Health needs top priority after Albania’s devastating quake

During the evening of November 25, Piro, a young architect from Tirana, Albania, had just finished setting up the Christmas tree at his home. "I fixed it firmly so it could survive an earthquake," he joked with his fiancée. A few hours later, just before dawn, a massive jolt shook their building. The strong 6.4 magnitude earthquake that struck Western Albania lasted for nearly 30 seconds.

Thousands of people displaced and sheltered

Like Piro, many Albanians rushed out from their homes in the middle of the night. Many were in fear, often without any belongings.

Along with hundreds of citizens of Durrës, a city that was profoundly affected by the disaster, Besnik Biduli, 71, headed to the central square immediately after the quake. After first responders arrived and a doctor had examined him, Besnik was transferred to a temporary shelter organized by the government. He was later accommodated in one of the hotels where he has now been staying for ten days. Besnik is one of around 12 000 displaced persons in Albania waiting for a construction inspection of their homes, each of which prays that their home will soon be safe enough to return to.

Emergency response: saving lives and protecting people in need

On the day of the earthquake, Albania activated the national Civil Protection Mechanism, thereby mobilizing all national and subnational response agencies. "The earthquake has taken 51 lives so far and rescue teams have saved 49 people. Rescuing people and supporting the families who lost their beloved ones were the top priorities of the government in the first days of the response," says Rovena Voda, the emergency coordinator, under the Deputy Minister of the Interior, in Durrës.

Authorities are dealing with the next phase of the emergency by assessing damage and taking care of those affected. Health care is one of their key priorities, together with housing and schools. "Respecting human rights means treating people with dignity and trying to give them the best we can," Mrs Voda emphasizes. Along with accommodating displaced urban people in hotels and providing shelter for those living in affected villages, the Albanian government immediately deployed health workers to the hotels and shelters. Primary health care centres switched to 24/7 operational mode to avoid any interruptions in health care service provision, and sanitary and disinfection measures were put in place to prevent potential infectious diseases from spreading in temporary residential facilities.

Also in Durrës, Dr Florinda Beu from Durrës took her children away from the city after the quake and now covers twelve-hour shifts at the medical post in the hotel which houses displaced people. "We provide first aid, give medicines to patients with chronic conditions, such as hypertension and diabetes, and treat gastroenterological diseases," says Dr Beu. Medical posts refer patients with severe diseases to local hospitals. After talking to the WHO supporting team, Dr Beu asked a psychiatrist to see one of her female patients that was suffering from acute stress disorder.

Coping with stress and anxiety is often challenging for survivors of disaster. Many adults and children experience emotional pain, grief and fear after experiencing an earthquake. The Albanian Association of Psychologists has mobilized dozens of professionals to provide psycho-social support to people in need, but the demand for such services continually increases.

WHO works on the ground to cope with the disaster's aftermath and support recovery efforts. This includes working with Albania's authorities to assess health needs in the aftermath of the earthquake. At this stage, a thorough examination of the disaster's impact on health infrastructure and health systems is crucial. This is essential for developing a cost-effective and inclusive recovery plan.

"The aftermath of an earthquake is a critical time of the response as we need to prioritize saving lives from trauma and injuries from building collapse, and continue to provide access to health services, including treatment for chronic conditions and vaccinations for those in need,” explains Dr Raul Gonzalez-Montero, WHO Representative in Albania. “Therefore, the health system needs to adapt to these exceptional circumstances by shifting priorities, and repurposing facilities and personnel, focusing on primary health care. We are working as one with the Albanian health authorities to support this phase in the most effective way.”

Through its support to the people of Albania, WHO has identified key priorities for reinforcing the country's health system in the following areas:

Emergency care system: supply of lifesaving medical equipment, and training the health care workforce;

Mental health and psycho-social support for affected communities;

Post-Disaster Needs Assessment (PDNA): assessment of damaged health care infrastructure and technical support in identifying and filling gaps in service provision; and

Building Back Better: restoring and strengthening the resilience of the health system and communities to better manage future disasters and their health risks.

Nearly two weeks after the earthquake, Albania's government reported that over 900 buildings in Durrës and approximately 1500 in Tirana had "serious damages". Over 20 were deemed uninhabitable in Durrës and in Thumana village and were demolished. Assessment in all of the affected counties, including Thumane, Kruje, Lezhe and Scutari, is ongoing. The country's officials have called on the international community for financial and expert assistance to ensure the prompt recovery of housing and infrastructure, and to enable people to get back to their lives.

"We witnessed the excellent work done by the government and the Ministry of Health and Social Protection of Albania during this emergency response," continues Dr González. "However, we need the attention and the support of the entire national and international donor community to recognize the needs of affected Albanians and help in their recovery. We will continue our work hand-in-hand with the Ministry of Health until everyone’s health has been cared for and no one is left behind."

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Written by: Ana Borshchevska for WHO Europe