Introduction
Earthquakes, which occur as a result of sudden fractures within the Earth’s crust and the subsequent propagation of vibrations in the form of seismic waves, cause significant ground shaking and destruction.1 Since the formation of the Earth, successive earthquakes in seismically active regions have led to the loss of millions of lives and the destruction of shelters. Among the largest earthquakes recorded in the 21st century are the 2004 Indian Ocean earthquake, the 2010 Haiti earthquake, the 2008 Sichuan earthquake, and the 2005 Kashmir earthquake, all of which stand out due to their extensive damage and high mortality rates.2 In addition to these events, the 2011 Great East Japan Earthquake and Tsunami caused extensive infrastructural destruction and long-term community disruption, and is considered one of the most economically devastating disasters in modern history.3 In 2023, earthquakes represented 32 of the 399 reported natural disasters, affecting more than 20 million people, causing 62,451 deaths, and accounting for 72% of all disaster-related fatalities.4
The Kahramanmaraş earthquakes in Türkiye of February 2023 represent one of the most recent examples of this global burden. On February 6, 2023, 2 earthquakes of Mw 7.8 and Mw 7.5 struck Pazarcık and Elbistan (Kahramanmaraş)5, resulting in 53,537 deaths, 107,204 injuries, and the displacement of approximately 9 million people.6–Reference Goldberg, Taymaz and Reitman8 The initial earthquakes were followed by >40,000 aftershocks, with maximum magnitudes reaching 6.7. Devastating 11 southern Türkiye cities (Kahramanmaraş, Hatay, Adıyaman, Gaziantep, Osmaniye, Malatya, Adana, Diyarbakır, Şanlıurfa, Kilis, Elazığ) across 120,000 km2—impacting 14 million people, an area larger than 133 countries and more populous than 157.9
The Turkish government has declared a level 4 emergency, the highest level of emergency, which includes calls for aid from international organizations and countries in response to natural disasters and pandemics in earthquake-affected regions. Furthermore, a 3-month state of emergency was declared in 10 provinces affected by the earthquakes, while the World Health Organization (WHO) announced a level 3 emergency.6, 7 Health professionals from all regions of the country were deployed either as volunteers or on duty. Earthquake survivors were placed in tents and containers built by the Turkish central government, municipalities, and civil society organizations. However, the harsh winter conditions, the vast geographical scope, and the prolonged rescue operations, along with the destruction or severe damage to health institutions in the region, significantly affected access to post-earthquake health services. Additionally, many health care professionals residing in the affected areas lost their lives or were injured, further straining the already limited health care capacity.
The WHO noted that health threats arising from earthquakes could vary depending on the magnitude of the earthquake, the structure of the affected residential stock, and other seismic hazards such as tsunamis and landslides.7 Earthquakes can have both immediate and long-term effects on health. Mid-term consequences following the acute phase—which involves deaths and injuries—include secondary infections of untreated wounds; increased morbidity and complication risks related to pregnancy and childbirth due to interruptions in maternity and neonatal services; heightened risk of infectious diseases in overcrowded conditions; increased complications from chronic disease due to treatment disruptions; growing psychosocial support needs; and potential environmental contamination resulting from chemical or radiological exposure following industrial damage. Moreover, earthquakes can damage health care facilities and transportation infrastructure, disrupting service delivery and access to care. In such cases, health care personnel may be unable to reach operational health centers, and essential medical supplies may be lost.7
In this context, conducting detailed diagnoses in earthquake zones and preparing field reports to identify existing problems—crucial for health service planning—is essential for public health workers. Accordingly, a post-earthquake field report was prepared by the Turkish Association of Public Health Specialists (HASUDER) between February 12 and 17, 2023. The report, prepared by 6 public health experts in Hatay, one of the most heavily affected cities, identified key issues such as shelter, drinking water, sanitation, security, hygiene, environmental health, waste management, infectious diseases, psychosocial challenges, and women’s reproductive health. However, upon review, it was noted that the report was not based on a structured diagnostic tool; rather, it relied on pre-visit demographic and health data, field observations, and interviews with survivors, health workers, and Disaster and Emergency Management Authority (AFAD) officials.Reference Okyay, Pala and İnandı10 This underscores the need for valid, reliable, and systematic diagnostic instruments in disaster contexts to ensure accurate, comprehensive, and comparable data collection on affected populations.
