Horrors of the Haiti Earthquake and the Power of Human Understanding

"There is so much to tell, but I hope that this small sample will convey the feelings and needs of the Haitians. In many ways, I feel that our trip was such a small contribution that it barely has meaning."
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Yesterday I received this moving account from Los Angeles psychotherapist, Dr. Nancy Sobel, describing her experiences volunteering on a medical team in Haiti. It illustrates the incomparable power of human understanding in times of devastating collective trauma:

"As I watched the compelling coverage of the earthquake on Anderson Cooper, there was one scene that captivated me more than the rest. It took place at an orphanage that had been destroyed and about thirty babies were lined up on the ground on sheets. Some of the caregivers were holding children, but most of the infants were on their backs, lying side-by-side outdoors in the sun. As I viewed the scene, the shock and grief that the caregivers must have been feeling was palpable, and I couldn't stop myself from the fantasy of going there and picking up each baby, one by one to hold and soothe it. I also wanted very much to speak with the caregivers in an effort to assist them with the overwhelming combination of dealing with their own losses and caring for the children.

"Within days of this thought, an opportunity arose through people I knew in the music industry. Scott Stapp of the band Creed, and Dan Catullo, a well-known rock and roll DVD producer, were organizing a trip. Scott has a nonprofit called Arms Wide Open that helped fund the effort. Dan has worked with the Wheelchair Foundation. Together Scott and Dan raised money and supplies to fill a large private jet that was donated by Ken Behring, the founder of the Wheelchair Foundation. A small team of medical professionals was assembled along with a film crew. Scott, his sister-in-law, Jeanette, who is a medical doctor, and her brother, Dani, flew over to the Dominican Republic the night before we arrived. Scott bought a used SUV and drove through the night to Haiti. They had coordinated with a local Haitian pastor named Pierre who rented a bus for us and identified people who needed our help. We drove out to the tent city in Leogane that first morning and set up a couple of tents that were transformed into medical clinics.

"It is impossible to describe fully what I experienced in Haiti, but the reporting on CNN has been very accurate in terms of there being no infrastructure or arrangements to distribute supplies and other resources. We arrived in the night with a couple of tons of medical supplies, and no one was there to check our passports, ascertain our mission or help with moving the gear to the side of the tarmac. We were lucky to befriend members of the 82nd airborne who ended up assisting us with a flatbed truck to settle us in on our piece of the airfield where we camped throughout our stay. "I did, however, want to share a few vignettes of my experience there. We worked with a local Haitian pastor named Pierre who helped us rent a bus and identify where we could best be useful. On the first day, we went to an outlying area called Leogane, where there was a tent city with very few services. We arrived to see about five hundred people standing in line waiting for us. As quickly as possible, we set up a tent for wound care and another tent for general medical services. The rest of the day is a blur of people of all ages with bruises, stomach troubles, dehydration and fevers. Everyone was hungry and stressed and yet they were very patient and generous with their gratitude. There were many wonderful stories from that day, but one that stands out is the mother who appeared within hours of giving birth and who delivered her afterbirth in one of our tents. This somehow reminded us that Haiti has a future and that we must do all that we can to help insure it.

"Another clue to the resilience of the Haitians happened while we were treating a mother and her child for the flu. Keep in mind that all of the treatment was done in the open air in front of the long line of hungry and tired people waiting to be served. We had treated the baby and the mother had shifted her position to allow the doctor to now treat herself. As she shifted, the baby started crying, and I reached in to take her from her mother's lap. The poor little thing was crying and, without really thinking about it, I started to sing her a Hawaiian lullaby. She immediately settled down, and I was suddenly aware that all of the people in line were smiling and whispering, "belle chanson..." The energy of the entire scene changed and a connection was made. I don't know if it was my own projection, but I found myself feeling at home and that these island people were connected to music and simple soothing in a way that was very familiar to me from my years of living in the Hawaii.

"On the second day, we provided a mobile service in which we rounded up busloads of people and brought them to our camp where we again treated a great variety of maladies. Earlier that day, I had the privilege of meeting a woman named Loune, who works for the NGO, Partners in Health and is in charge of coordinating services for all of Haiti. She hadn't really slept since the earthquake. She invited me to come with her to visit an orphanage which had been part of the Children's Hospital. These kids were all physically disabled with cerebral palsy, blindness, and other birth defects. They ranged in age from fourteen months to fourteen years old. They were staying in a school temporarily but Loune was desperate to find another location because the school was set to re-open in a few days. Donations enabled me to bring crayons, paper, and small musical instruments to them in addition to medical supplies. I can't stop thinking about those kids and their caregivers and wondering where they are sleeping tonight.

