More than seven months have passed since the magnitude 7.8 earthquake struck southern Turkey and Syria on February 6, 202311. Immediately after the earthquake, dozens of cases of crush syndrome were reported24, and risk factors for infectious disease outbreaks were concentrated in the affected areas in both countries. Tens of thousands of people were displaced as their homes either collapsed or were severely structurally damaged, making it impossible for them to return to their homes. A lack of access to safe drinking water, overcrowding, and poor sanitation resulting from the destruction of lifelines were the main risk factors of infectious disease outbreaks in the earthquake-affected areas of Eastern Anatolia; in addition, crises of various origins—such as the war conflict, the COVID-19 pandemic, and the cholera epidemic—coexisted and synergized with the disaster-related events25.
After the Turkey–Syrian earthquake, many researchers published insights on how to address the mental health needs of those affected26,27,28,29. Still, the effective prevention of mental health problems following disasters tends not to involve a major initial focus on mental health interventions right after the crisis. This is because affected populations tend to not be ready to receive mental healthcare in the immediate aftermath of a natural disaster29. Instead, the primary the focus should be on meeting the specific basic and physical needs of survivors, for whom there tends to be a lack of life-sustaining resources. Thus, comprehensive knowledge of post-disaster care is necessary when devising measures to alleviate pressure on health services, prevent mental health impacts on those affected, provide therapeutic benefits, build collective resilience to cope and, above all, recover from disasters. Our research has allowed us to present the evaluation of a booklet on post-disaster care developed based on the experiences of the Great East Japan Earthquake, which may be used by stakeholders for a more effective distribution of the limited medical resources after a disaster to victims in need of medical knowledge.
Few previous studies have examined the effectiveness of booklets on post-disaster care. One of the few related studies involved a telephone questionnaire to assess sources of health and safety information, recalled information, and behavioral responses among residents of the town of Fielding, New Zealand, following a major flood in February 200430. The primary sources of information were radio (41%), brochures (23%), and newspapers (20%). This past evidence showcases that pamphlets/booklets are an important source of post-disaster health and safety information.
In the current survey, local government officials and others expressed a high level of satisfaction with the booklets prepared by Tohoku University experts (81.5%), albeit many expressed the opinion that the booklets may be difficult for the general public to understand. Although the graphs in the booklet showing the results of surveys conducted on the Great East Japan Earthquake are trustworthy, there were concerns that the public would not be able to understand their meaning and not know how to utilize the findings. Meanwhile, many preferred for the booklet to contain contact information for specific consultation services; if such information is indeed added, people would then be able to refer to a single source (i.e., the booklet) for information on whom to consult and the contact information, instead of having to search for contacts individually.
In Japan, local government officials are generally heavily involved in the collection of post-disaster public health information. Previous studies have considered the participation and knowledge of local government officials as important; for example, after the Great East Japan Earthquake, the knowledge of local government officials on radiation risks has been investigated31. Furthermore, while Japanese local governments have primary responsibility for disaster management, they often have limited capacity and experience in disaster management32. Therefore, it is a challenge for Japanese local government officials to learn from disasters that have occurred in other regions. This may explain why, in our sample, the “Post-Disaster Health Care” booklet was deemed useful by the officials for dealing with these challenges and facilitating the learning from other disasters. Most of the general public, in Japan and worldwide, obtain post-disaster information from TV, radio, and other media, and rarely obtain direct knowledge from experts33. These past findings once again underpin how the post-disaster booklet may be used and distributed by local government officials to further explain the situation to disaster victims.
Among the contents of the “Post-Disaster Health Care” evaluated in this study, the highest level of comprehension was for “prevent infectious diseases” (86.3%). This was clearly influenced by the COVID-19 pandemic, as the first case of coronavirus disease (COVID-19) had been detected in Japan on January 15, 2020, and the survey period for this study was shortly after this period (January 30 to February 28, 2020). In addition, the percentage of respondents in their 20s who responded that they took care of their health using health checkups and cancer screening was higher than the overall percentage. For the period after the Great East Japan Earthquake, only data on cervical cancer screening rates were presented in booklets when talking about cancer screening, which might have been a factor in the higher interest of people aged in their 20s. This may be because our survey was conducted during an ongoing campaign in Japan to encourage women aged 20–24 years to undergo uterine cancer screening34, as resistance to such screening has become an issue35.
The free text responses also revealed that it may be difficult for the public to accept the university- and scientific-based knowledge, which in turn was derived from past experiences of the Great East Japan Earthquake, relayed through the booklet. Specifically, participants remarked that the results should preferably be presented in concrete terms—rather than solely as graph data—to encourage the public to consider the issues. In addition, changing the design and font size may be beneficial for public acceptance of post-disaster care booklets.
The results suggest that more collaboration with the public is necessary to ensure the appropriate distribution of academic research knowledge to the public. Thus, it is beneficial for local governments, which serve as a bridge between universities and the public, to evaluate the contents of booklets. The findings of this study, which provide reference data based on the evaluations of governments and organizations of a post-disaster care booklet, may be useful for universities in making informed decisions about appropriate actions and initiatives for the benefit of local residents in disaster-affected areas in the future.
A limitation of this study is that the respondents were limited to Japanese local government officials, who in turn played and continue to play a central role in disaster management in Japan. Outside of Japan, local government officials do not always play a central role in disaster and post-disaster management, and they may not be appropriate respondents. While these limitations may have compromised finding accuracy, it is unlikely for this to have severely compromised the general finding patterns found.