Turkey: what UNICEF is doing Update 16 Dec 1999

When the earth shook
Twice within three months, on 17 August and 12 November 1999, massive earthquakes rumbled beneath the northwestern region of Turkey, causing widespread death and destruction in the nation's heartland of industry and population.

The exact number of deaths is unknown, but the Turkish authorities report that over 18,100 people were killed and 49,000 people injured as a result of the earthquakes.

Although UNICEF and dozens of other relief organizations responded quickly to the disasters, the road to recovery has been littered with the unsettling and sometimes destructive aftershocks. At least 1,268 aftershocks have been reported since August 1999, an average of 12 per day.

The towns of Bolu, Duzce, Kaynasli, Izmit, Golcuk, Adapazari and Yalova were the hardest hit. Over 700,000 people were living in these cities at the time of the first quake.

Conditions Now

It is estimated that 200,000 people are currently housed in approximately 130 tented camps and prefabricated cities in the affected areas. As of 30 November 1999, a total of 10,960 prefab houses had been built, of which 4,283 have been handed over to families for resettlement (about 20,000 people). As the construction of prefab houses continues, people are continuously being transferred from tented camps.

On 25 November the first heavy snowfall of the year was reported in Bolu Province. Freezing temperatures, snow and heavy rains are considerably worsening the living conditions of the homeless in affected areas. With temperatures dropping to minus 8 Centigrade, the Turkish authorities still report a critical need for winterized tents.

The UNICEF Response

In consultation with the Government of Turkey, UNICEF developed a Recovery Plan for Turkish Children to immediately address the needs of children and women affected by the earthquakes. Valued at US $14.2 million, the plan includes programs in health, nutrition, education, water & sanitation, and psychosocial recovery.

In the early days of the disaster, UNICEF rushed basic relief items to the affected areas. Supplies included medicines and vaccines, blankets and tents, community water tanks and family water jugs, water purification tablets, and much more. Most of the hundreds of winterized tents provided by UNICEF are still being used as medical centers, classrooms, and play areas for children.

In fact, one of UNICEF's highest priorities has been to create a friendly environment for children and their mothers in the tented camps and prefab cities, using the concept of "Child Friendly Space." A child friendly space is a specially located and outfitted play room that gives children a place to relieve stress and escape from the rigors of the disaster scene, even if just for a few hours. These facilities, which UNICEF pioneered in the Kosovo crisis, also give UNICEF a location in which to offer an integrated set of services that address the basic needs of children and their mothers, such as psychosocial counselling.

In addition to relief activities, UNICEF has focused on rehabilitation efforts and is actively advocating with government counterparts and humanitarian partners to ensure that all basic services are restored for the affected populations.

To that end, UNICEF's relief and recovery plan was designed for a period of 6 months and is being implemented in all the affected areas. UNICEF has established a strong field presence, with over 16 staff and scores of volunteers deployed in the affected areas.

Relief Activities

Tent Cities

UNICEF has played a central role in providing supplies and technical guidance for many of the tent cities that have been created to temporarily house the thousands of people who lost their homes. Following the 12 November earthquake in Bolu Province, for example, UNICEF established a camp of 161 winterized tents in Kaynasli, a town of 8,000 inhabitants in which 90% of all structures were damaged. This tented camp was established on the basis of the Child Friendly Environment concept. It also benefited from the cumulative experience acquired by UNICEF during 3 months of operation in the provinces affected by the 12 August earthquake, such as the importance of ground leveling and gravel surfacing of the site, proper flooring, construction of storm drainage, and fire safety stations.

On 29 November 1999, the daily Turkish newspaper Sabah referred to UNICEF's tent cities as "an exemplary place to live in". The camp in Kaynasli is serving 742 people and offers water, sanitation, education and health facilities, in addition to a Child Friendly Space where children and mothers are provided with psychosocial support. UNICEF also provided generators, blankets, stoves, plastic sheeting, sleeping bags, and wooden pallets to benefit most families of the camp. UNICEF is cooperating with the Ministry of Health and National Education, the Department of Social Welfare and Child Protection (SHCEK), the French Red Cross, the Turkish Psychological Association (TPA) and Caritas in providing services in Kaynasli.

Water and Sanitation

UNICEF interventions in this sector aim at providing safe drinking water and sanitation facilities in tented camps and prefab cities. To date, 15 water tankers, six of which operate around the clock, are on the job in Adapazari Province and continue providing safe drinking water to over 100,000 people daily. UNICEF has also supplied nearly 3 million water purification tablets in the affected provinces.

In addition, UNICEF has installed 12 water and sanitation clusters to benefit 7,200 people in 12 tent camps in Bolu, Kocaeli, Sakarya, and Yalova provinces. A cluster benefits 600 people and offers 12 latrines, 10 hot water showers, 2 water tanks, and 2 septic tanks. An additional 36 clusters have been ordered and are being manufactured for tented camps, prefab cities, and schools.

As of 1 December 1999, US$ 2.56 million worth of equipment and materials have been distributed in Bolu, Kocaeli, Sakarya, and Yalova provinces to support water and sanitation interventions.

Health and Nutrition

UNICEF work in this sector focuses on the following areas: an Expanded Programme of Immunization (EPI), nutritional surveys and support, and revitalization of health centres.

EPI: Following a contained outbreaks of nine cases of measles in Golcuk area - six among children older than five years - the Ministry of Health agreed to extend the UNICEF vaccination programme to all children under 15 years of age. Altogether, the EPI targets 500,000 children from 9 months to 15 years of age. UNICEF has so far supplied 500,000 doses of measles vaccines and 500,000 syringes. To date, a total of 134,500 children have been immunised in Izmit, Sakarya, Golcuk and Yalova.

