Syrians Face “Crush Syndrome” Following Earthquake

More than 100 cases of crush syndrome have been reported in opposition-controlled parts of northwestern Syria in the Idlib region following the devastating earthquake that struck the region last month.

Crush syndrome, or traumatic rhabdomyolysis, is a condition in which skeletal muscle cells in the extremities are destroyed by external compression, causing the contents of the fibres to escape and spread. It also causes severe pain.

“The muscle prevents blood circulation from flowing to its fibres when it’s exposed to pressure for hours or days,” explained Hassan Hammoud, a vascular surgeon at SAMS Hospital in Idlib city. “In which case, it will release a protein called rhabdomyoglobin and cellular potassium causing kidney failures.”

Hammoud told IWPR that the patient’s wound needed to be cleaned frequently, with infection and dead tissue cleared away. The lack of hemoglobin and ongoing electrolyte disorder had to be dealt with, and the patient seen by both vascular and orthopedic surgery specialists.

“Some of the injured, despite all the procedures we follow, have to have one of their limbs amputated to save their lives,” Hammoud said.

The issue was highlighted on February 23 when local authorities in northern Syria transferred nine-year-old Sham al-Sheikh Muhammad and her 15-year-old brother Omar to Turkey to receive medical treatment after both were diagnosed with crush syndrome.

The case of Sham, who spent 40 hours under the rubble after her house collapsed, received widespread media coverage.  

However many other cases, doctors warned, were not getting the attention they needed due to the poor facilities in Idlib and difficulty accessing medical care across the border in Turkey.

Hospitals suffer from a shortage of medical supplies and equipment across all specialties, due to a long-term lack of humanitarian aid.  Following the earthquake that struck parts of Syria and Turkey on February 6, Ankara’s closure of border crossings put extra pressure on local medical services.

“The region needs to increase intensive care beds and ventilators, in addition to the dialysis machines and disposables that it requires,” said Idlib health director Zuhair Kharrat. He described unprecedented pressure on dialysis services, not least because transferring patients for treatment following the earthquake was a great challenge due to the lack of ambulances.

The doctor estimated that Idlib health services were dealing with more than 100 cases of crush syndrome, although there was no accurate data available.  

“Previously, when there were a large number of injuries, we used to rely on the transfer of critical injuries and those unable to treat them to Turkey to receive treatment in Turkish hospitals, but now the borders are closed to medical cases,” he continued.  

The Turkish authorities have not issued any statement clarifying when the crossings with northwestern Syria will be fully reopened