2023 Turkey–Syria earthquakes

Map of the Anatolian Plate, showing the location of the East Anatolian Fault

Central southern Turkey and northwestern Syria are affected by the interaction between three tectonic plates; the African Plate, Arabian Plate and Anatolian Plate. The boundary between the African and Arabian plates is represented by the Dead Sea Transform (DST)—a major zone of left-lateral strike-slip fault—it accommodates the relative northward movement of Arabia with respect to Africa. The northern end of the DST truncates at the East Anatolian Fault (EAF) another major left-lateral strike-slip fault zone that accommodates the overall westward movement of the Anatolian Plate as it is extruded in that direction by the northward movement of the Arabian Plate. The DST and EAF meet at the Marash Triple Junction. The EAF continues west of the triple junction, forming the boundary between the African and Anatolian plates, linking into the Cyprus arc to the west via the Latakia Ridge.[21]

The 700 km-long (430 mi) EAF is subdivided into seven segments, from the northeast; the Karlıova, Ilıca, Palu, Pütürge, Erkenek, Pazarcık and Amanos segments.[21] The Amanos segment is also considered part of the DST by some geologists,[22] or a transitional structure between the EAF and DST by others.[23] A northern strand to the EAF has also been recognized, including the Sürgü, Çardak, Savrun, Çokak, Toprakkale, Yumurtalık, Karataş, Yakapınar and Düziçi–İskenderun segments. The estimated slip rate on the main strand of the EAF system decreases south-westwards from 10 mm (0.39 in) per year on the Karlıova segment down to 2.9 mm (0.11 in) per year on the Amanos segment. On the northern strand, a slip rate of 2.5 mm (0.098 in) per year was estimated on the Çardak segment.[21] The Sürgü-Çardak Fault is an east-west striking 160 km (99 mi) long fault that runs north of the EAF. It branches away from the EAF west of Çelikhan and extends westwards to Göksun.[24] Comprising two segments; the Sürgü Fault runs 70 km (43 mi) between Çelikhan and Nurhak; the Çardak Fault runs 90 km (56 mi) between Nurhak and Göksun.[25] Seismicity on the fault is low—the only associated earthquake was a M 6.8 event in 1544.[26]

The northern part of the DST is subdivided into several segments, although there is some disagreement between scientists as to which faults should be assigned to the DST and which to the EAF, at the northernmost end of the structure. Following the 2013 "Active Fault Map of Turkey", seven DST segments are recognized in Turkey and neighbouring parts of Syria; the Afrin, Sermada, Armanaz, Hacıpaşa, Yesemek, Sakçagöz and Narlı segments.[21]

The EAF has produced large or damaging earthquakes in the past few hundred years along various segments, including the 1789 (M 7.2, Palu), 1795 (M 7.0, Pazarcık), 1866 (M 7.2 Karlıova),[27] 1872 (M 7.2, Amanos), 1874 (M 7.1, Palu), 1875 (M 6.7, Palu), 1893 (M 7.1, Erkenek), 1971 (M6.6, Karlıova) and 2020 (M 6.8, Pütürge) events.[28][29] Other large historical earthquakes have been tentatively assigned to segments of the EAF, such as the 1114 and 1513 Marash earthquakes, both thought to have ruptured the Pazarcık segment.[30][31]

The Palu and Pütürge segments in the east display a recurrence interval of about 150 years for M 6.8–7.0 earthquakes. The Pazarcık and Amanos segments in the west have recurrence intervals of 237–772 years and 414–917 years, respectively, for M 7.0–7.4 earthquakes.[28] A research paper published by Earth and Planetary Science Letters in 2002 studied stress accumulation and increased seismic hazard along the East Anatolian Fault. The study concluded two sections of the fault with a considerably high potential for future earthquakes. One of these sections was in Elazığ and Bingöl, located between the rupture zones of the 1874 and 1971 earthquakes. The seismic gap ruptured during a M_w  6.1 earthquake in 2010. The 2020 M_w  6.8 earthquake ruptured to the southwest between the 1893/1905 and 1874 earthquakes.[32] Another seismic gap was located in Kahramanmaraş—this 103 km (64 mi) long section—according to the study, believed to last rupture in 1513 has the potential to produce magnitude 7.3 earthquakes.[33]

Large earthquakes on the northern part of the DST include events in 115, 526, 587, 1138, 1170 and 1822, which resulted in several tens of thousands to several hundreds of thousands of fatalities.[2][34]

Over 570 aftershocks were recorded within 24 hours of the M_w 7.8 earthquake and over 30,000 recorded by May 2023.[6] An aftershock measuring M_ww 6.7 occurred about 11 minutes after the mainshock.[50] There were 25 aftershocks M_w 4.0 or greater recorded within six hours of the main tremor, according to the USGS. More than 12 hours later, the USGS had reported at least 54 aftershocks of 4.3 or greater magnitude, while the Turkish Disaster and Emergency Management Presidency (AFAD) recorded at least 120 total aftershocks.[51] A M_ww 6.3 aftershock struck near Uzunbağ in Hatay Province on 20 February; the earthquake was the result of oblique-normal faulting.[52] The M_w  7.8 earthquake had aftershocks distributed along ~350 km (220 mi) of the EAF.[43]

The M_w 7.7 earthquake triggered its own aftershock sequence,[53] including two mb 6.0 aftershocks.[54][55] Aftershocks of the second earthquake continued through at least 9 February.[56] Thousands of aftershocks associated with this earthquake were distributed along an east-west trend corresponding to the Çardak Fault[25] for about 170 km (110 mi).[43]

M_w 7.8 finite fault

Distribution of slip across the rupture

Surface projection of finite fault model

M_w 7.7 finite fault

Distribution of slip across the rupture

Surface projection of finite fault model

A source model for the M_ww 7.8 earthquake produced by the USGS from observed seismic waves, taking into account preliminary rupture mapping from satellite data, uses three fault segments with individual lengths, widths, strikes and dips of >40 km (25 mi) × 30 km (19 mi), 028°/85° (Segment 1), >175 km (109 mi) × 30 km (19 mi), 060°/85° (Segment 2) and >160 km (99 mi) × 20 km (12 mi), 025°/75° (Segment 3). The mainshock produced a maximum slip of 11.2 m (37 ft) along Segment 2, beneath Sakarya in Kahramanmaraş Province, northeast of the junction where it meets Segment 1. Another zone of large slip estimated at 4.96 m (16.3 ft) occurred further northeast along Segment 2, northwest of Adıyaman.[2]

The USGS source model for the M_w 7.7 earthquake which struck nine hours later has three large fault segments with individual lengths, widths, strikes and dips of >70 km (43 mi) × >20 km (12 mi), 276°/80° (Segment 1), >40 km (25 mi) × >20 km (12 mi), 250°/80° (Segment 2) and ~80 km (50 mi) × >20 km (12 mi), 060°/80° (Segment 3). Maximum displacement occurred on Segment 1 at 11.4 m (37 ft).[44]

Three segments of the EAF were involved in the M_w  7.8 rupture; the Amanos, Pazarcık and Erkenek segments. The earthquake ruptured ~370 km (230 mi) of the EAF, producing a maximum slip of 9 m (30 ft) along the Pazarcık segment.[57] The northern end of the rupture was about 20–30 km (12–19 mi) south of the M_w  6.8 earthquake that struck in 2020. This section of the EAF, the Pütürge segment, between both earthquakes, may represent a seismic gap. The southern segment of the EAF rupture was at its termination, near Antakya. Slip peaked at 12 m (39 ft) from the surface to 7 km (4.3 mi) depth during the M_w  7.7 earthquake; slip was 11 m (36 ft) at the surface. Slip along the fault was compact—mostly confined to within the Çardak Fault; it was also shallower—attenuating from 8–12 km (5.0–7.5 mi). Slip during the M_w  7.8 event extended to 18 km (11 mi) and 12 km (7.5 mi) for the M_w  7.7 event. The M_w  6.4 aftershock that struck Antakya on 20 February had a rupture area of 25 km (16 mi) × 25 km (16 mi) and produced a peak slip of 0.93 m (3 ft 1 in) at 8.3 km (5.2 mi) depth.[58]

Preliminary analysis of the effects of stress changes caused by the M7.8 earthquake on the Çardak–Sürgü Fault, based on the USGS fault model, indicated up to 3 bars of added stress near the epicenter of the M7.7 shock, sufficient to trigger rupture on that zone, assuming that is was already close to failure.[59][60] Stress on the Hatay Fault, source of the 20 February M_w  6.4 aftershock, increased by 1 bar following the 6 February earthquakes.[26]

Map showing faults active during the Holocene, the extent of observed or inferred surface rupture and the location of epicenters for all earthquakes in the sequence of magnitude M≥5.0 in the first 21 days

Preliminary analysis based on seismology and observations of surface rupture suggest the following sequence of events: initial rupture at the site of the epicenter of the M7.8 shock on the Narlı Fault, the northernmost section of the Dead Sea Transform.[61][62] The fault ruptured unilaterally northwards until it reached the Pazarcık segment of the East Anatolian Fault. Ruptures then continued bilaterally to the northeast and southwest along this segment. This subevent on the Narlı Fault corresponded to a M_w  7.0 earthquake which ruptured for 20 seconds. It had a focal mechanism corresponding to oblique-normal faulting.[26] A preliminary analysis of near-field (within 1 km (0.62 mi) of the fault rupture) seismic records indicates that the initial rupture speed transitioned to supershear after propagating about 19.5 km (12.1 mi) away from the epicenter along the Narlı Fault before it reached the EAF.[63] Back projection suggest the total rupture length was ~560 km (350 mi).[64]