Using a systematic and validated diagnostic tool to assess the health problems of earthquake survivors enables a comprehensive and structured evaluation of post-disaster needs. The Omaha System is a valid and reliable diagnostic framework widely used by nurses and other health care professionals across various disciplines, including public health, occupational health, school health, elderly care, home care, and migrant health. Unlike disaster-specific assessment tools that primarily focus on population-level needs, infrastructure damage, or behavioral health outcomes, the Omaha System allows for a person-centered and holistic approach, capturing the complex and overlapping health issues that often emerge in post-earthquake settings.Reference Ardic and Aktas11–Reference Onder and Ardic17
As a diagnostic tool, the Omaha System comprehensively diagnoses not only the individual but also the family and community across environmental, physiological, psychosocial, and health-related behaviors domains. In addition, the system provides the opportunity to identify not only acute problems but also risks and potential future problems.Reference Martin18, Reference Martin and Scheet19 Its diagnostic depth and flexibility make it particularly suitable for community-based nursing assessments, where immediate intervention and long-term care planning must be integrated.Reference Martin18 Furthermore, the Omaha System’s structured taxonomy enables the production of standardized and internationally comparable data, which is essential for both local action and global learning.
To date, no studies have employed a structured diagnostic framework such as the Omaha System in a post-disaster setting, despite its proven utility across multiple health care domains. This makes the present study unique in its application of a comprehensive and person-centered tool for identifying post-earthquake health needs. The Omaha System’s adaptability also allows for use by multidisciplinary teams operating in disaster zones. In this context, the objective of this study was to identify the health problems of individuals residing in tent and container settlements in Adıyaman, following the 2023 Kahramanmaraş earthquakes, using the Problem Classification Scheme of the Omaha System.
Methods and Measurements
Study Design
This study employed a descriptive cross-sectional design to identify health problems at a specific point in time. Cross-sectional designs are defined as approaches in which data are collected during a single time period to describe the status of a population and, when applicable, to examine associations between variables without establishing causal relationships.Reference Erdoğan, Nahcivan and Esin20 It was conducted over a 7-day period in Adıyaman to assess the health problems of earthquake survivors using the Omaha System. Data were collected at a single point in time without follow-up. The study was reported in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines to ensure methodological transparency and reporting quality.21
Sample and Participants
The data for this study were collected through face-to-face interviews with 297 earthquake survivors who agreed to participate in the study. They were aged ≥18 years and residing in tents and containers in Adıyaman. Individuals with cognitive impairment were not included in the sample. Given the unpredictable and challenging conditions in the post-disaster setting, a convenience sampling strategy was employed. Randomization or stratification was not feasible. Due to the challenging circumstances in the area following the February 6 earthquake, which affected numerous provinces and caused significant damage, the researchers remained in the field for 7 days. All eligible and accessible individuals who agreed to participate during this time were included in the study sample.
Measurements
Data were collected using 2 primary instruments: a Socio-demographic and Health Conditions Form developed by the researchers, and the Problem Classification Scheme of the Omaha System. All data were documented and managed through the Nightingale Notes electronic health record system.
Socio-Demographic Characteristics and Health Conditions Form
This structured form was designed to gather information on participants’ age, sex, marital status, place of residence, smoking habits, presence of chronic conditions, medication use, and general health status.
Omaha System
The Omaha System, developed by Karen Martin, comprises the following components: Problem Classification Scheme, Intervention Scheme, and Problem Rating Scale for Outcomes. In this study, only the Problem Classification Scheme was used because the aim was diagnosis.Reference Martin18, Reference Martin and Scheet19 The Problem Classification Scheme contains 42 problems related to the following domains: Environmental, Psychosocial, Physiological, and Health-Related Behaviors. A total of 335 signs and symptoms were associated with these problems (Figure 1).
The Omaha System concept map.
