Vol.1, No.4, 298-303 (2009)
Copyright © 2009 Openly accessible at http://www.scirp.org/journal/HEALTH/
Health status of transitional resettlement sites after the
earthquake in Mianyang city of Sichuan province
Ying-Hua Li, Ling Qian, Xue-Qiong Nie, Li LI, Xian-Peng Meng, Jin-Bin Zhang, Li Tong, Li
Xiao, He Xing, Chang-Sheng Huang, Tao Hu, Yan Ning, Yan Chen, Yu Ma, Mao-Xuan Tao
Chinese Center for Health Education, Beijing, China; liyinghua729@sina.com
Received 5 August 2009; revised 1 September 2009; accepted 1 September 2009.
Objective: To understand the health status of
transitional resettlement sites and the needs
of residents on health education, and to pro-
vide basis for conducting health education
after ear- thquakes and other public emergen-
cies. Method: From May 31 to June 2, 2008 (19
to 21 days after the earthquake), field obser-
vation, questionnaire survey, and structured
interviews were conducted in five transitional
resettlement sites. Information on health
status, health service, health education, and
residents’ needs on health education was col-
lected. Results: 430 questionnaires were dis-
tributed and 424 valid completed ones were
returned. Food and water were adequately
supplied. Clinics for health assistance were
established and environment disinfecting was
conducted regularly by public health profes-
sionals. Health education was available to
residents. The large proportion (98.6%, 97.9%,
88.7%, and 93.2% respectively) of the residents
acknowledged that water supply, food supply,
lavatories, and health service were adequate
to fulfill basic needs. The overall disease in-
cidence of surveyed residents was 44.8%, and
diarrhea and fever with respiratory symptoms
were the most common diseases. Among
residents’ needs on disease prevention knowl-
edge and skills, basic knowledge of infectious
diseases was most desirable (49.8%), and
safety knowledge of water uses was secon-
darily most desirable (36.8%). The most fa-
vored approach of obtaining knowledge was
watching television. Conclusions: In the pe-
riod of 20 days after the earthquake, Living
security, health facilities, and health care ser-
vice could satisfy residents’ basic needs.
Post-disaster health education should con-
centrate on basic knowledge and skills of
communicable diseases and health- risky be-
havior. Timely distributing disease prevention
materials could be effective.
Keywords: Earthquake; Disaster Areas; Health
Status; Health Education; Needs;
On May 12, 2008, an earthquake with magnitude 8.0 hit
Wenchuan, Sichuan Province. The quake caused thou-
sands of deaths and injured, destroyed buildings and
roads, and brought about huge financial loss. In the af-
fected area, water and electricity supply were interrupted,
and health care facilities and systems were enormously
damaged, which resulted in the high risk for the outbreak
and epidemic of intestinal communicable diseases, vec-
tor-borne diseases, food-borne diseases, diseases of
natural focus, and infectious diseases transmissible be-
tween human and animals. Food and water safety, envi-
ronmental health, health care service, and
post-earthquake health education were the most impor-
tant issues in disaster relief. To understand the health
condition of transitional resettlement sites and residents’
needs on health education, Health Education Institute,
Chinese Center for Disease Control and Prevention
(China CDC) (Notenow named Chinese Center for
Health Education/ Heath News Communication Center,
Ministry of Health of China) conducted this study from
May 31 to June 2, 19 to 21 days after the earthquake.
2.1. Participant
The resident in five transitional resettlement sites in
Mianyang city, Sichuan Province were surveyed by the
same questionnair, and they were from Beichuan
county, one of the worst-hit areas. Four hundred and
thirty questionnaires were distributed, and four hun-
dred and twenty four valid questionnaires were re-
Y. H. Li et al. / HEALTH 1 (2009) 298-303
SciRes Copyright © 2009 Openly accessible at http://www.scirp.org/journal/HEALTH/
turned. Sixty participants (14.2%) were currently liv-
ing in Huangtu transitional resettlement sites, seventy
two (17.0%) in Anzhou driving school, one hundred
and fourteen (25.9%) in Leigu, Beichuan, and sixty
eight16.0%) in Gaoxin. Participants were Beichuan
County residents, 208 males and 216 females. The
average age was 35.3±13.3,, the minimum age was 10
and the maximum age 84. Most of them (70.5%had
an elementary or middle school degree,and 78.3% of
them were from Qiang minority race.
2.2 Sampling Methods
Convenience sampling method was used to select five
sites for observation and participants for survey. Age and
gender were proportionally distribute.
