After Deadly Earthquake, MIGA Helps Türkiye Build Resilience for Future Disasters

Earthquakes shake Türkiye thousands of times a year.

Most are minor, but occasionally one is devastating, like the quake that struck in February, wreaking death and destruction across the country’s southern region and neighboring Syria and causing nearly 60,000 fatalities.

Unfortunately, there will be more such deadly episodes.

That’s why the World Bank Group’s Multilateral Investment Guarantee Agency (MIGA) is returning to the region with additional support to expand health care and support the building of resilience to disasters that may range from earthquakes to pandemics – and everything in between.

Located at the nexus of three tectonic plates, Türkiye is particularly vulnerable to seismic activity, though the 7.8 magnitude quake that shook it early this year was the most destructive since 1939. It is no surprise that disaster preparedness is top of mind for Turkish citizens and policy makers alike.

Yet it’s not just earthquakes driving the need for health care in Türkiye.

For more than a decade before the February disaster – since 2008 legislation that established universal health care – Türkiye had been working to increase access to health services and expand available hospital space. Funding for such an undertaking can be difficult to obtain, however, so the Turkish government turned to the World Bank Group to help devise the Public Private Partnership program to support the finance and construction of state-of-the-art hospitals, part of a larger effort to build 30 new hospitals across the country.

Subsequently, MIGA supported the financing of six new hospitals. As part of that ongoing effort, this month MIGA increased its guarantees to keep construction of one such facility – a hospital in Gaziantep – on track.

Located in southeastern Türkiye just 26 kilometers (about 16 miles) from the epicenter of the February quake, the Gaziantep facility will have 1,875 beds and consist of a general hospital, a women and children’s hospital, and a cardiovascular and oncology hospital. A diagnostic and treatment center, health support facilities, and a heliport will also be built.

MIGA’s $134 million guarantee will cover Meridiam Eurasia SAS – a global investor and asset manager based in Paris – against political risks that include breach of contract and war and civil disturbance for 15 years. The Gaziantep project was in need of additional capital to meet its new expected completion date of July 2024, and this investment was unlikely to proceed without MIGA’s guarantee.

It’s just the latest guarantee MIGA has issued to support expanded health care in Türkiye.

MIGA guarantees have enabled investments in five other hospital projects in Türkiye, including Yozgat hospital (with 475 beds), Elazig hospital (1,038 beds), Bursa hospital (1,355 beds), Adana hospital (1,550 beds), and Ikitelli hospital (2,682 beds). In total, MIGA has provided $952 million in guarantees to the six health care sites, including Gaziantep.

The final result of these MIGA guarantees will be six ultramodern health facilities that are also –critically – earthquake resilient. All six were designed to withstand violent earthquakes and remain open to serve survivors in their aftermaths.

That’s exactly what two of them did in February. While the deadly quake demolished as many as 7,000 buildings across 10 provinces, MIGA-supported and Meridiam-invested hospitals in Adana and Elazığ – both perilously close to the earthquake’s epicenter – withstood the disaster, sustaining little damage and remaining fully operational to care for thousands of survivors.

“During the earthquake our hospitals in Adana and Elazığ, beyond becoming hubs for the affected communities, were 100 percent redirected to provided health solutions to affected people,” said Günay Gökcen, Country Director, Türkiye, for Meridiam.

The 5.9-million-square-foot Adana facility was completed in 2017 and includes 1,512 seismic isolators, which are sandwich-like devices that sit beneath massive support columns and move in response to seismic shaking, protecting the building above and its human inhabitants. The hospital is among the largest buildings in the world to feature these protective devices.

Similarly, the Elazığ hospital has 872 seismic isolators protecting its 1,038 beds and the patients they serve.

Because of their seismic isolators, the two health facilities were highly resilient and became a focal point for care to the community and response to the crisis in the hours and days after the February disaster, Gökcen said.

The Gaziantep facility is the fifth MIGA-supported hospital in Türkiye that Meridiam has invested in. And Gökcen says Meridiam would have struggled to make those investments without MIGA’s guarantees. “It would have been quite difficult,” she said. A MIGA guarantee “is an important risk mitigation tool for us.”

And like the facilities in Adana and Elazığ, the Gaziantep health complex is being built to stringent seismic standards.

When it opens next summer, the Gaziantep facility is expected to serve some 19,000 patients a day, a 50 percent increase from the current volume of patients reached in the province. Health services the hospital provides will also be available to the estimated 650,000 Syrian refugees living in the Gaziantep region.

Construction of the health facility involves some 8,000 workers from nearby areas. When it is completed it will continue to provide service and procurement-related jobs.

“We’re proud that MIGA has been able to support these disaster-resilient health facilities across Türkiye,” says MIGA Executive Vice President Hiroshi Matano. “These hospitals were specifically designed to continue to treat people when earthquakes inevitably occur, and it looks like they’re up to the task.”

There will undoubtedly be more disasters to deal with in Türkiye. In particular, earthquakes, even ones as damaging as the February disaster, will reoccur.

But the new MIGA-supported hospitals, built to withstand earthquakes and with thousands of beds and the most modern health care technologies, will go a long way to respond to future disasters, however and whenever they occur.