The rupture continued northeast onto the Ekernek segment and to the southwest onto the Amanos segment.[65] The northeastern rupture ceased 55 seconds after initiation while the southwestern rupture ceased near Antakya about 80 seconds later.[43] A M_w 6.8 aftershock occurring 11 minutes later and west of the first M>7 epicenter may have ruptured along the Sakçagöz Fault, the next segment of the Dead Sea Transform to the south.[65] Rupture along the EAF during the event occurred at subshear velocity (maximum 3.2 km (2.0 mi) per second).[66] An analysis of near-field seismic data revealed transient supershear rupture episodes throughout the EAF rupture. Supershear rupture occurred along the northernmost section of the Narlı Fault where it meets the EAF. The rupture transitioned onto the EAF and propagated northeast at supershear velocity until its termination near Malatya. Rupture towards the southwest was mostly subshear, but at the southern termination in Hatay, where the fault has multiple branches and kinks, supershear was likely observed. Supershear rupture at the southern termination contributed to the intense ground motion in Antakya.[67]

The second M>7 earthquake initiated on a separate fault[68][69] known as the Çardak–Sürgü Fault Zone,[70] part of the northern strand of the East Anatolian Fault.[21][71][72][73] The rupture propagated bilaterally along the Çardak segment, continuing eastwards onto the Sürgü segment before continuing eastwards to Malatya along the northeast–southwest trending Doğanşehir Fault Zone. Rupture also propagated towards the southwest along the Çardak segment. The total rupture length was estimated at 160 km (99 mi).[65] The westward-propagating rupture occurred at supershear velocity (maximum 4.8 km (3.0 mi) per second) while the eastward-propagating rupture occurred at subshear velocity (maximum 2.8 km (1.7 mi) per second).[66] The rupture lasted about 35 seconds.[43]

The M_w  6.4 aftershock on 20 February occurred along the Hatay Fault. The focal mechanism indicated normal faulting along a northeast-southwest striking fault.[26]

Interferogram of the M_w  7.8 mainshock

The extent of surface ruptures associated with the M7.8 and M7.7 earthquakes have been mapped using a mixture of satellite imagery and ground observations. Pixel matching on images captured by Sentinel-1 before and after the earthquakes showed sharp discontinuities in displacement, revealing two separate zones of surface rupture. The longer of the pair, produced by the first earthquake, measured 320 km (200 mi) while the second earthquake produced 150 km (93 mi) of surface rupture.[43][74] These observations were backed up with direct imaging of the ruptures using other satellite data, such as from the DigitalGlobe's WorldView-1, 2 & 3 and GeoEye-1,[75] and by field work.[76][70] Remote sensing using satellite imagery indicated 30 km (19 mi) of surface rupture with large normal faulting component.

The zone of surface rupture extended from north of Antakya, Hatay Province towards Pazarcık, Kahramanmaraş Province and Gölbaşı, Adıyaman Province.[73] Surface ruptures continued north of these cities. Surface rupture occurred in the Amik Valley. The westernmost part of Hatay Airport was damaged by surface ruptures but cracks in the runway were attributed to ground deformation. A major canal was damaged and lead to flooding in parts of the Amik Valley which was formerly Lake Amik.[77] Field observations indicate a maximum displacement of 7.3 m (24 ft) on the surface.[78] Geologists traced a 15 km (9.3 mi) surface rupture trending south from Pazarcık with an offset of 2.5 m (8 ft 2 in). From Golbasi to Nurdağı ground displacements were up to 5 m (16 ft).[70] The surface rupture observed during the M7.8 earthquake was unusually large, comparable to that during the 1906 San Francisco earthquake along the San Andreas Fault.[79]

Large surface offsets of 6–8 m (20–26 ft) were observed along the Sürgü-Çardak Fault. Along a road west of Gözpınar, the rupture displaced the road left-laterally for 8.6 m (28 ft).[80] The largest maximum surface offset was 10.0–12.6 m (32.8–41.3 ft); one of the largest surface offset ever observed from an earthquake.[81]

Cracked land after the earthquake in Gölbaşı, Adıyaman Province

Ground acceleration values recorded in some areas near the fault rupture were in excess of 1 g.[82] Three USGS seismic installations, two at Antakya and one at Hassa, recorded large ground accelerations and velocities. The town of Hassa recorded 0.9082 g in ground acceleration (pga) and 215.34 cm/s (84.78 in/s) in ground velocity. The station data corresponded to a Modified Mercalli intensity of X (Extreme). A peak ground acceleration of 1.62 g was recorded by a station at Fevzipaşa.[83] The peak ground acceleration generally exceeded 0.5 g in a large area around the epicenter, near Adiyaman and a large part of Hatay. High pga values of 2 g were recorded in Hatay.[43] The maximum recorded pga was 2.212 g at a station in Pazarcık Belediyesi Parkı, Pazarcık; a government health facility nearby had limited damage but the surrounding town was devastated.[84] The maximum recorded pga during the M_w  7.7 earthquake was 0.59 g at Göksun.[85]

According to Kandilli Observatory, the maximum Mercalli intensity (MMI) of the mainshock was estimated to have reached MMI XI–XII (Extreme) in Antakya and near the epicenter. MMI XI (Extreme) or higher was observed along the fault rupture from the epicenter to Antakya.[86] The MMI also reached IX–X (Violent–Extreme) in Kahramanmaraş and İskenderun, VIII–IX (Severe–Violent) in Malatya and Adıyaman, VII–VIII (Very strong–Severe) in Gaziantep, Kilis, Idlib and Aleppo, and VI–VII (Strong–Very strong) in Adana and Şanlıurfa.[87] The maximum MMI of the second earthquake was X (Extreme).[88]

An example of soil liquefaction and a partially tilted apartment building in Gölbaşı

Liquefaction was identified via satellite and remote sensing along the southern portion of the M_w 7.8 rupture on the East Anatolian Fault from Antakya to Golbasi. Liquefaction and lateral spreading were observed at and near coastal areas, fluvial valleys and drained lake or swamp areas, covered by Holocene sediments.[89] These effects were widespread in the Amik Valley and Orontes River plain, north of Antakya, Hatay Province. Limited observations were made in high-elevation areas due to snow cover and lack of satellite observations.[89] Liquefaction was also observed in Samandağ. At Lake Gölbaşı, Adıyaman Province, lateral spreading occurred along the northern, eastern and southern coast. Parts of the lakeshore were also submerged. Gölbaşı was also damaged by liquefaction and lateral spreading.[77]

Subsidence at Lake Gölbaşı from lateral spreading lead to floods along the shore

Subsidence due to lateral spreading caused extensive damage in İskenderun. Liquefaction produced sand ejecta that buried Atatürk Boulevard in Çay District. Regular flooding in the city was observed after the earthquakes. Earlier flooding may be attributed to liquefaction while subsequent occurrences may be due to damage to the coast and water infrastructure.[90] The sea inundated parts of the city by as much as 200 m (660 ft). Large areas of the coast and sections of piers were flooded due to lateral spreading. Large waves from bad weather and a tsunami may have contributed to the effects observed at İskenderun.[91]

Both earthquakes caused shaking levels (≥0.12 g) sufficient for landslide-triggering across a 90,000 km² (35,000 sq mi) area. About 3,673 earthquake-triggered landslides were identified using satellite imagery, aerial photos, and one field survey of the area. Landslides mainly occurred in the northern region of the affected area. Rockslides were the most commonly observed; there were also many bedrock rotational landslides, translational slides and lateral spreads. Surface ruptures propagating through hillsides also triggered landslides. These landslides blocked roads and river channels, destroyed or seriously damaged buildings and caused many deaths.[92]

One of the largest landslides occurred near Tepehan village, Hatay Province; a translational slide which detached a block 1.3 km² (0.50 sq mi). This landslide occurred in a region comprising marl and clay-rich limestone. It produced a 20 m (66 ft) vertical displacement along its scarp.[92] ITV News reported the landslide scarp was up to 1,000 ft (300 m) long and "wider than a football pitch" in some areas.[93]

Despite an epicenter 90 km (56 mi) inland, a tsunami was recorded in the Mediterranean Sea.[65] It was the first recorded tsunami in the eastern Mediterranean Sea region since that produced after a 1953 M_L  6.2 earthquake in Cyprus. The largest wave measured 40 cm (16 in) along the Mediterranean coast of Turkey. Although no underwater surveys results have been made available to identify the sources of these tsunamis, they were likely produced by landsliding at Iskenderun Port and liquefaction on the coastal flatlands of Antakya.[94]

Small tsunami waves were recorded off the coast of Famagusta, Cyprus, without damage.[95] The tsunami measured 0.17 m (6.7 in), and tsunami waves were recorded at 0.12 m (4.7 in) at İskenderun and 0.13 m (5.1 in) at Erdemli.[96] Tsunami warnings were issued for the southern Turkish coast, southern and eastern Italian coasts and the whole eastern Mediterranean Sea area, but later withdrawn.[97][98][99][100][101]

There were 50,783 deaths,[116] 297 missing[117] and 107,204 injured across 11 of the 17 affected provinces of Turkey.[118][119] At least 15.73 million people[120] and 4 million buildings were affected.[121] About 345,000 apartments were destroyed.[122] More than 2 million residents in the affected provinces were evacuated to nearby provinces including Mersin, Antalya, Mardin, Niğde and Konya.[123] More than 20 percent of Turkey's agriculture production was affected. The United Nations said crops, livestock, fisheries, aquaculture and rural infrastructure were heavily damaged.[120] At least 516 university buildings were affected, of which 106 were heavily damaged.[124]

