The eerie silence ordered by the search-and-rescue team was filled by a heart-rending cry. Frantic hand-by-hand scrambling in the rubble revealed an infant protected by its dead mother. Hope and despair vied, and life and death intertwined, as courageous rescuers defied brutal earthly forces. That was 1992 in Erzincan, Eastern Turkey during my first earthquake response. The sky was full of relief planes from numerous nations. Unable to land on the over-crowded air strip, spontaneous un-coordinated generosity was perversely magnifying the chaos of bewildered thousands wandering in the bitter cold. As I sheltered from the frequent aftershocks in my hire-car, I could see the surface scars of the deadliest 1939 Erzincan earthquake on the horizon. Geography is destiny and Turkey’s is shaped by its location amid the shifting Anatolian, Arabian and African tectonic plates that cause many earthquakes. An M7-plus earthquake releases the energy equivalent of about 32 Hiroshima atomic bombs. Monday’s twin earthquakes measured M7.8 and M7.5 and caused several aftershocks exceeding M6, as well as landslides, subsidence, and some flooding. The quakes struck without warning at a shallow 15-kilometre depth over 290 kilometres of fault lines in the Earth’s crust. Most people were asleep as thousands of buildings collapsed across densely populated cities and remote villages. About 23 million are affected across south-eastern Turkey and north-western Syria – spanning 120,000 square kilometres, equivalent to Austria and Netherlands combined. Millions are displaced or homeless, the most vulnerable including some 1.5 million Syrian refugees in Turkey’s border region as well as 4 million conflict-affected people (including Palestinian refugees) within Syria’s opposition-controlled area. Post-quake survival rates average about 74 per cent in the first 24 hours dropping to 22 per cent after 72 hours and just 6 per cent by the fifth day. But people are found alive as long as two weeks afterwards if they find air pockets, condensation, and keep motivated. The general rule of thumb is that rescue efforts must continue for at least 48-72 hours after the last retrieval of an alive person. The death rate in Turkey and Syria may eventually exceed 50-60,000 and injuries 130,000. Many of these are life-changing because of their disabling nature or will succumb later to crush trauma complications. A secondary disaster is in the making with electricity, gas, roads, food, water, sanitation, shelter and health care disrupted amidst the bitterly cold weather. Looting and insecurity are reported. Unaccompanied children, vulnerable women and elderly need safe spaces along with emergency mental first aid for whole communities. Engineers should inspect standing or slightly damaged buildings to determine which are safe for people to return. Others need accommodation further away, for months or years to come. It is understandable that desperate survivors blame slow and insufficient aid provision. But no amount of preparedness would be sufficient for huge catastrophes – even in the most developed nations as we have seen with hurricanes in the US. When mega-disasters strike, it is always self-help and locals who save most lives. So also in Turkey and Syria, where thousands managed to crawl out or were rescued by first responders often with bare hands and shovels, before limited heavy machinery could arrive. Local volunteers rushed to help strangers even as they feared the worst for their own families. Rescuers dug out others as they grieved for their own losses. Local officials reported for duty not knowing if their own homes were standing. This is the humanitarian instinct at its noblest. It is in full flow as some 95 countries and hundreds of organisations offer assistance. Within 96 hours of the earthquakes, more than 120,000 nationals and internationals were active in Turkey and thousands of tonnes of relief under distribution. It is a vigorous, speedy and large-scale effort. But this does not console those who cry and rage because they remain cold, hungry and homeless, while aid convoys struggle along broken roads amid winter storms. Nevertheless, it is still testimony to progress since the inefficiency I witnessed in Erzincan more than 30 years ago or the inter-agency competition I battled as a UN official with the Indian Ocean tsunami 20 years ago, or the mind-numbing US bureaucracy I navigated in Hurricane Katrina shortly thereafter. Disaster response has transformed over past decades by recognising that it is not primary hazards that determine mortality but how risk and vulnerability are reduced. The science of disaster management has reduced annual deaths by a remarkable 75 per cent over the past century, even as global population has quadrupled. Organisational improvements are integral