Disaster and Mental Health - Athens Earthquake PDF

DISASTER AND MENTAL HEALTH Athens Earthquake Submitted by: Doble, April Rolls, Mariekris Ong, Vivien Punsalan, Deline Allyson Sue Tagulao, Ace Justin, C. BEFORE THE TRAGIC EVENT HAPPENED IN GREECE… The 1999 İzmit earthquake struck Kocaeli Province, Turk...

DISASTER AND MENTAL HEALTH Athens Earthquake Submitted by: Doble, April Rolls, Mariekris Ong, Vivien Punsalan, Deline Allyson Sue Tagulao, Ace Justin, C. BEFORE THE TRAGIC EVENT HAPPENED IN GREECE… The 1999 İzmit earthquake struck Kocaeli Province, Turkey on August 17, 1999, with a magnitude of 7.6 Mw. It occurred at 03:01 local time (00:01 UTC) and lasted 37 seconds, with a shallow depth of 15 km (9.3 miles). The earthquake had a maximum intensity of X (Extreme) on the Mercalli scale and caused widespread destruction, particularly near the city of İzmit, close to the epicentre. The earthquake was part of the ongoing seismic activity along the North Anatolian Fault, which has produced large earthquakes since 1939, progressively moving from east to west. The total casualties were estimated between 17,127 and 18,373 deaths, with 43,953 to 48,901 injured and 5,840 missing. It caused damage valued between $3–8.5 billion USD. The earthquake is remembered as one of the deadliest in modern Turkish history, and it prompted the creation of an earthquake tax to aid recovery efforts. ATHENS EARTHQUAKE According to Lekkas (2001), On September 7, 1999, Athens was hit by a devastating earthquake, resulting in 143 fatalities, around 700 injuries, and significant damage to approximately 70,000 buildings. The earthquake, with a magnitude of 6.0, struck at 2:56:50 PM local time (11:56 GMT) and lasted several seconds, primarily affecting the area of Ano Liosia. The epicenter was located about 17 kilometers northwest of the Athens city center, in a sparsely populated region between the working-class town of Achanes and Mount Parnitha National Park. The highest recorded peak ground acceleration was 0.3g, detected 15 kilometers from the epicenter, though estimates suggested that acceleration at the center reached 0.6g. Greek seismologists were caught by surprise as the quake originated from an unknown fault in a region considered to have low seismic activity. Preliminary assessment shows that 672 homes were destroyed beyond repair while 2,217 more were in need of repair. The greatest damage to buildings occurred in the Athens suburbs of Menidi, Ano Liosia, Nea Filadelphia, Nea Ionia, Kifissia and Zefyri. There was no apparent damage to the Acropolis, to the Temple of Zeus, and other antiquities in the area. Many buildings, including three large factories, collapsed, trapping numerous individuals beneath the rubble, while dozens of other structures suffered severe damage. This earthquake became Greece's deadliest natural disaster in nearly 50 years and the most severe and costly disaster in the country in two decades. Fortunately, the Acropolis and other famous ancient monuments in Athens remained mostly unscathed or sustained only minor damage. However, there were reports of a landslide and cracks along the road to Mount Parnitha, as well as some minor damage to the water and waste systems near the epicenter. The total cost of the damage was estimated between $3 and $4.2 billion. EARTHQUAKE EPICENTER, ORIGIN TIME, MAGNITUDE AND AFTERSHOCKS The earthquake's epicentre (38.13N, 23.55E) was located roughly 20 kilometers northwest of Athens, between Menidi and Mount Parnes, an area that is part of a national park and sparsely populated. According to the Athens Seismological Institute, the earthquake had a magnitude of 5.9 on the Richter scale and struck at 23:07:41. Its effects were felt across the Aegean Sea and as far as Izmir, Turkey, about 180 miles east of Athens. In Athens and its surrounding suburbs, the quake was felt with significant intensity. This was due to the orientation of the fault that caused the earthquake, which aligned with the city, as well as the relatively shallow depth of its focus (10 kilometers). In the days following the main quake, more than 700 aftershocks were recorded, including eight with magnitudes above 4, and one reaching 4.7. IMPACT OF EARTHQUAKE - Numerous buildings collapsed, including three major factories Rikomex, Faram, and Fourlis, while leaving dozens of workers dead - Many people were trapped under the debris. - Dozens of other structures were severely affected. SIGNIFICANCE OF THE EVENT This earthquake is Greece's deadliest natural disaster in nearly 50 years. It is the most devastating and costly natural disaster to strike Greece in nearly two decades. The estimated total cost of damage is between $3–4.2 billion. CONDITION OF HISTORICAL SITES The Acropolis of Athens and other renowned ancient monuments emerged largely undamaged or with only minor harm. However, the worst destruction and casualties have been reported in working-class and immigrant neighborhoods