By 23 February 2023, the Ministry of Environment, Urbanization and Climate Change conducted damage inspections for 1.25 million buildings; revealing 164,000 buildings were either destroyed or severely damaged.[125] A further 150,000 commercial infrastructure were at least moderately damaged.[126] The International Organization for Migration estimated over 2.7 million people were made homeless.[127] A damage assessment by the Turkish government revealed at least 61,722 buildings had to be demolished including 11,900 in Gaziantep Province, 10,900 in Hatay Province, 10,800 in Kahramanmaraş Province and 36,046 in Malatya Province.[128][129][130] Broad fissures appeared on roads.[131] During recovery efforts, body parts were often found in the rubble.[132]

Bodies at the Training and Research Hospital in Adıyaman

In Adana, 12 buildings collapsed in the city center, 23 were badly damaged and 120 were moderately damaged.[133] Three apartments were among the buildings that collapsed in the city.[134] Across Adana Province, damage assessments revealed 59 buildings and 1,274 apartments were destroyed or required demolition.[129]

At least 300 buildings were razed in Malatya. Sixty percent of the city's buildings received damage. Nearly every neighborhood of the city was affected by collapsed buildings. Out of the 968 mosques in the city, 25 were destroyed and 420 others were damaged.[135] Two hotels collapsed in Malatya, causing many casualties.[136] The ceiling of Malatya Erhaç Airport experienced a partial collapse,[137] as did the historic Yeni Camii mosque.[138] Damage was also reported at the Arslantepe Mound.[139] In Akçadağ, 11 people died, including four attributed to the second earthquake.[140] At least 263 deaths were reported in Doğanşehir.[141]

In Gaziantep, many of the historical sites were severely damaged, such as Gaziantep Castle,[142][143] Şirvani Mosque[144] and Liberation Mosque.[145] The city recorded 16,211 collapses and buildings which were severely damaged or required demolition.[146] In the city center, at least 154 people died after a four-story building collapsed; four other collapsed buildings left another 102 dead.[147] In Nizip, at least 51 people were killed when a six-story apartment building collapsed.[148]

In Nurdağı, nearly 2,500 people died and about 50 percent of the houses were badly damaged or destroyed. An additional 30 percent of its building stock received moderate damage.[149] Mass graves were created to bury the overwhelming number of dead.[132] Gaziantep Oğuzeli Airport was forced to restrict its service to rescue flights.[150] Ninety percent of houses were heavily damaged or destroyed in Sakçagözü, and 256 people died.[151] In İslahiye, there were 1,368 deaths, over 1,500 injuries and more than 200 destroyed apartments.[152] There were over 130 deaths in Sulumağara; 200 in Altınüzüm; and 300–400 in Keküklü.[153]

Wreckage of the collapsed Galeria Business Center, Diyarbakır

Satellite view of the destruction in Antakya

In Hatay Province, 13,517 buildings collapsed, 8,162 required demolition and 67,346 were heavily damaged.[154] The districts of Antakya, Kırıkhan and İskenderun were the most affected.[155] In Antakya, 70 percent of homes[156] and 6,369 buildings collapsed, 3,734 had to be demolished and 21,830 were badly damaged. The collapse of the luxury Rönesans Rezidans apartment trapped an estimated 800 people[157] and killed 750 residents.[158] The runway of Hatay Airport was split and uplifted, causing flight cancellations.[159] The Ankara Metropolitan Municipality completed repairs on the airport on 12 February,[160] allowing its reopening.[161] Two provincial hospitals and a police station were destroyed,[162] and a gas pipeline exploded.[163] The building that housed the assembly of Hatay State was destroyed,[164] as was St. Paul's Church[165] and the Habib'i Neccar Mosque, while damage occurred at the Antakya Synagogue[166] and the Hatay Archaeology Museum.[165] Several dozen buildings in Güzelburç district[167] and nearly every house in the central and Cebrail districts collapsed.[155] Most of the squad and coaching staff of the local football club Hatayspor were initially trapped in the collapse of their headquarters in Antakya before being rescued, with player Christian Atsu and sporting director Taner Savut dying.[168][169] In Kırıkhan District, 1,886 buildings collapsed and 7,190 others were severely damaged or required demolition.[154] At least 982 buildings were destroyed, 8,894 others were badly damaged and 943 had to be demolished in Defne.[154] In Reyhanlı, 318 buildings collapsed and 1,661 others were severely damaged or required demolition.[154] At least 187 buildings collapsed, 2,176 others were badly damaged and 194 others had to be demolished in Arsuz.[154] In Kumlu, 131 buildings were destroyed, 738 others were severely damaged and 84 others required demolition.[154] At least 58 buildings collapsed and 669 others were badly damaged or had to be demolished in Payas.[154]

Satellite view of the blaze at İskenderun

In İskenderun, an industrial city in Hatay Province, a large fire at the port was reported on 6 February at 17:00,[170] believed to have originated from a container carrying flammable industrial oil,[171] forcing the port's closure and the diversion of many ships. It was extinguished on 6[172] and 8[173] February, only for it to reignite the next day each time.[174][175] It was finally extinguished on 10 February.[176] A total of 3,670 containers were destroyed by the fire and the port managing authority said it would take three months for operations to resume.[177] The city saw 534 buildings collapse, 337 requiring demolition and 4,622 receiving severe damage.[154] Flooding occurred along the city shoreline, inundating streets up to 200 m (660 ft) inland.[178] The Cathedral of the Annunciation, seat of the Roman Catholic Apostolic Vicariate of Anatolia, was almost completely destroyed.[179] At least 3,109 people died in the city and over 12,000 were injured.[180] In Erzin District, 31 buildings collapsed and 897 were heavily damaged or had to be demolished.[154] However, there were no collapses or major damage in Erzin, the largest town in the district. Multiple factors including strict building codes prevented destruction. An estimated 20,000 people fled to Erzin, increasing its population by about 50 percent.[181] In Samandağ, 670 buildings collapsed, 9,212 were badly damaged or required demolition[154] and 7,850 people died.[182] At least 1,046 buildings collapsed and 3,452 others were severely damaged or had to be demolished in Hassa District.[154] In Altınözü, 838 buildings were destroyed, 3,892 others were badly damaged and 650 others required demolition.[154] There were 213 collapsed buildings and 1,453 others had been severely damaged or had to be demolished in Yayladağı.[154] At least 139 buildings collapsed, 755 others were badly damaged and 87 others had to be demolished in Belen.[154] In Dörtyol, 115 buildings were destroyed and 2,030 others had to be demolished or were severely damaged.[154]

Rescue workers in Osmaniye

Mass burials occurred in Kahramanmaraş[183][184] for more than 5,000 bodies.[185] A city official said the mass grave would eventually be the burial ground for 10,000 bodies.[185] Around 75 percent of the city's buildings were damaged or destroyed.[87] In Elbistan, 924 people died and 1,825 were injured.[186] An estimated 2,000 buildings were destroyed.[187] At Ordekdede, a village in Pazarcik District, almost all single-story buildings were decimated. None of the 140 houses in the village were structurally stable. Thirty-four people died in the village.[188] At least 11 people died, 107 houses were destroyed and 70 percent of the building stock were damaged in Ekinözü.[189] In Afşin, at least 180 people died. At least 335 buildings including 90 in the city center were destroyed. The Afşin-Elbistan Thermal Power Plant was also damaged.[190] In Ericek, a village in Göksun, 95 percent of homes were affected and 152 died.[191] In Nurhak, there were around 200 deaths and all houses were severely damaged.[192] In Türkoğlu, 1,171 buildings collapsed and 4,500 others required demolition.[193]

Destruction in Kahramanmaraş

In Adıyaman Province, over 20,000 buildings and 56,600 apartments were destroyed.[125] In the city of Adıyaman, four neighborhoods were razed.[194] Many buildings along Atatürk Boulevard collapsed.[195] The city hall, a 6th-century mosque and Gölbaşı District's state hospital were also destroyed.[196][197][198] Isias Hotel, the largest hotel in the city, also collapsed, killing 65 people.[199][200] Up to 10 percent of Adıyaman's population perished.[201] The mayor of Kömür said the Karapınar and Bahçelievler neighborhoods were nearly destroyed. Destruction was also observed in Barbaros, Çelikhan, Sümerevler and Karapınar districts. In Harmanlı, a village in Gölbaşı District, 80–90 percent of it was destroyed.[136] The second earthquake destroyed three buildings in the province.[197] In Gölbaşı, 71 percent of the town's infrastructure was damaged or destroyed and 695 people were killed with over 400 injured, including 286 deaths in the town center.[202] There were also 410 deaths in Besni District, about 90 percent of them in the town itself.[203] In Kâhta, at least 55 people died.[204]

In Diyarbakir Province, 8,086 buildings were damaged, required demolition or were destroyed.[129] Diyarbakır Fortress, a UNESCO World Heritage Site, was also partly destroyed.[179] The adjacent World Heritage Site of Hevsel Gardens was also damaged.[150] Part of the Galeria complex in Yenişehir, which included a shopping mall and dozens of apartments collapsed, killing 89 and injuring 22.[205]

Debris removal efforts in Islahiye, Gaziantep

At least 466 buildings were heavily damaged in Şanlıurfa Province; 201 were destroyed.[206] Structures around the Pool of Abraham were damaged. The minaret at the religious shrine partially collapsed, sending rubble into the pools below and discoloring the water, which was also contaminated by seeping sewage.[166] In Eyyübiye District, the minaret of the Eyüp Prophet Mosque was damaged and removed.[206] Thirty-three people were killed in the collapse of the Osman Ağan Apartment.[207]