"Because most Haitians speak Creole, we employed as translators a couple of local guys who were wandering around the airfield begging for work. It turned out that I was the only French speaker (barely literate on a high school level) on our crew, so my new friends, Bruneau and Jean, became my right and left arms as we worked at a fever pitch translating from Creole to French to English. These guys worked so hard alongside us in spite of suffering their own trauma and losses from the quake. At one point, we held a mini-group-therapy session with a few people who complained that they were unable to sleep because "animals were running around inside their heads." It was in these moments that I also tried to intervene with Bruneau and Jean in terms of skills for stress management and grief processing. Jean shared that although he was able to rescue his children, his wife and mother were killed in the quake. It was a completely overwhelming challenge to create a meaningful intervention in the twenty minutes or so that I had with them. The best I could think of was to teach them some breathing exercises to respond to the stress and to try to find a simple way to access their resilience. Each person in the group made a picture in their mind of a time from their past when they were able to overcome a big problem. Then I asked them to make a picture of what they hoped things would be like in a few months. We tried to memorize these pictures by repeating descriptions of them within the group to use as a source of strength during these difficult days. The fact that in the middle of such terror and chaos, people were able to access hope and resilience is a big part of what I will take with me from this experience. "Another experience was with a little boy who looked about ten years old. As we tried to examine him, I asked his age and he told me that he was fourteen. I thought that I must have misunderstood him and asked him again. Then I had him stand up and turn around. He realized that I didn't believe him, and he puffed out his chest and did everything he could to look older. It was adorable. He told me that his name was Sammy, and I told him that was my father's name. Before my father died, he had told me that even when we were far away I should think of him as an angel on my shoulder and he would be with me. In this distant place and horrendous time, I felt that my dad was visiting. Later, as we were about to say goodbye to that busload of people, Sammy leaned out the window to me and pointed to an empty cardboard box. I explained that it was empty, but he insisted that he wanted it. As I folded it up and passed it through the window to him, I asked what he would do with it. He said, "je do." (I will sleep on it). Soon, all the cardboard boxes were also on the bus, and as it pulled away, Sammy leaned out and called, "Dr. Nancy, vous etre toujours dans mon Coeur." (You will always be in my heart). Moi aussi, Sammy... (Me, too)

"On the last night, the University of Miami hospital that was set up at the airport asked if we could pull a night shift because they were short staffed. I went over expecting them to turn me away because I am a psychologist not a medical doctor. As I checked in, I apologetically identified myself and my credentials. They asked if I was licensed, and when I said yes, they urgently requested that I sign in with my license number and come quickly to an isolation tent. A Haitian woman was sobbing as an American doctor stood awkwardly by her side. The woman's name was Nancy (my name). They had spent the whole day deliberating whether to amputate her fourteen year old sister's leg. Nancy's sister had finally decided to consent to the surgery and two hours later died from tetanus. Nancy was inconsolable and full of regret for the decision to amputate. There was no point in trying to help her understand that her sister's injuries would have been terminal either way. All that I could do was to hold her and listen. One important change that resulted from the death of Nancy's sister was that each patient received a tetanus shot prior to surgery after that event. It was a huge price to pay for a simple procedure that is a routine part of surgery in American hospitals. Her surgeon explained that her death saved many lives.

"Later that night, I checked in with the surgeon to help him debrief. He confessed that back home he would never participate in a debriefing, but that here he found himself talking a lot in bits and pieces with complete strangers. He admitted that it actually felt good and wondered aloud if it was because they were strangers and that he would return home and not see them again. He explained that back home he felt that he had an image of strength to maintain and would not allow his vulnerability to show. He said that he was thinking about bringing this new skill home with him. Throughout my stay, I was struck by the unexpected ways that this tragedy brought gifts.

"There is so much to tell, but I hope that this small sample will convey the feelings and needs of the Haitians. In many ways, I feel that our trip was such a small contribution that it barely has meaning. On the other hand, I am forever changed by the experience. More importantly, I hope that this description of our trip captures the openness, warmth, resilience, and gratitude that were expressed in every encounter...from both sides of the ocean."

--Nancy Sobel, Psy.D.

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