north of Athens, where construction standards were not as rigorously enforced. As dust-covered and shocked victims are pulled from the rubble and rushed to hospitals in ambulances, the scenes in Athens bear a haunting resemblance to the recent tragedy in Turkey, although on a smaller scale. Remarkably, the Acropolis of Athens and other renowned ancient monuments emerged largely undamaged or with only minor harm, preserving Greece's cultural heritage. However, there were reports of a landslide and several cracks along the road leading to the summit of Mount Parnitha, indicating localized risks to infrastructure. Minor damage to the water and waste networks was also noted near the epicenter, complicating recovery dynamics in the immediate aftermath of the disaster MITIGATION In the aftermath of the 1999 Athens earthquake, significant changes were implemented in Greece's building codes to enhance seismic safety. These modifications aimed to address the vulnerabilities exposed by the disaster and included the introduction of stricter construction standards and the development of comprehensive regulations for retrofitting and reinforcing buildings. Introduction of Modern Anti-Seismic Regulations Anti-seismic regulations in Greece were established as early as 1959, with subsequent updates made in 1978 and 1995. Greece's modern anti-seismic building regulations were first instituted in 1985, but they received a major upgrade in 2000 following the 1999 earthquake. However, it was the 1999 Athens earthquake, which resulted in substantial damage and loss of life, that prompted a comprehensive reevaluation and upgrade of existing codes. This led to the implementation of the EAK-2000/2003 provisions, designed to bring the building codes in line with modern engineering practices and seismic hazard assessments. This revision addressed the need for stricter building standards to improve the resilience of structures against seismic forces. History of Greek Seismic Code The history of the development of the Greek regulations system according to Saber (2019). 1959 - The first Greek Seismic Code (E.A.K.) was drafted.  1984 - E.A.K. was supplemented with additional articles, the exclusive application of which started in 1985. 1995 - The New Greek Seismic Code (N.E.A.K.) was established and put into force and since 2000 the main regulations that are enforced is E.A.K. – 2000. 2000 - Since then multiple amendments and supplementations occurred, and clarifications added wherever needed. Adoption of EAK-2000/ EAK-2003 Provisions EAK-2003 stands for "Ελληνικός Κανονισμός Οικοδομικών Έργων" (Greek Seismic Code) and was developed as an improvement upon earlier seismic codes, particularly EAK-2000. It was promulgated after the devastating 1999 M5.9 earthquake in Athens, which underscored the necessity for stringent building safety measures to mitigate future earthquake risks. The EAK-2003 provisions introduced a series of significant updates and enhancements to the existing seismic design codes in Greece, aimed at improving the safety and resilience of buildings against earthquakes. These changes reflect a response to the vulnerabilities exposed by the 1999 Athens earthquake and align with modern engineering practices. Seismic Hazard Zonation Map An important aspect of the EAK-2003 provisions is the adoption of a new seismic hazard zonation map. This map categorizes different regions of Greece based on seismic risk, allowing for tailored building requirements that reflect localized hazards. The map was developed after extensive research and analysis of seismic activity in the country and is integrated into the regulatory framework to guide the design and construction of buildings. Integration of Advanced Design Concepts The EAK-2003 code incorporates more advanced seismic design concepts compared to its predecessors. It emphasizes performance-based design, which focuses on ensuring that structures can withstand varying levels of seismic activity without experiencing catastrophic failure. This shift represents a move away from purely prescriptive guidelines to more flexible, outcome-oriented standards. Enhanced Seismic Advanced Assessment The EAK-2003 provisions include a thorough seismic hazard assessment based on extensive probabilistic analysis. This approach allows for a detailed evaluation of seismic risks specific to different regions within Greece, taking into account factors such as geological conditions and historical seismic activity. Such detailed hazard assessments were less comprehensively addressed in earlier codes, which relied more on generalized risk profiles. Revised Structural System Requirements The updated code specifies stricter requirements for different structural systems used in construction. For example, EAK-2003 mandates that certain structural types, such as reinforced concrete and steel frameworks, meet higher standards for lateral forces and stability under seismic loads. These