Istinye University (ISU) Faculty of Medicine, Department of Internal Medicine, Lecturer Prof. Dr. Tevfik Ecder underlined the importance of taking hygienic measures by pointing out that one of the important problems that may be experienced after disasters is epidemics. Ecder stated that providing clean water and food to earthquake victims and ensuring the cleanliness of their shelters will reduce the risk of infection and epidemic. Ecder also pointed out that intense psychological problems may be encountered in earthquake survivors and said, “The most common disorders in earthquake victims are acute stress disorders, post-traumatic stress disorder, depression, anxiety, prolonged grief and delirium. For this reason, it is very important to provide psychiatric support to the earthquake area.”
After the earthquakes that shook Turkey deeply, some earthquake survivors migrated to other cities, while others continue their lives in container cities and tents set up in earthquake zones. It is necessary to pay attention to issues such as the risk of epidemic disease in earthquake regions and acute kidney failure and psychological problems that may occur in earthquake victims rescued from the rubble. Istinye University (ISU) Faculty of Medicine, Department of Internal Medicine, Lecturer Prof. Dr. Tevfik Ecder, against the risk of epidemic in the earthquake region
He pointed out that hygiene measures should be taken. Stating that the most common disorders in people who experienced the earthquake are acute stress disorders, post-traumatic stress disorder, depression, anxiety, prolonged grief and delirium, Ecder emphasized the importance of providing psychiatric support to the earthquake area.
“An important problem waiting for those who are under the rubble is acute kidney failure”
Referring to the health problems that may occur in earthquake victims after the earthquake, Prof. Dr. Tevfik Ecder said:
“After the earthquake, varying levels of problems are encountered depending on the intensity of the earthquake and the infrastructure of the affected area. Some of the people who were trapped under the debris lost their lives due to the fatal traumas they received during the earthquake. Some earthquake victims may have severely damaged body parts under the debris. Patients who are saved in this way and can be transported to the hospital alive may need to have their damaged limbs amputated. This situation not only affects these patients physically, but also causes a serious psychological trauma. Another important problem waiting for the patients who are under the rubble after the earthquake is acute kidney failure. The toxic effects of some substances released from the damaged muscle tissues of extremities such as arms and legs, which are crushed by the debris, play an important role here. This picture is called the ‘crush syndrome’. Being dehydrated for a long time facilitates the development of this phenomenon. Among the substances released from the muscles, there is also potassium. Rapid elevation of potassium in the blood can cause sudden death. The main reason for sudden death, which can be seen immediately after the person is rescued from the wreckage, is the rapid rise of potassium in the muscles by mixing with the blood. In order to prevent this dramatic event called ‘death of salvation’, when a hand, arm or foot of the patient is reached during the rescue procedure (without waiting for the body to be fully recovered), intravenous fluids should be started immediately. Patients with this crush syndrome, who can be transported to a health institution alive, are kept alive by taking dialysis treatment. Dialysis treatment support should be given to these patients, whose kidney functions usually recover spontaneously within days. In a small proportion of these patients who develop acute kidney failure due to crush syndrome, their kidney functions do not improve, and therefore the person may need chronic dialysis treatment.
“Immediate measures should be taken for patients undergoing chronic dialysis treatment”
Ecder, who also gave information about the measures that can be taken for people with chronic diseases after the disaster, continued as follows:
“After the disaster, in addition to the health problems related to the disaster, the problems related to the diseases of chronic patients should also be taken into consideration. The treatment of chronic patients should not be interrupted in any way. Urgent measures should be taken for these patients. Dialysis centers in the earthquake area may have been destroyed or severely damaged. Physicians, nurses and other health personnel working in the dialysis center may have been damaged by the earthquake or may not be able to reach the center. In this case, transportation to the dialysis centers closest to that area is required. In addition, the workload of dialysis centers may increase as there will be patients who are removed from the rubble and need dialysis treatment due to acute kidney failure. It may be necessary to bring additional health personnel to these areas and to transfer patients to other centers as much as possible and safely. There should be no disruption in the drug treatments used by chronic patients. Diseases such as hypertension, diabetes, chronic lung disease and coronary heart disease, which are common health problems in the society, may become uncontrolled after a disaster. For this reason, after the earthquake, physician and nurse support from other places should be given to the region and sufficient amount of medicine should be delivered. Since dialysis may be disrupted in patients undergoing chronic dialysis treatment, it is vital for these patients to have a stricter diet, especially a potassium-poor diet as much as possible, and restrict their fluid intake.”
“It is of great importance to take hygienic measures in the region”
Drawing attention to the danger of epidemics and infectious diseases that may occur, Prof. Dr. Ecder said, “One of the important problems that can be experienced after disasters is epidemics. For this reason, it is of great importance to take hygienic measures: The infrastructure is also damaged due to the destructions experienced after the earthquake. Pollution of water resources and damage to the sewer system pose significant risks to human health. Providing clean water and food to earthquake victims and ensuring the cleanliness of shelters reduces the risk of infection and epidemic. This issue should be taken into account in the services provided after the earthquake,” he said. Pointing out that earthquake survivors may face intense psychological problems, Ecder added:
“The most common manifestations in people experiencing earthquakes are acute stress disorders, post-traumatic stress disorder, depression, anxiety, prolonged grief and delirium. Therefore, it is very important to provide psychiatric support to the earthquake area.”
Source: (BYZHA) – Beyaz News Agency