to progress. Nowadays, most countries have national disaster and emergency authorities with trained staff holding contingency stocks and conducting regular exercises. Such as the Turkish agency, AFAD, that originally arose out of the 1939 Erzincan earthquake. From the 1992 Erzincan shambles grew the modern international enterprise, including the UN Office for the Co-ordination of Humanitarian Affairs, along with sophisticated tools for systematic needs appraisals, stockpiling essential supplies and smart logistics. The preceding disaster tourism and donor competition have given way to joint field assessments, and random aid shopping replaced by consolidated emergency appeals. Nowadays we have new technologies and communications to give early warning and trigger targeted early action. Nevertheless, earthquakes are more complicated. According to the US Geological Survey, up to 14,000 occur annually of which 120 are large (M6.0-6.9) and 19 are major (exceeding M7). But despite monitoring the three main seismic belts – Circum-Pacific, Alpide (including Turkey), and mid-Atlantic – we cannot predict when and where the next quake will strike, and how big it will be. It is not Earth tremors that usually kill but concrete. This is not a random life-and-death lottery but a direct consequence of development that determines the quality of a country’s built infrastructure. For example, the 2010 Haiti’s M7 quake at 15km depth killed more than 200,000 people while the bigger and shallower 2015 Nepal quake (M7.8) killed 7,000, and the similar 2016 New Zealand quake took two lives. Turkey’s construction sector is renowned and its expertise is a major export. It tightened building regulations after a much-criticised 1999 quake and strengthened the seismic code further in 2018 to require high-quality concrete and reinforcing steel bars with effectively distributed weight-bearing columns and beams. Properly constructed buildings may crack and shift but will collapse only rarely, even after big tremors. The pancake-like crumpling seen here suggests these were pre-2000 buildings or, if recent builds, they were non-compliant with set standards. Accountability for shoddy construction is important for justice to innocent victims, and to learn the right lessons for reconstruction. A huge programme to retrofit millions of existing buildings – using innovative techniques pioneered in Japan and Taiwan – is needed. Repairing, replacing and extensively expanding resilient infrastructure challenges any country, even a fast-growing developed economy and G20 member such as Turkey. Public-private-government partnerships investing billions of dollars are required. As that will not happen quickly or fully, future tragedies are likely for which there must be better preparation. However, disasters are also opportunities for change. Huge shocks can be social and political game changers. I witnessed how the Indian Ocean tsunami precipitated the closing-down of Indonesia’s Aceh insurgency and Sri Lanka’s civil war. The division of Pakistan to create Bangladesh was influenced by grievances around inadequate responses to repeated lethal cyclones. Extreme drought has destabilised the Sahel as have large volcano eruptions in eastern Democratic Republic of Congo. Earlier, a different type of catastrophe – HIV and Aids – triggered socio-political shifts in southern Africa and perhaps, Covid-19 has done the same in the US and China. Elections are due in Turkey in May and perceptions around the current crisis are bound to influence state-citizen relations. The traditional tensions between Turkey and Greece have taken a back seat as also arguments between the EU and Turkey. Critically, will the disaster alter the trajectory of the 12-year-long Syrian civil war? Could the humanitarian torrent sweep away old obstacles? Re-opening and increasing the number of Turkey-Syria border crossings is not just logistic convenience. It signifies unblocking the UN Security Council that can but benefit the whole world. Ukrainians are doing relief in Turkey, and Russian forces in Syria. Could cross-line aid delivery from government to opposition areas in Syria provide pathways out of currently entrenched positions? The US has eased some aid-related sanctions and donors such as the UAE are helping via both Ankara and Damascus. Similar vibes from the EU provide hopeful signals. Recovery from the Turkey-Syria earthquake shock will be long as survivors work through the different stages of grieving, and affected territories get back on their feet. Shattered bodies will mend, mental scars will fade, and rebuilding will bridge earthly fissures. But this is too great a tragedy not to take the opportunity to also reset fractured minds. The outpouring of global solidarity shows that at least our broken hearts are willing.