One year ago, catastrophic earthquakes shook 11 provinces in southern Turkey and northern Syria. The devastating 7.8-magnitude earthquake and the aftershocks that followed reverberated through multiple provinces, and the combined impact of the earthquakes killed more than 50,000 people and injured more than 100,000. Hundreds of thousands were displaced by dangerous and uninhabitable buildings and forced into temporary shelters.
In response, Direct Relief immediately mobilized to equip and fund response and recovery efforts, dispatching medical aid, field medic packs, hygiene kits, and requested medications, as well as providing emergency funds for search and rescue operations supporting several groups, including Turkey’s Ministry of Health, metropolitan municipalities and local organizations in both Turkey and Syria.
As the scale of devastation mounted, the extended recovery phase needed strong support as well, and thousands of people continue to live in temporary shelter zones, in tent or container housing, where challenges to health and sanitation access remain.
As the recovery phase moves forward, Direct Relief is focused on physical therapy and rehabilitation services, mobile maternal and child health services, mental health and psychosocial support services, strengthening primary health care, and supporting the well-being of healthcare professionals, including accommodation for those whose homes were destroyed. Shipments of medical aid continue on an as-needed basis with local groups.
In the year since the earthquake, the organization has provided more than $8 million in financial assistance to groups providing essential health services in Turkey and Syria. Direct Relief has also provided 577 tons of medical aid, valued at $133.1 million wholesale, to support the work of health workers in the wake of the earthquakes.
Financial Summary
The information included in this report, by necessity, includes unaudited figures because the organization’s formal audit coincides with its fiscal year, which is from July 1 to June 30. Audited figures for this period will be included when that audit and report are completed. Numbers are as of Dec. 31, 2023.
Who Donated to the Response?
In response to the crisis, Direct Relief received contributions from 55,253 donors totaling $16,657,322 from individuals, foundations, businesses, and organizations located in 111 countries (including the U.S.). Donations from all 50 U.S. states and four territories were received.
Of the total amount of Turkey-Syria earthquake-designated contributions —
- $9,469,680 was contributed by 54,988 individuals
- $5,974,182 was contributed by 141 businesses
- $1,068,000 was contributed by 41 foundations
- $145,460 was contributed by 83 organizations
How Were the Funds Used?
Of the total Turkey-Syria earthquake response-designated cash contributions received to date, Direct Relief has expended or committed $11,877,002 to improve the health and lives of people affected by the disaster.
This includes:
- $6,869,596 on financial assistance to organizations supporting emergency response
- $2,118,763 on transportation (paid and pending)
- $1,729,291 on emergency personnel costs and other organizational response management expenses
- $1,159,352 on procurement of oxygen concentrators, field medic packs, and other supplies
Consistent with Direct Relief’s Donation Policy, 100 percent of funds received for specific emergency events are devoted entirely to those events, and none of the funds donated for Turkey-Syria earthquake response have been used for fundraising.
(As explained here, all Direct Relief's fundraising expenses are paid by the Direct Relief Foundation, which uses earnings on previously received bequests to the organization for this purpose and other non-programmatic costs.)
Medical Material Assistance
Direct Relief’s earthquake response support can be divided into three categories: medical material assistance, direct financial assistance, and information assistance.
Direct Relief’s main objective in any large-scale disaster response is to deliver emergency medical resources safely and securely – requested, approved by the responsible government authority, and appropriate for the circumstances – where they are most needed, as fast and efficiently as possible.
As aftershocks continued, Direct Relief began working with local, regional, and country-level organizations, including Turkey's Ministry of Health, to determine needs and requests for aid.
In Syria, Direct Relief leaned into strong, existing relationships with organizations that have long worked in the country to channel a high volume of aid.
At the start of the emergency, Direct Relief’s first emergency shipment consisted of more than 100 field medic backpacks for search and rescue personnel dealing with injuries, infections, and other acute medical needs. Working with organizations such as the Society of Critical Care Medicine and the Renal Disaster Task Force, Direct Relief supported intensivists working to treat and stabilize those with traumatic injuries.
