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Trauma increases health emergency

Psychological aid is lacking in Haiti

By Frank Bajak
Associated Press / February 8, 2010

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PORT-AU-PRINCE, Haiti - As many as 1 in 5 Haiti earthquake victims have suffered trauma so great with the multiple shock of lost homes, jobs, and loved ones that they won’t be able to cope without professional help, doctors say.

In a country where mental health services barely existed before the quake, building the required support is a huge challenge. The symptoms can’t be diagnosed by stethoscopes, blood tests, and X-rays, and can take time to surface after the initial shock of the disaster.

“It’s not about immediate psychological counseling,’’ said Dr. Lynne Jones, a senior medical adviser for International Medical Corps. . “It’s about assisting mourning. People cannot recover if their social needs are not met.’’

Jones, a veteran of natural disasters and wars from Bosnia to Indonesia, is teaching front-line doctors how to identify disabling fear and, quite literally, hold people’s hands and listen.

Hugo Emmanuel is one of the untold thousands who doctors say have lost the ability to cope.

“Stay away! I don’t want you to touch me,’’ he yelled at an American nurse who had only wanted to wash his shattered lower leg.

Emmanuel, 49, is an educated man of spindly limbs but voluble spirit who lies on a mattress on the floor of the kitchenette in the Espoir Hospital in the capital’s eastern hills.

He tore the cast off his leg last week. For days after he arrived two weeks ago, he only let the hospital director feed him; he claimed everyone else was trying to poison him.

Emmanuel, who lies in his underwear beneath a white sheet and towel, is at least getting personal attention. Most of those diagnosed with severe trauma are treated as outpatients because there is no room in the country’s 91 functioning hospitals.

The hospital’s director, Dr. Gusse Darline, said Emmanuel is sporadically amnesiac. But that’s only part of his problem. “He didn’t want to come into the hospital for treatment. We had to drag him in,’’ she said.

Darline says she doesn’t know what to do with Emmanuel once his leg heals.

Port-au-Prince’s only psychiatric hospital is barely functioning. All but 11 of its more than 100 pre-quake patients were removed by relatives who feared the building would collapse in another quake, said Dr. Peter Hughes, an Irish psychiatrist who arrived late last week and is studying what to do.

It is not known how many mental health workers are available to help in Haiti. Pan American Health Organization officials who are coordinating medical care among more than 200 aid groups have only just begun to create a database of hospitals, patients, doctors and medical resources.

But it seems clear that Haiti will have to train more of its own personnel to work on the front lines with people suffering from psychological trauma.