Earthquake

The news, and the scenes, from Turkey and Syria are horrific. There's nothing more to be said about that except that the response of the world community is heartening. It does remind us that the planet is knit together as it has never been before.

But it's necessary, and I don't think it's crass, to talk about the complexities from a public health perspective. If you've seen video of those multi-story apartment buildings collapsing like houses of cards, you'll know why the death toll is so high. This was a very powerful earthquake, but if it happened in, say, Los Angeles, which is far more densely populated and has thousands of buildings as tall or much taller, the toll would be far smaller. 

It is obvious from the video that those buildings were unreinforced masonry. In fact, as far as I could tell, they had no framing at all. They were just piles of cinderblocks, apart from floor joists and lintels over the doors and windows, which afforded no structural value. I understand that Turkey instituted modern building codes in the 1990s, but one suspects they aren't rigorously enforced and in any case, there was no retrofit of older buildings. 

The dilemma should be obvious. In a wealthy country like the U.S., we can afford to require that buildings be expensive. We tend not to get around to it until after a big disaster -- Florida building codes became much more stringent, and better enforced, after Hurricane Andrew, and as we have recently seen, a lot of older buildings are still getting wiped out by hurricanes. (Obviously, even some newer buildings couldn't stand up to 8 feet of storm surge, but building quality still makes a big difference in many cases.) 

But this makes housing much more expensive. In a low income region, requiring that buildings be earthquake resistant would mean that most people wouldn't be able to afford housing at all. Earthquake sin the past two decades in Haiti and Pakistan have been similarly devastating, for the same reason -- lots of unreinforced masonry construction. In the case of Haiti, the problem goes back even farther, to deforestation. Even the most basic wood framed house is far less vulnerable to an earthquake. So as always, the poor are far more vulnerable. But the authorities in such places don't have any easy solution. If people just don't have enough, there's no way out.