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The prevalence and longitudinal course of post-traumatic stress disorder were studied in a group of 459 firefighters who were exposed to the Ash Wednesday bushfires in South Australia. The main finding, that the level of morbidity four months after the disaster remained almost unchanged at 29 months, indicates the long-term nature of post-traumatic stress disorder. Twenty-nine months after the fire, 21% of the firefighters were continuing to experience imagery of the disaster, in a way that interfered with their lives. The failure of present disaster management plans to recognize the psychological impact of natural disasters and the long-term nature of post-traumatic stress disorder is emphasized, and the need for preventive mental health programmes to minimize such morbidity in the future is discussed.
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