March 2011, Tohoku University compiled and published a booklet with post-disaster healthcare information based on the experiences with the Great East Japan Earthquake. This study aimed to promote the introduction and use of this booklet for post-disaster care in Turkey and Syria by presenting the results of a satisfaction survey conducted with relevant Japanese organizations about the booklet. A total of 505 Japanese organizations participated in the satisfaction survey of, and evaluated, the booklet. The results indicated the need to consider the ease of understanding for the general public when providing information on post-disaster care through booklets. We hope that this study leads to the appropriate provision of easy-to-understand, post-disaster healthcare information to the victims of the Turkey-Syria earthquake and future disasters.

Environmental Health Risks After the 2023 Turkey-Syria Earthquake and Salient Mitigating Strategies: A Critical Appraisal

A 7.8-magnitude earthquake in Turkey and Syria, followed by a 7.6-magnitude earthquake, caused over 50 000 deaths and over 100 000 injuries. The immediate physical injuries were severe, but the health repercussions, including the strain on healthcare services and the possibility of disease outbreaks, were equally concerning. Infections due to multidrug resistant microbes were also a matter of concern. Earthquake has caused not only loss of property and physical damage but also has a great negative impact on the mental health of the people. It is associated with serious psychological trauma. Moreover, the risk of malnutrition also became evident. Food aid and nutritional supplements can reduce the risk of malnutrition, but they are not a long-term solution. Establishment of sustainable food systems and restoration of agricultural productions are essential. Other demanding issues like derth of access to essential services related to health care, chances of child birth related complications following earthquake also need to be addressed. Emerging crises and disasters (conflicts, pandemics, epidemics), in addition to pre-existing conditions (collapsed health facilities, cold winter conditions, destruction of lifeline infrastructures, overcrowding in emergency shelters, poor sanitation, and unfavorable socio-economic conditions), may further exacerbate the already precarious public health situation and significantly delay the recovery process. The early warning and protection against the development of infectious diseases in earthquake-affected areas depend on good disease surveillance at the local and regional levels, which has been proposed as one of several techniques for prevention and management of infectious diseases in these areas. Our article outlines high-level approaches to reduce the risk of health issues among victims of Turkey and Syria.