In Osmaniye Province, of the 22,841 buildings surveyed, 1,739 were heavily damaged, destroyed or required urgent demolision. At least 1,088 of the 13,667 buildings examined in Merkez District were destroyed, seriously damaged or needed to be demolished.[208]

In Kilis Province, 119 buildings were destroyed and 138 others were heavily damaged.[209] In Batman Province, 218 buildings were damaged, and an additional 15 were completely destroyed.[210] In Mardin Province, 59 buildings were heavily damaged and another 190 were slightly damaged[211] and a death related to a heart attack occurred in Kızıltepe District.[113] In Bingöl Province, several houses cracked and some livestock were killed by collapsing barns.[212] In Samsun, damage occurred in Samsun Stadium.[213] In Kayseri Province, eight buildings collapsed, while 5,252 others were damaged to some extent.[214] Several houses were damaged and a barn collapsed in Muş Province.[215] In Sivas Province, the second earthquake destroyed a few houses.[216] In Giresun Province, a five-story building was damaged and evacuated.[217] An unoccupied apartment in Elazığ was damaged and later collapsed during the second earthquake.[218]

The dead included member of the Grand National Assembly of Turkey for Adıyaman Yakup Taş,[219] Yeni Malatyaspor goalkeeper Ahmet Eyüp Türkaslan,[220] former Turkish national handball team player Cemal Kütahya and his five-year-old son,[221][222] and Saul Cenudioğlu, leader of the Jewish community in Antakya, who died along with his wife.[166] Former MP for Kahramanmaraş Sıtkı Güvenç died from earthquake injuries on 9 February.[223] Three Turkish soldiers died during rescue operations.[224] Twenty-six local journalists,[225] four doctors,[226] 120 police officers and 32 gendarmeries were among the dead.[227]

Destruction in Jindires, Aleppo Governate, Syria

At least 8,476 people died[228] and over 14,500 were injured in Syria.[229] Among the dead included 2,153 children and 1,524 women.[230] The Syrian Ministry of Health recorded over 2,248 earthquake-related deaths and 2,950 injuries in government held areas,[231] most of which were in the governorates of Aleppo and Latakia.[232] In rebel-held areas, at least 4,547 people died[231] and 2,200 others were injured.[233][234] The Syrian Network for Human Rights stated 73 medics, five media personnel, 62 workers in humanitarian agencies, and four civil defense personnel were among the dead.[235] The Syrian Observatory for Human Rights said additional dead were buried before being registered and some victims died in hospitals.[231] Syria's National Earthquake Centre said the earthquake is "the biggest earthquake recorded" in its operational history.[236]

An estimated 5.37 million people across Syria may have been made homeless,[237] while 10.9 million people, nearly half of Syria's population, were affected.[238] More than 123 residential areas, villages, towns and cities were badly damaged. Many power plants, water facilities, hospitals and public infrastructure also sustained damage.[231] At least 453 schools were damaged.[239] A total of 10,600 buildings had partially or fully collapsed, while thousands of others were damaged in the country.[240][241]

Hundreds were killed in the town of Atarib.[233] In Jindires, over 1,100 people were killed[242] and at least 250 buildings were razed;[243] among the deaths were a family of 7—the only survivor was a newborn.[244] In Jableh, at least 283 people died, 173 were injured and 19 buildings collapsed.[245] Four bodies were recovered and 15 bodies were in the process of recovery during debris clearance on 10 February.[246] On 11 February, six bodies were retrieved from the rubble of a collapsed house along al-Maliyeh Street.[247] Civilians were stuck under the rubble for hours due to the lack of rescue teams in several villages such as Atarib, Besnia, Jindires, Maland, Salqin and Sarmada.[248][249][250] In Latakia Governorate, 142,000 people were affected; at least 805 people died and 1,131 others were injured. The region's governor said 105 buildings were destroyed, 247 were at risk of collapse and 900 others were severely damaged.[251][252][253] At Tishreen University, 10 students, 3 employees and a professor died.[254] At least 48 people were killed in Hama, of which 43 were from the collapse of an eight-story building.[255]

The Associated Press, citing local residents, said the Afrin Dam had cracked.[256] On 9 February at 04:00, the dam burst and flooded the village of Al-Tloul, which was exacerbated by heavy rains along the Afrin River basin. Nearly all its residents fled; about 500 families were displaced. According to Reuters, citing local residents, between 35 and 40 people died and most buildings in Al-Tloul were damaged or destroyed by the earthquake.[257] In Atarib, 148 bodies arrived at an underground hospital. A doctor at the hospital said some bodies were missing their head or limbs.[258] Various archaeological sites in Tartus Governorate were damaged, including the Khawabi Castle and Aleika Castle, which partially collapsed. Damage to historical towers and infrastructure were also reported in Tartous and Safita.[259]

The president of the Syrian American Medical Society, Amjad Rass, said emergency rooms were packed with injured.[260] In Idlib Governorate, one hospital received 30 bodies.[261][262] In the village of Azmarin, Idlib Governorate, at least 260 people died, including 51 members of one family; at least 300 were injured and 100 were rescued. Fifteen buildings in the village were leveled and about 50 percent of its housing stock had cracks.[263] Footballer Nader Joukhadar, who played for the national team, was killed alongside his son when their home collapsed in Jableh.[264]

Building wreckage in Aleppo, Syria

According to the International Rescue Committee, the earthquake struck when rebel-held areas were preparing for a blizzard and experiencing a cholera outbreak.[265] In Aleppo, dozens of buildings collapsed[266] and at least 444 people died, including 163 children.[267] By 8 February, the bodies of 210 victims were returned to their families.[268] The Directorate-General of Antiquities and Museums said various archeological sites across the city were extensively cracked or collapsed.[269] Cracks were also reported in the outer façade of the Aleppo National Museum.[270] In Atarib, Aleppo, the Syrian American Medical Society hospital said 120 bodies were recovered.[271] About 20,000 homes were affected in Aleppo, leaving 70,000 homeless.[272] In Rajo, the doors and walls of a prison facility cracked. Twenty prisoners, believed to be Islamic State (ISIS) members, escaped the facility.[273]

In Damascus, many people fled from their homes onto the streets.[274][275] In the northern parts of the city, many buildings were cracked.[276] Many buildings in Syria had already been damaged by an almost 12-year-long civil war.[277] The Crusader-built castle Margat suffered damage, with part of a tower and parts of some walls collapsing.[274] Cracks also opened up in the walls of the Krak des Chevaliers castle.[166] The Citadel of Aleppo was also affected.[278] In addition, one of the towers of Sahyun Castle near Latakia was destroyed.[279] The minaret of the Grand Mosque in Kobanî was also damaged.[280]

Foreign casualties by country

Country	Deaths in		Ref.
Syria	6,600		[118]
Afghanistan	300	—	[281]
Haiti	85	—	[282]
Palestine	54	51[lower-alpha 3]	[285]
Northern Cyprus[lower-alpha 4]	29	—	[286][287]
Yemen	29	—	[288][289]
Morocco	20	—	[290]
Lebanon	16	3	[291]
Iraq	13	—	[292]
Azerbaijan	10	—	[293]
France	8	—	[294]
Italy	7	—	[295][296]
Iran	6	—	[297]
Philippines	6	—	[298][299]
Somalia	6	—	[300]
Georgia	5	—	[301]
Ukraine	5	—	[302]
Indonesia	4	—	[303][304]
Netherlands	4	—	[305]
Russia	4	—	[306]
Uzbekistan	4	—	[307]
Australia	3	—	[308]
Egypt	3	—	[309]
Moldova	3	—	[310]
United States	3	—	[311]
Algeria	2	—	[312]
Austria	2	—	[313]
Greece	2	—	[314]
Kazakhstan	2	—	[315]
Belarus	1	—	[316]
Belgium	1	—	[317]
Bosnia and Herzegovina	1	—	[318]
Bulgaria	1	—	[319]
Cameroon	1	—	[320]
Canada	1	—	[321]
China	1	—	[322]
Colombia	1	—	[323]
Czech Republic	1	—	[324]
Ghana	1	–	[325]
Gibraltar	1	–	[326]
India	1	—	[327]
Jordan	1	—	[328]
Kyrgyzstan	1	—	[329]
Saudi Arabia	1	—	[328]
Serbia	1	—	[330]
Sri Lanka	1	—	[331]
Sudan	1	—	[328]
Thailand	1	—	[332]
Uganda	1	—	[333]

At least 6,600 Syrians residing in Turkey were killed.[118] According to Turkey's Presidency of Migration Management 1.75 million Syrians live in southern Turkey; 460,150 in Gaziantep; 354,000 in Antakya; 368,000 in Şanlıurfa; 250,000 in Adana. Turkey's health ministry returned the bodies of 1,793 Syrian victims to their relatives in Syria,[334] while thousands of Syrians were buried in Turkey due to difficulties transporting them to Syria.[335] At least 11 Iraqi war refugees died in Turkey.[336]

At least 100 Afghans were killed by the earthquake in Turkey, mostly refugees who fled the country after the Taliban takeover in August 2021.[337] Among the deaths of Lebanese was an entire family of three in Malatya.[291] Ten Azerbaijanis were killed in Turkey, including four students in Malatya.[338] An Italian family of six, and an entrepreneur also perished.[295][296] Nineteen students, two teachers and a parent from Northern Cyprus died when the Isias Hotel in Adiyaman collapsed.[286] Seven other Turkish Cypriots died in Hatay and Kahramanmaraş.[287]

