By now, the chances of survivors being found under the rubble left by the devastating earthquakes in Turkey and Syria are extremely slim. The death toll has already climbed to 22,000, surpassing that claimed by Turkey’s huge quake in 1999. The human cost will inevitably climb higher still. But aid and attention must now focus on how to limit the secondary consequences of this cataclysmic disaster, from ensuring adequate sanitation to stopping those now made homeless from perishing in freezing conditions. It will be far from easy.

The two countries present vastly different challenges. Turkey’s death toll is much higher at 19,000, and its area affected by the quake contributes an estimated 10 per cent of GDP to what is a key Nato and G20 member. Some towns have been almost razed by the 7.8-magnitude quake and a second large tremor. Freezing conditions and damaged infrastructure have hindered rescue efforts and the state is struggling to cope with the sheer scale of the disaster. But aid and resources can flow into Turkey relatively unencumbered.

The same cannot be said for Syria — a war-torn, isolated country — where some of the worst-hit areas have had no functioning state for years. Millions were in the grip of a humanitarian disaster long before Monday. During a decade of civil war, bodies have been pulled from buildings flattened through air strikes care of the regime and its Russian backers rather than any earthquake. Western outrage ceded eventually to fatigue after Bashar al-Assad regained control over most of the country and efforts to find a political settlement to the conflict floundered. This week’s events are a tragic reminder that a forgotten conflict is not a resolved one.

Getting aid to opposition-held areas in north-west Syria is a logistical nightmare, even if on Friday the regime said it would allow deliveries across the frontline. The first UN convoy of trucks only reached the region on Thursday. It passed through the only crossing into Syria from Turkey. The consequences of allowing the regime to shut the other two, with the help of the Russian veto at the UN Security Council, have been laid bare. For government-held areas, the thorny issue for the west will be how to assist Syrians ruled by a despotic regime that has weaponised aid for years.

For Turkey, too, politics loom. Elections are due in May in what is modern Turkey’s centenary year. Already, Turks are suffering a cost of living crisis and rampant inflation. Many may now judge President Recep Tayyip Erdoğan, who came to power a few years after the 1999 earthquake, by his response to this one. Erdoğan has steadily eroded the independence of state institutions and the central bank in recent years, cultivating the image of a strongman that a natural disaster could bolster. The concern among opposition parties is that he uses the earthquake to suppress campaigning, to their detriment. He has already announced emergency powers in quake-affected areas and is trotting out familiar warnings against “provocateurs” criticising his government’s response. Yet there are also legitimate questions being asked about the poor quality of many of the buildings that crumbled, despite pledges to make Turkey better prepared for earthquakes.

But the key focus now — in Turkey and Syria, and for the international community — should not be on politics but on saving lives and supporting the rescue and reconstruction efforts. After the 1999 quake, foreign aid did much to ameliorate Turkey’s western ties — particularly with its old foe, Greece. One small positive in these dark days is that through adversity Turkey and the west could bolster relations again. Sadly for long-suffering Syrians, that cannot happen for their country as long as Assad is in power.

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