Two Turkish children wait to receive medication at a field hospital in Sakarya on Friday to help fight off outbreaks of disease    GALLERIES: A country lies shattered The story of a rescue VIDEO CNN's Jim Bittermann looks at construction problems that may have contributed to the high numbers of casualties in Turkey (Aug. 20) Windows Media 28K 80K CNN's Ben Wedeman reports that hope is fading in the efforts to save those trapped (Aug. 20) Windows Media 28K 80K INTERACTIVE: Chronology of major earthquakes over the last 20 years MESSAGE BOARDS: Turkey Quake RELATED AUDIO Click here to listen to reactions to the earthquake in Turkey

August 21, 1999
Web posted at: 4:06 a.m. EDT (0806 GMT)

In this story: Miraculous rescues bring flashes of hope Construction 'absolutely inadequate' Rescuers echo Turks' complaints RELATED STORIES, SITES

IZMIT, Turkey (CNN) -- As the death toll from Turkey's devastating earthquake climbed above 10,000, rescue workers warned that a lack of clean water and toilets could spread disease and drive the death toll even higher.

Four days after the 7.4 earthquake struck, the Turkish Crisis Center in Ankara said the death toll had risen to l0,059, and government sources told a Turkish newspaper they feared the death toll could rise to 20,000. More than 45,000 were injured and thousands were still missing.

Medical teams on were immunizing rescue workers against typhoid and warning of health dangers as more bodies were pulled from the rubble. Smashed sewage lines and the thousands of homeless living on garbage-strewn streets without portable toilets or fresh water compounded the risk of cholera and other infectious diseases.

Officials in the hard hit port city of Golcuk have decided to quarantine parts of the city to avoid the spread of disease.

Rescue officials said in Yalova there was no drinkable water; in Izmit and Bursa, medicines, milk and food were the biggest needs; and in Golcuk, calls were made for medicines, especially antibiotics. With temperatures soaring in the 90s and corpses piling up, rescue crews wore surgical masks to fend off the overbearing stench.

Frank Donaghue of the Red Cross said a team of doctors stopped him Friday and pleaded for vaccines to treat 600 people. He said he had seen people drinking water from broken sewers.

The prime minister's crisis office said medical teams had begun picking up garbage, spraying disinfectants and distributing water purification tablets.

"There are many people, animals and food under the debris," said Health Ministry official Rifat Kose. "An epidemic could occur as they decay, but we are taking necessary measures."

But the World Health Organization in Geneva on Friday called the health risk from unburied cadavers "negligible," saying resources were better spent on providing portable toilets and clean water and monitoring for outbreaks.

Three days after the quake flattened densely-populated cities along the Sea of Marmara, rescuers began writing off the missing for dead. But a few stories of survival brought flashes of joy to stunned and grieving residents.

A three-year-old girl was pulled from a collapsed house in the hard-hit Izmit region on Friday, after being trapped for 75 hours. Turkish emergency workers heard a voice in the rubble and summoned Hungarian specialists with dogs who pinpointed the girl's location. After five hours of digging, rescuers plucked her to safety.

A few miles away, a team of Russian rescuers saved a 16-year-old girl in Golcuk.

Austrians pulled a 39-year-old man from a collapsed building in Cinarcik 85 hours after the quake. The man had heard his brother's voice and shouted: "Big brother, I'm here," attracting the rescue team's attention.

But despite scattered miracles, rescuers said Friday that those still trapped beneath the rubble are most likely dead.

Turkey is no stranger to earthquakes: In the worst, 60 years ago, more than 30,000 people died. But Turkish officials said Friday the death toll from this quake could top that long-ago catastrophe.

As many as 1 million people camped outdoors for fear of more destruction, with a Friday morning aftershock unnerving many.

Peter Yanev, an engineering consultant, said the Turkish quake was worse than any in the past 15 years -- including ones in Mexico City in 1985, in Armenia in 1988 and in San Francisco in 1989.

A combination of a powerful quake striking before dawn, construction techniques Yanev called "absolutely inadequate" and the region's soft soil combined to produce the widespread devastation and rapidly climbing death toll.

"Here we have literally hundreds and hundreds of buildings in the middle of the night, full of people sleeping. So I think the death toll ultimately will be much larger than it appears to be today," Yanev said.

Residents of the hardest-hit area -- an industrial belt east of Istanbul -- complained that the reaction of the Turkish government has been sluggish at best and mostly futile.

In Golcuk, home of a major Turkish naval base, would-be rescuers say they expect to remove only corpses from now on. Golcuk's mayor estimated at least 10,000 of his people remained unaccounted for on Friday.

But there is not enough heavy lifting equipment to go around, and many survivors are left to desperately sift through the rubble of what were once their homes in the faint hope of saving loved ones trapped inside.

At one apartment complex in Izmit, four of the six buildings -- built only a year ago -- collapsed. Neighbors and relatives poured into the site on Friday, bringing whatever tools they could find as they tried to reach survivors. But there were no experts, they complained, and no professional rescue teams nor any government officials had shown up.

"If there was a military official or a high level person lying here, they would have rescue teams. But here, we are only citizens, digging alone," one man said.

An Istanbul man who came to Izmit to help find family members said someone should be held accountable for the damage.

"Whichever official gave permission to this project is responsible. These people want those responsible to be taken to court," he said.

A Turkish family grieves over the loss of their children, whom rescuers found underneath the rubble of a housing complex they lived in for only a month

A Turkish government spokesman defended the government's efforts on Friday, telling CNN, "The magnitude of the disaster is beyond all imagination."

Sukru Sina Gurel added, "Such criticism is based on very right concerns." But with tens of thousands of buildings destroyed, 20 million people affected -- and thousands of public employees among them -- "This is beyond the capability of any government in the world.

"It would have been much easier had the tragedy been concentrated in one center, one urban center. There are several urban centers, and it's an area of industrial activity, and it's a densely populated area.

"Therefore, it was very hard to actually mobilize emergency measures, at least during the first two days."

But some international rescuers have echoed the Turks' complaints.

"There is a problem of coordination on all levels among those helping," said Brig. Gen. Arieh Eldad, the Israeli Army's chief medical officer.

The government can no longer deal only with immediate events, said Jurgen Weyand, a spokesman for the Red Cross. Crisis managers must plan for the immense logistical problems they will encounter three weeks from now.

Correspondents Ben Wedeman, Rula Amin, Jerrold Kessel and The Associated Press contributed to this report.

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