Nightingale Notes
Nightingale Notes is used in >130 public health departments in the United States to document nursing practices and create nursing application guides. The system was developed as an electronic record and reporting system based on Omaha System terminology. Nightingale Notes comprises two sections. In the first section, patients’ demographic and health data are recorded. In the second section, the 3 components of the Omaha System—Problem Classification Scheme, Intervention Scheme, and Problem Rating Scale for Outcomes—are included. In this study, data were recorded using only the Problem Classification Scheme section of Nightingale Notes. Data reports from the Omaha System can be generated in PDF, Excel, or graphic formats and can be transferred to statistical programs. The Turkish validity and reliability of the Omaha System were investigated in 2006. The κ values of the problems, categories, and targets were found to be between 0.72 and 0.83.Reference Erdogan and Esin22
Data Collection
In this study, the data were collected between May 13 and 21, 2023, through face-to-face interviews and observations with 297 earthquake survivors using the Omaha System Problem Classification List. The interviews that lasted approximately 20 minutes were conducted in the tent and container cities where the earthquake survivors lived. Depending on the living arrangements, interviews were held individually or with small groups, such as families living in the same unit (typically 4-5 people per tent or container). While environmental and household-level questions were often answered collectively, individual and psychosocial data were obtained separately. The fieldwork was conducted by 2 specialist public health nurses trained in the use of the Omaha System. The researchers made a diagnosis by discussing together the signs/symptoms and problems that they had difficulty deciding at the end of the day.
Data Analysis
The data were transferred to the statistics program by entering the Problem Classification Scheme section of the Nightingale Notes. These were analyzed using Statistical Package for the Social Sciences. Demographic data and outcome variables were assessed using descriptive statistics.
Ethical Consideration
Ethical approval for the study was obtained from the Social and Human Sciences Ethics Committee (Date: May 12, 2023; Ref. No: 2023-180; Protocol No: 686368). Permission to collect data was granted by the Disaster and Emergency Management Authority. All participants were informed about the purpose of the study, the data collection tools, confidentiality procedures, and their right to withdraw at any time; written informed consent was obtained prior to participation. No adverse events were reported during the interviews. Urgent needs identified through interviews with earthquake survivors were promptly communicated to the relevant local authorities. All identified problems in the domains of physiological, psychosocial, environmental, and health behaviors were documented and formally reported.
Results
In the interview with 297 earthquake survivors, 62.6% (n = 186) of them were living in tents and 37.4% (n = 111) in containers. The average age of the survivors was 45.4 ± 16 years; 63.3% were female; and 36.7% were male. The 84.2% were married, 11.4% were single, and 4.4% were widowed or divorced. In total, 58.2% (n = 173) had at least one chronic illness, with 29.3% (n = 87) having circulatory system diseases; 10.8% (n = 32) having respiratory system diseases; 19.5% (n = 58) having endocrine, nutritional, and metabolic diseases; and 11.8% having musculoskeletal system diseases. Furthermore, 39.1% (n = 116) of the participants were taking medication constantly, whereas the 38.4% (n = 114) were smokers. Among the female earthquake survivors, 8 were pregnant while 5 were in the 14 postpartum period. Detailed findings are presented in Table 1.
Socio-demographic characteristics and health conditions of earthquake survivors (n = 297)
Of the 42 problems in the earthquake zone that were listed in the Problem Classification Scheme of the Omaha System, 38 were diagnosed, including 4 in the Environmental domain, 9 in the Psychosocial domain, 17 in the Physiological domain, and 8 in the Health-Related Behaviors domain. The 97.5% of these problems were identified as actual, 2.5% as potential, 90% as individual, 5% as familial, 2.5% as community-level, and 2.5% as community-level and individual. Problems identified in all earthquake survivors included Income, Sanitation, Residence, and Neighborhood/workplace safety in the Environmental domain; Communication with community resources in the Psychosocial domain; Communicable/infectious condition in the Physiological domain; and Nutrition in the Health-Related Behaviors domain. Furthermore, Personal care (99.3%), Health care supervision (97%), Mental health (96.6%), Physical activity (87.5%), Oral health (84.8%), Sleep and rest patterns (83.5%), Grief (78.5%), Social contact (75.4%), Interpersonal relationships (59.6%), Pain (55.2%), Vision (53.5%), and Digestion–hydration (52.5%) were among the most common problems. Detailed findings are presented in Table 2.
Health problems of earthquake survivors according to the Omaha System (n = 297)
Notes. aEnvironmental domain; bPsychosocial domain; cPhysiological domain; dHealth-related behaviors domain.
Discussion
This study was conducted during the secondary surge period, three months after the Kahramanmaraş-centered earthquakes, with the aim of providing a baseline assessment of needs emerging after and identifying health care demands among earthquake survivors who constitute a high-risk population. In the affected region, 350 tent cities and 392 container cities were established, providing temporary shelter to a total of 2.5 million individuals in tent cities and 675,291 individuals in container cities.9 To assess the health problems of earthquake survivors residing in these tent and container settlements, the internationally validated Omaha System was employed—marking one of the first structured, multidimensional diagnostic applications in a post-disaster setting.
