For many thousands of years it has been recognised that disasters have significant physical and psychological effects on human society. Some of the earliest written records from Sumeria comment on the destruction of Nippur in 2000 bc and report on the anguish and suffering of the population.1 More recently, research has provided ample evidence of psychiatric morbidity in the wake of natural and human-caused disasters.2 Much of the research has focused on post-traumatic stress disorder (PTSD), but other conditions such as depression and anxiety disorder have also been reported. Initial high rates of distress usually diminish over the ensuing months, except for the people most intensely exposed to disaster stressors such as threat to life, loss of loved ones and loss of home. Earthquakes have been associated with enduring rates of PTSD as high as 25% in the affected population, highlighting the need for mental health interventions.3 Children are particularly vulnerable in such circumstances.4
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