Hurricane Matthew has killed hundreds of people in Haiti. Winds exceeding 200km/h destroyed cities and towns in the southern peninsula.
Images of the destruction in the southern part of the country remind me of the January 12, 2010 earthquake.
Many of my colleagues, including psychologists, social work professionals, humanitarians, and professors from the State University of Haiti, have also observed this. They visited the destroyed cities of the South and Grand’Anse regions. Aerial photos show the towns of Jeremie, Dame Marie, Les Cayes, Port Salut, and others in a total state of devastation.
Hurricane Matthew once again demonstrated the vulnerability of modernity’s first black nation to natural disasters.
The destruction of southern Haiti. Carlos Garcia Rawlins/Reuters
Post-traumatic Stress Disorder
Natural disasters have more than just physical effects. When people are directly exposed to a situation in which other people die, and they feel fear for their lives, they will likely develop post-traumatic symptoms and severe depression.
We also see recurrent nightmares in survivors. Other symptoms include psychological distress, difficulty concentrating or making a decision, learning disabilities, anxiety, and depressive symptoms, as well as social dysfunction. The 2010 earthquake was the subject of research that revealed all these traumatic effects.
Survivors of natural disasters also report symptoms like nausea, headaches, and chest pain.
After the earthquake of January 2010, studies found that two years later, over a third of children, adolescents, and adults had severe symptoms of PTSD. Nearly half of children and adolescents, and more than one-quarter of adults, also displayed severe depression symptoms.
Psychological support programs are needed to help survivors. We know time alone cannot heal the injuries caused by traumatic events. Mental health professionals can help survivors build resilience without making them talk about their trauma.
Lessons learned from 2010
International NGOs have been investing heavily in psychological support for survivors since the 2010 earthquake. However our studies reveal that these programs were not effective and were often culturally inappropriate.
The programs started at a moment when survivors weren’t necessarily ready to speak about the event because there wasn’t a physical, social, or cultural infrastructure in the nation. Everything was destroyed.
We must create a living environment that is acceptable in these circumstances. According to psychologist Alessandra Pigna, “You cannot give peace of mind to people if they do not have a place to live.”
The aftermath of the 2010 earthquake at Port-au-Prince. Eduardo Munoz/Reuters
After rebuilding, people can express their feelings and understand what happened. It also explains the fact that after natural disasters, very few people visit psychologists who are installed in relief camps by NGOs and why emergency social support may not be as effective.
Long-term studies of populations affected by disasters and the testimonies that we have heard on the ground have shown that people need the most psychological support after two years when life is returning to normal. Unfortunately, NGOs and psychologists will be far, far away by that time.
How can we ensure that we don’t make the same mistakes as 2010? We can learn from some important lessons.
Start with the schools.
With all of the people in schools – teachers and students, as well as support staff, they can provide excellent first aid. There are less than 200 graduate psychologists in Haiti and only 30 psychiatrists for a population that exceeds ten million. It is, therefore, essential to support the existing help systems such as schools and families.
It is essential to train teachers in order to help children return to school. Teachers need to be equipped with the skills to recognize the pain in children and help them relax and breathe. They should also guide them to appropriate services.
The school is one of the most important places to recover. Swoan Parker/Reuters
The recovery programs should make sure that all children return to school and pay special attention to orphans. In the Haitian school, humor can be combined with generosity, solidarity, altruism, and empathy to create what psychologists refer to as “Multifactors of Resilience.”
Art programs should be included in the curriculum on a long-term basis since artistic creation is a factor that protects psychological resilience.
Facilitate grieving processes
The way in which the dead were treated was one of the worst disasters that followed the earthquake of 2010. The grieving process and funeral rituals were not properly supported. Nearly seven years after the death of the first person, it still has no official list.
The government of Haiti must ensure that it has a complete and accurate list of all the deceased and missing. This list could be used to build monuments in each city, with the names of all victims.
This monument will act as a cemetery for families to visit in the event of an emergency. This will help survivors grieve more easily, given the importance and role of the dead within Haitian Culture.
In Les Anglais in Haiti, clothes are hung in a destroyed area. Andres Martinez Casares/Reuters
Long-term counseling centers
After rebuilding is complete, survivors will need support in dealing with the trauma caused by Hurricane Matthew. For the time being, counseling units for those who lost loved ones should be established. It is important to have long-term programs that last for at least two years.
In the most affected areas, it is possible to set up periodic temporary counseling missions lasting several weeks if ongoing field missions cannot be conducted. Haiti should set up mobile psychiatry clinics with Haitian professionals.
In cases where local care isn’t possible, survivors who have special needs need to be regularly followed up by long-distance telephone calls. Haitian Creole-speaking professionals with knowledge of Haitian culture should carry out these programs.
Plan for the future.
Physical reconstruction must be accompanied by the recovery from the psychological trauma caused by Hurricane Matthew. Haiti’s government must take immediate action to address the deaths. This is part of providing proper care to survivors.
In the short term, support for psychological issues should be based on social structures like schools and churches.
On a long-term basis, it is important to establish psychological counseling centers that are appropriate for Haitian culture.
Johns Hopkins University’s Emergency Mental Health Guide makes a key recommendation: “Community-based mental healthcare is the most effective solution.” We should never forget one key recommendation from Johns Hopkins University’s emergency mental health guide: “Community-based mental health care is the best solution/a>.”