Demographic
The majority of participants were female, married, and living in containers (Table 1). Nevertheless, broader regional data indicate that the affected provinces also include a disproportionately high number of children and young adults. Specifically, 21.3% of Türkiye’s child population (4.8 million) and 16.7% of its young adult population (2.6 million) reside in the 11 provinces impacted by the earthquakes.9These demographic dynamics have important implications for recovery and resilience planning.
Unmet psychosocial or physiological needs among women—who comprise the majority of the affected population in this study—may impair not only individual well-being but also caregiving capacities and community cohesion. International research and frameworks recognize women as both vulnerable and active agents in disaster risk reduction and recovery, as evidenced by initiatives like the Women’s Voices project in New Zealand and those of the Gender and Disaster Network (GDN), where women have led response, caregiving, and rebuilding efforts.Reference Du Plessis, Sutherland and Gordon23 These insights have informed global policy, with the Sendai Framework for Disaster Risk Reduction emphasizing gender as a cross-cutting priority and calling for the integration of women’s perspectives into every stage of disaster planning and recovery.24 Similarly, if the specific health needs of younger populations, such as education disruption, stress-related symptoms, or access to reproductive and mental health services, are not addressed, long-term human capital development in the region could be compromised. In recognition of these risks, post-disaster recovery strategies have included efforts to create employment opportunities, especially for women and young people, to prevent outmigration from the region. Identifying and addressing such group-specific problems is essential not only for restoring baseline health but also for fostering equitable, sustainable recovery.
Environmental Domain
Environmental challenges were the most critical issues, marked by inadequate infrastructure, limited access to clean water, and sanitation below SPHERE standards (1 toilet/shower per 6 people).25 These problems were observed in a context where 676,946 residences were reported as moderately or severely damaged. Survivors struggled to meet basic needs due to flooding, winter conditions, insufficient heating, overcrowding, and malfunctioning hygiene facilities. Despite ongoing efforts to restore infrastructure, living conditions were inadequate. Field reports by HASUDER identified environmental problems as the primary concern.Reference Okyay, Pala and İnandı10 Following the Haiti earthquake, significant problems were reported regarding infrastructure, sanitation, and temporary shelter.Reference Broach, McNamara and Harrison26, Reference Tomak, Demirel and Demir27 In the present study, environmental issues were associated with physiological outcomes such as infectious conditions, raising potential epidemic risks. Consistent with these findings, inadequate hygiene and lack of access to clean water were linked to increased infectious disease risk.Reference Ateş and Erdem28 The interaction between environmental and physiological vulnerabilities underscores the need for effective surveillance and targeted interventions to mitigate epidemic threats.Reference Babaie, Ardalan and Vatandoost29
Psychosocial Domain
This study identified frequent psychosocial problems among earthquake survivors, including limited communication with community resources, mental health issues, grief, reduced social contact, and strained interpersonal relationships. Common symptoms included sadness, hopelessness, anxiety/fear, and flashbacks of traumatic experiences, reported by 37% of participants. In response, initiatives such as psychosocial support areas in shelters, trauma-informed group sessions for young women, and women’s cooperative workshops were implemented in affected provinces. A meta-analysis estimated the prevalence of prolonged grief disorder following natural disasters at 38.8%, underscoring the psychological toll of such events.Reference Zareiyan, Sahebi and Nejati-Zarnaqi30 The disruption of social support networks post-earthquake likely exacerbated psychological vulnerability. Previous studies have emphasized the importance of strengthening psychosocial support following disasters.Reference Geng, Liang and Li31–33 Neurological and psychological disorders were similarly reported after the HaitiReference Van Berlaer, Staes and Danschutter34 and Bam earthquakes,Reference Montazeri, Baradaran and Omidvari35 while recent studies from Türkiye highlighted dizziness, anxiety, and fear as common adolescent symptoms post-earthquake.Reference Bozduman and Akdağ36, Reference Efendi, Temeltürk and Çakmak37 Subari et al.Reference Subari, Demir and Kizikli38 also documented high rates of peritraumatic stress, post-traumatic stress disorder, and depression among adult survivors.
