Iran is one of the top ten countries most frequently stricken by natural disasters.

More than 120 000 killed in such disasters during the last century

in Iran, most commonly due to earthquakes.

ICEBERG OF TRAUMAS

During past 8 years:

924 earthquakes 3 -7.3 R

17686 dead (17% world )

53300 injured

275000 dwellings destroyed

2500 billion Rls damage

5 Different Proposals

Epidemiologic surveyDirect needs assessment surveyRescuers’ educational needs

assessmentObjective lossesQualitative research

1- Epidemiologic StudyHistorical cohort2 earthquake ridden areasGhaen - Birjand Ardabil1 year after eventCase : n=703Control: n=684Tools: GHQ-28 ,RUTTER,WATSON,YULE

Main Findings:GHQ-28: 34.1 VS 15.85 P<0.001

RUTTER: 13.08 VS 8.19 P<0.001

OR = 3.29 for adults

OR = 2.05 for children

PTSD IN CHILDREN(cut off point under consideration)

MILD44%

MODERATE

35%

SEVERE12%

NONE9%

PTSD IN ADULTS(cut off point under consideration)

MILD19%

MOD32%

SEV45%

NONE4%

Anniversary effect?

2- DIRECT NEEDS ASSESSMENT57 ITEM QUESTIONNAIREEXPOSURESINFORMATION NEEDSNEED FOR EMOTIONAL SUPPORTNEED FOR EDUCATION

VISUAL EXPOSURES

PEOPLE UNDER

RUBBLES27%

DEAD BODIES OR INJURIES

37%

DESTROYED HOUSES

15%OTHERS

5%ANIMAL BODIES

16%

NEED FOR INFORMATION

0

10

20

30

40

50

60

PERCENT

WHAT KIND OF INFORMATION ?

107.1

3.4

10.2

75.3

FAMILY MEMBERSHEALTH

RELIEF SERVICES

FINANCIAL DAMAGE

AFTERSHOCKS

OTHERS

NEED FOR COUNSELLING

0

10

20

30

40

50

60

70

PERCENT

WHO PROVIDED PSYCHOLOGICAL SUPPORT?

010203040506070

PERCENT

RECEIVED “DON’T CRY” ADVICE

YES = 63.7 %

NO =36.3

HAVE YOU BEEN PLAYING SINCE THE EVENT?

YES 43.7%NO 43.3%NO ANSWER 13.0%

WHO SAID "DON'T CRY"

RELATIVES81%

RESCUERS8%

OFFICIALS8%

STRANGERS3%

WHOM DID YOU EXPECT ?

PERCENT UNAWARE OF ROLES

GOV. AUTHORITIES 64.7 3.6 CLERGIES 53.2 4 PSYCHIATRISTS 22.0 5 SOCIAL WORKERS 19.04 46 PSYCHOLOGISTS 14.70 53.2

3- EDUCATIONAL NEEDS ASSESSMENT FOR RESCUERS

NOT MUCH DIFFERENT

RISK COMMUNICATION

MISINFORMING 20.5%GRADUAL BRIEFING 42.2%OUTRIGHT 6.5%

WHAT WOULD YOU DO ABOUT DRUG ABUSE TO COPE WITH THE STRESS?

I WOULD IGNORE? 5.3%NOT A PROBLEM FOR A LIMITED

PERIOD 11.5%I RECOMMEND THEM NOT TO DO?

83.2%

4- OBJECTIVE LOSSES

MORTALITYINJURIESNO OF DESTROYED HOUSESNO OF AFECTED FAMILIESNO OF KILLED CATTLETIME LAG TO RESCUE

QUALITATIVE STUDY

SOME FINDINGSMOST TRAUMATIC EXPERIENCE OF

LIFEWORRIES ABOUT CHILDRENDEPRESSIONACADEMIC DECLINEREEXPERIENCECONTINUITY OF SYMPTOMSSHELTERLACK OF PRIVACYPRAYING AND RELIGIOUS BELIEFSPS NEEDS NOT ADDRESSED