Li Ying lost his daughter and son both in the quake. But the 42-year-old headmaster of a vocational middle school in Beichuan, one of the worst hit counties in the May 12 quake, has refused to talk about it.

"I'm too busy transferring my 120 students to Shandong province where they will resume their classes. I don't have time to think or to talk about my own children," he says, taking a long drag on a cigarette.

His eyes are red for lack of sleep but he does not seem to care; at least he does not show. "Safeguarding my students is my priority," he says softly.

It is exactly men like these that Sun Xueli is worried about. Sun is the head of the Mental Health Center of West China Hospital, affiliated to Sichuan University.

He fears that people on the frontline of relief work are likely to have suffered from post-disaster stress that could harm them in the long run.

There is a pressing need to comfort and soothe men who have lost their dear ones and may have been traumatized. Psychological counseling is now available for survivors and the displaced, especially women and children.

But men, conventionally considered mentally stronger and with greater responsibility to shoulder, could suffer from deeper and more complex post-disaster stress.

"Unlike women and children, who can cry and seek psychological counseling, men have fewer outlets to release their feelings. The trauma, combined with suppressed emotion, could thus cause more serious problems."

Worse still, men often try to seek solace in alcohol and cigarettes to overcome their sorrow. "This mix, especially alcohol, could harm them mentally and physically both. Some could become alcoholics," he said.

Li's is a case in point, though fortunately he has not hit the bottle. Zhang Minghui, one of Li's colleagues, says: "He has never talked with anyone about the loss of his children. He hasn't consulted a psychologist either, or shed any tears. But the pain is there, and we can sense it."

According to Hu Yongdong, the headmaster could be suffering from a mental condition that denies the primary symptoms. The Beijing-based clinical psychologist, now heading a mental crisis intervention team in Deyang, Sichuan, says unalloyed devotion to work is actually a way of fending off deep grief. "In fact, many men (in the rescue and relief teams) are doing that."

About 29 km from Wenchuan county, the epicenter of the quake, Zhao Qiang has been leading his colleagues in salvaging costly equipment from damaged workshops.

The 41-year-old man had a narrow escape, and soon joined his colleagues in rescuing the survivors and pulling out the dead from under the rubble. He has lost count of the number of bodies he has handled. But he can feel the pain.

"Deep into the night when I am alone in my tent, the horrible scenes come back to haunt me," Zhao says. "I cannot sleep without a strong dose of alcohol."

Like Li, he too has not sought any psychological help, and says time is the best healer.

"That's wrong," says Sun. "Without proper and timely mental therapy (and medication), the impact can last for the rest of a person's life."

Psychologists have to treat men differently from women, he says. For instance, men hate lectures and the more traditional conversational counseling. "Rigorous physical exercise such as playing basketball or soccer can help distract them from their sorrow."

Also, the health authorities have to come up with a special plan for traumatized men, he says.

(China Daily June 10, 2008)