In this study, survivors reported that recreational areas were quite limited in temporary settlements in Adıyaman, where shelter and basic needs were given priority due to the large number of affected populations. Such limitations are known to heighten psychosocial vulnerabilities. For example, after the 2010 Haiti earthquake, restricted recreational opportunities were linked to increased isolation and depression.Reference Martinez, Reich and Ndulue39 Elderly individuals, in particular, face difficulties resuming daily routines and maintaining social interactions, which negatively affects health.Reference Ahmadi, Khankeh and Sahaf40 Kuru Alici et al.Reference Kuru and Kalanlar41 also identified mobility limitations, health care inaccessibility, and psychosocial stress as primary challenges for older adults post-earthquake. These findings align with post-disaster evidence from Nepal, where disrupted social networks intensified long-term distress among children and the elderly.42 Vulnerable groups—especially women, children, and the elderly—require enhanced access to health care and psychosocial services. Pregnant and postpartum women have reported elevated anxiety, stress, and fear in similar contexts.Reference Yalniz, Çakır and Ada43–Reference Mankuta, Levy and Benedek45 Evidence from the Great East Japan Earthquake further emphasizes the need for integrated, community-based psychosocial interventions to address medium- and long-term mental health and rehabilitation needs.Reference Chase, Marahatta and Sidgel46–Reference Cartwright, Hall and Lee49
Physiological Domain
In addition to communicable/infectious conditions, the most frequently identified physiological problems included pain, vision, digestion–hydration, circulation, urinary, neuromusculoskeletal, reproductive and bowel functions, and pregnancy. Common symptoms were anorexia, dental caries, pruritus, coughing, gait disturbance, pain, abnormal vaginal discharge, urinary incontinence, urgency, dysuria, and bowel irregularities (Table 2). Similar findings were reported following the Haiti earthquake, with respiratory, gastrointestinal, and genitourinary conditions among the most common.Reference Broach, McNamara and Harrison26, Reference Van Berlaer, Staes and Danschutter34, Reference Cartwright, Hall and Lee49 These problems stem not only from the effects of the disaster situations in which they occur but also from cultural insensitivity and inadequate coordination. As in this study, health problems can arise due to deficiencies in services specific to women, especially menstrual hygiene and reproductive health. Ohkouchi et al.Reference Ohkouchi, Shibuya, Yanai, Kikuchi, Ichinose and Nukiwa50 examined the deterioration in regional health conditions after the acute phase of a major disaster and emphasized the critical importance of ensuring the continuity of health care services after the disaster. Sacchetto et al.Reference Sacchetto, Raviolo and Lovesio51 demonstrated, through their experiences in an Italian field hospital in Mozambique, that multidisciplinary teams and local solutions ensured the continuity of essential health services in resource-constrained settings.
Health-Related Behaviors Domain
This study identified issues such as unbalanced diet, sleep disturbances, lack of physical activity, and difficulties in personal care within the Health-Related Behaviors domain. Notably, all survivors reported dietary imbalances and an inability to maintain prescribed diets, underscoring the urgent need for secure and appropriate food supplies. Distributed meals were often cold, monotonous, and nutritionally inadequate, particularly problematic for individuals with chronic conditions requiring special diets. In response, national efforts have been initiated to develop a Disaster Nutrition Guideline to address the acute-phase dietary needs of at-risk populations.9Additionally, survivors reported limited access to family planning methods. Although contraception was not perceived as an immediate priority compared to nutrition, shelter, and clothing, the Omaha System enabled a comprehensive assessment, revealing unmet needs in reproductive health as well.
Moreover, the most frequently reported findings related to health care supervision and Medication regimen problems included failure to obtain routine/preventive health care, inadequate source of health care, lack of continuity in health care resources, failure to seek care for symptoms requiring evaluation/treatment, and failure to replace finished medications, leading to nonadherence to the prescribed dose/treatment program. In the affected area, 36 health care facilities sustained varying levels of damage, including 3 hospitals with severe damage. While services continued through field hospitals, mobile teams, and temporary primary care points, delays in rebuilding hindered continuity of care—especially for those with chronic and specialized health needs.9 Given that 58.2% of survivors had at least one illness, primarily circulatory diseases, and 39.1% were on medication, these problems require urgent intervention (Table 1). Similar patterns were noted in a systematic review of 17 studies, which identified frequent post-disaster occurrences of end-stage renal disease, COPD, diabetes, and heart failure.Reference Bell, Horowitz and Iwashyna52 Global evidence following the 2010 Haiti earthquake similarly highlights increased morbidity due to disrupted chronic disease management during the secondary surge.Reference Broach, McNamara and Harrison26 Tomak et al.Reference Tomak, Demirel and Demir27 also reported inadequacies in managing chronic illnesses post-disaster. Noncommunicable diseases, in addition to early-stage infections, contribute significantly to post-earthquake mortality and morbidity.Reference Broach, McNamara and Harrison26, Reference Cartwright, Hall and Lee49, Reference Tan, Lee and Chang53 Runkle et al.Reference Runkle, Brock-Martin and Karmaus54 emphasized that chronic conditions are exacerbated when access to care is compromised.
