Electrical wires in the Boulard neighbourhood of Port-au-Prince, Haiti, stretched tight between rusty tin roofs, shorted and sparked in the early afternoon of Oct. 23. Within minutes, the tightly packed slum houses were engulfed in flames.
Francia Caidor, who was orphaned and made homeless at 16 after the 2010 earthquake, was selling rice in the market a block away. She saw the smoke and ran towards the flames, hoping to save something of the life she had painstakingly rebuilt after the earthquake. She was too late. By the time Caidor reached her home she found smoking rubble.
Her neighbour, Rosemonde Joseph, was at home that day, her 11-year-old daughter Harraza sick in bed. Joseph heard the fire racing towards her house before she saw it. By the time she realized what was happening, the thin poles holding up her roof were on fire and the house next door was collapsing. She picked up her sick daughter and carried her through the narrow winding walkways of the neighbourhood to safety.
MCC photo/Paul Shetler Fast
“We nearly died,” Joseph says. “I almost couldn’t carry her. We lost everything…thanks to God we are alive.” Joseph motions toward the charred concrete slab where her home once stood, “But my daughter did not completely make it out in her head. She lost something of herself in there. It’s been three weeks, and she still can’t sleep. She has nightmares every night; she can’t go to school; she can’t stop thinking about that fire. She’s lost her memory, can’t think well.”
MCC photo/Paul Shetler Fast
In a place like Haiti, these personal tragedies will never make the news. Most survivors won’t receive outside support to get back on their feet. MCC in Haiti responded to the 49 people, including 27 children, who lost their homes that day by giving them relief buckets, water treatment tablets and handmade comforters. But even when immediate, physical assistance is available, deeper psychological scars and trauma often go unaddressed.
Supporting mental health care in Haiti
In response to persistent and unaddressed mental health needs in Haiti, we have launched a three-year project with our partner Zanmi Lasante (the Haitian branch of Partners in Health) to expand mental health care to communities across Haiti.
This project aims to provide treatment to those suffering from trauma so that people like Harraza can receive effective treatment for their emotional pain. Even in a country like Haiti, with limited physical health care and high rates of infectious disease, mental health conditions still make up an estimated 18 percent of all productive years lost to disability.
MCC photo/Rebecca Shetler Fast
Zanmi Lasante focuses on delivering effective mental health treatment through a community-based system integrated with its existing primary healthcare system. This project will support 31 community health workers and 14 psychologists working across all 11 Zanmi Lasante health centres. They will to provide treatment and support for people suffering from a range of conditions, from depression to post-traumatic stress disorder to schizophrenia.
Dr. Peter Desameau is a passionate young psychologist at the University Hospital of Mirebalais. The challenges of delivering this mental health care in Haiti are immense. As Desameau explains, “Our work is never done. Our patients have such scarce resources, to even be able to afford public transportation to come into appointments is something many of them struggle with.”
In a context that has never had quality, accessible mental health care before, stigma is also a big challenge. Some people are afraid to look for help, but Deameau says that’s slowly changing in the areas where they work.
Without mental health services, our health care is like a stool with two legs…you can prop it up with a rock, but it is unbalanced and weak." — Dr. Peter Desameau
Many mental health conditions are highly treatable, even in resource-poor context like Haiti. But without access to effective treatment, people will continue to suffer. The program’s psychologists, including Dr. Desameau, are trained in nine mental health therapies, for example, the team uses a locally adapted form of Interpersonal Psychotherapy, a treatment for depression that is recommended by both the World Health Organization and American Psychological Association. Program psychologists also complete in-depth evaluations, manage care coordination with medical staff, ensure follow-up with community health workers and provide psychotherapy and psychoeducation.
International mental health care is a growing field, but it often takes a back seat in contexts like Haiti where other seemingly more basic needs are lacking. However, as the Haitian proverb says: “Tout moun se moun” — all people are people and equally deserving of care and compassion.
During the next three years, this project will continue adapting mental health care to the local context, with further services developed in the areas of trauma and mental health services for children and adolescents. This will bring desperately needed care to more than 7,000 people and will include training for a new group of Haitian mental health professionals.
As Dr. Desameau says, “Without mental health services, our health care is like a stool with two legs…you can prop it up with a rock, but it is unbalanced and weak. We in mental health are the other leg, serving an equally important need and helping to stabilize a system of care that can truly serve the whole person and the whole community. We can walk with them through their darkest moments. We can relieve their gravest suffering and help people to live full lives again.”