structural requirements are designed to enhance the  overall resilience of buildings against earthquake impacts, addressing inadequacies found in previous regulations. Retrofitting Structure Guidelines Recognizing that many older buildings remain vulnerable, the EAK-2003 provisions also address retrofitting strategies for improving the seismic resistance of existing structures. Guidelines were established for upgrading these buildings to meet modern safety requirements, particularly those constructed before the introduction of more rigorous codes. This proactive approach aims to protect both residents and vital infrastructure in seismically active regions. Effectiveness of EAK-2003 Provisions Several notable case studies illustrate the positive impact of EAK-2003 regulations on building safety and performance in seismic conditions in Greece. These case studies primarily focus on the enhanced structural resilience of modern buildings constructed under the EAK-2003 provisions, particularly in their ability to withstand significant seismic forces and the lessons learned from recent earthquake events. 1. Case Study of Reinforced Concrete Buildings One significant example involves the evaluation of reinforced concrete (RC) buildings designed following the EAK-2003 provisions in the aftermath of the 2011 seismic event in the region. These buildings showed remarkable performance during seismic testing, with many structures experiencing minimal to no damage when exposed to forces that exceeded the nominal seismic design requirements. The structures demonstrated adequate energy dissipation and flexibility, which were critical in minimizing structural failure during the earthquakes. This study reinforced the effectiveness of modern building regulations, confirming the importance of compliance with EAK-2003. 2. Evaluation of Traditional Masonry Structures Another notable case study examined the performance of traditional masonry buildings aligned with EAK-2003 regulations during the 30 October 2020 Aegean Earthquake. The observations gathered during the Earthquake Engineering Field Investigation Team (EEFIT) mission highlighted that a substantial number of these buildings successfully resisted significant seismic forces, sustaining only non-structural damage such as cracking or damage to plaster. Approximately 40% of the surveyed masonry buildings emerged from the earthquake with little to no damage, underscoring the effectiveness of the seismic code in enhancing resilience in older construction typologies. 3. Performance of Hybrid Timber-Masonry Structures A specific case study within this context focused on hybrid timber-masonry structures, which were also analyzed after the 2020 earthquake. The findings revealed that around half of the surveyed traditional timber-masonry buildings performed well in the seismic event, sustaining minimal or no visible damage. Importantly, the connection quality between different structural components was identified as a determining factor in structural performance. The buildings that exhibited good connections and robust detailing in their construction successfully absorbed seismic energy and resisted collapse, demonstrating the case for meticulous design as prescribed by EAK-2003. 4. Observations from Post-Earthquake Reconnaissance The reconnaissance missions conducted post-disaster have further provided valuable insights into the performance of various building types under EAK-2003. In particular, the examination of new constructions and retrofitted buildings across Athens revealed that adherence to the seismic code contributed to fewer casualties and structural failures. This is especially significant considering the high density of urban settings in which these buildings operate. The documented outcomes have been instrumental in guiding future designs and retrofitting efforts across the region. Overall, these case studies emphasize that the EAK-2003 provisions have not only improved the immediate safety and resilience of buildings in Greece but have also created valuable guidelines for future construction practices. The positive performance of buildings constructed or retrofitted under these regulations highlights the importance of ongoing education and enforcement of seismic codes to ensure community safety in earthquake-prone regions. RESPONSES TO THE 1999 ATHENS EARTHQUAKE The 1999 Athens earthquake, which struck on September 7, was a catastrophic event that resulted in insignificant loss of life, destruction of infrastructure, and widespread displacement of residents. With a magnitude of 5.9 on the Richter scale, the earthquake left 138 people dead, over 70,000 homeless, and thousands without employment. In the context of disaster management, disaster response refers to the organized efforts and actions taken directly before, during, or immediately after a disaster to save lives, reduce health impacts, ensure public safety, and meet basic human needs. The multi-faceted response involved a structured and coordinated effort from key sectors, including the Greek government, which coordinated relief through local authorities and disaster management bodies. Charged with implementation of all relief activities, the Hellenic Red Cross is seeking assistance from sister Red Cross and Red Crescent societies to ensure it can meet the day-to-day needs of a 50,000 beneficiary caseload, many of whom are traumatised and fear another earthquake (Athens Earthquake Appeal No. 22/99 - Greece, 1999). This outlines the key sectors leading the responses to the disaster, detailing the actions undertaken by these agencies to address the urgent needs of the affected population. 