After the dust settles: The mental health needs in Türkiye

The consequences of the devastating earthquakes that hit Türkiye in February are all too visible in destroyed buildings, makeshift camps and the rebuilding in affected areas. With the coming of spring, heavy rain has caused flooding, adding another layer of destruction.

Médecins Sans Frontières (MSF) is supporting local organisations in Türkiye in their efforts to provide psychosocial support to people as they try to rebuild their lives. 

Days after the earthquakes struck, people waited outside what remained of their homes, while search and rescue teams tried to save people stuck under the rubble. To add to the trauma, people had to to identify every dead body that was found, to check whether it was their loved one or not.

According to the Turkish authorities, as of early April, over 50,300 people were killed in Türkiye alone.

“Despite the problematic hygiene conditions and sometimes unfavourable weather conditions, most people are still too scared to enter buildings,” says Nazlı Sinem Koytak, a psychologist for Imece Inisiyatifi in Adıyaman, a local NGO supported by MSF.

“They don’t feel safe. People stay outdoors out of survival instinct,” says Koytak.

Our teams continue to support local organisations in providing psychosocial support to people in affected areas, through Imece Inisiyatifi in Adıyaman and Malatya provinces, and Maya Vakfi in Hatay and Kahramanmaras. As of 24 March, over 7,500 people in individual and group consultations received support.

“People used to take refuge in their homes, but now their homes have turned into a place of fear, a place that kills them,” says Koytak.

Mental health workers encourage people to share their emotions, stories, and challenges, letting them know their feelings are normal given what they’ve been through. Group sessions build a bond among participants, bringing people together so they can support each other during difficult moments. 

People continue to be hyper alert and have difficulty concentrating and sleeping. Some have nightmares every night, are forgetful and have lost their appetites. Aftershocks are still happening daily, and people constantly relive past experiences in their minds and believe another disaster could happen. 

“I can’t sleep well these days. I also can’t study. It feels like all the information I had in my mind is now gone,” says 13-year-old Eylül, who lives in Kayatepe (Rezip) village in Adıyaman. 

“Whatever I used to know before, I don’t know anymore,” she says.

According to the Turkish Disaster and Emergency Management Presidency, over 25,000 aftershocks have occurred since 6 February, 47 of which with a magnitude higher than five on the Richter scale. Psychologists on the ground have noticed that post-traumatic stress symptoms are not decreasing. 

The psychological toll of the disaster has also affected people physically, sometimes causing panic attacks, muscle pain and eating disorders. 

In rural areas, such as Başpınar (Küllüm) and Kayatepe (Rezip) villages in Adıyaman, most families have lost at least one person and are trying to rebuild their livelihood and communities. They also host relatives coming from other locations. People coming from the cities often feel like urban spaces are too dangerous and so head to the countryside. 

For those who remain in urban areas, there are tensions between groups over the scarce resources left in the wake of the earthquakes. The scale of the disaster means that needs for food, water and sanitation, as well as tents and other essential items, are overwhelming.

Yardım Konvoyu (Aid Convoy Association), with the support of MSF, focuses on distributions to people in informal makeshift camps, set up in parks and parking lots. 

“Losing livelihoods creates yet another challenging situation people must adapt to. People can’t get back to work or to their household routines,” says Koytak. 

“Adıyaman is a destroyed city. With time, this situation will affect more and more people’s emotions and behaviours, making recovery a lot more difficult in the long run.”

The local organisations that our teams support provide psychosocial assistance to a wide range of people affected by the earthquakes: Turkish healthcare workers, Syrian refugees, volunteers, children and adults. Psychosocial support can take many different forms, particularly for children who often benefit from simple activities such as drawing, dancing or listening to music. 

The earthquakes have been absolutely devastating, and their consequences will affect people’s lives for years to come. Working with local organisations in providing psychosocial support, we aim to support people to further develop the strength and resilience necessary to rebuild and to process the immense trauma they have experienced.