23 February 2023 - Türkiye

“Hidden Scars”: Children at risk of toxic stress as more earthquakes hit Türkiye and Syria


Samer*, 6 with the paints and hat he got at the child-friendly space (Credit: Khalil Ashawi/Save the Children)

In Antakya city centre, it was hard to imagine any more damage was possible. Just over two weeks ago one of the worst earthquakes in Türkiye’s history devastated this part of the country and turned most of the city to ruins. 

Twisted wreckage lays in all directions - all that’s left of homes, shops and offices. It is one of the hardest hit areas in a disaster that has claimed more than 48,000 lives across Türkiye and northern Syria. 

But just after 8pm a fortnight after the first disaster, two more earthquakes struck. Not as powerful as before, but enough to make the ground shake violently and bring down even more of the few buildings left standing. Panicked families fled into the streets and in Syria there were reports people jumping from windows to get out of buildings as fast as they could. 

Tragically, it has also been deadly. It’s gut-wrenching to think there are those who made it through the first earthquakes, who were trying to recover and rebuild their lives, but who didn’t survive this one. 

The first I knew was when the car I was in started shaking and veering across the road. We were able to pull over and wait in the open for the shaking to pass, while desperately hoping the wider impact would be limited. 

Thankfully all our Save the Children team members were quickly accounted for. That night many of those closest to the epicentre chose to sleep in cars or tents, or under tables for protection. But the shock was worst for Turkish and Syrian colleagues and partners going through the ordeal once again. Blue lights and sirens of the emergency services soundtracked the night and in the morning new scars had opened up on the roads. 

It was a terrifying blow for those whose lives have already been ripped away without warning in a matter of minutes. After two weeks, some families with homes that are still standing felt it was safe enough for them to start returning. Now their confidence has been shattered and they have been forced into the cold again. For children, it must have been like reliving a nightmare.  

The children we are seeing on a daily basis were already struggling to recover from the incredibly traumatic experience of the first earthquakes. Many have witnessed their friends and family members die before their eyes. Others have been buried under the rubble of their collapsed homes.  

Before recovery can begin, it is vital a child starts to feel safe. Children with whom our teams are working had just started to reach that point, meaning we could begin to actively help them process their trauma and loss. This new tremor has plunged many children back into the fear and danger they felt two weeks ago. Our child protections specialists who went to see children the day after the earthquake said it was like starting again. 

Without the right support to recover, repeated traumatic events and lasting stress can lead to toxic stress in children, and this can impact their brain, mental health, and overall well-being. Toxic stress can have lifelong impacts on their lives and development. Outside of the physical danger and damage, that’s one reason these aftershocks are so concerning. It is critical we are able to scale up our work to provide the emotional and mental health support children need to recover – for as long as it takes. 

Beyond the significant mental health impact, this week’s earthquake is a stark reminder that millions of families in Türkiye and Syria are struggling to piece their lives back together in the toughest circumstances imaginable. Many are still sleeping outside, crowded around fires for warmth against the bitter nights. 

We’re now in a race against time to avoid the secondary impacts of the earthquakes, which could lead to even more death and destruction. A public health emergency is waiting in the wings. Thousands of people are without safe drinking water, toilets, or washing facilities. Many are turning to contaminated water sources and are being forced to relieve themselves in the street, which is creating the perfect breeding ground for an outbreak of waterborne diseases. A cholera outbreak had already taken hold in Syria, where families were already reeling from more than a decade of conflict. 

Save the Children is distributing blankets, essential hygiene items, firewood, food, clothes and beds to families who have lost everything in the earthquake. Our specialists are working to protect children’s mental health and hep them recover. 

With swathes of the two countries turned to rubble and dust, and trauma shadowing children wherever the earthquakes continue to strike, this is only the start.  


Dan Stewart is the Head of News at Save the Children UK. He's worked on several emergency responses at Save the Children, including in Afghanistan, Somalia and supporting the Ukrainian refugee response in Romania. Dan is currently in Hatay,  and available for interviews.

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