Sunday, October 10th was World Mental Health Day, which HAS observed the following Monday with a presentation by a psychologist who discussed the long-term effects of traumatic events such as natural disasters. As he talked, I, and I am sure others in the room, were carried back to the days after the January earthquake.
Several weeks after the earthquake, we visited several churches and schools which had welcomed people from Port au Prince, and provided them with temporary shelter before they could be placed with generous families. The pastor asked me to look in on a young woman who had moved her cot to a corner and lay on it in a fetal position with her face to the wall. Unresponsive to any overtures, she huddled in her bright Chinese blanket.
I asked if she was like this all of the time, and the pastor said that no, she had terrible nightmares whenever she tried to sleep, and appeared to be reliving her experience in the falling houses. He asked for help for her, saying that he was worried about her and the other refugees in the church.
The pastor’s wife then introduced me to several other people who were suffering from flashbacks and nightmares, and then told me that her husband was also waking up every night, reliving the experiences of the people who were in the church and who had shared their stories with him. She asked if the hospital could help them. I explained that in most cases the reactions of the people at the church were understandable, and common following traumatic events. I told her that I would see what we could do for her guests.
Before the earthquake, HAS had been fortunate to find a young Haitian psychologist to work with the AIDS program. Her contract was coming to a close with the transition of the AIDS patients to Partners in Health, and she had stayed on the staff to support that transition. During the earthquake, she had come into the hospital for long hours every day. Initially she supported the acute needs of patients and their families, and then offered counseling to the physicians and nurses (and occasionally administrators) who had been caring for the crush of patients.
I found the psychologist in her office, which was the hallways of the crowded hospital, calmly listening to a patient whose terrible memories were now accompanied by the fear of the unknown in an operation on her leg later that day.
She agreed to come to visit the people in the church, and another group which had been housed temporarily in an empty rice warehouse (all of these groups were placed with families within weeks of their arrival in the region, and most remain today). She was able to provide immediate support to several patients, and to the families who were with them.
On the way back to the hospital, we talked about what she had been able to achieve in the past weeks, and her heroism and professionalism poured through her simple reports of types of cases she had seen. We discussed what we could do in the coming days, recognizing that everyone on the staff had been stretched beyond their limits of endurance. She sat in her seat, looking out the window, obviously reflecting deeply, and suggested that we could talk about it the next day.
When I saw her, she shared with me that she had been on the phone with several of her classmates from the psychology program who had suffered personal losses in the city. She asked if it would be possible for her to host them in her small house on campus. Of course, I assured her, and asked if there would be a chance that they might wish to work here. One step at a time, she said with a sly smile.
Today, HAS has three psychologists, which represents approximately one-quarter of the professional psychologists in Haiti. They offer individual, as well as group counseling, and their schedule is fully booked all day and into the early evening. Their residence has been converted into an office, and signs guiding people there are dotted throughout the campus and hospital.
With the good fortune which seems to been gifted to HAS in recent months, Rolf Maibach contracted with AMURT, an international emergency aid organization, to support this program, and we have come to recognize that, as is the case with physical therapy and prosthetics, that this will be a permanent element of our service package.
At the Monday conference, the psychologist presented statistics of our service volumes, with an estimate of the current need for counseling services throughout the country, as well as the small resources available to meet these needs. As with many other clinical services in Haiti, there is a tragic mismatch between the demand and the resources, and in this case, HAS is fortunate to be able to serve many of those who come to us in need.