By Kevin James Moore
4 February 2010 [MediaGlobal]: After the immediate emergency aid leaves, Haitians will have to deal with the lasting psychological effects of the recent earthquake that struck on 12 January 2010. The loss of family, limbs, and livelihoods have left lives in ruin, mirroring the buildings that use to make up their towns and cities. The organizations that are providing relief are assessing how best to handle treating the mental health of the Haitian people, and taking into consideration the Haitian culture.
An aid worker helps a survivor of the 12 January earthquake in Haiti. (Photo credit; Creative Commons.)
Monika Oswaldsson, of Doctors Without Borders/Médecins Sans Frontières (MSF), described to MediaGlobal how Haitians are coping in Port-au-Prince. “[The Haitians are very religious,” Oswaldsson said. She explained that to deal with the trauma they often pray, relying on their own customs. Oswaldsson also noted that the solidarity the Haitians are showing is another way of coping. “They gather together, the families, the neighbors, and they stay in the same area and help each other out as much as they can,” she added.
Understanding how Haitians are dealing with the earthquake in a cultural context is part of the long-term strategy that is being compiled by the Inter-Agency Standing Committee (IASC), which includes both the Word Health Organization (WHO) and MSF. IASC administered the “Guidance Note for Mental Health and Psychosocial Support for Haiti Earthquake Emergency Response” (MHPSS). Noted in the MHPSS is that professionals should only go to Haiti if they have knowledge of the Haitian context or experience in disaster response outside their own cultural context, or if they receive a basic orientation on the context including the situation in Haiti before and after the disaster.
To have a greater insight into the Haitian psyche, Oswaldsson says, MSF is working with three teams of national Haitian psychologists. They are providing counseling for patients and working with MSF staff to relate how the earthquake is experienced culturally.
The need to work closely with Haitian officials is important, emphasizes Dr. Mark Van Ommeren of the WHO. Van Ommeren tells MediaGlobal that, “WHO will focus its work on supporting the Haitian Government in developing sustainable mental health services throughout the country.”
A growing understanding of the need to be culturally sensitive is important in treating mental illness, Ethan Watters tells MediaGlobal. In his new book Crazy Like Us, Watters cautions against the Westernization of psychological treatment around the world. Watters said, “Cultures have modes of healing and modes of understanding, and they have institutions in place by which people gain mental health support.”
Watters speaks about a fundamental difference in how PTSD (Post Traumatic Stress Disorder) is perceived. He says an American going through trauma will most likely point to their head and say the PTSD is in their mind, while after the 2004 tsunami that hit Sri Lanka, a Sri Lankan would’ve been more likely to point to their social group as being the source of their pain. This is a result of the difference in cultures.
When Haitian families stay together, as Oswaldsson witnessed, this is a positive coping strategy according to the MHPSS. This shows that Haitians have an understanding of their own psychological trauma and their own understanding on how to heal from it, according to Watters.
“If we go in there and understand [their culture] we can help that community center, and that school, and that local village regain its place in their lives, then the mental health will come from that,” said Watters. The MHPSS stated a similar view in that support is provided from within the community as well as by outsiders, and there should be respect for the fact that people are affected by the disaster in different ways.
The MHPSS also advocates that local services be a part of the response for long-term mental health. These include, for some people, participation in religious or traditional cultural practices, which may have a calming effect and offer a sense of meaning and perspective regarding their situation.
“Social support and cultural considerations is a positive trend,” said Watters. The mental health aid currently provided by MSF and WHO shows an awareness of cultural sensitivity, which will help the Haitians in their recovery. Hopefully, other aid organizations will heed the call to provide the type of cultural-sensitive mental health treatment that is most beneficial to devastated communities.