Iran is one of the top ten countries most frequently stricken by natural disasters. More than killed in such disasters during the last century in Iran, most commonly due to earthquakes.

ICEBERG OF TRAUMAS During past 8 years: 924 earthquakes R dead (17% world ) injured dwellings destroyed 2500 billion Rls damage

5 Different Proposals Epidemiologic survey Direct needs assessment survey Rescuers’ educational needs assessment Objective losses Qualitative research

1- Epidemiologic Study Historical cohort 2 earthquake ridden areas Ghaen - Birjand Ardabil 1 year after event Case : n=703 Control: n=684 Tools: GHQ-28,RUTTER,WATSON,YULE

Main Findings: GHQ-28: 34.1 VS P<0.001 RUTTER: VS 8.19 P<0.001 OR = 3.29 for adults OR = 2.05 for children

PTSD IN CHILDREN (cut off point under consideration)

PTSD IN ADULTS (cut off point under consideration)

Anniversary effect?

2- DIRECT NEEDS ASSESSMENT 57 ITEM QUESTIONNAIRE EXPOSURES INFORMATION NEEDS NEED FOR EMOTIONAL SUPPORT NEED FOR EDUCATION

VISUAL EXPOSURES

NEED FOR INFORMATION

NEED FOR COUNSELLING

WHO PROVIDED PSYCHOLOGICAL SUPPORT?

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%

WHOM DID YOU EXPECT ? PERCENT UNAWARE OF ROLES GOV. AUTHORITIES CLERGIES PSYCHIATRISTS SOCIAL WORKERS PSYCHOLOGISTS

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 MORTALITY INJURIES NO OF DESTROYED HOUSES NO OF AFECTED FAMILIES NO OF KILLED CATTLE TIME LAG TO RESCUE

QUALITATIVE STUDY

SOME FINDINGS MOST TRAUMATIC EXPERIENCE OF LIFE WORRIES ABOUT CHILDREN DEPRESSION ACADEMIC DECLINE REEXPERIENCE CONTINUITY OF SYMPTOMS SHELTER LACK OF PRIVACY PRAYING AND RELIGIOUS BELIEFS PS NEEDS NOT ADDRESSED