Responding to physical and psychological health impacts of disasters: case study of the Iranian disaster rehabilitation plan

This paper describes the process of developing a national pre-disaster plan for physical health and psychological rehabilitation of disaster-stricken communities. Data gathered from a literature review and expert panel discussions informed the process of drawing up unified definitions of physical and psychological health rehabilitation, carrying out stakeholder and STEEP-V analyses, and assigning the responsible organization and the collaborative organizations for each task. The Ministry of Health and the Welfare Organization were selected as the two responsible organizations. Integrated management at all levels, and sharing information, education and funding, were identified as ways to improve stakeholders' participation and collaboration. A system is needed for evaluating the implementation of the disaster rehabilitation plan, using valid and reliable indicators

Deaths and injuries due to the earthquake in 2010 damghan's earthquake: a case study

Earthquakes cause thousands of deaths and injuries worldwide every year. Islamic Republic of Iran has a deadly history of earthquakes. The aim of this study is to describe injuries rate, causes of injuries, structural characteristics of buildings and occupant actions immediately after earthquake in Damghan in 2010. This case-study was conducted one week after occurring the earthquake in five villages of Damghan city in Iran. We used the Physical Injuries Assessment Questionnaire which was particularly designed for injuries after earthquakes. Also for acquiring information about region and amount of losses, some interviews was conduct with local authorities. Four death and fifty six injuries occurred in five villages of Damghan city. There were three types of injuries including superficial injuries [50%], contusions [35%] and fractures [10%]. The findings of this study indicating building structural failure [87.4%], nonstructural factors [7.1%] and trapping [5.3%] seems the most possible cause of injuries in this region. This study showed that the building structural failure is the main cause of injuries [87.4%]. Increasing structural resistance of building especially in village regions and education about earthquake preparedness should encourage in order decreasing the total number of people affected by earthquake

[ case study of the health system response operation to flood in chaldoran township on July 2011]

Due to casualties and financial losses, floods are the most horrible natural disasters. It is responsible for 40-50% of all deaths in the world, about 43% of total population damaged by disasters that have occurred between 2009-2000. Despite the high abundance of floods in Iran, yet little research has been done on how the health system response to the flood. This article aims to study the health system response operation to Chaldoran township flood. In this descriptive case study, data was collected by using checklists that were prepared by researchers through interviews with authorities of health system in affected areas; reviewing existing documentation; and observing of how the response has been provided. A flash flood was occurred and damaged some parts of Chaldoran Township on 16 July, 2011. Initial investigation team dispatched immediately to the affected areas and surveillance system was exacerbated. 24 samples of water had been taken in the region that 6 cases had bacterial contamination. However, no chemical sampling was prepared, 6 drinking water sources restored and also 34 kg of calcium hypochlorite was distributed. Chlorine measurement was performed in 206 cases which 182 were favorable cases. 8 toilets of 11 were reconstructed after damaging in flood. Meanwhile, there were not any unwanted problems in maternal and child and family planning health services. Fortunately, losses resulting from the recent flood were not noticeable and have been managed well by the health system. But for broader disaster management involving high mortality, the health system should design a proper disaster plan in order to prepare and improve employees by training programs in various maneuvers. The health system and employees should be ready. Otherwise, such disasters are very difficult to manage and also the results will be tragic

[ effect of a disaster nursing education program on nurses' preparedness for responding to probable natural disasters]

Nurses, as the pioneers of healthcare in societies, play an important role before, during, and after disasters. Enhancement of their professional skills for the purpose of helping the injured is one of the basic principles in health management in accidents and disasters. The aim of this study is to investigate the effects of a disaster nursing education program on the improvement of nurses' preparedness. It was a quasi-experimental, single group study. The sample including 113 nurses working in Razi psychiatric hospital were selected by census and asked to fill out the "preparedness for confronting disasters" questionnaire, which was developed by the authors. The preparedness program, which consisted of a one-day workshop on disaster management, top-table maneuver, and an operational maneuver, were performed for the participants. The preparedness of all participating nurses was measured one week and also one month after the program. Data were analyzed ANOVA for repeated measures by SPSS-PC [v.17]. Our results showed that the mean scores of knowledge, attitude, and performance improved from 5.55 to 19.88, from 66.18 to 72.41, and from 3.36 to 12.48, respectively in pretest and follow up measurements, which indicated a statistically significant difference [p<0.001]. In addition, the mean score for total preparedness was increased from 75.14 in pretest to 104.77 in follow up, which is statistically significant [p<0.001]. According to the findings in order to promote and maintain the preparedness of nursing staff, inclusion of disaster programs in their academic educational curriculum and as a continued educational program is recommended

