Lessons in Posttraumatic Stress Disorder From the Past: Venezuela Floods and Nairobi Bombing

Identification and treatment of posttraumatic stress disorder (PTSD) are important following a disaster.Insights into how these aims can be achieved may be obtained from previous disasters. Thisarticle describes mental health initiatives following the 1999 flooding in Vargas State, Venezuela, andthe 1998 U.S. Embassy bombing in Nairobi, Kenya. Following the Vargas State floods, a specialistmental health center devoted to the diagnosis, treatment, and follow-up of PTSD was established.Awareness and acceptance of the clinic was promoted by media campaigns and community-basedactivities. After 18 months, approximately 5000 people had been screened, of whom 62% were diagnosedwith PTSD and treated. Moreover, the clinic’s activities had expanded to include treatment ofother medical conditions and assistance with nonmedical needs. Following the Nairobi bombing, amass media campaign was initiated to create awareness of PTSD symptoms and help victims come toterms with their experience. This campaign was found to be well received and helpful. In addition,counselors were trained to support people living or working close to the blast. These examples showthat mental health initiatives are feasible after a disaster and highlight a number of issues: (1) Theintervention should be tailored to the needs of the target population; (2) Communication should besimple and appropriate; (3) Community-based activities are valuable in promoting awareness and acceptanceof mental health initiatives; (4) Reducing the stigma often associated with mental healthproblems is important; and (5) The mass media can be helpful in promoting awareness of mentalhealth issues following major trauma.