How Did Baby Azra Survive 47 Hours Under Rubble?
2-week-old Baby Azra survived 2 days under rubble. How did she do it?
Oct. 25, 2011— -- Just like her namesake, 2-week-old Baby Azra, which means "desert flower" in Turkish, defied the odds by surviving in conditions that most would deem impossible.
On Tuesday, rescue workers pulled Azra Karaduman from the rubble of a building in the eastern city of Ercis, 47 hours after the 7.2 quake hit Turkey. Television footage showed a worker pulling the naked baby from the wreckage before handing her off to a medic.
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As of Tuesday, officials said the disaster had killed 366 people and injured 1,301, but Baby Azra, along with her 25-year-old mother and grandmother, were saved. Their condition remains uncertain, and it is also uncertain whether Azra's father, who was also believed to be in the rubble, survived.
Born only 14 days before the earthquake, how did Baby Azra survive such a harrowing catastrophe? Are babies tougher than we think?
"We all can tolerate a lack of food and water for 48 hours," said Dr. Ian Holzman, chief of the division of newborn medicine at Mount Sinai School of Medicine in New York. "The concern in a baby is that they can't maintain their blood sugar if they haven't been well-nourished previously, so I would assume this was a healthy, chubby baby."
Full-term babies hold additional fat stores in their bodies, said Dr. William Walsh, a professor of pediatrics and head of neonatology at Monroe Carell Jr. Children's Hospital at Vanderbilt University in Nashville, Tenn.
"Babies are born with a little extra fluid and energy stores that they can mobilize because the breast milk from their mothers does not usually start immediately," said Walsh. "So, the ability to fast for a day or two is built-in."
In general, survival from collapses often depends heavily on the amount of pockets that exist in the wreckage after the disaster. Children may have greater luck in fitting into smaller pockets throughout the rubble. Babies also have softer bones, which may be more likely to bend than break in certain crushes, said Walsh.
Other risk factors include extremes in ages and chronic medical conditions. Babies and the elderly have lower chances of surviving a disaster than healthy teenagers and adults, experts said. People with chronic medical conditions are also at greater risk of death when trapped in a collapse.
"Once actually in a collapse, the real risk is crushed versus not," said Dr. David Markenson, chairman of the American Red Cross Advisory Council on First Aid and Safety. "A person who is trapped longer will usually do better than someone who is trapped a much shorter period of time with a crush injury."
Along with the risk of a crush injury, Markenson said the factor that likely saved Baby Azra was the temperature outside.
"Extreme heat or cold -- that is what is more limiting in survival of a baby," said Markenson. "Forty-seven hours is pushing the limits without water and food. She probably could not have exceeded that time too much more, but the weather conditions were the most helpful to this child. Children are more susceptible to extreme weather conditions than adults."
According to the weather site, Foreca.com, Tuesday's temperature in Ercis reached a high of 55 degrees Fahrenheit.
Of note, in general, premature baby girls tend to have a higher survival rate than boys in the Neonatal Intensive Care Unit. Doctors say the phenomenon is difficult to explain, because so many confounding factors contribute to a preemie's survival.
Nevertheless, Walsh said, "estrogen is a potent steroid and gives girls a definite advantage during the first month of life, but that has not been studied in this circumstance."
But in the case of earthquakes and collapses, Markenson said those gender statistics do not come into play. The most important components of a child's survival during a collapse are the temperature, injuries and the amount of pockets in the rubble.
"The message here is that healthy children are likely to survive if they can find cavities in the building, so rescue efforts need to be continued for several days after the disaster," said Markenson.
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