As needs became clearer, Direct Relief began to channel large volumes of aid via three separate charter flights to the region as part of the response. In April, an 80-ton charter, with transportation provided by FedEx, included specifically requested antibiotics, respiratory medications, anti-seizure therapies, vitamins for children and adults, personal protective equipment, hygiene items, and other needed medical products. FedEx also provided funding for many of the emergency medical backpacks sent.
As of Jan. 31, 2024, Direct Relief’s Turkey-Syria response efforts have resulted in the delivery or pending delivery of 577 tons of medical aid, valued at $133.1 million wholesale, to support the work of health workers in the wake of the earthquakes.
One Doctor's Story: Dr. Ali Kanatli
On the morning of Feb. 6, 2023, Dr. Ali Kanatli was jolted awake by the earthquakes and immediately jumped into action, checking on his family and neighbors. Dr. Kanatli is a primary care physician in Hatay, Turkey, where he was born and has lived all of his life. The scope of the destruction came into focus when the doctor attempted to get to the local hospital, a trip that would normally take 15 minutes took 3 hours.
"All the buildings were down and the streets were blocked with rubble," he recalled. Arriving at the hospital and seeing the scope of the destruction, Dr. Kanatli began reaching out to doctor colleagues over WhatsApp to organize emergency response. He set up a coordination center in a local park where people could access services.
"The first 3-4 days were visibly chaotic, without fuel, electricity, food, water and shelter," he said. Dr. Kanatli is on the board of the Hatay Medical Chamber, which covers all the doctors in the city, so they began coordinating with other groups to bring doctors, nurses, midwives, and mental health professionals into the coordination center.
"We implemented six mobile health units carrying one doctor, one nurse and one psychologist to reach out to the far villages. The population of the mountain villages increased significantly due to internal displacement after the earthquakes, which caused huge environmental and hygiene-related health problems. So, we conducted public and environmental health activities as well," he said.
"Direct Relief’s approach to support us in the long term is so unique. It’s been one-year, but the Direct Relief team still is with us and knowing that, feeling that, means so much to us. This support and ongoing communication have been strengthening us so much."
- Dr. Ali Kanatli, a primary care physician based in Hatay, Turkey
The group established six healthcare units inside containers, where health services continued.
When lack of access to sanitation caused outbreaks of skin diseases like scabies, Direct Relief mobilized personal care kits with hygiene items for distribution in temporary camps, he said.
"One of the most important needs that we did not have in the beginning was… emergency medical equipment to take care of our patients, as most of the primary health care centers were collapsed, hospitals as well, and the ones still operating were overloaded," he said."Direct Relief’s emergency medical backpacks saved our lives, actually saved our patients’ lives."
Currently, keeping health professionals housed locally is a need, as many have left the area due to unsafe housing conditions. Inconsistent power is also a challenge to local health services.
When asked what motivates him to this work every day, "support and solidarity by both individuals and organizations, like Direct Relief," he said. "We feel like that we are a part of a very big family with this solidarity."
In Turkey
Healthcare facilities and organizations in Turkey that have received medical goods include:
- Turkey's Ministry of Health
- AKUT Search and Rescue
- Ahbap Dernegi
- Adana Metropolitan Municipality
- Ankara Metropolitan Municipality
- Istanbul Metropolitan Municipality
In Depth
In Syria
Healthcare facilities and organizations in Syria that have received medical goods include:
- Syrian American Medical Society
- Syrian Relief and Development
- Independent Doctor's Association
Direct Financial assistance
Thanks to the outpouring of financial support from donors, Direct Relief continues providing cash assistance to help facilities and organizations effectively respond to the ongoing needs of patients impacted by the earthquakes.
To date, Direct Relief has identified, vetted, and awarded emergency financial support totaling $4,694,240 for groups responding to medical needs related to the earthquake. The organization has supported groups in Turkey with $1,530,000 in funding and groups in Syria with $3,164,240.
