On the Ground in Haiti: A Psychiatrist's Evaluation of Post Earthquake Haiti
Rahn Kennedy Bailey Theresa Bailey
Hilary Akpudo
Journal of Health Care for the Poor and Underserved, Volume 21, Number 2, May 2010, pp. 417-421 (Article)
Published by The Johns Hopkins University Press DOI: 10.1353/hpu.0.0295
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Journal of Health Care for the Poor and Underserved 21 (2010): 417–421.
RepoRt fRom the field
on the Ground in haiti:
A psychiatrist’s evaluation of post earthquake haiti
Rahn Kennedy Bailey, MD, FAPA Theresa Bailey, MA Hilary Akpudo, MD
O
n January 12, 2010, one of the worse natural disasters in the Western Hemisphere, the worst earthquake in 200 years—7.0 in magnitude—hit Haiti, leaving the capital city of Port-au-Prince in ruins. The initial quake was later followed by twelve aftershocks greater than magnitude 5.0. Structures of all kinds were damaged or collapsed, from shantytown homes to national landmarks. Haiti is the poorest country in the Western Hemisphere, with limited infrastructure and makeshift dwellings. Figures released by the Haitian government estimated the dead at 140,000. However, it is widely believed that the death toll is much higher. The body count continued to rise as rescue work- ers from all over the world mounted heroic rescue efforts. What will it take to rebuild Haiti? What are the dimensions of the Haitian catastrophe?1On January 28, 2010, the lead author went on a disaster relief mission to Haiti under the joint auspices of Arise and Walk Ministries Foundation,2 and Bethel Gospel Assembly. Dr. Bailey, Chairman of the Department of Psychiatry and Behavioral Sci- ences, and Executive Director of the Lloyd Elam Mental Health Center, at the School of Medicine, Meharry Medical College is the speaker of the House of Delegates of National Medical Association (NMA). Dr. Bailey is a disaster relief veteran who led NMA’s outstandingly successful relief efforts during the infamous hurricane Katrina that devastated New Orleans on August 29, 2005.
The Arise and Walk Ministries Foundation is a disaster relief organization led by Mark J. Wade, MD, a pediatrician based in Newark, New Jersey. Dr. Wade is the founder and CEO of Wade Healthcare Systems, Inc. (WHS), a physician-owned and operated health care management and consultation company. Arise and Walk Ministries Foun- dation is a Christian-based ministry whose mission is to equip and empower the local church with the health care personnel, expertise, and resources necessary to provide health care excellence as an integral part of their missionary outreach to the nations of the world as a tangible demonstration of God’s power and His love for all people.2 Dr. Mark Wade is a member of the Board of Trustees of the NMA.
Rahn Kennedy Bailey is Chairman of the Department of Psychiatry and Behavioral Sciences, and Executive Director of the Lloyd C. Elam Mental Health Center, at Meharry Medical College. TheResa Bailey is currently a doctoral student in psychology, specializing in group/organizational behavior and change management. hilaRy aKpudo is a Research/Forensic Psychiatry Associate at the Department of Psychiatry and Behavioral Sciences at Meharry Medical College.
418 On the ground in Haiti
Bethel Gospel Assembly, under the leadership of Bishop Carlton Theophilus Brown is a Christian church based in Harlem, New York, committed to reaching the world, making disciples locally and globally through the Gospel of Jesus Christ.3 Bethel Gospel Assembly Ministries includes six churches in Transkei, South Africa. Bishop Brown has served in missions assignments. He has been a conference and crusade speaker overseas in Azerbaijan, Russia, Cuba, India, Kenya, Nigeria, Panama, South Africa, Venezuela, Jamaica, St. Vincent, Trinidad, Barbados and Aruba, as well as around the United States Bethel Gospel Assembly.
The NMA, Arise and Walk Ministries Foundation, and Bethel Gospel Assembly are attempting to work with other well-meaning professional and philanthropic orga- nizations for ongoing support. The goal is to nurture these relationships into fruitful, effective, productive, and helpful resources that will help Haitian people rebuild their devastated lives.
Dr. Rahn Bailey and his team arrived at Santo Domingo, Dominican Republic on Thursday, January 28, 2010 amidst great concern about security required to enter Haiti.
