The appalling earthquake in the ancient city of Bam on December 27th 2003 was one of the worst disasters since the last century in Iran. Further to the chilling statistics of human loss, essential services including water supply, power, telephone, health care services, main roads, and the city's only airport were crippled. From the 'public health' and 'health emergency' perspectives, the initial priorities were to minimise avoidable further mortality and morbidity. This required prompt evacuation of the injured, defining catchment areas, establishment of efficient systems for disease control, organising a disaster management plan, out patient management, co-ordination of international aid, and re-organising the current PHC network in the district. The second stage, each department planning health delivery for the subsequent year, was rapidly initiated. This paper discusses these strategies, which were designed specifically for Bam but are likely useful in similar situations.