The Earthquake




© Springer International Publishing Switzerland 2015
Laura Weiss Roberts, Daryn Reicherter, Steven Adelsheim and Shashank V. Joshi (eds.)Partnerships for Mental Health10.1007/978-3-319-18884-3_14


14. The Earthquake



Jayne E. Fleming  and Daryn Reicherter 


(1)
Firm Reed Smith LLP, New York, NY, USA

(2)
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA

 



 

Jayne E. Fleming (Corresponding author)



 

Daryn Reicherter



Keywords
Posttraumatic stress disorderCross-cultural psychiatryHuman rights lawHaitiDisaster psychiatryTorture survivorTelepsychiatryInterdisciplinaryImmigration lawHumanitarian paroleGender-based violence


This is the story of how four doctors, a global law firm, and three human rights lawyers launched a humanitarian parole project in response to the catastrophic impact of an earthquake in Haiti in 2010.

On January 12, 2010, there was a magnitude 7.0 earthquake in Haiti. It was centered in the city of Leogane but cut a much wider path of destruction. Huge areas of Port au Prince and the surrounding cities were destroyed. Over a half million buildings collapsed, including 250,000 homes, 30,000 businesses, 4000 schools, the Presidential Palace, the Port au Prince Cathedral, the Palace of Justice, churches, hospitals, clinics and the national penitentiary. All but one government building was destroyed, as well as 60 % of hospitals and 80 % of schools.

The earthquake was on a Tuesday, just before 5:00 pm. The time of day is meaningful for two reasons. First, it was late enough that many school-aged children were not at their desks when their schools caved in. Second, it was early enough that many adults were at work when their offices and shops collapsed. Many children escaped death; many adults did not. Nobody knows how many Haitians were buried under rubble. Officials estimate that more than 250,000 people died and more than 200,000 children became orphans. Over a million people became homeless. Port au Prince became a labyrinth of camps spilling onto streets, filling public spaces, and climbing the hills surrounding the capital. There were over a thousand camps.

The day after the disaster, military troops, aid workers, diplomats, and Good Samaritans began arriving in Port au Prince. Dozens of foreign journalists descended on the capital to broadcast the tragic images: a man searching through rubble for a missing relative; a mother cradling the body of a dead child; an old woman bent in prayer before a collapsed church. Some saw this endless coverage as an assault on the privacy of victims. Others saw it as key to mobilizing a global relief effort.

A month after the disaster, four Stanford doctors, a global law firm (Reed Smith LLP), and three human rights lawyers teamed up to send a delegation to Haiti. All of the team members had worked with refugees and displaced populations from around the world; all had studied the intersections between extreme poverty, international crisis, and human rights abuses. The goal was to evaluate the impact of the earthquake through a human rights lens and ask whether the Haitian government, the United Nations (UN), and non-governmental organizations (NGOs) were living up to their duty to protect displaced people. A related goal was to identify Haitians who might qualify for evacuation to the United States on the basis of extraordinary circumstances like a life-threatening medical problem or other threat of serious harm. Four years and some 30 trips later, the team evacuated 60 vulnerable women and children from Haiti to the United States and Canada. This is how we did it.


Arrival


We arrived in Haiti in early March 2010. As we approached the airport to land, we could see a hospital ship and at least 20 smaller ships anchored off the coast of Port au Prince. A line of cargo planes on the tarmac grew bigger as we approached the runway. We could see thousands of tents covered with blue and orange plastic tarps surrounding the airport, covering flat brown fields and climbing the hills.

A Haitian man named Charles1 met us at the airport. He worked as a fixer for foreign journalists, part of a valuable cadre of trilingual interpreters who doubled as drivers. He was also a law student and prison rights activist. We had hired him to protect us, drive us, and interpret for us. He would soon become an indispensable member of our team.

After leaving the airport, we drove to downtown Port au Prince. Nearly every building was either badly damaged or destroyed. The streets were filled with rubble. People had set up tents on the sides of roads, on top of collapsed buildings, and in front of stores with gaping holes. Many streets were so crowded with tents they were impassable. It was like a world turned inside out, with everyone living under the sky, and all of the buildings turned upside down.

The pulse of activities in the streets seemed chaotic but had a rhythm, like a drumbeat or a dance. There were women grilling chicken on the side of the road. The women were also selling raw meat, and swarms of flies infected the meat like living measles. There were hundreds of women carrying things on their heads—baskets of avocados, buckets of produce, cooking pots, tubs of charcoal, housewares, cookware, baskets of live chickens drooping under the tropical heat. Some women carried babies in their arms, shielding their faces from clouds of black exhaust and dirt and ash. Some girls held hands as they walked; others sat on the edge of the roadside, staring as we passed.

It was a harsh and extraordinary scene. We wanted to take pictures but felt unsure. “Go ahead,” Charles said. So we did, and the older women cursed and shook their fists at us. “Haitians believe that being photographed by a blan is bad luck,” he explained. We passed the collapsed Presidential Palace. More than 20,000 poor Haitians had moved into a camp across the road. There were rows of seeping outhouses, and mountains of toxic waste, pools of stagnant water and ecstatic mosquitos that created a tornado of disease over and around and under everything.