2.3. Observation
Administrators examined the heath condition, health
care, and health education at transitional resettlement
sites. Collected information included water and food
supply, living health condition, environmental health
(i.e., lavatories, and garbage collection and manage-
ment), health care and drug supply, and the condition of
health education.
2.4. Questionnaire Survey
The questionnaire was self-designed and some contents
were derived from environmental assessment question-
naire developed by China CDC and WHO [1-3], includ-
ing several dimensions: water and food supply, health
condition, health care, incidence of diseases, and post-
disaster needs. Participants were interviewed face-to-
face by administrators.
2.5. Personal In-Depth Interview
Participants were randomly selected from those who
were recruited for questionnaire survey. Interviews fo-
cused on post-disaster water and food supply, personal
hygiene stuff, the interruption of cooking food, residents’
evaluation on health education materials, and the major
difficulties they were facing.
2.6. Quality Control Survey Administrators
Received Standardized Trainings
They were guided and supported by local health depart-
ments. Participants were informed of the intent and im-
portance of the study. Leaders of each survey group su-
pervised the information collection process and assessed
every returned questionnaire
2.7. Statistical Analysis
Epi data 3.0 was used to help data entry, and SPSS 13.0
was used to conduct statistical analysis.
3.1. Health Condition and Health Care
It was indicated by observation and survey that there
was sufficient drinking water and food supply in transi-
tional sites. Lavatories were enough to serve temporary
residents. Every transitional site had established tempo-
rary health assistance and professionals to carry out en-
vironmental disinfection. Health education in form of
health materials, posts, lectures, and volunteer in-door
health promotion was delivered. However, water for
living was not adequate at several sites, and the types of
medicine were limited, as shown in Table 1 and Table 2.
3.2. Diseases and Sought for Health Care
Fifty eight participants (13.7%) ever had diseases or
symptoms. Diarrhea (54.2%) and fever with respiratory
symptoms (32.1%) were the most common health prob-
3.3. Health Education Condition and Needs
3.3.1. Residents’ Health Knowledge, Belief and
Participants had some health-related knowledge and high
level of awareness of drinking water safety and rabid.
However, unhealthy behaviors occurred among residents,
including drinking uncooked or unprocessed water, us-
ing domestic water that had not been disinfected, and
failing to discharge leftovers as shown in Table 3.
3.3.2. Health Education Needs
In response to the question of the two most desirable
things, 101 participants (23.8%) expressed that one of
them should be health and disease prevention knowledge,
while the majority of them supported that they should be
the living necessities including water, food, and resi-
dence. Thirteen participants thought that they did not
need any assistance. In response the question of the two
most desirable medical assistances, 188 participants
(44.3%) supported that one of them should be diseases
prevention knowledge and skills, while the majority of
them wanted convenient health care service. Twenty six
participants (6.1%) thought they did not need any health
assistance. When it came to knowledge and skills of
diseases prevention, basic information about communi-
cable diseases was most favored, as shown in Table 4.
3.3.3. Where to Access the Knowledge and
Skills of Disease Prevention
Participants gained knowledge and skills mainly from
the health education materials, including booklets, bro-
chures, foldouts, and posts, and the programs broad
casted by the speakers in transitional sites were the most
popular strategy to deliver health education. The most
favorable way is television and materials.
K. C. Chou et al. / Natural Science 1 (2009) **-**
SciRes Copyright © 2009 http://www.scirp.org/journal/HEALTH/
3.4. Personal Interview Results
One hundred and thirteen participants were inter-
viewed. Twenty eight (24.8%) were currently living in
Huangtu transitional resettlement sites, twenty five
(22.1%) in Anzhou driving school, thirty six (31.9%)
in Leigu, Beichuan, eighteen (15.9%) in Yong’an, and
six (5.3%) in Gaoxin. There were 43 males (38.1%)
and 70 females (61.9%). The average age was 40.3±
6.5, the minimum age was 10 and the maximum age
was 71. Most of them (78.9%) were from 18 to 59
years old.
The percentages of participants who experienced in-
terruption of food, drinking water, domestic water, lava-
tory, safe living places, health care, bathroom stuff, and
food processing stuff were 45.0%, 45.5%, 44.4%, 46.2%,
53.3%, 48.1%, 53.8% and 83.0%, respectively.
Table 1. Health condition and Health care.
