Survivors of the earthquake that jolted Turkey and Syria 15 days ago, killing tens of thousands of people and leaving hundreds of thousands homeless, are dealing with more trauma after another deadly tremor rocked the region.

The 6.4 magnitude earthquake that struck on Monday evening had its epicentre in the Defne district of Turkey’s Hatay province – one of the areas worst affected by the magnitude 7.8 quake on February 6 which killed nearly 46,000 people in the two countries.

Turkey’s AFAD disaster management authority said the new quake killed six people and injured 294 others, including 18 who were in critical condition.

MIDDLE EAST Earthquake
(PA Graphics)

In Syria, a woman and a girl died as a result of panic during the earthquake in the provinces of Hama and Tartus, pro-government media said.

Monday’s quake was felt in Jordan, Cyprus, Israel, Lebanon and Egypt. A magnitude 5.8 quake followed, along with dozens of aftershocks.

The White Helmets, north-west Syria’s civil defence organisation, said about 190 people suffered injuries in rebel-held areas and several flimsy buildings collapsed but there were no reports of anyone trapped under the debris.

Turkish officials warned residents not to go into the remains of their homes, but people have done so to retrieve what they can. Three of the people killed on Monday were inside a damaged four-storey building when the new quake hit.

Aftershocks and the instability of the structure complicated the rescue effort, and it took several hours for search crews to find the bodies, Turkish news agency DHA said.

Turkey Syria Earthquake
Rescue team members search in a destroyed building (Ugur Yildirim/DIA/AP)

Dr Tahsin Cinar, an anaesthetist using holiday time to help provide medical care in Hatay as a representative of the Turkish Medical Association, said survivors need serious help with their mental health.

“They feel so alone, so deserted and very anxious. Even a small tremor leads to a big anxious reaction,” he said.

Dr Cinar and other volunteers initially provided emergency care for people with physical injuries. Now they are seeing more signs of psychological trauma, depression and the stress that comes with a lack of safe housing, winter weather and a pause in education.

“There is nearly nothing to create social well-being,” he said.

The UN’s World Food Programme said Monday’s quake frightened employees who were distributing food to hundreds of thousands of people in north-west Syria and Turkey.

The employees are sleeping in their cars in freezing temperatures while still trying to do their jobs, the programme said.

About 13.5 million people live in Turkey’s 11 quake-hit provinces, where authorities said more than 139,000 buildings were either destroyed or so severely damaged they need to be torn down.

President Recep Tayyip Erdogan said 865,000 people were living in tents as of Tuesday. Some 270 tent cities have been set up in the affected provinces, and winter weather added to the suffering of displaced citizens.

The majority of deaths in the February 6 quake, which was followed by a magnitude 7.5 tremor nine hours later, were in Turkey, where at least 42,310 people died, according to the disaster management agency.

Turkey’s defence minister said about 20,000 Syrians living in Turkey had returned to Syria after the quakes.

“They are returning to their lands because they lost their homes and their relatives,” Hulusi Akar said from Hatay.