The World Health Organization warns that tens of thousands of survivors of a series of powerful 6.3 magnitude earthquakes that struck western Afghanistan’s Herat province between October 7 and 15 are in desperate need of humanitarian aid and essential health services.

“I have personally seen how these multiple earthquakes flattened villages, displaced thousands of people and left many families in urgent need of humanitarian and health assistance,” said Alaa AbouZeid, health emergencies team lead for WHO Afghanistan.

Speaking in Kabul on Friday, AbouZeid said, “Over 114,000 people are in urgent need of lifesaving health assistance. … The health consequences are staggering.”

Those most seriously affected by the disaster, he said, are women, girls, boys and the elderly, “who account for over 90% of the deaths and injuries. Many children are left orphaned.”

The Office for the Coordination of Humanitarian Affairs, or OCHA, reports that the earthquakes directly affected more than 66,000 people — about 1,500 killed, some 2,000 injured, at least 3,700 homes destroyed and another 21,300 buildings damaged.

“I have talked to people affected by earthquakes, and the sense of loss is heartbreaking,” said Luo Dapeng, WHO representative in Afghanistan. “Many people spent days digging under the rubble to search for members who either died or got injured.”

According to an initial assessment by the WHO, at least 40 health facilities across nine districts were damaged, resulting in severe disruptions of health services for an estimated 580,000 people.

AbouZeid said health providers were afraid to go into those buildings, which showed visible cracks and risked collapse. “So, most health services for now are provided from tents,” he said, calling the situation untenable.

“We need immediate action to restore, renovate and ensure services that provide health facilities, especially in wintertime. The survivors need water [and] better shelters that can protect them from the harsh winter,” he said.

“Last year, Herat experienced minus 30 degrees centigrade during wintertime, and winter has already started in Afghanistan,” he said. “So, there are needs for water and sanitation to stop any possible disease outbreaks.”

He said that WHO staff in Afghanistan was on the ground within hours of the disaster and able to treat the injured, provide medicine and medical supplies, and give mental health and trauma care.

“Thanks to the long and established presence in Herat, we were able to rapidly mobilize resources … and extend immediate lifesaving support to the affected population at the most critical time of the emergency.”

He said the WHO has deployed 21 female health workers, including doctors and midwives, to Herat to ensure that women have unimpeded access to the health services they need.

“They have been distributed over different facilities to provide services for their female patients, with a special focus on reproductive health services, obstetrics, gynecology services and child health services,” AbouZeid said.

The WHO launched an appeal for $7.9 million Wednesday to provide urgent and essential health services for 114,000 of the most vulnerable people in the next six months.

AbouZeid said the WHO needs to scale up emergency health needs urgently and swiftly “as the upcoming winter season is bringing new health risks and exposure to the affected population currently living outdoors or in tents.”

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