SHAKEN UP: Mental health issues may prove to be a longer lasting concern than other diseases after the earthquake in Haiti. But more than specialized care, preventing these illnesses might be as simple as helping people meet their basic needs and reestablish normalcy.
Image: WIKIMEDIA COMMONS/UN DEVELOPMENT PROGRAMME/LOGAN ABASSI
-
What a Plant Knows
How does a Venus flytrap know when to snap shut? Can it actually feel an insect’s tiny, spindly legs? And how do cherry blossoms know when to bloom? Can they...
Read More »
As the aftershocks of the January 12 magnitude 7.0 earthquake outside of Port-au-Prince, Haiti, taper off and the dust settles, new needs are coming to light. The health of many of the three million residents said to have been shaken by the quake will be determined in the coming weeks as aid workers and others rush to treat the wounded, provide food and water, and try to prevent disease outbreaks.
Concern already has run high about the spread of cholera and typhus in a country whose everyday "water supply and basic sanitation services are still very deficient," according to the Pan American Health Organization. Many diseases, including malaria, HIV and typhoid, were already widespread issues in Haiti before the earthquake struck, and the intensely weakened health care system (established hospitals and clinics having collapsed or been damaged) and other infrastructure is expected to exacerbate these problems.
"In the weeks to come, we may have huge issues with public health," Pino Annunziata, who is helping to coordinate responses for the World Health Organization (WHO), told TIME. "This will be a major concern." And the tens of thousands who are reportedly seeking medical help at the few remaining hospitals and overwhelmed clinics speak to the urgent need for physical care. Doctors Without Borders (Medecins Sans Frontieres) reported already having treated more than 2,000 patients in Port-au-Prince as of January 14.
But not all of the human harm from this disaster will be of the physical variety. For example, many experts have noted that the multitude of dead bodies—some 50,000 possibly having died in the disaster already, the Red Cross estimates—don't pose an infectious disease risk so much as a psychological threat to the survivors.
Sandro Galea, chair of the Department of Epidemiology at Columbia University's Mailman School of Public Health in New York City, explains how and why so many Haitians will likely be hurting for months after food and water have been restored and the corporeal wounds have healed.
[An edited transcript of the interview follows.]
What are the biggest health and disease concerns for Haiti in the wake of the earthquake?
There is relatively little evidence of water-borne diseases appearing in the short term. It's actually relatively rare after these events. Cardiovascular disease and heart attacks could go up, and all of the dust could cause asthma. Unfortunately, these events happen and daily life continues. And when daily life continues, other injuries and other illnesses happen. This event introduces a layer of illness that is extra.
The largest burden of disease after these events is probably mental health issues.
What sorts of mental health issues will likely appear?
In the short-term you end up seeing, in the first few days, that people are dealing with wounds and trying to stay alive and stay well. You start seeing mental health issues within the weeks following the event. There is acute stress, which is considered to be a transient condition.
Post-traumatic stress can only be labeled a month after an event. You will start seeing high rates of post-traumatic stress and depression. You will probably end up seeing them three or four times higher than baseline.
What can be done to minimize these effects?
We know that stressors and challenges of daily life after these events can compound the impact of these events. The best thing we can do is to provide psychological first aid. In the long-term, behavioral therapy or medication might be beneficial based on the individual.
The key here is restoring lives—that will provide support to people.
Will initial counseling be important in administering this "psychological first aid"?
There is actually no good evidence that early counseling after an event actually makes things better, and there is some evidence that it actually makes things worse. Psychological first aid is giving people what they need to rebuild their lives. It will mean restoring people to their jobs, restoring people to their schools, restoring families.
See what we're tweeting about
9 Comments
Add CommentHow about a word from Cuban doctors working in Haiti? How about 82nd Division impeding distribution of Humanitarian Aid? Where the hell is FEMA (once again)? How about cutting all this censorship off?!
Reply | Report Abuse | Link to thiswow, Haiti is in need of some dire help. they already had problems with diseases and now, because of the earthquake, it is worse.
Reply | Report Abuse | Link to thisI'M SURPISED THAT COUNSELING IMMEDIATELY AFTER SOMETHING TRAUMATIC HAPPENS DOES NOT HELP WITH POST-TRAUMATIC STRESS. POST-TRAUMATIC STRESS IS NOT SOMETHING I HAD CONSIDERED TO BE A PROBLEM.
Reply | Report Abuse | Link to thisI am very sorry for the Haiti people. I am glad our people are down there doing what ever they can to help them. But to me yes we can go down there and help them from the earthquake but help them with the diesease that are going down there I dont think so. I mean the more we help them the more they are going to ask for our help and our money. Our society does not have money growing from trees. And we spend so much time down there and spending our money what is going to happen if something happens in out country?? Im not trying to be mean, we can help out but not for everything that is wrong doen there. so I hope things get better with them and god bless them all
Reply | Report Abuse | Link to thisI feel so bad for the people in Haiti. i so blessed to live in a place that notice so bad has happened. i could not imaging myself living after a scary event life the couple earthquakes such as in Haiti. i hope that things will get better for everyone living there and the survives. GOOD LUCK
Reply | Report Abuse | Link to thisThe biggest problem of the Haiti people is something shared by all poor peoples. It is the condition called POVERTY and it is responsible for all of the other claimed diseases and related disorders and failures for educated children to build better lives and homes.
Reply | Report Abuse | Link to thisTo eliminate poverty is simple and effective provided the class of people who are causing it agree (but due to fear of having to work and selfishness they are not so inclined). This class of people are the LANDOWNERS and many of them stop the land being available for responsible use and earning of wages through saleable produce. By speculating in the value of the land and not allowing for its proper use, the cost of goods becomes high and few purchases of consumables are possible. Some of these class of owners allow the work to be done but then take so much of it away as rack-rent as to make the family lives of the landless peasants almost as abject as that of slaves.
Good government anywhere can stop poverty from continuing to be experienced by making the advantage of land ownership a public right. This is best done by taxing land values. Unfortunately the corrupt governments of Haiti and elsewhere have been causing poverty through land monopoly for such a long time that it is almost impossible to get them to change, yet a movement for this change is badly needed and in the few places where such change has been made the results are wonderful.
However much money the richer help-giving nations send to Haiti, only a small part of it will get to relieve the people of that place. And to relieve the effects of poverty does nothing to cure it because the basic CAUSE of poverty is not answered, indeed it is made worse by allowing some temporary relief to the poor, who are then with enen greater need and the same limited means of achieving them.
It is in trouble and require our help, but we should also look at it as reminder there are many other countries in the world that are far worst condition than what Hati is in. We should look at the whole picture not just one piece of it.
Reply | Report Abuse | Link to thisHaiti already had a problem with many diseases, malaria, HIV and typhoid, Before the 7.0 magnitude earthquake struck. I bet has made diseases harder to control do to less medical attention from the earthquake. Hospitals that have collapsed or been damaged along with other infrastructure, many people can not receive the care that they need Resulting in weaker conditions to death.
Reply | Report Abuse | Link to thisThis is really sad because those people have suffered enough from the natural calamities. Now the news goes that Infectious diseases are creating lot of troubles. There is lack of awareness amongst the people and the government is not doing enough. Adequate measures need to be taken. http://edmedication.blogspot.com/
Reply | Report Abuse | Link to this