Financial Support for Response in Turkey
| Grant Recipient | Purpose of Funding | Amount |
|---|---|---|
| Emergency Medical Association of Turkey | Expanded mental health and psychosocial services for first responders, as well as disaster response training. | $650,000 |
| Turkish Medical Association | Purchased and transported container housing units for medical staff, stethoscopes, tablet computers and fuel so primary care services could continue. | $600,000 |
| Society of Critical Care Medicine | Emergency operating grant supported trauma care and delivery in Turkey. | $500,000 |
| Turkish Family Health and Planning | Strengthened sexual and reproductive health education and services. | $375,000 |
| HASUDER | Expanded reproductive and mobile healthcare services to women and children affected by the earthquake in the Hatay region. Translation services also reached Syrian refugees. | $305,596 |
| Hatay Medical Chamber | Supported primary care services, as well as rehabilitation and physical therapy services. | $195,000 |
| Psychiatric Association of Turkiye | Supported volunteer psychiatrists providing services for earthquake survivors, first responders, and health workers. | $175,000 |
| MedGlobal | Expanded critical care infrastructure for rehabilitation services. | $100,000 |
Turkish Midwives Association | Funded emergency operating expenses for midwifery care. | $100,000 |
| World Human Relief | Supported face-to-face psychological services to those impacted by the earthquakes, funded staff, and purchased modular units to house staff. | $100,000 |
| Turkish Society of Surgery of the Hand and Upper Extremity | Provided surgical services and a mobile rehabilitation suite for those injured or disabled by the earthquakes. | $100,000 |
| AKUT Search and Rescue Association | Supported urban search and rescue efforts, and field medic packs for triage care. | $100,000 |
| Association for Human Health and Education | Bolstered family public health screenings and mental health services and psychosocial support for children. | $100,000 |
| Turkish Society of Intensive Care | Purchased and transported container housing units for medical staff. | $50,000 |
| Ankara Medical Chamber | Established and equipped women's health center and van for mobile health screenings and referrals in Malatya Province. | $50,000 |
| Turkish Society of Nephrology - Renal Disaster Task Force | Purchased and transported container housing units for medical staff cycling into Adiyaman, Hatay, and Kahramanmaras to provide care for crush wounds and resulting kidney issues from acute traumas. | $34,000 |
| Total | $3,534,596 |
Financial Support for Response in Syria
A top priority of grantmaking in Syria focused on improving the operational capacity of local NGOs in Syria with warehousing improvements, repairing storage damaged by the earthquake, and improving inventory management systems so groups could coordinate aid to northwestern Syria most effectively. Grants also focused on strengthening health services and infrastructure weakened by more than a decade of civil war.
| Grant Recipient | Purpose of Funding | Amount |
|---|---|---|
| Syrian American Medical Society | Funded the procurement of medications and surgery supplies unavailable locally, along with customs clearance, and transportation costs. | $2,308,715 |
| Syria Relief and Development | Supported emergency operating costs, customs clearance, and transportation. Expanded medical warehousing capacity and purchased medical equipment. | $1,115,000 |
| Independent Doctor's Association | Bolstered emergency operating costs, warehousing and distribution of medical supplies, customs clearance, and transportation. Provided specialized education and training for healthcare staff, procured medical equipment and implemented health management systems. | $1,160,000 |
| Total | $4,583,715 |
Information Assistance
In addition to providing medical material and financial aid, Direct Relief has been a critical information supplier to key organizations involved in the response. Working with technology companies, academic institutions, and health providers, Direct Relief has used human mobility data, geospatial analysis, and other data collection and analytics instruments to help understand key issues.
Within Turkey, Direct Relief has focused mainly on understanding the scale of human displacement. Using data from Meta on change in population density and movement between places, linked to surveys on the needs of internally displaced persons, Direct Relief has shared nearly two dozen reports and analytical data feeds focused on population displacement with agencies ranging from AFAD to the World Food Program.
Corporate Support
Direct Relief was able to supply a large array of medical material support without the expenditure of donor funds due to the in-kind donations from healthcare manufacturers and distributors, many of which Direct Relief works with on an ongoing basis.
