Researchers Focus on Psychological Care for Haiti's Earthquake Survivors

In the immediate aftermath of a natural disaster, addressing the physical needs of survivors—providing emergency medical care, food and water—can make the difference between life and death. But in the weeks, months and sometimes years that follow, the mental health effects may linger well after physical wounds have healed. Attention to psychological and emotional well-being, say experts from Columbia’s Mailman School of Public Health , is therefore critical to the long-term recovery of both individuals and communities.

Sandro Galea and Moise Desvarieux are both researchers in Mailman’s Department of Epidemiology who have joined together to look at the mental health of Haiti’s earthquake survivors and how they are coping. They have emergency, short-term funding to work with Institut Fame Pareo, a local organization in Port-au-Prince, on a multi-year study of mental health, substance abuse, and resilience among survivors in Belair, a poor neighborhood heavily hit by the Jan. 12 earthquake.

Post-traumatic stress disorder (PTSD) can be experienced by any individual exposed to a traumatic event. Common symptoms include severe depression, severe anxiety, substance abuse and hypervigilance, and extreme sensitivity to signs reminiscent of a potential threat, such as loud noise. Galea, Gelman Professor of Epidemiology and chair of the Department of Epidemiology, estimates that roughly one in every five people who survive a disaster will experience PTSD or depression.

“There is a misconception that mental illness is not important in resource-poor areas, but it is, and [the world] has consistently underestimated its importance,” said Galea, who has studied the impact of traumatic events on health among people affected by disaster, conflict and violence in Palestine, Liberia, Ethiopia, and the cities of New Orleans, Madrid and New York. “Mental illness can be debilitating, and can delay both individual and community recovery—that’s why paying attention to mental health issues after a disaster is extremely important.”

The researchers are specifically interested in what factors shape the trajectory of disaster-related mental illness, such as PTSD, depression and anxiety, and substance abuse over time, looking at a random sample of people every three months for several years. In particular, they want to understand how some people remain resilient in the wake of a traumatic event, and why others find it more difficult to cope. The team will administer screening tools for mental illness, and the Institut Fame Pareo will help provide treatment and care.

“We want to document the impact of the disaster on people, and look also at the positive lessons one can learn. Among all these traumas, there is a lot of resilience,” said Desvarieux. “Some people do better than others, and we want to know how and why.” The team plans to look at what factors help people develop coping mechanisms and how quickly they return to a sense of normalcy.

A long-time specialist in chronic disease epidemiology, Desvarieux’s involvement in the study is both professional and personal. Originally from Haiti, he received his medical degree from the Universite d’Etat d’Haiti in 1986, then left his home country to study in France and New York. While his family survived the earthquake, they have had to adapt to shuttling between Port-au-Prince and neighboring Dominican Republic, where they have temporarily relocated. “The earthquake was life-changing for my family, particularly for my mother who lived there all her life,” said Desvarieux, associate professor in the Department of Epidemiology. “But we were lucky; our loss is nothing compared to people who have lost everything and their loved ones.”

Galea and Desvarieux, who will be returning to Haiti for the second time since the earthquake to initiate the project, hope that this effort will give survivors a forum to help them talk about their experiences.

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