Public health advice in the aftermath of an earthquake

After an earthquake, there may be unpredictable aftershocks, landslides and fires. Aftershocks may occur immediately after the earthquake or after days, weeks or even months.

Stay informed by using official sources of information. Follow instructions from your local community and authorities. 

Check the condition of your dwelling. If you consider it unsafe, notify the authorities and go to a temporary shelter or stay with acquaintances or family members.

If you can, help injured and trapped persons and seek medical attention for them. If you are trained to do so, provide assistance.  

Don’t move seriously injured persons unless the surroundings are unsafe, and seek medical help.

If you need to access a hospital, check official sources to find out which hospitals are functioning. Keep in mind that those with serious injuries and urgent needs will be prioritized. Let health care workers know if you have any chronic medical conditions.

If you can, dress warmly and wear many layers instead of one warm one. Choose shoes with thick soles. Protect exposed skin: wear gloves, and protect your nose and ears with a hat, scarf or raised collar. Change out of wet clothes and into dry ones.

If you can, eat before going outside, preferably something high-calorie. Drink enough fluids, possibly warm. If you are staying outside for long periods, go inside to warm up at regular intervals, if it’s safe to do so.

Do simple exercises for hands or feet to increase blood circulation. Move your toes in the same way.

Do not touch metal or wear metal jewelry, which can freeze your skin on contact.

Hypothermia happens when your body temperature drops below 35C.

Signs of hypothermia are:

• shivering
• pale, cold and dry skin – skin and lips may be blue
• slurred speech
• slow breathing
• tiredness or confusion.

A baby with hypothermia may be:

• cold to touch and their skin may be red
• flaccid
• unusually quiet and sleepy and may refuse to feed.

First aid for hypothermia includes:

• moving the person indoors or somewhere sheltered as quickly as possible, if it’s safe to do so;
• removing any wet clothing, wrapping them in a blanket, sleeping bag or dry towel, and making sure their head is covered;
• giving them a warm non-alcoholic drink and, if they're fully awake, some sugary food like chocolate;
• keeping them awake by talking to them until help arrives; and
• making sure you or someone else stays with them.

Frostbite is damage to areas of the body due to exposure to low temperatures. Exposed areas of the skin, such as the nose, ears, cheeks, chin, fingers or toes, are most vulnerable.

Signs of frostbite are:

• white or grey-yellow patches of skin
• waxy skin that is hard to the touch
• numbing.

If you notice these symptoms, seek medical care immediately. Frostbite can cause serious harm to the body and severe cases can even lead to amputation.

DO NOT touch frostbitten areas of the body, rub the skin with snow, put the affected parts into hot water, or warm them next to a heater. This can lead to more damage.

If possible, carry your medicines in an emergency pack.

If you do not have your medicine, notify health authorities about your condition and the treatment you are following, so that you can continue treatment. 

If you have a chronic condition with acute complications (e.g. diabetes, hypertension, or a condition requiring dialysis) and cannot get access to your usual medicines, try to get to a health care facility as soon as possible. 

If you are in a vehicle when an earthquake occurs, pull over slowly, put on the emergency brake and switch off the engine. Keep your seat belt on until the earthquake has finished.

Once the worst of the earthquake is over, use your car radio to receive news about evacuation routes, rescue efforts, and instructions for people who are hurt or trapped.

When it is safe to begin driving again, watch for hazards created by the earthquake. Before taking refuge in a vehicle, assess it for any damage, and look for hazards in the surrounding area, such as damaged buildings and unstable trees.

If possible, keep roads clear for use by emergency vehicles.

If your fuel tank has been damaged or you can smell gasoline, exit the car immediately. It can become unsafe, catch fire or explode. You may also be at risk of carbon monoxide poisoning.

After an earthquake, the water from your tap may be contaminated with microorganisms.

Making sure water is safe is not always easy after an earthquake, but it is essential to keep you and your family healthy.