In Lebanon, residents were awakened from their sleep. Buildings in the country shook for up to 40 seconds. In Beirut, residents fled their homes and stayed in streets or drove in their vehicles to flee from buildings. The earthquake damaged 16,200 buildings across the country, including 10,460 in Beirut and 4,000 in Tripoli.[274][339]

In Ashdod, Israel, a building was evacuated after cracks were observed in a pillar,[340] and Champion Motors Tower in Bnei Brak was slightly damaged by the second earthquake.[341] In Nicosia, Cyprus, some windows cracked, and the wall of a house collapsed, damaging two nearby vehicles.[342][343] Six Cuvier's beaked whales were found dead along the island's northern coast on 10 February. The Department of Fisheries and Marine Research said there was a possible link between the beaching and earthquake as these whales' echolocation system are affected by sea disturbances.[344]

The European-Mediterranean Seismological Centre said shaking was felt in Armenia, Egypt, Palestine, Georgia, Greece, Iraq, Jordan, Israel, and Russia. In Iraq, minor damage occurred in some houses and buildings in Erbil, and the city's citadel was severely damaged.[345][346] In Egypt, tremors were strongly felt in the capital Cairo,[347] and is considered the strongest earthquake felt since 1975.[348] A 20 m (66 ft) crack appeared in the Corniche in Alexandria.[349]

On 20 February, a M_ww 6.3 aftershock struck near Antakya,[52] causing additional buildings to collapse in Samandağ and further damage in Antakya.[350] Six people died in Antakya, Defne and Samandağ.[351][352] At least 562 were injured including 18 in serious condition who received immediate medical attention before being taken to Adana and Dörtyol.[353][354] AFAD warned residents to stay away from the coast as there was potential for a tsunami of up to 50 cm (20 in).[355] The mayor of Hatay said several people were trapped under debris. A bridge was damaged and an empty three-story building in İskenderun collapsed.[356][357] In Syria, five people died during stampedes and panic across several governates and at least 500 people were injured.[358][359] The White Helmets said people in Aleppo and Idlib were injured by collapsed buildings.[350] Some residents in Jinderis were injured after leaping off buildings. In northwestern Syria, damaged and abandoned buildings collapsed without casualties.[360] Shaking was felt in Lebanon, Egypt and Jordan.[361]

A M_ww 5.2 aftershock occurred on 27 February, near Yeşilyurt.[362] It collapsed about 30 buildings in the town.[363] Two people died and 140 others were injured; 12 in serious condition.[364] One fatality and four injuries were attributed to a factory collapse in Kahramanmaraş Province.[365]

On 25 July, a damaging M_ww  5.5 aftershock struck Kozan, Adana Province.[366] The shock left 63 people injured in Adana and Osmaniye provincess.[367][368] A house in Sumbas was also damaged by rockfalls.[369] Another aftershock struck Malatya Province on 10 August, measuring M_ww  5.3.[370] Twenty-three people were injured; 22 in Malatya and one in Adıyaman.[371] One building collapsed and two were damaged in Malatya.[372]

Cars under a heavily damaged building in Adıyaman Province

The USGS Prompt Assessment of Global Earthquakes for Response (PAGER) service estimated a 35 percent probability of economic losses between US$10 billion and US$100 billion. There was a 34 percent probability of economic losses exceeding US$100 billion. The service estimated a 36 percent probability of deaths between 10,000 and 100,000; 26 percent probability of deaths exceeding 100,000.[373] For the second large earthquake, there was a 46 percent probability of deaths between 1,000 and 10,000; 30 percent probability of deaths between 100 and 1,000. The service also estimated a 35 percent percent probability of economic losses between US$1 billion and US$10 billion; 27 percent probability of economic losses between US$10 billion and US$100 billion.[374]

Risklayer estimated a death toll of between 23,284 and 105,671.[375] According to geophysics professor, Övgün Ahmet Ercan, "180,000 people or more may be trapped under the rubble, nearly all of them dead."[376] On 11 February, when the death toll was reported at about 28,000, United Nations emergency relief coordinator Martin Griffiths said the death toll was expected to "more than double".[377][378][379] The World Health Organization said up to 26 million people may have been affected; 15 million in Turkey and 11 million in Syria.[380]

Immediately after the earthquakes the Turkish lira value struck a record low of 18.85 against the US dollar, but rebounded to its starting position at the end of the day.[381] Turkish stock markets fell; main equities benchmark fell as much as 5 percent and banks fell 5.5 percent but recovered from the losses. The country's main stock market dropped 1.35 percent on 6 February.[382] The Borsa Istanbul fell 8.6 percent on 7 February, and declined by more than 7 percent on the morning of 8 February before trading was suspended;[383] the exchange then announced it would close for five days.[384] Total cost of earthquake damage in Turkey was estimated by TÜRKONFED at $84.1 billion US dollars; $70.75 billion on rebuilding, $10.4 billion loss in national income, and an additional $2.91 billion loss in workforce.[385] Turkish president Recep Tayyip Erdogan said rebuilding would cost $105 billion.[386] The European Bank for Reconstruction and Development said potential losses may be up to 1 percent of Turkey's GDP in 2023.[387] The Turkish government released a preliminary report estimating the total damage cost at $103.6 billion; corresponding to 9 percent of its GDP in 2023.[388] About half of residential property in the affected area is thought to be covered by Compulsory Earthquake Insurance.[389]

Empty plots of land in Antakya after debris clean-up

The United Nations Development Programme estimated between 116 million and 210 million tons of debris must be cleared in Turkey.[390] The volume of building debris was estimated at 100 million m³ (3.5 billion cu ft); greater than any recent natural disaster. The amount is 10 times that produced during the 2010 Haiti earthquake.[391]

In Syria, the World Bank estimated $5.1 billion in damages, excluding economic impact and losses. Nearly half the cost was direct damage to residential buildings and 18 percent on infrastructure.[392] Aleppo Governate, the worst-affected governate, accounted for 45 percent of the damage cost (equivalent to about $2.3 billion),[393] followed by Idlib and Lattakia governates. The amount of destroyed or damaged capital stock was about 10 percent of Syria's GDP.[392] The World Bank estimated the reconstruction cost at $7.9 billion, additionally the economy may contract by up to 5.5 percent in 2023.[394]

President Recep Tayyip Erdoğan said on Twitter, "search and rescue teams were immediately dispatched" to the affected area. Interior Minister Süleyman Soylu urged residents to refrain from entering damaged buildings.[411] On 7 February, President Erdoğan declared a 3-month state of emergency in the 10 affected provinces: Adana, Hatay, Osmaniye, Kahramanmaraş, Gaziantep, Kilis, Şanlıurfa, Adıyaman, Malatya and Diyarbakır.[399]

The national government declared a level four alert to appeal for international aid.[412] According to the Disaster and Emergency Management Presidency, 25,000 search and rescue personnel were dispatched to the 10 affected provinces.[413][414] At least 70 countries offered to help in search and rescue operations.[399]

Emergency Service of Ukraine in Hatay Province

Emergency services in Turkey were activated and looked for survivors trapped under many collapsed buildings. By 8 February, more than 8,000 people were rescued from rubble across 10 provinces.[402][415] About 380,000 individuals took refuge at relief shelters or hotels.[400]

An "air aid corridor" was established by the Turkish Armed Forces to mobilize search and rescue teams. Many military aircraft including an Airbus A400M and C-130 Hercules planes transported search and rescue teams and vehicles to the area. Food, blankets and psychological teams were also sent.[416] Turkey sent an official request to NATO and allies for assistance.[417]

Over 53,000 Turkish emergency workers were deployed to the regions affected from the earthquakes.[418] A team of 90 miners from Soma arrived at Osmaniye to provide assistance. The Izmir Metropolitan Municipality also sent dozens of vehicles and equipment.[419]

Poor weather conditions including snow, rain and freezing temperatures disrupted search and rescue efforts undertaken by rescue workers and civilians. Rescuers and volunteers wore winter clothing while searching for survivors.[420] Damaged roads also slowed down aid delivery.[421]

On 8 February, Erdoğan visited the town of Pazarcık, Kahramanmaraş Province and Hatay Province.[384] He acknowledged "shortcomings" in the response to the earthquake, but denied that there was an insufficient number of personnel involved in rescue operations.[384] He also described people saying they hadn't seen security forces at all in some areas as "provocateurs".[422]

AFAD announced on 19 February that search and rescue efforts in most of the affected provinces had ceased.[423] The chairperson of AFAD, Yunus Sezer, said efforts would largely be discontinued by the night of 19 February.[424] Operations were still ongoing for 40 buildings in Kahramanmaraş and Hatay provinces by 19 February.[425][426]

Aid collection in Istanbul

President of the Turkish Red Crescent, Kerem Kınık, said the national blood stock may not be sufficient and made an appeal on social media urging people to donate blood across the country.[427] On 7 February, many search and rescue teams from various cities, many from Instanbul, and AFAD volunteers reached the affected areas.[428] At Istanbul, 12,752 volunteers were flown on 73 flights to the region by 06:00.[429] By 11 February, there were over 159,000 volunteer and professional search and rescue personnel in the affected area.[430]