We followed a UN military jeep into a demolished area called Carrefour. A group of children ran after us. “Hey you, hey you,” they cried out in English. As we slowed to go around some potholes, they ran to our windows with their hands open, begging for food or money. We wanted to give them something but felt uncertain, not because we thought they were dangerous, but because we did not know the rules of engagement. A group of bigger boys began washing our car windows with rags. Charles turned on the windshield wipers to discourage them, but they ran along the side of the car, imploring us to give them something. A smaller boy washed a window with the torn sleeve of his shirt. “Can we give him a dollar?” someone asked. What we really wanted was to rescue him from this nightmare. He couldn’t have been more than 6 years old. The concept of “rescue” would well up over and over in some of us as a conflict in the days and weeks to come. We knew that Haitians did not need rescue; they needed liberation. They did not need white saviors; they needed access to education and opportunities so they could realize their full humanity. But in that moment, confronted with that child, these truths seemed theoretical. This child was real.

We visited the largest camp in Haiti, located on a golf course in an area called Delmas. Over 50,000 people were living there. As we entered the camp a group of children grabbed our hands, dancing and singing “hey you.” We stopped every few minutes to speak with anyone willing to talk with us. We learned that even with the huge amount of aid flowing into Haiti, people in the camp were living in terrible conditions. Some had untreated wounds from the quake. Most had no food or clean water. Many said their children were sick, and many children had swollen bellies.

We passed a young mother bathing an infant in a plastic bucket. She told us the baby’s father had died in the earthquake and she was alone in the camp. She could not nurse her baby because her milk had “dried up.” Her tent was made of rags and sticks. Every time it rained the floor turned to mud and she had to stand all night holding the baby in her arms.

We saw a woman standing alone in the middle of a dirt path. She had the saddest eyes in the world. She told us her house was destroyed, and her husband and two sons had gone to the countryside to live with relatives. Her three daughters were working as maids at the Hotel Montana when it collapsed. “Workers came and dug out the bodies of the blan,” she said, “but my daughters are still buried.” She told us she would not leave Port au Prince until she could give her daughters a proper burial. We asked Charles if aid workers would dig them out. “No,” he said. “Bulldozers will clear them away with the rubble.”

Charles said that after the earthquake tens of thousands of dead bodies filled the streets and public squares and fields. The bodies decayed, and the smell of death hung in the air. The government resorted to mass burials in mass graves, using garbage trucks to clear the dead. Vodou priests protested this desecration of the body, this abandonment of sacred tradition in the name of public health. The spirits of the dead will be tormented, they said.

We passed a group of three women balancing tubs of charcoal on their heads and they asked us if we were with an aid organization. We explained we were there to try and understand the situation in Haiti. We could feel their assessment: “What good are you if you have not come with aid?” We asked the oldest how much she earned selling charcoal. On a good day, she might make a dollar. We asked how often she had a meal. “On days we get food we eat,” she said. “On days we cannot get food we don’t. It’s like the proverb says: sometimes things are up and sometimes they are down.”

Further along, we met a teenage girl who told us she had been living in the camp with her younger siblings since the quake. Four children hid behind her, emaciated, dirty, and silent. She said their mother had died, and she was the only one who could care for them. She asked us if we could help her. When we told her that we were not from an aid organization, her eyes became hard and she turned her back on us. “I am not in the mood to talk,” she told Charles. “I cannot talk anymore. I may not be able to talk tomorrow because there are things that hurt me a lot. I am suffering a lot.” We were in Haiti to help, but how? In listening to these testimonies we were bearing witness, but what good was it if we walked away? Of course we could publish a report—raise awareness—but how would it help this girl and these lost children?

It was late afternoon when we left the camp. Our next stop was at a public interest law firm in Haiti. The organization had agreed to let us work at their center and camp out in the yard. The director listened carefully as we explained our project to him. We told him that our goal was to understand the human rights situation in Haiti, and to identify people who might qualify for evacuation because of some extraordinary circumstance – displacement alone was not enough. We wanted the most compelling cases, but we did not have time to interview thousands of people to find them. “The key is to outline your priorities,” he said. We identified the three most likely categories of cases: people with medical issues that could not be treated in Haiti; orphaned children with biological relatives in the diaspora; elders or disabled individuals with no means of survival in Haiti. The director offered to connect our team with a coalition of women’s organizations working in camps in Port au Prince.

We met with three Haitian women leaders. They confirmed on a large scale what we had witnessed that day. Many Haitians were malnourished, but food distribution had stopped. There were serious medical, security, and sanitation problems in the camps, which they described as lawless and violent. Given our impression that the world had pledged billions in aid to help Haiti, we couldn’t understand why there was no food or security. “There is a lack of communication between the government, the United Nations and NGOs,” they said. We asked if they had attended any of the UN coordination meetings we’d heard about. “The blan conduct the meetings in French,” they explained. “We speak Creole.”

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Jun 22, 2017 | Posted by in PSYCHIATRY | Comments Off on The Earthquake

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