On the morning of Feb. 6, Brigham emergency medicine physician Morgan Broccoli, MD, MSc, woke to the news that a 7.8-magnitude earthquake had hit Turkey and northwestern Syria. By noon, she was exchanging texts with other members of Team Rubicon, the humanitarian organization she has been involved with since 2021. A team was mobilizing, and they wanted to know if she could join.
Broccoli immediately replied: Yes. She had experience volunteering in Haiti after the 2021 earthquake and in Poland last year during Russia’s invasion of Ukraine. She also happened to be off for two days and had supportive colleagues in the Brigham’s Emergency Department who helped cover her six upcoming shifts. “Everyone in my department was amazing,” she said. “I was on a plane by 6 p.m. that same night.”
Remote Support Activated
As Broccoli headed to Turkey, several of her Brigham colleagues heeded the call to help in other ways.
“Coordination of humanitarian response efforts is complex,” explained Sean Kivlehan, MD, MPH, emergency medicine physician and director of the Emergency Health Systems Program at the Harvard Humanitarian Initiative (HHI). “On-the-ground personnel are needed to offer immediate aid, forge relationships and provide direct situational awareness while collecting key data. Remote support is important because it connects the various on-the-ground actors to ensure coordination and planning, and allows for the rapid aggregation and dissemination of data.”
As HHI’s representative to the World Health Organization’s (WHO) Global Health Cluster based in Geneva, Kivlehan works to strengthen all aspects of humanitarian response, particularly within the health sector. After the Turkey-Syria earthquake, the Health Cluster focused on sharing and analyzing data, as well as connecting health experts and partners in their networks to address urgent needs.
One of those experts was Brigham endocrinologist M. Furkan Burak, MD, who had both personal and professional ties to the country. In addition to being a native of Turkey, he served as ambassador to the U.S. for Turkey’s Ministry of Health (MoH). When the earthquake hit, Burak was devastated. “First, this is a humanitarian crisis. And second, I’m Turkish, so there I was, thousands of miles away from my country and my people. I felt helpless.”
Advised by his friends and colleagues in Turkey not to come, Burak made the difficult decision to stay in Boston, where he leveraged his connections to serve as a local coordinator between Turkey’s MoH and the Turkish Consulate General in Boston. Providing support remotely, Burak connected with HHI and other contacts to distribute Turkey’s list of urgent health needs and ensure the right supplies were delivered to the right place as efficiently as possible.
Assessing the Needs
Broccoli and colleagues were some of the first to arrive in Turkey, where they found the country’s government requesting type 2 and 3 emergency medical teams (EMTs), which have surgical capacity as classified by the WHO, as part of their focus on the search-and-rescue effort. Team Rubicon is considered a type 1-mobile EMT, approved only to provide outpatient emergency and primary care.
“I found it remarkable that the entire world seemed to be in Turkey, wanting to help,” she said. “There were urban search-and-rescue teams from all over the world. There were also many non-governmental organizations waiting just outside the affected area to assist with medical, logistics and water, as well as sanitation and hygiene needs.”
Broccoli spent two weeks in the southern Turkish city of Adana, about 140 miles from the quake’s epicenter, where she provided the WHO with critical medical needs assessments. She attempted to travel to Syria to assist efforts there, but it was ultimately determined too unsafe. “I would have liked to do more, but the system was created for a reason,” she said.
That perspective resonated with Erica Nelson, MD, MPhil, MS, Brigham emergency medicine nocturnist and Team Rubicon’s deputy medical director, who supported Broccoli from the U.S.
“This is largely about rejecting a colonialist model of humanitarian aid,” she said. “We are not going to come in and tell you what you need, and we are not going to traverse your space without an invitation. The most effective response is when you support local infrastructure and local expertise.”
The day the earthquake struck, Nelson was putting in 60-hour weeks of clinical work in Navajo Nation through a partnership with the Indian Health Service. Even so, she managed to make time for all the backend work that is critical to any disaster response — advising on a variety of needs, including ethics, security, logistics and mobilization, and monitoring and evaluation.
Reflections in the Aftermath of Disaster
Now back at the Brigham, Broccoli, Nelson, Burak and Kivlehan have been reflecting on their recent experiences.
“Humanitarian crises, even with all of their tragedy, are remarkable for the good they bring out in society and are a reminder that while there is much work to be done, the desire to improve humanity is there,” Kivlehan said. “All of us humans are in this world together, and we need to work collectively to reduce suffering wherever it is found.”
Broccoli is currently involved in a large-scale trauma education project in Ukraine, and will continue seeking humanitarian response opportunities outside of the U.S. “While I enjoy helping offload the system in acute response, the more important work is to prepare countries to respond internally to their own disasters,” she said.
For Nelson’s part, she is now helping support a response to Cyclone Freddy in Malawi, working to support local health and WASH (water, sanitation and hygiene) infrastructure in Guatemala, and continuing to foster opportunities to build local capacity for disaster response.
Burak has a trip to Turkey planned in May, where he will visit the earthquake site and assess the mental and physical health needs of the area’s young people. He is also hoping the trip will help him further process his feelings. Since February, Burak has had flashbacks of carrying bodies after the 1999 İzmit earthquake, one of the country’s deadliest natural disasters.
“Witnessing that horrible scene as a child was what made me decide to be a doctor, because I didn’t want to feel helpless,” he said. “I know there are many things we will have to do in the days, weeks, months, years and decades ahead. We will be helpful.”