Eight of Turkey's most-watched television channels organized a joint broadcast of an aid campaign. The channels; ATV, FOX, Kanal D, Kanal 7, Show TV, Star TV, TRT 1 and TV8 ortak organized the Türkiye Beats with One Heart Campaign on 15 February.[431] The broadcast was featured on 213 television channels and 562 radio stations.[432] The campaign received $6.1 billion in donations; the Central Bank of the Republic of Turkey was the largest donor, pledging $1.6 billion. Ziraat Bank and VakıfBank each pledged $1 billion.[433] The Ministry of Youth and Sports, Turkish Football Federation, Super League Clubs Association Foundation and beIN Media Group organized the Omuz Omuza campaign which raised $44.8 million on the first day.[434]

Relief center at Hatay Stadium

The government said it would pay compensation to those who have lost their homes.[435] President Erdoğan said ₺15,000 in relocation assistance per household would be given to those whose homes were moderate, heavy or total destruction. Rent assistance of up to ₺5,000 would be given to homeowners and ₺2,000 to tenants.[436]

On 9 February, after touring the city of Gaziantep, Erdoğan promised to rebuild destroyed homes of survivors within one year.[256] He also said the government is working on temporary accommodation for those made homeless.[256] That same day, force majeure was imposed in the affected region and tax obligations between 6 February and 31 July 2023, were postponed until 31 July 2023.[437]

On 10 February, while touring Adıyaman Province, Erdoğan reiterated the promise to rebuild all homes within one year, and added that the government will subsidize rents for those unwilling to stay in tents.[438] He later added that more than 141,000 rescue personnel, including foreign teams, were working in the 10 affected provinces, that 100 billion lira (US$5.3 billion) were allocated to the disaster response.[435] On 22 February, the Turkish government announced plans to construct 200,000 homes in the 11 affected provinces and a further 70,000 in villages.[439]

Over 1.9 million people were rehoused in dormitories, guest houses, tents, hotels and containers.[440] AFAD issued a statement on 16 February, detailing that 387,000 tents had been established in the affected area by local and international organizations. Erdoğan said 890,000 survivors were placed in dormitories and 50,000 in hotels. He added that 1.6 million people had access to shelter.[441] Across the affected region, 162 container cities were established.[440] The Governor of Şırnak, Osman Bilgin, said the district would be demolished and reconstructed.[442]

On 22 April, at an opening ceremony for new homes in Gaziantep, Erdoğan said construction had begun for 105,000—more than half had been completed. He added that the government was constructing 507,000 houses and 143,000 village homes; 319,000 homes were planned for completion by the end of 2023. New facilities including schools, hospitals, bazaars, markets, green areas, and parks were also being built.[443]

On the morning of 7 February, Turkey accused the People's Defense Units of having overseen an MRL attack on its border checkpoint, and that the Turkish army responded with further attacks.[444][445]

The Kurdistan Workers' Party (PKK) declared a ceasefire in its conflict with Turkey.[438] Co-founder of the PKK, Cemîl Bayik, said "thousands of our people are under the rubble" and pushed for the focus on recovery efforts. He requested for all groups engaged to stop military actions and added that the PKK would not be engaged "as long as the Turkish state does not attack".[446]

On 17 February, a Syrian family of seven, including five children, were killed during a fire that struck a home in Nurdağı, Turkey, in which they moved to after surviving the earthquake. Seven other people were injured during the fire.[447] A natural gas explosion at a building in Şanlıurfa on 20 February killed two, left five injured and damaged businesses. Şanlıurfa's governor, Salih Ayhan, said due to the earthquakes, gas supply to the city was cut and an investigation was ongoing.[448] A bus ferrying earthquake survivors from Hatay to Konya collided with a truck on the Tarsus-Adana-Gaziantep Motorway on 23 February, killing two and injuring six.[449]

On 20 April, an IF1 tornado struck a camp housing people affected by the earthquake in Pazarcık, Kahramanmaraş; three people died and 50 others were injured.[450][451][452][453]

After the earthquakes, looting was observed in the affected provinces. In Hatay, some desperate survivors tresspassed into supermarkets for food when aid took too long to arrive. However, ATMs were also broken-in and emptied; looters also began ravaging through clothing and electronic stores.[454] President Erdogan said on 11 February that serious actions would be taken to address the issue. A rescuer in the affected area said many looters carried knives with them.[455] Looting occurred at damaged shops and buildings. Videos also circulated online allegedly showing goods stolen from aid vehicles, looting at buildings and alleged looters being beaten by officials or crowds. On 11 February, Anadolu Agency, citing unnamed sources, said Turkish officials arrested 98 people and seized stolen goods.[456] In Hatay Province, 42 people were held for stealing cash, smartphones, computers, weaponries, jewellery and bank cards. Authorities also arrested six people for cheating a survivor in Gaziantep.[454]

Turkey's Human Rights Association recorded several instances of violence and torture against alleged looters in Hatay Province. In one instance, a person died while in custody of officials after he was arrested in Hatay's Altinözü District alongside his brother. The surviving brother said he had been tortured. The siblings' father who identified the body said the victim died from a blood clot and had broken ribs and a broken nose. There were many reports of people mistaken as looters and violently beaten, including the beating of volunteer rescuers. A video which showed the lynching of three alleged refugees was posted on Twitter.[457]

German and Austrian rescuers deployed to Hatay suspended operations, citing a worsening security situation due to the slow arrival of aid or sporadic clashes between armed groups.[458][459] The teams later resumed operations when the Turkish Land Forces provided protection.[460] On 12 February, rescuers from the Israeli search-and-rescue group United Hatzalah left Turkey, citing "intelligence of a concrete and immediate threat on the Israeli delegation".[461][462]

On 9 February, three inmates were killed and 12 more injured after soldiers opened fire during a prison riot in Hatay. The prisoners were demanding to see their families affected by the earthquake.[463]

Flooding in Şanlıurfa

Floods which struck the provinces of Adıyaman and Şanlıurfa in March killed at least 21 people.[464] The floods swept away cars, affected homes and campsites housing earthquake survivors. Twelve people, including five Syrians, died in Şanlıurfa. An intensive care unit in a hospital in the province was evacuated. In Adıyaman, two drowning deaths occurred when floodwaters swept away a container home with a family. Over a dozen professional divers participated in search and rescue efforts in each province.[465]

Before the earthquake, the government had planned the elections to be held on 14 May 2023, a month earlier than its latest possible date as a snap election.[466] After the earthquake, doubts arose if elections could be held on schedule. On 13 February, Bülent Arınç of the AKP demanded the elections be postponed despite the constitution disallowing such a possibility in the absence of war. Arınç's declaration has been criticized by media outlets and politicians.[466] However, the possibility of this passing through amending the constitution was uncertain, as the governing coalition, with its 333 seats in parliament, could not surpass the 400-number hurdle needed for the motion to succeed.[467] On 18 February, AKP authorities stated that the elections would not be delayed.[468]

Kemal Kılıçdaroğlu of the CHP opposed its postponement on constitutional grounds. Mustafa Tolga Öztürk, YSK member of the İYİ party stated that YSK does not have any power to postpone an election and only parliament has the right to do so, adding that Turkey had no more time to lose with the AKP. Selahattin Demirtaş of the Peoples Democratic Party (HDP) has described the postponement as a political coup. The declaration of state of emergency in the affected regions was also interpreted as a possible measure to postpone elections.[466] Nevertheless, the earthquake led to the opposition Nation Alliance postponing its 13 February meeting for the selection of its consensus presidential candidate to 6 March,[467] which was eventually assumed by Kılıçdaroğlu.

At the elections on 14 May, Erdoğan's People's Alliance retained its majority in the Grand National Assembly,[469] while Erdoğan won in the first round of the presidential election, receiving 49.5%, and won 52.2% of the vote in the second round against Kılıçdaroğlu on 28 May.[470] This marked the first time a Turkish presidential election went into a run-off.[471] In both instances, Erdoğan retained the support of a majority of voters in most of the provinces devastated by the earthquake.[472][473]

On 9 February, the Council of Higher Education said education and training at universities in the affected provinces would be suspended until further notice.[474] Student hostels managed by the General Directorate of Higher Education Credit and Hostels would be used to house affected individuals.[475] The minister of national education, Mahmut Özer, ordered a week-long closure of all schools in the country,[476] which was later extended to two weeks.[256] Schools in the affected provinces were suspended until 10 March.[477] Students studying in schools located in the affected provinces would be transferred to other provinces of their choice.[478]

After the earthquake, Süper Lig was suspended for over a week to mourn the victims. Clubs from affected regions: Süper Lig clubs Hatayspor,[479] Gaziantep FK, TFF First League club Yeni Malatyaspor,[480] Adanaspor, TFF Second League club Adıyaman FK, Diyarbekirspor and TFF Third League clubs Kahramanmaraşspor, Osmaniyespor FK and Malatya Arguvan SK withdrew from competition. Sivas Belediyespor, Tarsus İdman Yurdu and Niğde Anadolu requested to withdraw but TFF did not approve their requests.[481]

On 6 February, it was announced the 2023 ISF World School Winter Games, which were due to be held in Erzurum, were canceled due to the 'force majeure' situation in the country.[482] On 10 February, it was announced the 2023 Men's EuroHockey Indoor Club Cup was canceled due to the impact of the earthquake. The tournament was intended to be held from 17 to 19 February in Alanya.[483][484] In an official statement, Minister of Youth and Sports Mehmet Kasapoğlu announced that every national championship would be suspended with immediate effect, until further communications.[485][486]

All 39 members of the Northern Cypriot Türk Maarif Koleji's high school volleyball team including players, teachers, parents and a trainer died in the collapse of a hotel in Adıyaman.[487]