Healthcare company donors responded expansively to requests for their participation. Included among them are the following:
- AbbVie
- Accord Healthcare
- Amgen
- AmerisourceBergen
- Apotex
- AstraZeneca
- Baxter
- Bayer
- BD
- BioMarin
- BMS
- Boehringer Ingelheim
- Carlsbad Technology
- Corza Medical
- Edenbridge
- Eli Lilly & Co.
- Embecta
- Genmab
- Gilead
- Grifols
- GSK
- Haleon
- Henry Schein
- Hikma
- ICU Medical
- Integra Lifesciences
- Janssen
- Jazz Pharma
- J&J
- Kenvue
- Liquid IV
- McKesson
- Medline
- Merck & Co.
- Pfizer
- Sandoz
- Takeda
- Teva (Turkey)
- Ultragenyx
- Unilever
- Unite to Light
- Vertex
- Viatris
- Westminster
Direct Relief also received financial support through other companies and campaigns, including the Bungie Foundation, FedEx, Humble Bundle, Pubity, TE Connectivity, and Yardi Systems, among others.
Looking Forward
With the amount of infrastructure damage and displacement of people still significant one year later, true recovery from the earthquake's damage will likely be decades-long. As this phase continues, Direct Relief remains committed to providing support to strengthen local health systems, as well as focus areas in Turkey and Syria.
Those areas of focus include access to oncology care, maternal health and reproductive health services, rehabilitation, recovery of the primary healthcare system, maintaining the cold chain and power systems at the primary healthcare level, improving the well-being of healthcare providers, and support of medical aid and funding for mobile health units for internally displaced people, including Syrian refugees in Turkey.
Supporting first responders
In the year since the quakes, Direct Relief facilitated several trainings for first responders. At the World Intensive and Critical Care Congress, doctors from Syria and Turkey were invited to Istanbul, Turkey, to be equipped with new skills and professional support as they face emergency situations. Doctors in Turkey from various professional societies, including those from earthquake-affected cities, also attended with Direct Relief’s assistance.
In total, Direct Relief provided funding for 182 doctors, including 29 from northwest Syria and 153 from Turkey, to attend the training, where hundreds of healthcare professionals from various countries gathered. The training focused on emergency and essential critical care, an approach that helps decrease mortality by detecting patients who are critically ill.
Strengthening primary healthcare centers with container housing: 58 primary health centers in Hatay collapsed or were highly damaged (out of service) and are operating inside containers. As the main responsibility to maintain the needed medical equipment remained on primary healthcare doctors who were also EQ-survivors; Direct Relief supported Hatay Medical Chamber and Turkish Medical Association to procure the essential medical equipment needed for these primary health centers. Medical staff who lost housing are also using Direct Relief-funded containers.
Access to reproductive and maternal care, as well as mental health services: In Turkey and Syria, Direct Relief is focused on increasing and supporting maternal and reproductive healthcare services, mobile health services, and sustaining primary care access. Direct Relief has supported HASUDER's women's health and reproductive service unit, which provides health services and screenings, counseling, and personal care and family planning items for people displaced by the earthquake.
Supporting access to psychosocial services for those affected by the earthquake, including health workers, also remains a priority. One example of support includes the Turkish Psychiatric Association, which deploys volunteer psychiatrists to earthquake-impacted areas to provide psychosocial services for survivors and first responders.
As the response continues, Direct Relief remains able to provide support as a result of its existing strong relationships with non-governmental organizations that were already receiving Direct Relief medical product shipments, ongoing work with clinical experts in the field to guide distribution and procurement decisions, existing partnerships and contracts in place to quickly request and receive high-quality medications from pharmaceutical manufacturers and distributors, and a strong track record of shipping large volumes of product, including those requiring cold chain packaging and storage, to difficult-to-access places to reach the most vulnerable patients.
Direct Relief is focusing on these areas for long-term recovery by directing funding and medical product support for the continued strengthening of the health system.
