Responding to anguish - emotional and social support

Program Manager for Psychosocial Support and Mental Health posts from Haiti:

In the midst of all of the distress the earthquake brought in its initial days, the immediate response of many in the countryside was to rush to Port-au-Prince to look for family and friends—a very natural response given the circumstances. With cell phone communication down, this was the only way to verify they were ok, or in need of help.

For our patients receiving treatment for multi-drug resistant tuberculosis (MDR TB) at one of two treatment centers in the Central Plateau, this was not an option. Their illness requires a two-year treatment regimen, the first of which is administered as an inpatient. For them, leaving in search of their families was out of the question. Without communication capabilities and only listening to radio reports explaining the extent of the destruction, one can only imagine how distressing these first few days were for them.

In the days since, as cell phone service improved and patients were able to reach their families, many learned of the sudden and untimely death of their family and friends. One of our patients, Benjamin, who has been battling tuberculosis off and on for 18 years, learned that he lost 10 family members. Others lost siblings, aunts, uncles, mothers, fathers, cousins, friends. In their grief, they immediately started asking themselves why were they saved from this tragedy and not others? How would they continue to live? Why did some people have to die in an instant while they have been able to receive life-saving treatment for their deadly illness? Should they abandon treatment and give up on life?

The Zanmi Lasante staff at the Monseigneur Decoste Infectious Disease Pavilion at the St. Therese Hospital in Hinche immediately recognized their patients' anguish and called on the support of Zanmi Lasante's head psychologist and Director of Psychosocial Support Services, Father Eddy Eustache, to help work with their patients.

Drawing on a technique he has used at PIH's Rwanda project working with genocide survivors, Father Eddy led us in a memorial service remembering the lives of all those we had lost in this unthinkable disaster. Patients and staff alike sang songs, read scripture, shared stories of their memories of their loved ones, and in arguably the most moving part of the service, lit candles for each of the people we had lost while reading their names out loud. To conclude, staff provided words of encouragement and advice for patients on continuing to adhere to treatment and find support in each other.

Efforts such as these are part of a more comprehensive psychosocial support plan for Zanmi Lasante staff, patients, and their families as we work together to address the psychological impact that the earthquake has had on everyone in Haiti.

Kenbe Fem,

Cate Oswald
Program Manager for Psychosocial Support and Mental Health, Haiti

For the last 25 years, Partners In Health and Zanmi Lasante (our Haitian sister organization) have been delivering community-based care that extends well beyond the hospital. It involves building houses, bringing clean water, and providing emotional and social support to those in need. While the enormous task of treating people physically injured by the earthquake still looms large before us, we cannot ignore the mental health injuries that are also ubiquitous at a time like this, particularly for those who were already living on the margins, suffering from the vicious cycle of poverty and disease.