Ravaged by an earthquake three years ago, Haiti is slowly recovering. To help in that recovery, seven students from AUNE’s Department of Clinical Psychology, members of the Multicultural Center’s Disaster Shakti group, traveled to Haiti for eleven days in May. Accompanying Gargi Roysircar, professor of clinical psychology and founding director of AUNE’s Multicultural Center, they went to provide mental health counseling and to continue research into how Haitian children adapt to stressful living conditions.
The PsyD students: second-year Molly Conley, Kelsey Moran, and Kevin O’Leary; third-year Perrin Tellock, Katherine Russell, and Megan Lord; and fourth-year Beth Briggs, worked with Partners in Development, a nonprofit based in Ipswich, Massachusetts, to provide disaster mental health services for a third year (Disaster Shakti also went to Haiti in 2010 and in 2012). The Haiti PsyD clinical practicum, for which the students were awarded course credit, involved both health as well as mental health counseling.
Although the disaster may have made some Haitians stronger, many others were traumatized and most still must grapple with everyday life in one of the world’s poorest countries. [Last year] we were still seeing the after-effects of the earthquake, what they call the ‘goudou-goudou’, Perrin said. There were a lot of buildings reduced to rubble or pancaked; people were living in tents. This year, most people have been relocated and much of the street rubble has been cleaned up and removed. But we’re seeing a lot of people suffering from poverty and long-term neglect.
Students Offer ‘Psycho-Education’
Partners in Development (PID) runs a small community clinic in Blanchard, in the outskirts of Port-au-Prince. During PID’s three weekly health clinics, the AUNE group led classes in psycho-education, with their presentations in English translated simultaneously in Creole by PID translators. The students also explained through their translators and wall charts how better nutrition and clean water can help them deal with mental and physical stress. The Haitians’ poor nutrition has not been helped by an influx of earthquake aid replacing the traditional diet with mostly carbohydrates and very little protein (a favorite meal is pasta with a sauce of ketchup and mayo).
The AUNE classes explained to people about the effects of stress and how it can exacerbate diabetes, cardiac problems, and sickle cell disease. The patients report they have problems that don’t have an easy fix and that they can’t change, Perrin said. So the students taught muscle relaxation techniques, useful to stressed-out Haitians who often feel marginalized and helpless. The Shakti students also helped patients follow their treatment regimens. For example, Perrin said, patients taking medicine for hypertension or insulin for diabetes may feel better after a while, so they give their meds to family and friends and disrupt their own care.
The psycho-education proved effective in reaching the clinic’s patients, because many of the class participants requested individual counseling before or after their medical appointments. Individual and family counseling involved stress reduction, facilitating family and couples relationships, suicide assessment and prevention, building self-efficacy to deal with depression, and empowerment groups for girls, boys, and parents. Each Disaster Shakti counselor was assisted by a PID translator for each counseling session.
The poverty is so overwhelming. To see it for the first time, you think it’s hopeless, Perrin said. But it’s not a place where change can be measured in days or weeks; if you think of it as year after year, you do see that it is going forward.
AUNE Research: How Adaptable are Children?
Some AUNE students also continued research begun last year, when they asked Haitian children to make house-tree-person drawings to measure their reactions to a post-disaster challenging environment. Would the children’s drawings indicate trauma? Or were there more positive responses in children more adaptable to their circumstances? We hypothesized that both positive (e.g., resilient) and negative (e.g., trauma) adaptations would be shown by the drawings, Gargi said.
This year the students collected data from several dozen children living in three different areas, said Kevin O’Leary, who plans to develop the research for his PsyD dissertation. They elicited drawings and gave questionnaires on self-concept, resilience, and trauma to children in Canaan, a desolate relocation camp outside of Port-au-Prince; in the PID clinic in Blanchard; and at the orphanage located on the ground floor of the guesthouse where the students were staying. They also held focus groups with the children’s parents on their parenting of children to withstand crises. All questionnaires and instructions were translated in Creole by GeneviÃ¨ve Dagobert, a Haitian student in AUNE’s Waldorf Teacher Education program, and cross-checked by the Haitian staff at PID.
The research, Kevin said, is intended to determine if the house-tree-person test, a standard American psychological test never used in Haiti before, can function as a useful, objective system to gauge the resilience of Haitians to disasters like the 2010 earthquake, poverty, hunger, and medical epidemics, such as cholera. The coding of the drawings was, however, adapted to be sensitive to the Haitian culture, so that the scoring and their interpretations would be cross-culturally valid for Haiti as well as other international settings affected by disasters and various environmental crises, Gargi said.
Gargi, Kevin, Melissa Boudreau (fourth-year PsyD), and Abimbola Afolayan (fourth-year PsyD) are presenting a symposium at the American Psychological Association annual convention in Hawaii July 31-August 4 on the quantitative and qualitative findings from the 2012 study.
The Power of the Witness
In experience and insight, the AUNE students returned with as much as they gave. It’s interesting to find yourself in a situation in which so many parts of the story are outside our control, Perrin said. You have to be careful you can easily become very despondent very quickly. But there are beautiful moments when you’re sitting one-to-one with someone and you realize that, person to person, you can make a change.
The amazing effect of being a witness and being an ear to what they’re experiencing is really powerful in its own right. You’re not there to give them food or money but to hear and bear witness to what they’re experiencing. That’s the real value of it.