Seroprevalence of hepatitis E in Nahavand, Islamic Republic of Iran: a population-based study

A 2-month community-based survey in February/March of 2003 was carried out to study the seroprevalence of hepatitis E virus [HEV] infection in Nahavand, Islamic Republic of Iran. From each of 6 urban regions of Nahavand, 304 inhabitants >/= 6 years were recruited through systematic random sampling [total 1824]. Participants were tested for anti-HEV IgG using ELISA. The overall seroprevalence of HEV was 9.3% [95% CI: 8.2%-10.9%]. Based on multivariate adjustment, only sex [OR = 1.61, 95% CI: 1.13-2.28] and age [OR = 1.03, 95% CI: 1.01-1.04] emerged as significant risk factors. This intermediate prevalence urges further investigations on HEV infection in the Islamic Republic of Iran

Seroprevalence of hepatitis B in Nahavand, Islamic Republic of Iran

We determined the seroprevalence of hepatitis B in Nahavand in a sample of 1824 subjects > 5 years in 2002. Face- to- face interviews were conducted and blood samples taken. The association between risk factor and hepatitis B was assessed using logistic regression. The prevalence of HbsAg positive cases was 2.3%, and HBcAb and HBsAb were isolated in 7.8% and 11.6% of the participants respectively; 11.9% were positive for both HBcAb and HBsAb. History of surgery and imprisonment were the major risk factors for infection with odds ratios of 2.14 [95% CI: 1.22- 3.05] and 3.57 [95% CI: 1.68- 5.4] respectively

epidemiology of primary infertility in the Islamic Republic of Iran in 2004-5

Infertility is a common problem around the world followed by psycho-social conesquences. Determining the prevalence of infertility in society can assist health system decision-makers to plan the provision of health and medical services more precisely. This study was conducted in response to the question of the Iranian Scientific Association of Fertility-Infertility with the aim of determining the prevalence of life-time primary and current primary infertilities in the Islamic Republic of Iran. This study was conducted by using a cross-sectional method on 12000 Iranian women aged 19-49 as the couples' representatives in 28 provinces of the country in 2004-2005. The sampling method was based on the systematic random selection of 400 thirty-household clusters with a proportionate probability to the size of the population of urban and rural areas of each province. The lifetime primary infertility was defined based on one of the two scenarios that follow: The first scenario: 1] A safe contraceptive method has been used after marriage, 2] but the use of contraceptive has been discontinued after a while, 3] 12 months or more past the first discontinuation of the contraceptive method at the time of the study and 4] The case has not become pregnant within 12 months after discontinuation of the contraception method. The second scenario: 1] A safe contraception methods has not been used after marriage, 2] No conception was achieved within 12 months after marriage. The term current primary infertility was applied to a woman who had never been conceived up to the study, as well as being defined by one of the above definitions. Data analysis was conducted by using STATA 8.0 software while considering the concepts of descriptive statistics and computing the 95% confidence intervals. Lowess smoothing method was also used to smooth the scatter plot of the relationship between infertility and age at the time of the first marriage. In this study, 7350 urban and 4650 rural Iranian women, aged 19-49 in 28 provinces were interviewed. Among the 12000 interviewed subjects 630, [5.3%], cases were not eligible for the study and were left out of the study and the denominator of the primary infertility computation fraction. A history of life-time primary infertility was observed in 24.9% of the couples, [95% CI: 23.6-26.2%], as was the prevalence of current primary infertility in 3.4% of them, [95% CI: 3.0-3.8%]. The trend of lifetime primary infertility showed that the highest estimate was related to the lowest marriage age and the lowest prevalence was observed at the marriage age of 22 in 19% of the cases. This trend remained stable up to the age of 28 but it increased afterwards. The mean age of the subjects at the first marriage was 18.1 +/- 3.8 and a median of 18 years. About one fourth of Iranian couples experience primary infertility in their lives and 3.4% of them have this problem at any time in their life. In interpreting the prevalence of life-time primary infertility and provision of its related health and medical services, paying attention to age at the time of marriage and couples state of fertility is of importance