1. Government Action The Greek Government took immediate steps to coordinate all relief activities in the aftermath of the earthquake through the Ministry of the Interior, along with municipal authorities and the Hellenic Red Cross, which was given primary responsibility for the relief efforts. The Ministry of Environment and Public Works initiated inspections of damaged buildings and established dedicated phone lines for affected individuals to request assistance. After an initial quick assessment of the structural damage, authorities are now conducting more thorough surveys to establish a timeline for rehabilitation. ​It is anticipated that tens of thousands of people will likely require temporary housing during the winter months. 2. Hellenic Red Cross Action Despite suffering communication issues due to damage at its headquarters, the Hellenic Red Cross quickly mobilized staff and volunteers to the disaster area for search and rescue, first aid, shelter, and relief operations. Seven relief centers were established in Liosia, Menidi, N. Ionia, Metamorphosi, Petroupoli, Zefiri, and Thracomacedones. Support teams at these centers included rescue workers, doctors, nurses, and social workers responsible for providing medical care, psychological support, and distributing relief materials and hot meals. By the end of the initial response phase, 821 volunteers and 705 paid staff had been deployed across 18 areas, with an average of 300 staff functioning in the field daily. They have distributed 5,260 tents, 10,000 mattresses, 15,600 blankets, and hygiene items for 50,000 people. ​Additionally, the Hellenic Red Cross is providing three meals daily to 57,000 individuals, offering medical and psychological support to victims, and running tracing services through 13 permanent teams across 18 municipalities. 3. International Federation Support The International Federation of Red Cross and Red Crescent Societies played a critical role in coordinating international support efforts. An alert was issued immediately after the earthquake, followed by a preliminary appeal for CHF 750,000 to provide immediate relief items such as tents and blankets. Contributions poured in from various national societies, including the German, Iranian, and Turkish Red Cross, which provided thousands of tents, blankets, and other necessary supplies. This international collaboration significantly bolstered the capabilities of the Hellenic Red Cross, allowing them to meet the essential needs of affected families. International Federation of the Red Cross and Red Crescent: 13,000 mattresses and 10,000 blankets, drawn from Red Cross Red Crescent Balkans emergency stocks (with donor agreement) were dispatched by truck from Skopje to Athens German Red Cross: 690 tents, 3,000 bed-linen sets and 2,000 pillows Iranian Red Crescent : 4,000 tents (including 500 donated by the Society-the remainder procured by the International Federation) and 30 rolls of plastic sheeting from emergency stocks were flown from Tehran Finnish Red Cross: 28 tents, three tent-heaters and 67 hospital beds Turkish Red Crescent: 44 tonnes of relief materials (including tinned food, blankets and medical consumables) Yugoslav Red Cross: 269 tents, 98 cartons of bottled water, 6 rolls of plastic roofing and 144 packets of nappies Czech Red Cross: 38 large tents United Arab Emirates Red Crescent: 3,000 blankets and 200 tents Netherlands Red Cross: 7,000 bed linen sets Swedish Red Cross: 1,200 bed linen sets, 2,000 blankets, 78 bales of used baby clothes and 77 cartons of used baby quilts. Cash contributions have been received from the National Societies of Cyprus, Iceland, Japan ​ n International Federation liaison officer has been working with the Hellenic Red Cross to A coordinate the international relief effort, including reporting and monitoring.​ A Federation telecommunications delegate, who had just completed a mission in Istanbul following the Turkish earthquake, travelled to Athens to install a satellite telephone at the Hellenic Red Cross headquarters and assist with other telecommunications needs. 4. Other Agency's Action ​ he Greek government is in touch with the European Union regarding immediate and long-term T assistance to alleviate the effects of the quake.