Adaptive Response in the Secondary Surge Phase
In the aftermath of the Kahramanmaraş earthquake, both local and national interventions were implemented to address immediate and long-term recovery needs, as outlined in the Earthquake Reconstruction Report.9 These efforts included expansion of mobile health clinics, medication delivery outreach, and improvements in water and sanitation infrastructure, alongside significant financial and human resource allocation to rebuild the region with greater earthquake resilience across social sectors (housing, education, health, nutrition, employment, environment), infrastructure sectors (water supply, sanitation, municipal services, energy, transportation, communication), and economic sectors (agriculture, mining, manufacturing, industry, tourism). However, unmet needs persisted—particularly in mental health and social integration—mirroring global “secondary surge” literature that highlights ongoing psychosocial and service gaps in post-disaster recovery.Reference Runkle, Brock-Martin and Karmaus54 These findings emphasize the importance of adaptive health system responses capable of evolving to meet changing needs and priorities during the secondary surge phase.
Moreover, this post-disaster assessment not only reflects the immediate needs but also provides evidence-based insights to inform future disaster preparedness and response planning. Such an evidence-based approach supports the need for adaptable health systems to address the shifting priorities of the secondary surge, underscoring the importance of integrating such tools into future disaster preparedness plans. Additionally, the wide range of identified symptoms demonstrates the diversity and complexity of health problems that can arise in disaster settings, and offers practical guidance to future response teams on where to begin and which often-overlooked issues should be prioritized. Collectively, these findings serve as a roadmap—illuminating symptoms and needs that might otherwise be underestimated or overlooked amid the chaos of early disaster response.
Limitations
The study faced several context-specific limitations due to the devastating earthquake that severely affected multiple provinces. During data collection, the research team was initially based in a tent city. However, following a single night of heavy rainfall, temporary flooding occurred, leading to the evacuation of the tent city. The research team relocated to a nearby container settlement, and many earthquake survivors were also transferred to other temporary shelters. As a result, data collection in the tent city had to be discontinued and was resumed in the container area. Given these circumstances, a probability sampling method could not be implemented. Instead, data were collected using convenience sampling within the 7-day period during which the research team remained in the field. Despite this disruption, all data were collected during daytime hours under suitable conditions, and the completeness and quality of the data were not compromised.
Conclusions
This study demonstrates that the Omaha System is an effective tool for systematically identifying the health problems of earthquake survivors across environmental, psychosocial, physiological, and health-related behavior domains. The findings indicate that unmet basic needs, poor shelter conditions, and disruptions in continuity of care significantly undermine both individual and community health in post-disaster settings, underscoring the urgent need for targeted public health interventions to prevent secondary health crises. For policymakers, the results provide clear evidence that structured diagnostic frameworks such as the Omaha System can guide more effective planning, prioritization, and allocation of scarce resources in disaster response. For nurses, the study emphasizes the critical role of using such tools to rapidly assess needs and deliver person-centered, evidence-based interventions that support both immediate care and long-term recovery. Overall, the findings advocate for prioritizing integrated shelter–health programs and community education to reduce long-term vulnerabilities and ultimately strengthen resilience and recovery in disaster-affected populations.
Acknowledgments
The authors would like to thank all the heroes and health care workers who selflessly risked their lives in the rescue efforts following this disaster in Türkiye. They dedicate this study to the citizens we lost in the earthquake and to all earthquake survivors.
Author contribution
Aysun Ardiç: Conceptualization, data curation, formal analysis, methodology, project administration, software, supervision, validation, writing—original draft, writing—reviewing and editing. Gözde Gür: Data curation, formal analysis, investigation, methodology, resources, software, supervision, validation, visualization, writing—original draft, writing—reviewing and editing.
Funding statement
The authors received no financial support for the research, authorship, and/or publication of this article.
Competing interests
None.
