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分析 2023 年 2 月土耳其和叙利亚地震初期医疗响应的差异。

Analysis of Disparities in the Initial Health Care Response to the February 2023 Earthquakes in Turkey and Syria.

机构信息

Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Harvard Medical School, Boston, MA, USA.

出版信息

Disaster Med Public Health Prep. 2024 Nov 18;18:e270. doi: 10.1017/dmp.2024.290.

Abstract

OBJECTIVES

This study analyzes disparities in initial health care responses in Turkey and Syria following the 2023 earthquakes.

METHODS

Using Humanitarian Data Exchange, Crude Mortality Rates (CMR) and injury rates in both countries were calculated, and temporal trends of death tolls and injuries in the first month post- catastrophe were compared. World Health Organization (WHO) Flash Appeal estimated funding requirements, and ratios of humanitarian aid personnel in Urban Search and Rescue (USAR) teams per population from ReliefWeb and MAPACTION data were used to gauge disparities.

RESULTS

56 051 096 individuals were exposed, with Turkey having 44 million vs 12 million in Syria. Turkey had higher CMR in affected areas (10.5 vs. 5.0 per 10,000), while Syria had higher CMR in intensely seismic regions (9.3 vs. 7.7 per 1,000). Turkey had higher injury rates (24.6 vs. 9.9 per 10 000). Death and injury rates plateaued in Syria after 3 days, but steadily rose in Turkey. Syria allocated more funding for all priorities per population except health care facilities' rehabilitation. Turkey had 219 USAR teams compared to Syria's 6, with significantly more humanitarian aid personnel (23 vs. 2/100,000).

CONCLUSIONS

Significant disparities in the initial health care response were observed between Turkey and Syria, highlighting the need for policymakers to enhance response capabilities in conflict-affected events to reduce the impact on affected populations.

NARRATIVE ABSTRACT

The 2023 Turkish-Syrian earthquakes, the most devastating in the region since 1939, heightened challenges in Syria's health care system amid ongoing conflict, disrupting Gaziantep's humanitarian aid supply route. The initial health care responses post-earthquakes in Turkey and Syria were analyzed through a descriptive study, where Crude Mortality Rates (CMR) and injury rates during the first week were calculated. The World Health Organization's funding priorities and the ratio of humanitarian aid personnel in Urban Search and Rescue teams per population were assessed. Turkey had 4-fold higher earthquake exposure and experienced higher CMR and injuries per population, while Syria had higher CMR in intensely seismic regions. Temporal trends showed plateaued death and injury rates in Syria within 3 days, while Turkey's continued to increase. Syria required more funding across nearly all priorities while Turkey had more humanitarian aid personnel per population. Significant health care response disparities were observed, emphasizing the imperative for policymakers to enhance initial responses in conflict-affected events.

摘要

目的

本研究分析了 2023 年土耳其和叙利亚地震后初始医疗应对方面的差异。

方法

利用人道主义数据交换,计算了两国的粗死亡率(CMR)和受伤率,并比较了灾难发生后第一个月死亡人数和受伤人数的时间趋势。世界卫生组织(WHO)的快速呼吁估计了所需资金,以及从 ReliefWeb 和 MAPACTION 数据中获取的城市搜救(USAR)团队中人道主义援助人员与人口的比例,以衡量差距。

结果

有 5605.1096 亿人受到影响,土耳其有 4400 万人,叙利亚有 1200 万人。受灾区土耳其的 CMR 更高(每 10000 人中有 10.5 人死亡,而叙利亚为 5.0 人),而地震强烈地区叙利亚的 CMR 更高(每 1000 人中有 9.3 人死亡,而叙利亚为 7.7 人)。土耳其的受伤率更高(每 10000 人中有 24.6 人受伤,而叙利亚为 9.9 人受伤)。叙利亚的死亡和受伤人数在第 3 天后趋于平稳,但土耳其的死亡和受伤人数仍在稳步上升。除医疗设施康复外,叙利亚为所有优先事项分配的资金均高于人口数。土耳其有 219 支 USAR 团队,而叙利亚仅有 6 支,人道主义援助人员明显更多(每 100000 人中有 23 人,而叙利亚为 2/100000)。

结论

土耳其和叙利亚在初始医疗应对方面存在显著差异,这凸显了决策者在受冲突影响的事件中增强应对能力的必要性,以减轻对受灾人群的影响。

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