It has been three weeks since Tuğçe Seren Gül's aunt and grandmother were killed in Antakya when a devastating earthquake struck Türkiye's southeast. And yet every night, she waits until 4.17 am in the morning, the exact time that the disaster hit, to try to go to sleep.
"I keep thinking another disaster will strike at that time and just wait for it to pass," said Gül, 28, who managed to run out of her family house with her mother moments before the walls of her house collapsed during the tremors.
After reaching the street barefoot, Gül saw the dead bodies of neighbours killed by falling concrete. She remembers the screams of people trapped in collapsed buildings.
Gül said the horror had put a heavy toll on the mental health of survivors who "lost everything" in the city of Antakya, which was devastated by the quake. She wants to one day seek professional help to address the trauma, but for now establishing a new life for herself and her family is the only priority.
The 7.8 earthquake magnitude earthquake, the most deadly in modern Türkiye's history, will have a deep psychological impact, experts and officials say. More than 44,300 people died in the country and over 1.5 million were left homeless in freezing conditions. Millions have lost family members, jobs, life savings and their hopes for the future.
CHILDREN AT RISK
Experts fear children will be hardest hit. The United Nations International Children's Emergency Fund (UNICEF) said many of the more than 5.4 million children who live across the quake zone were at risk of developing anxiety, depression and post-traumatic stress disorder.
"We know how important learning and routine is for children and their recovery," UNICEF Regional Director for Europe and Central Asia Afshan Khan said, after a visit to Türkiye.
"They need to be able to resume their education, and they urgently need psychosocial support to help deal with the trauma they have experienced."
At a large camp for displaced people next to Hatay Stadium on the outskirts of Antakya, psychosocial support teams have set up small play areas and pitched tents filled with toys. Children sat on multicolored chairs in front of a large portable screen that played cartoons. Some children played hopscotch.
Mehmet Sarı, a government psychosocial support worker, said he and others in his team have picked up signs of trauma in kids. "We see that some children can't sleep, others can't eat, others have flashbacks and wet their beds," he told Reuters.
They need long-term support to recover from trauma, he said.
Türkiye's Ministry of Family and Social Services said it has dispatched more than 3,700 social workers to support the survivors across the quake zone.
Volunteers with Izmir-based group Sokak Sanatları Atölyesi dress in Superman and clown costumes and run activities for children living in tents at a shelter in Hatay province.
But a large 6.4 magnitude earthquake last Monday shattered efforts to give the children some feeling of normalcy amid weeks of terrifying after shocks.
A video provided by Erdal Çoban, one of the volunteers and the art director of the Sokak Atölyesi, shows the children's cheers and singing turn to screaming.
"Stay calm," one yelled as another held onto a toddler she was carrying.
"CONSTANT, CHRONIC STRESS"
Turkish people had already been under significant pressure, said Ayşe Bilge Selçuk, a professor and psychologist at Koç University, due to the impact of the COVID-19 pandemic. Now the earthquake has taken it to the next level.
"The stress is chronic and constant and it is now beyond a level that we can cope with," Selçuk said. "For this nation to get back on its feet, we need to find that strength within us and that starts with our psychology," she added.
People look numb, likely a defense mechanism to deal with insurmountable stress, according to Selçuk. Anxiety, helplessness and depression are likely to be common and young people could feel a sense of rage.
Rebuilding efforts should include mental health, Selçuk said, urging the government to provide funding for trained psychologists to be sent to the quake zone and stay there. "Sustainability is key. We shouldn't withdraw our attention three months later," she said.