Nutritional Surveillance and Intervention Programme: A nutrition study carried out by Haccetepe University, the Health Ministry and UNICEF in October 1999 indicated that 17.2 % of pre-primary school children were chronically malnourished. In comparison, the Demographic and Health Study conducted in the Western regions of Turkey in 1998 indicated that 9.9 % of pre-school children were chronically malnourished. The study also showed that 11.5% of pre-primary school children were underweight in October 1999, against 3.8% reported in the DHS in 1998 for the same areas. The study finally indicated that 3.8% of pre-primary school children were acutely malnourished (wasted), against 2% reported in the western part of Turkey in the 1998 Health and Demographic Study.

As an explanation, the study points to the physical and psychological stress on the earthquake victims as one of the probable causes of malnutrition. Indeed, although the lack of food intake is the conspicuous cause of malnutrition, there is a possible correlation between the trauma experienced by children during the earthquakes and their nutritional status.

Within the framework of the Recovery Plan for Turkish Children, UNICEF and its partners are addressing the nutrition problems through a combination of psychosocial interventions and more traditional nutrition interventions. The former aims at decreasing the psychological negative after-effects of the earthquakes on children, adolescents, parents and teachers to contribute, among other things, to a renewal of appetite among affected population. This includes the distribution of supplementary food to benefit 150,000 children and pregnant/lactating mothers; interventions for growth monitoring and promotion; nutrition education; nutrition surveys; and control of daily diets and food hygiene in the tent cities.

On 29 November 1999, the first consignment of 40 metric tons of high protein biscuits out of an order of 900 tons was delivered in Izmit. Distribution through 79 schools for 37,800 students, and in health facilities for 8,600 pregnant and lactating mothers, started the following day in Yalova and Kocaeli provinces.

In the following weeks, the food supplement programme will extend to 150,000 children and pregnant/lactating mothers in all affected areas for a period of 5 months. The supplementary feeding programme is implemented together with MoH and covers approximately 33% of the daily need of children and pregnant/lactating mothers in terms of proteins, vitamins and minerals.

Revitalization of Health Centres: A total of 525 emergency health kits have been distributed in the affected provinces. In terms of essential drugs, the kits cover the needs of 550,000 persons for three months. In addition, refresher training seminars for health staff were organized in Yalova, Golcuk, Izmit, and Sakarya and benefited 1,350 health workers.

UNICEF programs in education are aimed at providing affected schools with educational and recreational materials and distributing supplementary food through. Over the past fortnight, activities mainly concentrated on the identification of teachers' and pupils' needs and the establishment of a distribution plan for educational, recreational and nutritional supplies in all affected provinces.

School Survey

In Yalova province, all primary schools will be repaired by the end of the year. The number of students in Yalova primary schools before the earthquake was 23,329. With the exception of kindergartens for children aged 3 to 6 years, most students of the province are back in schools.

In Kocaeli province, there is still a tremendous shortage of school buildings, especially in Golcuk areas. All schools are operating on a shift system. Less than half of the 198,942 students registered prior to the earthquakes are currently attending schools. Pre-school classes are operating in some of the districts with significantly reduced numbers of children. Some 24 prefabricated schools of 12 classrooms each have been completed and will accommodate 8,640 children. Teachers and students, however, are fearful of entering school buildings. A group of students interviewed explained that they do not attend schools when their lessons are on the third floor of the building.

In Adapazari Province, schools initially reopened on 11 October 1999, but close again following the 12 November earthquake. Nearly a third of the school buildings reported some damage after the first earthquake. Assessments of damaged school buildings are now redone, and schools remain officially closed.

In Bolu province, a government plan would reopen schools sometime in December. Although only 1 primary school was damaged in Bolu town, the psychological damage is immense. In Kaynasli, 3 of the 7 primary schools were destroyed, and in Duzce 15 schools are unusable with an additional 6 that need major repair work. A total of 16 pre-fabricated schools to accommodate 5,760 students are already planned. The number of teachers in the area is still unclear. Several headmasters and teachers have expressed their dilemma of wanting to move away from the area for the sake of their families, but on the other hand they feel obligated to stay.

Supply of School Materials

UNICEF is preparing to distribute 1,700 educational, recreational and pre-school kits to benefit 76,000 students in Bolu, Kocaeli, Sakarya, and Yalova provinces. Distribution to schools will start mid-December 1999. Distribution plans for Kocaeli and Yalova provinces have already been developed together with MoNE, and will benefit 26,019 students in 66 schools. Distribution plans for Bolu and Sakarya provinces are still under preparation. To date, 19 basic educational kits have been distributed in tented camps.


The School Project

This project consists of three phases and is being implemented by UNICEF and the government. The first phase consisted in the training of 65 experts, psychologists, psychiatrists, and school counselors on debriefing techniques. During the second phase, 289 school counselors in the affected areas were trained in debriefing techniques. In turn, the counselors trained 6,689 teachers. The debriefing of teachers is crucial, as it is believed that a teacher who himself is deeply traumatised and left on his own to recover, will not function at his or here best as a teacher - simply because he or she is too busy to cope with his own trauma.

The project has already entered its third phase with the training of 188 professionals and academicians on classroom interventions, which took place in Ankara and Istanbul from 17 to 25 November. Among trainees, 42 were Ankara-based professionals, 28 school principals, 85 guidance counselors, and 33 psychologists. An expert from the Boston Trauma Centre conducted the training. The third phase aims at accelerating normal recovery in 240,000 children who have survived the earthquakes, and who are having normal traumatic stress reactions to an abnormally stressful event. This phase will be based on classroom interventions in selected schools in affected.

For more information on UNICEF, visit its website at http://www.unicef.org