Items Condition Identified problems
Collectively and adequately supplied; Mainly
packaged food; Infant formula milk powder sup-
plied; A few cooked food supplied.
Singleness of food types; Impossible
for cooking processing.
Drinking water Mainly bottled; Collectively supplied. Cooked water supply not sufficient
Domestic water
Water disinfection by big water processing equip-
ments; Collectively supplied; Water collection sites
with 50 meters or five-minute walking distance.
If water from rivers or springs was
used, disinfection could not be done by
Residence condition
Mainly tents set by governments; Approximately
12 square meters for 8-10 residents; Temporary
wood buildings established for health care assis-
tance use.
Extreme density.
Mainly dry lavatories build after the tremor;
Cleaned every day; Within 50 meters and five-
minute walking distance.
The hygiene of the lavatories survived
from the tremor and commercial lava-
tories were not acceptable.
Most garbage cans topped and depleted every day;
Insecticide applied two times a day; Mosquito nets
distributed to children; Livestock feeding stuff
possible at several sites and animals fenced.
Uncanned garbage found in transi-
tional sites.
Health care One or more health care place for each site, within
50 meters and five-minute walking distance.
Supply of medicine for chronic dis-
eases adequate.
Health education
Posts and brochures distributed; Health knowledge
promoted by medical professionals and volunteers;
Broadcasting programs available in some sites.
Materials mainly in the form of leaflets
and brochures; Content deficient in
Table 2. Residents’ evaluation on health condition and health care.
Items Reaction Number %
Drinking water Completely satisfied 316 74.5
Basically satisfied 102 24.1
unsatisfied 6 1.4
Food Completely satisfied 295 69.6
Basically satisfied 120 28.3
unsatisfied 9 2.1
Lavatory Completely satisfied 222 52.4
Basically satisfied 154 36.3
unsatisfied 48 11.3
Lavatory condition Clean 341 80.4
Fairly clean 61 14.4
Less clean 22 5.2
Commit nuisance Commonly 14 3.3
Less commonly 73 17.2
Rarely 337 79.5
Mosquitoes and flies Many 143 33.8
Comparatively less 155 36.6
Few 126 29.7
Health care Completely satisfied 251 59.2
Basically satisfied 144 34.0
unsatisfied 29 6.8
Openly accessible at
Y. H. Li et al. / HEALTH 1 (2009) 298-303
SciRes Copyright © 2009 Openly accessible at http://www.scirp.org/journal/HEALTH/
Table 3. Health knowledge, belief, and practice.
Questions The number of yes
responses %
Knowledge and belief
Drinking uncooked or unprocessed water could do harm to health.402 94.8
Do not share washbasins and towels with relatives who had pink-
eye disease. 295 69.6
Rabid vaccine is needed after being biting or scratched by dogs
and cats. 391 92.2
Ever drunk uncooked or unprocessed water 55 13.0
Disinfected domestic water that was collected by themselves
(n=110)* 51 46.3
Ate overdue food (n=167)* 6 3.6
Discharged waste water everywhere 27 6.4
Cleaned garbage everyday 62 14.6
Made efforts to prevent mosquitoes, flies, and rats 195 46.0
Ventilated living places 378 89.2
Washed hands before meals and after using the restroom. 396 93.4
Leftover reheating (n=163)*
Completely reheated 123 75.5
Just warmed 16 9.8
Did not reheat, because of lack of needed equipments 19 11.7
Did not reheat, since it is not needed 5 3.1
Separated the raw and the cooked (n=58)*
Yes. 54 93.1
No, since not allowed by living situations. 4 6.9
No, since it is not needed. 0 0.0
Note:* indicated that only those ever had overdue food, needed stuff for cooking, and self collected water were
Table 4. Participants’ needs on general support, health care, and disease prevention.