There were reports that all of the country’s prisoners had to be released following the devastating earthquake. This report heightened the apprehension of having dangerous criminals in the streets of Haiti. Another group ahead of Dr. Bailey’s team had report- edly been intercepted by unidentified armed militia. Haitian police, a group of four armed policemen wielding semiautomatic rifles, provided escort for the NMA team en route to Haiti. The United Nations Security forces walked the streets, providing strong command presence. Their presence certainly helped bring a sense of stability to the pervasive feeling of vulnerability.
R. Bailey, T. Bailey, and Akpudo 419
Dr. Bailey and his team brought much needed supplies to the helpless and stranded people of Haiti. The supplies included food, bottled water, wheel chairs, medical and surgical supplies, and volunteer expert medical, surgical, and psychiatric resources. The Grace Catholic Church/Orphanage, which housed 200 hundred girls, had no running water, no plumbing, and only a three-day supply of food. There were reportedly 18,000 people living inside the preliminary barrier gate of the church. People bathed in the open, kids were stark naked, and the makeshift tents in which they lived were barely erect. The feelings of vulnerability and hopelessness were palpable. The need for food, shelter, health care, and psychological support among these displaced and devastated people was brutally obvious.
The Haitian people reached by Dr. Bailey and his team were deeply grateful for the lease of life afforded by the physical, medical, and psychological resources provided by the doctors. These people were badly in need of psychiatrists who could help them cope with their psychological torment, anxiety and depression. They asked, “How could things possibly get better?” a difficult, but appropriate, question. Dr. Bailey provided opportu- nity for groups to talk, to address their respective concerns, in a kind of on-the-ground psychotherapy. It was rudimentary at best . . . but was obviously beneficial: participants expressed a motivation to live through the difficulty until things improve.
Psychiatrically, in Haiti, a large number of individuals most likely met the diagnostic criteria for post-traumatic stress disorder (PTSD), pre-earthquake. The earthquake itself added a clearly catastrophic stressor to create a new paradigm in disaster relief/
recovery. There is a need to better understand to full impact of this type psychological assault on an individual’s psychological defense mechanisms. It stands to reason, that
420 On the ground in Haiti
any individual who has been so affected has fewer emotional reserves available to be able to address the primary day to day struggles to which they are exposed. Depressive and anxiety disorders can be very debilitating, especially in individuals with poor pre- morbid functioning.4 This is the case in Haiti. Social and economic deprivations, with all its ugly ramifications, had pervaded these people before the devastating earthquake added insult to injury.
Dr. Wayne Riley, the president of the Meharry Medical College has been, and con- tinued to be, a powerful ally in this most important endeavor. The astute support of Dr. Billy Ray Ballard, Interim Dean, School of Medicine, and Interim Vice President, Health Affairs, Meharry Medical College, made it possible to work around administra- tive hurdles that might have derailed the Haiti project. Ms. Lori B. Donnell, Executive Director, Meharry Medical Group Administration used her extensive network to provide much of the medical supplies taken by Dr. Bailey on the Haiti trip. The donations from the Meharry Medical College—including food, bottled water, cleaning solutions (e.g., betadine, alcohol), bandages, personal hygiene items (feminine), antibiotics, surgical and orthopedic supplies, and even a tent—were very well received.
The need in Haiti has far from abated. As Dr. Rahn Bailey prepares for his second trip to Haiti in April 2010, it is important to stress that no donation is too small. All donations to the suffering people of Haiti will be well received. Stepping up to the situation in Haiti is a noble objective. Your contribution can make a tremendous dif- ference in someone’s life.
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Notes
1. U.S. Geological Survey. Magnitude 7.0—Haiti region. Reston, VA: USGS National Center, 2010. Available at: http://earthquake.usgs.gov/eqcenter/eqinthenews/2010/
us2010rja6/.
2. Arise and Walk Ministries Foundation. Arise and walk ministries foundation mission and vision. Paramus, NJ, 2009. Available at: http://www.awmfoundation.org/about_us/
mission_vision.shtml.
3. Bethel Gospel Assembly. About Bethel Gospel Assembly. New York, NY: Bethel Gospel Assembly, 2010. Available at: http://www.bethelga.org/mission.aspx.
4. DepressionIsReal.org. Separating fact from fiction: offering help and hope. 2009.
Available at: http://www.depressionisreal.org/podcast/bio_bailey.php.
