Reflections of a Humanitarian Relief Physician During the 2023 Earthquake Disaster by Dr. Mustafa el-Adou, MedGlobal #2

After more than ten years, the Syrian people are still suffering from the ongoing crisis that swept over our country, leaving millions of people internally displaced and forced to live in camps, as well as hundreds of thousands of dead. Furthermore, the Syrian and Russian troops’ battle and relentless military operations have led to poverty and a pitiful economy, a weakened infrastructure, and a shattered and vulnerable health system. The humanitarian situation is also not much better, so the majority of people are dependent on humanitarian aid for basic survival necessities. Humanitarian organizations have supported the health system entirely, but even still, there has been a severe lack of medications and medical supplies, and occasionally, several hospitals and other health facilities have been forced to close partially or completely due to a lack of funding. As a result of these extreme factors, the populations in NW Syria were already in the midst of severe humanitarian conditions prior to the earthquake.

On February 6th, 2023, while everyone was sound asleep, I awoke at 4:20 am when the earth began to shake violently. My wife, children, and I were all awakened at the same time. At first, we were stunned and it took some moments for us to realize that it was an earthquake. I thought it would only last a few seconds, but as it grew stronger and longer, I began to scream, “Oh my God,” and my daughter began to cry and ask me to rescue her. I was immobilized due to the shaking and was unable to provide rescue from our flat on the 5th floor of the building. The earthquake grew worse and we heard loud, strange, and powerful noises coming from all directions. At that point, our furniture had started to break, the electricity was off, and I thought all the buildings around me had collapsed. According to the civil defense, more than 2166 people died and more than 2950 were injured, while 479 structures were entirely destroyed and 1481 sustained damage (1). Feeling like it lasted an hour, the earthquake did not subside for a very long time. When the shaking finally weakened, I frantically told my wife and kids to quickly exit to the ground level. We all raced down many flights of  stairs without shoes and in our pajamas. After we made it to the street alive, we saw thousands of people fleeing their houses in their sleeping clothes, terrified and in shock. No one knew what had happened to their family and friends; there was no internet or electricity, and it truly felt like the end of the world. We sat in the dark in a heavy frigid rain for three hours before deciding to go back inside. Fortunately, I had access to a solar power system, and I was able to access the internet. At that point, the crisis’ effects began to spread and the bad news started to arrive. I began to form a plan to help, analyzing where I should start and what I should do while working as a humanitarian aid worker for the MedGlobal organization. I started to talk to the affected hospitals and health actors to find out what they needed; there was a severe lack of diesel, medical supplies, and medicines. Then, and after securing a shipment of medicines and supplies, I couldn’t decide between protecting my family and doing everything I could to help the victims. Fortunately, my brother finally came to move my family into the IDP camp where we would live with my parents and brothers. As a result, I felt somewhat comfortable with their safety and left right away to deliver medications and medical supplies to hospitals in dire need of them.

 After a long and difficult day, I returned to the camp in the evening to discover that several international media platforms had asked me to speak with them about the earthquake, its effects, and the needs it created. I was asked to attend our meeting with my team in the US to update them on our activities, so I continued to work all night. 

On the second day, a number of hospitals asked me to give them diesel so they could run their facilities because the electricity was still off. I started by delivering diesel to two major hospitals and to the civil defense so they could run their vehicles.

On the third day, when many survivors began to congregate in temporary shelters without access to healthcare, I launched two mobile clinics to reach out to these individuals and provide them health, nutrition, and mental health services. I tirelessly carried on offering assistance to those in need throughout the days and attended our scheduled interviews and meetings in the evenings.

The first days of the earthquake had passed and the amount of destruction, victims and injuries were becoming known. The initial numbers were massive and scary, and a lot of people were still under rubble of the collapsed buildings. The most heartbreaking and challenging situations were when I heard adults and children alike pleading for help from beneath the rubble, but was powerless to help them. Time was running out and many men, women, and children still had an agonizing fight for their survival. Despite my anguish and incapacity to save them, I was to see the civil defense save a young girl and take her right to the nearest hospital. I was torn between feelings of heartache and happiness, hope and helplessness. I was elated when I witnessed survivors being rescued from the wreckage, grieved while observing the victims, hopeful when I observed the civil defense and volunteers working hard to rescue people, and despairing when I saw the severe lack of sufficient aid to dig out everyone, while being aware of the quickly diminishing oxygen levels to those who were still trapped.

The disaster overwhelmed my capacity and comprehension, and there were moments I was unable to function in front of a sizable number of victims. Even though I am a trained physician and humanitarian aid worker, the earthquake tragedy affected my physical and mental health. It was challenging to strike a balance between my responsibilities to the afflicted people and my own response, emotions and mental health. On the other hand, it was useful to learn how I should organize, react to, and prioritize our humanitarian relief response to such disasters in the future, as well as how I should organize and mobilize my resources to conduct efficient and effective emergency response. These lessons learnt are summarized as the following:

    • Secure my family in a safe place.
    • It is very important to stay in close coordination with my team (MedGlobal) to know what the available resources are to me.
    • It is crucial to coordinate with the health system leaders in our areas, such as WHO, Health Cluster and Health Directorates to fill the gaps, ensure efficiency and that your planned interventions are a top priority.
    • My emergency response must be rapid and qualitative, arriving quickly to the affected populations and health facilities.
    • I must be acutely aware of my own well-being to keep a balance between my duties and my physical  and mental health.

Despite the tragic and negative effects of the devastating earthquake on the affected populations, my own physical injuries and emotional trauma, I feel some degree of satisfaction with my efforts and humanitarian relief response. I took away hard-learned lessons from this catastrophe, and exist in the hope that it will not occur again.