[Experience of a population- based study on needs and health status of affected people in Bam earth Quake]

On 26 December 2003, an earthquake measuring 6.5 on the Richter scale struck the city of Bam and the surrounding villages. This study was conducted to determine the needs of the affected population on the 19[th] and 20[th] days after the quake to help with the prioritization of relief activities and efficient resource allocation. Following a feasibility study on 10 Jan 2004, a team consisting of volunteer students of School of Public Health at KUMS was assembled and trained. Each of the 8 groups consisted of 3-4 students with at least 1 man responsible for security on the field. On the 13th and 14[th] of January, using a cross-sectional design, 60 clusters including 420 households, 7 households in each cluster, were studied based on a Cluster Geographic-Based Sampling [GBS] Plan. Fifty-five households [13.1%] had children < 2 years, 81 [19.3%] had children aged 2-5 years and 68 [16.2%] contained people more than 65 years old. Thirty-seven households [8.9%, CI 95%: 6.4-11.7%] had changed their residence in Bam from one zone to another; the main reason for this was poor environmental health conditions [85%]. The main source of health and social messages for families was word of mouth 284 [67.6%]. The most commonly needed items were bathrooms [73.8%, CI 95%: 68.9-78.7%], food [68.8%, CI 95%: 62.6-75.0%] and warm clothes [67.4%, CI 95%: 60.9-73.8%]. The most frequent illness was acute respiratory infection [59.8%, CI 95%: 54.3-65.2%]. Two hundred households [47.6%, CI 95%: 42.6-52.6%] complained of difficulties in obtaining health and medical services. The main barrier to access was transportation problems due to long distance [38.1%, CI 95%: 35.6-40.6%]. We conclude that relief operations should be continued to provide basic public health facilities. Active delivery of health and medical services should be strengthened, and problems related to reproductive health should not be ignored. The GBS plan is a useful tool in the post-disaster surveys. Using volunteer university students was a rewarding experience and teaching and application of [Disaster Epidemiology] should be improved in this country

[The degree of unemployment and reasons for not finding appropriate jobs among Iranian physicians]

Unemployment which had been a problem of less educated and unskilled people has become a problem in most of the countries for even the educated and the skilled persons. Unemployment among physicians in Iran has been the subject of discussion during the past so many years, and its severity, causes and ways of combating it has been a focus of discussions in different circles. It is a mail survey conducted on random sample, sized 5482 physicians, from registered physician roster at the Medical Association of Islamic Republic of Iran. The questionnaire included items on employment and unemployment quality and some related factors. The final analysis is based on the 2789 returned questionnaires. Total unemployment has a point prevalence of 9.4% among Iranian physicians [95% CI: 8.3% - 10.5%]. When summed with physicians with qualitative unemployment, this figure reaches 13.7% [95% CI: 12.4% - 14.9%]. Considering quantitative unemployment, the total ratio reaches 25.5%. Half of the unemployed physicians have seeked jobs for more than a year, and they mostly attribute their failure to low income of medical jobs and limited positions for physicians in the governmental sector. Unemployment, in different forms from total to qualitative and quantitative forms affects from one-tenth to one fourth of Iranian physicians. This problem is not limited to Iran, but has been seen in many other countries, especially those that had increased the strength of their medical students in the past. The solution of this problem needs its accurate identification and factors affecting it or related to it. Solving this problem needs finding its accurate fissure and the related factors