Three players from Iran's national paralympic football team died in Turkey.[488] Hatayspor's Ghanaian winger Christian Atsu died in the collapse of Rönesans Rezidans in Antakya. His body was found on the morning of 18 February.[489][490] Atsu was a former Chelsea, Newcastle, Bournemouth and Everton player.[491] Basketball player Nilay Aydogan died in Malatya.[492]

In the first game of the Super Lig after the earthquake between Fenerbahce Istanbul and Konyaspor, fans protested against the Turkish government and shouted demands for its resignation, which was still heard even after the broadcaster of the game BeIN tried to censor the fans' voices.[493] In another football game in Istanbul between Besiktas and Antalyaspor the fans repeated their calls for the government's resignation and threw cuddly toys onto the field.[494]

Arab League

Arab League secretary-general Ahmed Aboul Gheit called for international assistance to help those affected by "this humanitarian catastrophe".[529]

The Secretariat of ASEAN expressed its heartfelt sympathies and condolences to the Governments and peoples of the affected countries, especially the families of the victims of the earthquake. ASEAN affirms its solidarity with the Governments and peoples of Turkey and Syria in these trying times and stands ready to extend its assistance to the relief efforts.[530]

The European Union's European Civil Protection Mechanism, in which Turkey participates despite not being a member of the EU, was activated at the request of Turkey.[531] The EU dispatched thirty-one rescue teams and five medical teams from 23 member states to Turkey, committed €3 million and €3.5 million to Turkey and Syria respectively, and announced a donor conference to raise money.[532] The Copernicus Programme was also activated to provide emergency mapping services and other help.[529]

NATO secretary-general Jens Stoltenberg said that member countries were mobilizing support.[533][534] The Strategic Airlift Capability was used to transport search and rescue equipment.[535] NATO deployed "fully equipped semi-permanent shelter facilities" to house displaced persons in Turkey.[536] Flags at NATO headquarters were also lowered to half-mast.[537] A vessel carrying the first 600 of 1,000 containers for temporary housing left Taranto, Italy for Turkey to accommodate at least 4,000 people.[538]

Several United Nations agencies announced coordinated responses to the disaster, including UNDAC, OCHA, UNHCR, UNICEF and IOM.[539] The World Health Organization's Regional Director for Europe, Hans Kluge, said the organization's regional offices were assisting international efforts to transport medicine and relief equipment.[529][540] The UN released $25 million from its emergency fund for humanitarian assistance in Turkey and Syria.[541] A second $25 million grant was released for relief efforts in Syria.[438] UN sent humanitarian aid to Syria through Turkey via the Bab al-Hawa border crossing.[542] Since then, 65 trucks have crossed, carrying health and nutrition items and other vital relief supplies for more than two million people.[543] On 14 February, the UN appealed for €396 million to help survivors in Syria.[544]

The World Bank said it would provide US$1.78 billion in aid for Turkey to support the relief and recovery process.[545] "We are providing immediate assistance and preparing a rapid assessment of the urgent and massive needs on the ground," said World Bank President David Malpass.[546]

Murat Kurum, Minister of Environment, Urbanization and Climate Change at an AFAD press conference

Destroyed buildings in Hatay

The Turkish Government was criticized on social media for allegedly trying to cover up the fact that there were not two, but three mainshocks above M_w 7. However, professor Hasan Sözbilir, Director of Dokuz Eylül University (DEU) Earthquake Research and Application Center, told Anadolu Agency that there were only 2 mainshocks reaching above M_w 7 between 6 and 17 February 2023, but of the smaller quakes, there was one that reached M_w 6.7.[547] Additional allegations were made when the death toll in Turkey was at 41,000, could in fact be up to five times higher. The Justice and Development Party (AKP) government was accused of manipulating the death toll of the earthquakes to mask the scale of the disaster amid growing criticism due to what many say was a delayed and ineffective response to the tragedy.[548]

The collapse of many newly constructed buildings caused public anger and doubts about the Turkish construction and contracting industry following seismic codes.[549] After the 1999 İzmit earthquake, new building codes were enacted to make buildings more resilient to earthquakes.[550] The quality of the concrete is often a factor in collapse, especially in older buildings, but the engineering and design of newer high rise buildings, and improper placement of support columns and beams, may contribute to collapse.[551] The building codes, last updated in 2018, required quality standards in engineering design, construction and material.[551] There were complaints that the building codes were poorly enforced.[550]

After the earthquake, Erdoğan had claimed "98 percent of the destroyed buildings were built in before 1999" and described it "as the indicator of an improvement in the quality of building codes and enforcement".[552] Erdoğan's claim was criticized by civil engineer and earthquake engineering academic Haluk Sucuoğlu, stating that field observations and more than half of the buildings in earthquake-affected areas being built after 2000 making Erdoğan's claims unlikely, though accepting that concrete data on the destroyed buildings do not exist yet.[553] The comparison of historical satellite images with those taken after the earthquake, especially of those showing the destruction in the newly built area of western Kahramanmaraş, were used to dispute Erdoğan's claim.[554]

In Adıyaman, the minister of transport and infrastructure, Adil Karaismailoğlu, and governor, Mahmut Çuhadar, were met with protests by locals. The state car of the governor was also kicked by protesters.[555] Turkish engineers previously warned that cities could become 'graveyards' with building amnesty.[556] Critics of President Erdoğan said contractors of housing projects were allowed to skip vital safety mandates which put residents at risk. Videos from several years ago showed Erdoğan applauding housing projects which eventually collapsed. During a campaign stop in anticipation of the March 2019 local elections, he listed, among his government's top attainment, new housing in Kahramanmaras. Erdoğan said "We solved the problem of 144,156 citizens of Maras with zoning amnesty," In another video, he said "We have solved the problems of 205,000 citizens of Hatay with zoning peace,"[557]

Before the 2018 general election, 3.1 million buildings were granted amnesty certificates, according to Istanbul Metropolitan Municipality Secretary General Assistant and city planner, Bugra Gokce. In the ten affected provinces, 294,165 certificates were granted; 59,247 in Adana; 10,629 in Adıyaman; 14,719 in Diyarbakır; 40,224 in Gaziantep; 56,464 in Hatay; 39,58 in Kahramanmaraş; 4,897 in Kilis; 22,299 in Malatya; 21,107 in Osmaniye; and 25,521 in Şanlıurfa.[558] After a destructive earthquake struck İzmir in 2020, Asia Times said the Turkish government generated US$2 billion in profit since the latest zoning amnesty law was approved in May 2018. During that earthquake, there were 811,000 certificates linked to illegal construction in İzmir.[559]

The leader of the opposition in Parliament, Kemal Kılıçdaroğlu of the Republican People's Party (CHP), pinned responsibility for the scale of the disaster on President Erdoğan.[422] He demanded from the CHP mayors not to back down from providing bread and blankets to people in need and reject bureaucratic blocking as they did during the COVID-19 lockdown.[560] It has also been reported that some donations from relief organizations arriving at the Adana airport were relabeled as assistance by the Disaster and Emergency Management Presidency (AFAD) or also the governing AKP.[561] Questions also arose as to how an "earthquake tax" (officially "special communications tax") levied by the Turkish government in the wake of the 1999 earthquake, estimated to have reached 88bn lira ($4.6bn; £3.8bn) and meant to have been spent on disaster prevention and the development of emergency services, were spent, given how the government has never given a public explanation.[422]

Some Kurdish and Alevi residents alleged discrimination and neglect in the government's recovery efforts.[562][563] The pro-Kurdish Peoples' Democratic Party (HDP) accused Turkish authorities of preventing equal distribution of aid[564] and favoring areas inhabited majorly by people loyal to the governing AKP.[565]

Kahramanmaraş after the earthquake

AFAD, the state organ for the disaster relief, was criticized on the grounds of slowness during the first days of the earthquake.[566] There were reports of unsuccessful attempts by people to contact AFAD.[566] Emergency management academic Kubilay Kaptan stated that the delayed reaction of AFAD was mainly caused by the increasing centralization of Turkish emergency response agencies under the current government. According to Kaptan, numerous relief agencies were merged into AFAD in the past years and since the implementation of the referendum, AFAD became part of the Ministry of Interior, losing its autonomy and self-governance. Kaptan added that the Ministry of Interior, responsible for making decisions, hindered the fast response since the organization required approval for its actions, contrasting more independent agencies like FEMA in the United States.[567] AFAD was also criticized on the claims of inappropriate board of management, since some members of the board had no disaster management background. İsmail Palakoğlu, the general manager of disaster response subdivision of AFAD and a theologian who previously worked at the Directorate of Religious Affairs, was criticized by several politicians and media outlets.[568][569][570]

Another criticism was the late deployment of military resources.[566] They were not mobilized for two days after the earthquake, and even then in what many considered in very modest amounts.[571] There were many instances where aid was forced to go through local governors, who were not elected but appointed by the government. In some instances, aid was held by the ruling party with the explanation that it would be managed by AFAD.[572] There were reports of aid trucks stopped and not let through unless ruling party placards and signs were placed on them, including stickers of the president placed on individual aid packages.[573] On 16 February the district governor of Pazarcik accompanied by the gendarmerie seized aid stored in a distribution center established jointly by the HDP and the Hasankoca Neighborhood Assistance and Solidarity Association in presence of the head of the Diyarbakır Chamber of Industry arguing they could not distribute aid independently.[564]

On 9 February 2023, the governing alliance between the MHP and the AKP approved a state of emergency in 10 provinces affected by the earthquakes.[466][574] The opposition voted no to the measure, claiming that it was unnecessary since the provinces were already declared as "disaster areas".[466][574]

