The general medical norm indicates that a person in isolation hardly exceeds three days without drinking water. One of the main enemies of someone who is trapped, for example, in the rubble of a landslide caused by an earthquake, is dehydration. It is not the only impediment, but it is the one that has a great weight.
You can go weeks without eating, but not without drinking water. Thus, the case of any person who overcomes the 72-hour barrier without hydrating or eating falls into the category of a miracle.
The rescue of people buried in the rubble after the earthquake in Turkey and Syria, even a week after the earthquake, have filled the media for what is exceptional about them. The chances of survival are always very low if someone cannot drink.
Little 13-year-old Kaan was rescued yesterday after spending 182 hours under the rubble of a building in Hatay province; a miracle. Four hours earlier, a 70-year-old woman and a 26-year-old girl were also pulled out alive from under the rubble.
The low temperatures recorded in this area have paradoxically been able to favor the survival of the victims, precisely because they have delayed dehydration, despite the danger of hypothermia, which is another danger faced by those who suffer from entrapment of this type.
To survive it is necessary to drink some liquid even if it is the condensation of humidity on some surface. "It is easy for this type of catastrophe to produce water leaks that can flood areas or holes, for there to be leaks, and the victim can take advantage of it," explains Dr. Valentín Río, an emergency doctor with international experience in catastrophes and conflict situations.
Leyla and Elif, two children, aged two and six, rescued with their mother by the Emergency Military Unit 72 hours after being trapped under the ruins of a building in the city of Nurdagui, survived largely because the mother had extended the lactation of her little girl and was able to give both children a little milk. That ensured hydration. "We were only able to get some liquid to them when they were still trapped for the two or three hours prior to the rescue," Lieutenant Commander Aurelio Soto, spokesman for the UME, describes to La Vanguardia from Turkey by telephone.
There must be more concurrent factors for the miracle to occur.
The cavity in which the victim remains must have a minimum of ventilation, no matter how little, so that enough oxygen arrives to ensure survival. Cracks created under the structures of a collapsed building allow air to enter, as long as the survivor is not buried under sand-type rubble.
If the circumstances that there is a minimum of hydration and ventilation occur, then the problem of malnutrition is addressed, as long as we take as a victim type one who does not have any injury and who does not suffer from severe crushing, who enjoys, even , of a minimum of mobility.
“On the third day of not consuming food, the metabolism changes. The fats are converted into oils and then into sugars to feed the muscles and the brain”, explains Dr. Río. It goes into a kind of hibernation.
In the event that the victim is strongly imprisoned by a structure, their survival may be threatened even after being rescued because they suffer from what is known as crush syndrome.
One of the most notable consequences of this syndrome, although not the only one, is kidney failure if those rescued are not quickly subjected to a dialysis process. "Squashed muscles generate waste that reaches the blood when the pressure on them subsides and ends up collapsing the kidneys," explains Dr. Río in "plain and informative" language, he comments.
In the psychological section, the victim who suffers an entrapment or simply suffers serious personal and economic losses after the catastrophe, suffers from post-traumatic stress.
The person who, in addition, remains trapped, suffers from previous psychological conditions that will cause more or less anguish while the confinement lasts, depending on the strength of the individual. “The normal thing is that during the entrapment it goes through several phases. First there is that of survival; find a way out, scratch the walls if necessary. Then come the phases of frustration for not being able to do it. Sometimes a noise can reactivate optimism, but again the frustration returns. Depending on each person, but in the end the alarm level is lowered and you let yourself go. In these circumstances, you sleep a lot ”, comments this specialist in emergency medicine.
For psychological recovery, according to Dr. Río, it is very important to comply with certain rites such as being able to follow an ordered mourning in which the survivor says goodbye to their loved ones with funerals and with the support of the family nucleus if it is preserved.
