Dear Editor,

Disasters affect each individual to a different degree. Individuals with celiac disease are at risk of experiencing nutritional difficulties after a disaster.Reference Wilcox¹ Celiac disease is a digestive disease that affects an individual’s small intestinal system.Reference Ludvigsson, Bai and Biagi^2, Reference Ludvigsson, Ciacci and Green³ The only current treatment for celiac disease is to follow a gluten-free diet for life.Reference Mędza and Szlagatys-Sidorkiewicz⁴ For these patients, exposure to gluten can cause infection and malabsorption in the small intestine and aggravate the disease.Reference Bianchi, Aronico and Santacroce⁵ Previous experiences have shown that celiac patients are vulnerable to disasters and that the importance of disaster preparedness in meeting the needs of these individuals is critical.Reference Harrington⁶ A series of earthquakes that occurred in Türkiye on February 6, 2023 affected 11 provinces and caused great destruction. Although the exact number of celiac patients in the region after the earthquake is not known, it is thought that there are 30 000 people, according to the Republic of Türkiye Ministry of Health data.Reference Türk⁷ The “Türkiye Disaster Response Plan (TAMP)” is put into effect to respond to disasters in Türkiye. According to TAMP, the main solution partner of the nutrition service group is the Turkish Red Crescent. Support solution partners were determined as public administration, local governments, NGOs and private sector.⁸ After the 2023 earthquake in Türkiye, the Ankara Celiac Association was observed to have offered gluten-free nutrition services with the “Support for Celiac Disease Victims in Earthquakes” project.⁹ An individual with celiac disease in Kocaeli prepared gluten-free food for celiac patients who were affected by the earthquake and sent it to the earthquake zone. During this process, the woman stated that she provided gluten-free food support with the support and cooperation of the public administration, local government, and volunteers.Reference Aktaş¹⁰ It was observed that a couple, whose 2 daughters have celiac disease, provided gluten-free food support to the earthquake region. It was stated that they managed the process within the framework of the support and cooperation of citizens, the private sector, and local governments.Reference Aydın Ceyhan¹¹ It has been determined that celiac associations sent gluten-free foods to celiac patients in the earthquake region. It is seen that a social network has been formed with the celiac associations in Türkiye and that gluten-free nutrition services are supported through this social network.Reference Ceylan¹²

Nutrition management is essential to minimize health vulnerability during the disaster process. It is important to determine proactive action priorities and take measures to reduce vulnerability in disaster plans. This is effective and successful implementation of nutritional management for individuals with celiac disease, who are a vulnerable group in disasters. Gluten-free emergency and disaster preparedness strategies need to be developed to reduce disaster vulnerability of celiac patients and to ensure effective disaster response. During disaster response, the dietary needs of celiac patients and individuals with other illnesses (e.g., diabetes, allergies) are important considerations that affect the nutritional diet and should be taken into account in the availability of essential food products. Furthermore, monitoring celiac patients and reducing their vulnerability by including them in a priority group in the disaster response process can be an important step. Improving the awareness of disaster workers about celiac disease and patients’ diets, and providing training, can improve disaster response capacity. Sustainable development goals, including Goal 2: “Zero Hunger,” Goal 3: “Good Health and Well-Being,” and Goal 10: “Reduced Inequalities,” should lead the actions. Strategies that can be implemented in disasters within the framework of inclusive, equal, and ethical principles should be developed. Therefore, this study may inform future research on determining the needs of celiac patients, who are a vulnerable group in disasters, and on developing capacity in this regard.