​ Several diplomatic missions, including those of Canada, the United States, and China, have been in direct contact with the Hellenic Red Cross and are in the process of contributing to the operation. 5. Coordination of Efforts Since the onset of the emergency, the International Federation has been in close contact with the Hellenic Red Cross, and its liaison officer has been working closely with the National Society to coordinate all international Red Cross/Red Crescent assistance. The Ministry of the Interior is coordinating relief efforts from the national to the local level, and the Hellenic Red Cross is in close contact with the Ministry and municipal authorities to ensure that its relief operation aligns with national and local efforts. 6. Intended Operation ​ he assessment of needs, through its rapid inspection of damaged buildings, has led the Greek T government to identify 13,000 families as vulnerable and in need of shelter and relief assistance.​The Hellenic Red Cross, responsible for all relief distributions, is conducting a continuous needs assessment with support from the Federation liaison officer. With large numbers of people still sleeping outdoors due to damage to their homes, the key immediate needs remain shelter (tents and plastic sheeting), relief items (including blankets, mattresses, bed linen sets, and pillows), as well as hygiene and baby parcels. At this stage, the intended operation focuses solely on supporting the Hellenic Red Cross program to address the immediate needs of vulnerable families. Additionally, the Hellenic Red Cross will continue its psychological support program for traumatized victims of the earthquake for months to come. 7. Red Cross/Red Crescent Objectives The overarching objectives set by the Red Cross and Red Crescent included providing immediate shelter and relief for 50,000 vulnerable individuals and replenishing disaster preparedness stocks. The planned actions also aimed to enhance the Hellenic Red Cross’s ability to respond to future disasters, with a focus on building resilience within affected communities. 8. National Society/Federation Plan of Action International Federation assistance in support of the Hellenic Red Cross is intended to help the Society complete the distribution of emergency relief items, including tents, blankets, mattresses, bed linen sets, pillows, hygiene items, and baby parcels, to 50,000 beneficiaries in the disaster-affected areas. Additionally, planned activities include the replenishment of the Hellenic Red Cross emergency stocks and initiatives to improve the Society's capacity to respond to future disasters. The Hellenic Red Cross comprises 115 local branches and committees, 500 paid staff, 7,500 members, and 30,000 volunteers active in four key areas: first aid, nursing, social welfare, and youth. The Society owns two central warehouses in Athens, each with a capacity of over 10,000 square meters. In the current emergency, the Society's extensive experience in responding to earthquakes has proven invaluable, as demonstrated by its quick response in the aftermath of the disaster, including search and rescue operations and the distribution of relief items and hot meals, as well as the role assigned by the Greek government to implement all relief activities. 9. Federation in Greece ​ he International Federation assigned a liaison officer to work with the Hellenic Red Cross and has T maintained close contact with the Society's international department and leadership through this officer.​ Following the completion of the liaison officer's mission at the end of September, the International Federation will provide specific technical assistance to the Hellenic Red Cross through short-term missions as needed. Additionally, the Federation's liaison officer is supporting the Hellenic Red Cross in ensuring that standard Red Cross/Red Crescent requirements for monitoring and reporting are met. 10. Outstanding Needs The following relief items are still urgently needed: 779 tents, 9,536 mattresses, 3,400 blankets, 7,800 bed linen sets, 20,000 pillows, 5,000 hygiene parcels, and 1,000 baby parcels. All these items are to be purchased outside of Greece. The Hellenic Red Cross would also welcome bilateral donations of folding beds and canned food (which are not included in this appeal). ​Although the Society is able to meet all its operating costs, including transport, distribution, warehousing, and personnel, cash is still needed to cover the purchase of some relief items. TURKEY/GREECE - EMERGENCY RESPONSE TO DISASTER After the devastating earthquakes in Greece and Turkey in 1999, the two governments agreed to cooperate in disaster response. ​In November 2001, they signed a protocol to create a joint standby disaster response unit, composed of personnel from both governmental and non-governmental organizations.