International experts are encouraging the Haitian Health Ministry, which they say is receptive and eager for help, to incorporate mental health care into the primary health care system and to make it available throughout the country.
Right now, though, the need for psychological first aid and emergency psychiatric treatment is so acute that foreign psychiatrists are seeing patients, setting up programs and rapidly training Haitian doctors, nurses and community workers in everything from psychopharmacology to group relaxation techniques. (Before the quake, there were only about 15 psychiatrists in all of Haiti.)
The foreign psychiatrists emphasize that they have found Haitians to be impressively resilient, but the disaster has nonetheless set off reactions ranging from anxiety through psychosis. Most worrisome are cases like that of Guerda Joseph, a 41-year-old woman who tumbled into a catatonic depression shortly after she was pulled from the rubble of her home. Mute and nearly immobilized ever since, she lies on floral sheets at the General Hospital, her Bible tucked beside her pillow, her 25-year-old adopted son by her side day and night.
More common, though, is what Dr. Lynne Jones, a child psychiatrist and disaster expert with the International Medical Corps, calls “earthquake shock,” a persistent sensation that the earth is still shaking, which makes the heart race and causes chest pain.
“This is an understandable response, and it’s important to let people know, ‘You are not crazy,’ ” Dr. Jones said. “I use a kind of metaphor: ‘Your body has a very effective fire alarm. One of the reasons you’re alive today is that it went off during the earthquake. You ran out of that building. Great, you survived. Unfortunately, the fire alarm is now sensitive and goes off when you don’t want it to, or maybe it never shut off.’ ”