Items Number %
General supportsThe most desirable two
Safe living places 259 61.1
Sufficient water and food supply 178 42.0
Knowledge and skills of health and diseases prevention 101 23.8
Ability and skills of escaping from the tremor and helping each other 63 14.9
Psychological assistance 26 6.1
Others 65 15.3
Needs on health and disease preventionThe most desirable two
Convenient health care service 191 45.0
Knowledge and skills 188 44.3
Disinfectants 182 42.9
Medicines 4 0.9
Needs on knowledge and skills of disease prevention
Basic knowledge of communicable diseases 211 49.8
Drinking water safety 156 36.8
Food safety 140 33.0
Prevent mosquitoes, flies, and rats 132 31.3
Local communicable diseases 126 29.7
Y. H. Li et al. / HEALTH 1 (2009) 298-303
SciRes Copyright © 2009 Openly accessible at http://www.scirp.org/journal/HEALTH/
Table 5. Where to access the knowledge and skills of disease
Already gained Expected to gain
Where Number % Number %
Television 131 30.9 195 46.0
Broadcasting 159 37.5 127 30.0
Newspapers 102 24.1 94 22.2
Books 61 14.4 89 21.0
Medical professionals 100 23.6 123 29.0
CDC staff 123 29.0 126 29.7
Relatives/ friends 62 14.6 42 9.9
Propaganda materials 209 49.3 160 37.7
The speakers in tran-
sitional sites 24 5.7 20 4.7
Never gained 22 5.2 — —
Although the problem of cooking food remained unre-
solved, other life necessities were fully supplied by gov-
ernments. The total period of the interruption was con-
trolled to be within two days at every site. The existing
difficulties include the singleness of food which caused
digest problems and stomach upset of the elder and chil-
dren, extreme density of living places where both tem-
perature and humidity were at a high level, lacking of
bathing stuff, children education, job interruption, the
loss of household asset, and financial crisis.
86.9% of participants supported that post-earthquake
health education was needed, and 41.6% of them thought
that brochures and books were the best method of educa-
tion since the content could contain a wide range of in-
formation, be systematic, and be understandable. 78.2%
of them had a positive evaluation toward the delivered or
posted health education materials.
The survey was conducted 19-21 days after the earth-
quake. The results indicated that basic life necessities
and health care facilities and service could fulfill resi-
dents’ needs. Water and food supply were adequate, and
there were sufficient lavatories and garbage recycling
sites that were cleaned every day. Environmental disin-
fection, mosquito, fly, and rat prevention had remarkable
effects. Few flies and rats were observed by residents.
However, many problems had been identified. There is
the risk of food safety issue since food was from outside
of the earthquake hit areas [4]. The mainly supplied food
was packaged noodles and cookies, which could effec-
tively prevent intestinal infectious diseases. However,
more efforts should be made to enrich the types of food
and provide appropriate food to the elder and children. It
was fairly crowded in temporary tents where the tem-
perature and humidity were high. Tents were not enough
to ensure family as the small unit to be accommodated.
Many health care sites only had emergency drugs like
anti-bacteria and flu treatment drugs, but the drugs for
chronic disease such as high blood pressure and diabetes
were not enough to satisfy the needs. Moreover, the
bathing stuff were so insufficient that residents could not
shower every day.
There were three kinds of lavatories available at each
site: dry ones established after the tremor, remaining
ones that survived from the tremor, and commercial mo-
bile lavatories. The dry lavatories were the most appro-
priate ones for environmental health. They were easy to
build at a lower cost and could serve many people. The
other two kinds of lavatory could not be cleaned easily
since the water supply was interrupted, which could re-
sult in the proliferation of flies and mosquitoes [5]. Ad-
ditionally, commercial mobile lavatories were not easy
to transport and their cost was high. Thus, it was sug-
gested that dry lavatories should be established in time
after earthquake.
The most common health problems among residents
were diarrhea, fever with respiratory symptoms, heat-
stroke, cold, and dermatitis. The post-tsunami effects
caused by stress sources such as lifestyle changes, the
death of relative, and the loss of incomes could cause
disorders of the immune system, make residents vulner-
able to varieties of diseases. The density and humidity of
the residence might be the cause for dermatitis.
The environment changed dramatically after the
earthquake. If residents lacked the knowledge and will-
ingness of disease prevention, or there were not enough
health facilities such as lavatories, personal hygiene stuff,
or even if related facilities were available but residents
did not have a healthy behavior pattern, communicable
disease could break out easily. Thus, post-earthquake
health education was highly important. According to the
results of the survey, residents had some unhealthy be-
haviors, like using non-disinfected river water as living
water. Post-earthquake health education should follow
the principles applying to outbreak public health emer-
gencies, be delivered in time, and focus on those at high
risk[6]. Booklets/brochures were the most favorable ma-
terials since they can have a wide range of information,
be systematic and understandable, be kept easily. Tele-
vision was the most method favored by the residents. It
was highly appropriate for those who receive less educa-
tion. As residents were being relocated, televisions
should be equipped. Furthermore, the speakers at each
site should be fully used to implement health education.
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in earthquake areas [EB]. http://www.chinacdc.net.cn.
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