​ The United Nations, through its Office for the Coordination of Humanitarian Affairs, has been helping to develop the arrangements for this unit. A memorandum of understanding between Greece, Turkey, and the United Nations is being finalized to outline the procedures for effectively mobilizing and deploying the joint unit to provide timely humanitarian assistance in response to sudden natural disasters. The General Assembly, in its resolutions 54/30 and 56/99, noted with satisfaction the decision taken by the Governments of Greece and Turkey to establish such a joint unit to reinforce and expand existing standby arrangements of the United Nations system, and urged the international community to further cooperate in humanitarian assistance (Turkey/Greece - Emergency Response to Disasters: Report of the Secretary-General (a/57/320) - Türkiye, 2002). 1. Protocol between Greece and Turkey ​ n November 8, 2001, as a result of discussions that took place in Ankara, Athens, and Geneva, the O Governments of Greece and Turkey signed a Protocol establishing a joint standby disaster response unit.​ The aim of the unit is to increase the collective capacity of the two countries to provide timely and effective humanitarian assistance to populations affected by sudden-onset natural disasters. At the request of both Governments, the United Nations provided technical expertise on the formulation of the operational elements referred to in the text of the Protocol and its annex. Moreover, in accordance with the provisions of paragraph 28 of the annex to General Assembly resolution 46/182 of December 19, 1991, and those of the Protocol signed by both Governments, the joint standby disaster response unit will work in coordination with the United Nations to reinforce and expand the existing standby disaster response arrangements of the United Nations system. The joint unit will consist of approximately 40 people from governmental and non-governmental institutions of each country. It will include personnel for urban search and rescue, emergency medical care, and technical expertise, including engineering and geosciences. To manage the joint unit, the two Governments also agreed to establish a Coordinating Committee with equal membership from each party to be chaired by the parties on an annually rotating basis, overseeing all administrative, financial, and operational aspects of cooperation. The United Nations will be invited to attend the meetings of the Coordinating Committee as required to discuss issues relevant to training, preparedness, and international cooperation. The national contingents allocated to the joint standby disaster response unit will remain at their permanent home base locations. They will come together for exercises and training activities, for which they will have jointly prepared programs, or for deployment to disaster-affected zones. The units will be configured according to the requirements of specific deployments or exercises/training. Each component of the joint unit will be ready to be transported to the disaster zone within eight hours of being alerted. The joint unit will work closely with the Office for the Coordination of Humanitarian Affairs to ensure its cooperation with international disaster response mechanisms, including the International Search and Rescue Advisory Group, the United Nations Disaster Assessment and Coordination Team, the International Strategy for Disaster Reduction (ISDR), and the United Nations Programme on the Use of Military and Civil Defence Assets in disaster relief. 2. Cooperation with the United Nations In order to further develop cooperation arrangements between the United Nations and the joint standby disaster response unit in the field of international humanitarian assistance for sudden-onset natural disasters, a memorandum of understanding among Greece, Turkey, and the United Nations is being finalized. ​The objective of this memorandum is to ensure the coordinated and effective deployment of the joint unit within existing international disaster response mechanisms.​ The memorandum will outline the deployment of the joint unit in disaster-affected countries under three circumstances: under the authority of the United Nations, as part of an international response, or on a separate basis as required. When operating under the authority of the United Nations, the personnel of the joint unit will hold the status of United Nations experts. Greece, Turkey, and the United Nations will share information on emergencies to prepare for and facilitate coordinated international humanitarian emergency operations. When necessary, the United Nations will send a request to the joint unit with specifications regarding requirements and other necessary details. At the end of each joint project, the United Nations, along with the Governments of Greece and Turkey, will jointly conduct an evaluation of the activities performed by the personnel of the joint unit. The training of the joint unit members and their engagement in international humanitarian emergency operations will have no financial implications for the program budget of the United Nations. 