A week after the earthquakes in Samandağ, a coastal town in Hatay Province, residents dug through the rubble to look for victims because of the slow and limited government response. "We have nothing left and the government barely helped us," one resident said, adding that assistance only came 48 hours after the earthquake.[575]

NetBlocks announced that ICTA limited access to Twitter from Turkey, with Turkish government officials claiming disinformation.[576][577] According to Reuters, citing an anonymous government official, the block was necessary "because in some accounts there were untrue claims, slander, insults and posts with fraudulent purposes," The block caused public anger as Twitter assisted in sharing information on arriving aid and the whereabouts of survivors still trapped in rubble. The Peoples' Democratic Party said Twitter helped in organizing aid to the affected and the block would "only cause more death." Ali Babacan, leader of the Turkey's opposition group, Democracy and Progress Party, also criticized the block.[578]

The Committee to Protect Journalists (CPJ) issued a statement critical of fines and penalties issued to Halk TV, Tele1, and Fox over their coverage of the earthquake by the Radio and Television Supreme Council. In addition to the fines, both Halk TV and TELE1 were required to suspend airing of the shows that had criticized the government for five days. The CPJ's statement said that Turkey officials should revoke both the fine and penalties along with refraining from silencing the media for its earthquake coverage.[579][580]

Ruins in Adıyaman

On 7 February, Turkish police said they detained four people over "provocative posts aiming to create fear and panic" on social media following the earthquake. It added that a wider investigation into social media accounts was ongoing, but offered no information on the content of the posts.[581] The number of detentions increased to a dozen on 8 February.[582] Following reports of property being ransacked by looters,[583][584] authorities arrested 98 people for robbery or defrauding victims.[585] Syrians have faced increased discrimination in the country, with some Turks blaming them for the looting.[586][587][588] Amnesty International and Human Rights Watch alleged that Turkish security forces tortured and ill-treated individuals arrested on suspicion of looting. In a report from both organizations, one person died while being held by authorities. The report said allegations of torture came from 10 provinces, with most of them coming from Antakya alone.[589]

On 9 February, minister of justice, Bekir Bozdağ, said a judicial investigation into the collapse of buildings was opened.[590] The probe attempts to hold accountable those who constructed the buildings or bore any responsibility for their collapse in the 10 hardest-hit provinces. Bozdağ said: "Those who have negligence, faults and those responsible for the destructions after the earthquake will be identified and held accountable before the judiciary".[590][591] Nearly 150 local prosecutors were authorized to establish units to investigate contractors, surveyors and other experts linked to the collapsed buildings.[592]

On 11 February, the justice ministry announced the plan to establish the "Earthquake Crimes Investigation" bureaus. The bureaus aim to hold contractors and other responsible for construction, gathering evidence, recommendation experts; including architects geologists and engineers; and inspecting building permits and occupation permits.[593] Vice President Fuat Oktay said 131 individuals linked to the collapse of buildings were identified.[594]

By 25 February, 612 people were investigated for their involvement in building collapses; 184 were arrested and awaiting trial. Those in jail included contractors and building owners and managers.[595] On 12 February, the Adana Chief Public Prosecutor's Office issued arrest warrants for 62 people;[596] Thirty one arrests were made on 14 February. In Malatya, city prosecutors issued arrest warrants for 31 people.[597]

The Committee to Protect Journalists (CPJ) published an article on 14 February covering journalists being detained and harassed for their reporting on the earthquake in Turkey. Some of those detained were being investigated for "spreading misinformation" or for ""provoking the people into animosity and hatred" in connection with their reporting.[598]

The owner of the Renaissance Residence which collapsed in Hatay Province was arrested in Istanbul while attempting to leave Turkey for Montenegro.[590] In Gaziantep Province, two people were arrested after being suspected of cutting-down columns to make extra space in a building that collapsed.[593] Bekir Bozdağ said 163 people were being investigated for their alleged involvement. Eight people were arrested and awaiting trial while 48 were held in police detention; another seven were prohibited from leaving Turkey. Officials detained two people at Istanbul Airport attempting to flee to Georgia. Among those arrested were a man and his wife who constructed several buildings in Adiyaman which collapsed. A contractor involved in developing the Bahar Apartments in Gaziantep was detained in Istanbul after his inspections were deemed negligent. The owner of a construction company which built several buildings in Adana was apprehended in Northern Cyprus.[597]

The majority of buildings that collapsed in Turkey were constructed before 2000, but some were constructed after that year. Following the 1999 earthquake, building construction followed new regulations and had improved materials. Sukru Ersoy, a geology professor at Yıldız Technical University, said "corruption is high in the construction sector in Turkey. And therefore, there were abuses".[599] However, corruption was not always present in local authorities;[600] in Erzin, which has a strict policy against the construction of buildings that violated safety codes in addition to having endured other earthquakes with less damage, became a popular location for survivors elsewhere to take refuge as no collapsed buildings were reported.[601][602]

Flag lowered because of national mourning

President Erdoğan declared seven days of national mourning in Turkey on Twitter.[603][402] Seven days of national mourning was observed in Northern Cyprus, and one day in Bangladesh and Kosovo.[604][605] Albania's prime minister, Edi Rama, said 13 February would be a day of national mourning.[606] On 13 February, all overseas diplomatic missions of North Macedonia lowered the North Macedonian flags to half-mast.[607]

Investigative reports revealed that Syrian government had deliberately obstructed aid to all of Syria's opposition-held areas, including the Idlib region, which was the worst-struck area in the earthquake.[608] Syrian government officials and state-run media blamed United States and European Union sanctions against the country for the lack of humanitarian aid and hampering rescue. On 10 February, Syrian president Bashar al-Assad[609] accused Western countries of having "no regard for the human condition."[610] The US Treasury said its sanctions "contain robust exemptions for humanitarian efforts" in the first place, and that after the earthquake it issued a blanket authorization for relief efforts.[256] The United Nations has also been criticized for its policy of focusing aid shipments solely to the regime, at the expense of Syrian lives in opposition-held territories.[611]

Idlib region, under the control of Syrian Salvation Government (SSG), was one of the hardest-hit territories.[612] Assad regime's policy of besieging North-West Syria; which blockades the supply of food, medicines and other humanitarian supplies, has further deteriorated the crisis in Idlib.[613] Abu Muhammad Al-Julani, commander of the SSG-aligned Tahrir al-Sham rebel militia, criticized aid agencies of neglecting the situation in Idlib and called on the international community to be more proactive in reconstruction and relief efforts, adding that the "United Nations needs to understand that it's required to help in a crisis".[614] Upon traveling to the Bab al-Hawa Border Crossing bordering the rebel-held territories, UNOCHA Under-Secretary Martin Griffith stated on 12 February that "We have so far failed the people in north-west Syria".[614] As of 13 February, Ankara and the Turkish-backed Free Syrian Army were accused of blocking aid convoys sent by the Autonomous Administration of North and East Syria from entering the north-west region.[615][616]

The United Nations criticized Russia's attempts to block delivery of aid through checkpoints to rebel-held territories. Secretary General António Guterres urged the Security Council to immediately permit aid flows into Northwestern Syria.[617] United States appealed for the immediate opening of all closed checkpoints to send in relief efforts to all parts of Syria; calling for an emergency UN Security Council meeting to increase humanitarian assistance through Bab al-Hawa and open up more border crossings for the entry of UN aid.[614][617] Stéphane Dujarric, a United Nations spokesperson, said on 14 February, "some aid is getting into the north-west, pointing to 58 trucks that arrived with aid through the Bab Al-Hawa crossing." However, the organization does not possess heavy equipment or search and rescue teams. He stressed that the "international community as a whole needs to step up to get that aid where it is needed."[522]

Raed al-Saleh, chief of Syrian Civil Defence, strongly rebuked the UN for its negligence and delay in responding to the rescue efforts:

"Let me be clear: The White Helmets received no support from the United Nations during the most critical moments of the rescue operations.. The UN's failure to respond quickly to this catastrophe is shameful. When I asked the UN why help had failed to arrive in time, the answer I received was bureaucracy. In the face of one of the deadliest catastrophes to strike the world in years, it seems the UN's hands were tied by red tape."[608]

Field hospital established by a Japanese health team in Gaziantep

Due to below-freezing temperatures in the affected areas in both Turkey and Syria, the mayor of Hatay, Lütfü Savaş, warned about the hypothermia risk.[618] In Adiyaman Province, some residents trapped under rubble died from hypothermia.[619]

Concerns arose regarding the possible spread of infection in areas where sanitation facilities were damaged or unfunctional.[122] Due to water shortage experienced in both countries, many survivors could not shower. International health organizations said the shortage of clean water would be a public health risk. The World Health Organization said water shortage "increases the risk of waterborne diseases and outbreaks of communicable diseases."[620]

On 18 February, Turkey's Health Minister Fahrettin Koca said there was an increase in intestinal and upper respiratory infection cases but "numbers did not pose a serious threat to public health."[122] At a stadium serving as shelter in Kahramanmaraş, a clinic managed by 15 to 30 medics attended up to 10,000 patients in the day. The clinic provided tetanus shots and sanitary items to residents. Many people at the stadium were unable to shower and the six toilets were unable to accommodate to the large number of people. In Antakya, residents said more portable toilets were needed.[620]

Health authorities in Turkey had to ensure earthquake survivors were free of disease. The World Health Organization collaborated with local authorities to monitor the rates of waterborne diseases, seasonal influenza and COVID-19 among the affected.[620]