If you can, boil water before you use it for drinking, brushing teeth, cleaning wounds and food preparation to prevent the risk of waterborne diseases. After the water has reached a rolling boil, remove the pot or kettle from the heat and allow it to cool naturally. Do not add ice.

Keep the hot water away from children to avoid scalding. Cool and store all boiled water in a clean and covered container. This protects the water from re-contamination.

You can use tap water for other domestic purposes (e.g. cleaning, laundry) and personal hygiene (e.g. hand washing, bathing, showering).

If tap water or other local water sources are not available, use bottled water. Make sure that the bottled water you drink is properly sealed before you use it. Do not drink from the bottle if the seal is broken or twisted.

Handwashing with soap is important, especially before and during handling food
and after going to the toilet. To be effective, wash your hands for 40–60 seconds with (un-boiled) water and soap, or 20–30 seconds with alcohol-based hand rub, if available.

After an earthquake, there is a risk of illness from eating food that is contaminated. Unsafe food and water can cause diarrhoea, vomiting, stomach cramps, fever, aches and fatigue and can lead to serious illness.

Making sure food is safe is not always easy after an earthquake, but it is essential to keep you and your family healthy.  

If possible, follow this advice to make sure your food is safe.

• Do not leave cooked food outside the refrigerator for more than 2 hours. Throw away perishable and cooked foods that have not been refrigerated properly due to power outages.
• Plan when to eat different types of food. For example, eat perishable food first.
• Avoid eating food that shows signs of spoilage or has come in contact with contaminated water.
• Keep clean and use boiled or bottled water, if possible.

If there has been a power outage in your area, refrigerated or frozen food may not be safe to eat. After 4 hours of a power cut, the following apply.

• Products can become unsafe if they have been exposed to temperatures above 5C for more than 2 hours. Throw out all perishable foods in your fridge, such as meat, poultry, fish and leftovers.
• Throw out all items in your freezer once they have thawed or cook them, if they have been exposed to ambient temperature for more than 2 hours.
• Never eat food to determine if it is safe. If in doubt, throw it away.

In case you are unable to store, cook or reheat your food properly, keep a stock of pre-packaged, tinned or ready-to-eat food to eat, if possible.

Handwashing with soap is important, especially before and during handling food
and after going to the toilet. To be effective, you should wash your hands for 40–60
seconds with (un-boiled) water and soap, or 20–30 seconds with alcohol-based hand rub, if available.

Check children for injuries, and clean and cover any wounds. Seek medical help if they are injured. 

Keep children in a safe place away from debris. Ensure they are wearing protective clothing, such as shoes, long pants and a long-sleeved shirt when outside. Don’t let them play in areas with debris.

Show children how to wash their hands with water and soap or an alcohol-based hand rub, if available. Make sure they practice good hand hygiene to protect them from illness.

Talk to children, listen to them and encourage them to share and express their feelings.

Your body can make enough milk for your baby, even in stressful times. If you have stopped breastfeeding, it is possible to restart. If you can, try to breastfeed.

Breastmilk is the best quality food for babies. If you can, try to breastfeed.

To help your body to breastfeed:

• feed in different positions, and if it hurts, get help
• let your baby suckle as long and as often as possible.

To help your baby to breastfeed:

• start soon after birth
• have a lot of skin-to-skin-contact with your baby
• attach your baby to your breast with a wide-open mouth

• ask for support and encouragement
• avoid artificial teats and dummies
• if your baby is not feeding, express milk to keep milk production going

• offer your breasts whenever your baby is hungry
• gently squeeze your breasts to stimulate the milk flow.

An infodemic, with too much information including false or misleading information, can intensify during emergencies when people are unsure about what they need to do to protect themselves and those around them.  

It is important to get information, advice and guidance from official sources of information, such as your national and local health authority. Always check the source and analyze the content before sharing it with others. 

False or misleading information causes confusion and can lead to behaviours that can potentially harm health.