3. Observation The cooperation between the United Nations and the Governments of Greece and Turkey serves as an example of integrated efforts in international disaster response preparedness. In line with the recommendations of the Fribourg Forum, the United Nations is prepared to support Member States in developing cooperative arrangements to ensure the quick and effective delivery of humanitarian assistance in emergency situations. Once the final text of the memorandum of understanding between the Governments of Greece and Turkey and the United Nations has been completed, all parties will organize its formal signing, and it will be submitted to the Parliaments of Greece and Turkey for their endorsement. The Fribourg Forum took place in June 2000. It was a United Nations-sponsored initiative that launched a continuing dialogue between European countries and international and regional organizations to enhance coherence and complementarity in the humanitarian aspects of crisis management. Economic consequences of the recent earthquakes in Turkey and Greece; Social consequences of the recent earthquakes in Turkey The Committee of Ministers has reviewed Parliamentary Assembly Recommendations 1447 (2000) and 1448 (2000) regarding the economic and social impacts of recent earthquakes in Turkey and Greece. ​The Committee emphasizes the need for effective preventative measures and earthquake construction standards in high seismic activity regions, and it decided in February 2000 to inform member states of these Recommendations.​ ​The Committee of Ministers agrees with the Assembly on the need for continued international support, especially financial aid to the affected regions.​ The Council of Europe Development Bank reached out to Turkey and Greece right after the earthquakes, offering loans for assistance. In September 1999, the bank approved loans of up to €300 million for Turkey and €80 million for Greece. By December 1999, it approved a project for Turkey worth €141.7 million to rebuild 18,900 urban and 4,000 rural housing units, co-financed by the World Bank, with plans for an additional 2,000 units underway. By July 2000, the loan amount increased to €279,465,000, covering a total of 42,761 housing units. The Committee of Ministers is pleased that 15,502 housing units have already been completed and are being distributed to earthquake victims. As the Assembly suggests in its Recommendations, the Committee of Ministers has consulted the Council of Europe's EUR-OPA Major Hazards Partial Agreement on measures to be taken at the European level for the prevention and management of natural disasters. In this context, the 8th Ministerial Meeting of the EUR-OPA Agreement, held in Athens in February 2000, adopted a Resolution instructing the Executive Secretariat of the Agreement, based on the implementation of the permanent telecommunications system planned between the national authorities for risk management (EDRIM), to develop a plan to make this system available to the Greek and Turkish authorities responsible for risk management, with a view to assisting in decision-making and cooperation (CoE: Economic Consequences of the Recent Earthquakes in Turkey and Greece; Social Consequences of the Recent Earthquakes in Turkey - Greece, 2001). Additionally, in regard to decentralization efforts in Turkey mentioned in Recommendation 1448 (2000), the Turkish authorities are actively participating in the Steering Committee on Local and Regional Democracy (CDLR) to promote effective administrative decentralization and have hosted key meetings in this area. Disaster Mental Health Responses in the Aftermath of the 1999 Athens Earthquake The 1999 Athens earthquake caused devastating physical damage and significant loss of life. The psychological aftermath was profound, necessitating immediate and sustained mental health responses to address the trauma and stress experienced by survivors, notably through organizations such as the World Health Organization (WHO) and the Hellenic Red Cross. Mental Health problems encountered included post-traumatic stress disorder (PTSD), anxiety, and depression among affected individuals, particularly children and adolescents. Additionally, with studies indicating that approximately 55% of survivors developed sleep disorders. Common psychological conditions included acute stress reactions, PTSD, anxiety, and depression, with many victims exhibiting severe symptoms related to trauma and loss (Madianos & Evi, n.d.). Various interventions, including psychological support and cognitive-behavioral therapy (CBT), were implemented to alleviate these issues and provide necessary care to the victims. 