Such an opportunity came to me two weeks ago when I received a call to come to Haiti. I knew then that the experience would change me as a person, but the jury is still out on exactly how much. But then, this is my personal journey. And a deeply personal one at that. It will be difficult for me to explain or describe what it is like here, but I hope that as you read this passage, you will begin to understand a bit about why this experience is so important. I also hope it gives you a window into the Haitian people, their suffering and their tremendous resiliency.
Relief International, an international humanitarian agency, has worked with The Permanente Medical Group to bring physicians to this devastated and impoverished landscape. The people you expect to be here are here: emergency room physicians and nurses, internists, surgeons. But I am none of those. I am a psychiatrist and have always wondered what my possible role could be in a land that is trying to exist day by day. Would they have the time and interest in thinking of their mental health? I wasn’t sure that this would be a priority when one is looking for food and shelter, and neither do many relief agencies. Was I ever wrong.
I left for Haiti one week ago, amid a flurry of emotion. I was scared and anxious but elated, energized to be of service. I arrived in Santo Domingo in the Dominican Republic and the next day, took a convoy transport to Haiti. My first view of this land was at the barren and desolate border, an area of rock quarries and dirt. As we drove through the countryside, the devastation became apparent, and as we pulled into the U.S. Embassy in Port Au Prince, the full weight of the devastation was obvious. Individuals living in tent cities, or less, with little cover over their heads, through rainy nights. Food was sparse, and children were begging for food. Immediately, I was overwhelmed. I had never seen devastation on this scale, even when I visited Nigeria in the mid-1990s. This was human suffering at its worst.
Then I arrived at my lodging. No running water, sparse electricity, and difficult living conditions. But at the heart of this house there was a dedicated team of workers from Relief International, a seasoned bunch who had worked extensively in parts of the world that most of us would never dare to tread. In them, I saw something that I had not seen in a long time: a drive to sacrifice themselves and their comfort for the good of a people they had never met. I was also surrounded by doctors and nurses who, like me, had sacrificed their time to come here. Immediately, the fear that I felt just days before melted away.
Later that night, I met the French psychologist from San Francisco with whom I would be working. Later, another TPMG doctor would join me, and the team of us would work in Port Au Prince in a very special mission.
Through the vision of Relief International and their prioritization of the mental health care of the Haitian people, and of course, the support of my many colleagues, I participated in a very important program of psychosocial support. Frequently, mental health is relegated to second place status in disasters because there are perceived to be more pressing needs. But Relief International saw a need and asked me to help fill it. I was brought to Haiti to develop a program for staff training at a local hospital.
Nos Petits Freres et Souers, otherwise known as St Damien’s Hospital, is a local facility that is dedicated to those who suffer from “social leprosy.” Their patron saint, Father Damien, was a man who worked in Moloka’i, Hawaii, with the lepers who had been exiled there. And the mission of the hospital where I would be working was to provide sustenance for those children who were social lepers because their families had abandoned them for whatever reason. A staff of 200 attended to these children, and their bright smiles and shining faces greeted me as I walked through the gates.
But the smiles belied their suffering, and as part of my work, I would be providing debriefing to these staff, followed by training them in brief interventions with traumatized patients. I was not prepared for what I would hear.
From a young interpreter who had lost his parents and a sibling and was living on the street, to the incredible story of a nurse who had lost 10 family members in the earthquake, I began to understand the extent of what these people had lost. In spite of the fact that they all were living in tents on the grounds, tent cities in the outlying areas, or walking the streets, they were coming to work. They would walk up to three hours to get there, and in many cases, they were volunteers. Freshly pressed, clean and better dressed than many of my American colleagues, they would come to work, ready to serve their fellow patients.
Over and over again, I heard their coping strategies: to give thanks for what they didn’t lose, to provide for those who had lost more, and to derive strength from their colleagues to move forward and god, was I amazed. A people that had lost so much could give thanks. Of course, they could shed their tears, talk about their loss and process what it meant for them. But they didn’t complain. Repeatedly I heard, “I have so much compared to the woman next to me. I have my work. I have my family. I must work as hard as I can to rebuild this country that I love.”
San Francisco Medical Center