Mental health experts believe Haiti is facing a long-term challenge after the earthquake, and special efforts are needed to help survivors cope with the psychological toll of the disaster.
Vancouver psychologist Dr. Jeanne LeBlanc went to Port-au-Prince the week after the Jan. 12 earthquake that killed over 200,000 people. Her mission was to provide post-disaster help to Haitians and aid workers in the ravaged capital.
“It’s overwhelming, the amount of despair and difficulty,” she said. “At the time of disaster, you are not there to do psychotherapy. You are concerned about providing a sense of calmness in the midst of chaos.”
Her job was to help people calm down, and “most people are very, very resilient,” she noted. For some who had lost so many family members that they wanted to kill themselves, she helped them carry on.
An expert in neuropsychology and rehabilitation, LeBlanc chairs the British Columbia Psychological Association's Disaster Response Network and has previously traveled to the sites of catastrophic events, including the Sichuan earthquake in 2006 and Hurricane Katrina in 2004.
“The people crying out in pain because they’re awaiting a procedure, I would hold their hand, soothe them, speak in a calming voice. Even if I am not able to speak Creole, people can tell when you’re trying to help,” she said.
In Haiti, LeBlanc supported the doctors and nurses who were doing near-round-the-clock surgeries—mostly amputations.
“The physicians were doing so many amputations, from 6 a.m. to 4 a.m., so I was spending a lot of time with people post-amputation, and letting them tell me their story, helping them find something to give them some hope for the next day.”
Amputees had limited family left to care for them, and even if they had a house, many slept outside for the fear of another earthquake. Aftercare and adaptive equipment were largely unavailable. These conditions resulted in a high infection rate for amputees, sometimes leading to additional amputations.
LeBlanc also helped people connect with others—wherever they could be found—whether it were relatives, friends, co-workers, church members, or other community members.
“You really have to find a way to connect them up with a group for support,” she said.
Ten Years to Rebuild
Running out of the shaking hospital building during the 5.9-magnitude aftershock on Jan. 20 gave LeBlanc “a whole different perspective” on infrastructure.
“I had a very clear realization that if something happened, my ability to be flown out and home was very limited. I could pick up a secondary infection and lose my leg, and there’s no infrastructure to protect me,” she said.
Akwatu Khenti, Director of International Health at the Toronto-based Centre for Addiction and Mental Health, said the organization plans to provide support in Haiti after the current emergency phase is over.
Following the 2004 tsunami, Khenti participated in a three-year mental health initiative in Sri Lanka that emphasized self-care for the community and the aid workers, trying to bring communities together across all levels and sectors. His project focused on training teachers to set up healthy schools, recognizing and dealing with trauma in children, and working with families.
According to Khenti, treatment after a natural disaster cannot follow the format of individual counseling.
“The whole community is affected, so the needs of the individual have to be matched with the needs of the group,” he said.
Khenti said that Haiti’s situation is worse because of severe poverty, political instability, and recent hurricanes. He noted that the country needs long-term investment in both regular infrastructure, like schools and clinics, and social infrastructure, such as education, training, mentoring, and support for the limited numbers of educators and health care professionals that remain.
“Ten years is a realistic time frame, provided there are no more disasters between now and then,” he said, referring to the rebuilding efforts.
Do with Others, Not for Others
Khenti raised a glimmer of hope by noting that following the tsunami in Indonesia and other conflict areas in Asia, “people moved beyond labels and factions and grew more united and cohesive.” That can be a potential outcome in Haiti.
He added that the violence and looting reported in the earthquake-devasted country has been well below what one would expect in such a desperate situation, considering that all prisoners escaped from the collapsed jail and the population of Port-au-Prince was two million.
“TV likes to show unrest, but what I saw was love, care, and concern,” said LeBlanc. “The amount of care and compassion that I saw from the Haitian people in regard to helping each other and striving to improve things was significant.”
She said she didn’t doubt there were pockets of violence, as it is not unusual to see increased anger out of desperation post-disaster. However, she never felt unsafe or saw any violence, even as part of a search-and-rescue team that walked for hours through many neighborhoods over debris and decay.
LeBlanc is currently in charge of deploying psychologists should a disaster occur during the Vancouver Olympics, but she plans to return to Haiti after the games. She hopes Haiti will continue to receive assistance for long-term construction efforts that involve local people in the rebuilding.
“Partner, collaborate, emphasize transparency, local leadership, local capacity building, and you can’t go wrong. But if you go in to do for others, it’s not going to work. You have to do with others,” said Khenti.