Imagine being trapped beneath the rubble of a collapsed building, unable to move, with no food or water and little room to breathe. As hours turn into days, the body begins to weaken. But how long can a person survive under such circumstances?
The answer depends on several factors, including a person's age, general health, body reserves, access to breathable air and the nature of their injuries, according to medical and emergency response experts.
Physician and gastroenterologist Dr Nashon Okanga says the body initially relies on its stored energy to sustain vital functions when food is unavailable. As starvation continues, it begins breaking down fat and eventually muscle tissue to meet its energy needs.
“Some people's body metabolism is slow, so it depends,” Dr Okanga explains.
He says survival varies from one individual to another, with children, older people and those with underlying medical conditions facing greater risks of deteriorating rapidly.
The absence of water, however, presents a more immediate danger. While a person may survive for weeks without food if they have access to water, severe dehydration can become life-threatening within days. There is no fixed period that guarantees survival without either food or water.
When the body begins to fail
According to Dr Okanga, prolonged starvation forces the body to draw on its energy reserves. As these reserves diminish, the breakdown of muscle tissue can compromise normal bodily functions and increase the risk of organ damage.
For people trapped beneath collapsed buildings, the situation can be even more complicated.
Dr Okanga says survival depends partly on whether a victim is trapped in a confined space with room to breathe or is pinned beneath heavy debris.
Someone trapped in an air pocket without severe crushing injuries may primarily face the effects of dehydration and starvation. However, a person whose body is compressed by heavy concrete or stones may sustain serious muscle damage, potentially leading to kidney failure and other life-threatening complications.
The extent of the injuries, the availability of breathable air and the duration of entrapment all influence the victim's chances of survival.
Dr Okanga emphasises that rescue alone does not eliminate the danger.
“If one is rescued and is already in a coma, investigations should be conducted to establish whether there are organ or head injuries,” he says.
Even victims who are conscious, breathing normally and have stable blood pressure should be taken to hospital for a comprehensive medical assessment. Internal injuries and complications arising from prolonged entrapment may not be immediately apparent.
The hidden dangers beneath the rubble
Fred Majiwa of St John Ambulance says the circumstances surrounding a building collapse can significantly affect a trapped person's chances of survival.
He explains that victims may be exposed to dust, restricted airflow, physical injuries and prolonged compression, all of which can complicate rescue efforts.
Movement can also increase the body's energy demands, particularly when a trapped person repeatedly struggles to free themselves.
“If they are awake, they are trying to lift themselves and use a lot of energy, and require a lot of oxygen supply to keep living,” Majiwa explains.
However, consciousness alone does not determine survival. An unconscious victim may still have serious injuries or breathing difficulties and requires urgent medical attention.
Majiwa says rescuers must also exercise extreme caution when dealing with victims pinned beneath heavy objects.
Removing the weight without proper assessment and medical support can expose victims with crush injuries to further complications. Prolonged compression can damage muscles, release harmful substances into the bloodstream and trigger dangerous disturbances in the body's chemistry, potentially resulting in kidney failure or cardiac complications.
He stresses that such rescues require trained personnel who can coordinate extrication with appropriate emergency medical care.
“A very special advanced cardiac life support ambulance should be on site to sustain their life,” Majiwa says.
Victims may require oxygen, close monitoring and specialised treatment during and after rescue. Their condition should be assessed carefully because serious complications can develop even after they have been freed from the rubble.
What should you do if trapped?
For people caught in a building collapse, Majiwa advises protecting the nose and mouth from dust and debris while trying to alert rescuers to their location.
He recommends conserving energy and avoiding unnecessary movement while waiting for help. If possible, trapped individuals should use available means to signal rescuers without exposing themselves to additional danger.
However, he cautions that no position or technique can guarantee safety during a building collapse. The priority is to protect the airway, avoid further injury and make one's location known to rescue teams.
For rescuers, the priority is to locate victims, establish whether they can breathe, assess immediate threats and coordinate a safe extraction. Where prolonged compression is suspected, medical support should be involved as early as possible.
Survival is not just about time
Research published by Healthline notes that survival without food or water varies considerably depending on individual circumstances. Such estimates are based largely on observations of real-life situations rather than controlled experiments.
While the human body can adapt to periods without food by changing how it uses energy, it still requires water to maintain essential functions. Dehydration, starvation, traumatic injuries and restricted oxygen can combine to make survival beneath rubble particularly challenging.
For Dr Okanga and Majiwa, the message is clear: the chances of survival depend not only on how long a person remains trapped, but also on the conditions they endure and the quality and speed of the rescue response.
Ultimately, every rescue is a race against time, and prompt, carefully coordinated emergency intervention can make a critical difference between life and death.