1. Mental Health Responses by the World Health Organization The World Health Organization played a crucial role in coordinating mental health responses following the earthquake. They emphasized the importance of integrating mental health services into primary healthcare systems to address the rising psychiatric disorders related to the disaster, advocating for psychological first aid and structured interventions (Giannopoulou et al., 2006). The WHO focused on enhancing the capacity of local healthcare providers to manage mental health issues, recommending early intervention strategies to mitigate long-term psychological problems. 2. Interventions Provided Post-Earthquake Various interventions were implemented to address the mental health problems experienced by survivors. Cognitive-behavioral therapy (CBT) was notably used as a short-term intervention targeted at children showing symptoms of PTSD, leading to a significant reduction in both PTSD and depression symptoms (Yılancıoğlu and Özbaran (2023b). Additionally, psychological first aid was recommended to provide immediate support and facilitate coping mechanisms among affected individuals1and preparatory education for prevention of future disasters was initiated. 3. Support Provided by the Hellenic Red Cross The Hellenic Red Cross was the primary organization responsible for coordinating immediate relief efforts following the earthquake. They provided a range of services, including shelter, food, medical care, and essential psychological support to approximately 57,000 people in the initial months post-disaster. The Red Cross also established health centers in affected areas to offer counseling and community support, addressing both physical and mental health needs (Athens Earthquake Appeal No. 22/99 - Greece, 1999). Their quick response was pivotal in alleviating the immediate psychological trauma experienced by many survivors. 4. Role of Healthcare Providers and Community Engagement Healthcare providers, including psychologists and social workers from the Hellenic Red Cross and other organizations, engaged in direct counseling and support services aimed at those suffering from acute stress and PTSD(Athens Earthquake Appeal No. 22/99 - Greece, 1999). Community support mechanisms were also reinforced to encourage social cohesion and shared experiences among survivors, which is vital for psychological recovery. Through a combination of direct healthcare services, community engagement, and structured intervention programs, efforts were made to create a holistic recovery environment for the affected population. RECOVERY The Greek government initiated several recovery programs post-earthquake, In the aftermath of the Athens 1999 earthquake, recovery efforts were spearheaded by organizations such as the 1. European Investment Bank (EIB) - EUR 900 million loan approved by the EIB, for financing the Earthquake Reconstruction Programme (ERP). Financing under this facility will be phased over a period of 2 to 3 years for the reconstruction of public and municipal facilities, industrial and commercial buildings and private sector housing destroyed or damaged by the earthquake.This program's aims included restoring damaged infrastructure and housing, along with improving building regulations to prevent future losses. (Graham, W., 1999). Despite these efforts, challenges remained long after the initial recovery phase. Many families were still displaced and living in temporary accommodation, with over 6,000 families reported to be residing in camps even a year post-earthquake.(Athens: One Year on, Earthquake Effects Linger - Greece, 2000). The continued need for temporary housing and support services illustrated the long-term impact of the disaster on the affected communities. Furthermore, the necessity for ongoing psychological support pointed to the persistent mental health issues faced by the trauma survivors. 2. Hellenic Red Cross - which provided essential relief services, including food, temporary shelter, and psychological support to the affected population. With the help and assistance from sister Red Cross and Red Crescent societies, they provided supply for a three (3) months period programme intended to cover basic shelter and relief activities for those who have lost everything in the quake and are without alternative means of support to ensure it can meet the day-to-day needs of a 50,000 beneficiary caseload, many of whom are traumatised and fear another earthquake.(Athens Earthquake Appeal No. 22/99 - Greece, 1999) 3. Medical and Psychological Support - Hellenic Red Cross staff and volunteers were assigned to provide disaster areas to undertake search and rescue, first aid, shelter and relief activities and the doctors, nurses and social workers, tasked to provide medical care, psychological support, and to distribute relief material and hot meals. (Athens Earthquake Appeal No. 22/99 - Greece, 1999) 4. Cognitive behavioral therapy programs - A short-term CBT intervention was applied to 20 children aged 8–12 with PTSD symptoms. 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