In October 2005, northern Pakistan was devastated by an earthquake killing 73 000 people. Some of the seriously injured were airlifted to a tertiary hospital in Rawalpindi, near Islamabad. This field report describes the psychiatric services delivered at that hospital. It explains how the needs were assessed and psychosocial interventions designed at different levels. The training needs of the medical staff were also identified and efforts were made to enhance their skills for psychosocial care. Finally, the report formulates some recommendations for improving such services.