Mental Needs of Haitian Earthquake Victims Not In Sync with Western Medicine
In the aftermath of the devastating earthquake in Haiti earlier this year, which took countless lives and did untold damage to the lives of the Haitian people, an outpouring of support from around the world has created an awkward situation for those who want to help, but are being warned to tread carefully. Post-traumatic stress treatment experts with desires to come work with the people of Haiti are learning a valuable lesson: mental health disorders and treatments are not universal.
Dr. Guerda Nicolas, a Haitian-born researcher with the University of Miami, is an expert on Haitian mental health, and is making known the tremendous cultural differences found in Haiti that may limit the effectiveness of mental health treatments that have been proven successful in the United States. Based on Dr. Nicolas’s research, Haitian psychological reactions to stressors vary greatly from those of the average American, and the treatment options used by American doctors could actually do more harm than good.
“Psychological issues don’t transcend around the globe,” said Dr. Nicolas recently. “It’s not just an issue of being trained as a psychologist.”
The Haitian mindset, when faced with trauma, differs greatly from that of Americans in similar circumstances. Dr. Nicolas’s fear is that American trauma workers, even with a great deal of experience, may actually exacerbate the extent of the mental trauma of Haitian earthquake survivors by instituting American mental health treatments that may actually cause harm. Though their intentions may be good, a lack of understanding of the Haitians’ typical reactions to trauma may lead to misdiagnosis of disorders and treatment that only causes larger problems that Haitian mental health officials are left to remedy after the American trauma worker has long since packed his bags and gone home, thinking he has done a good deed for mankind.
Traditional treatments in the United States for PTSD are based on talk therapies and restructuring of thought patterns so that the patient can learn to cope with the memories of the traumatic event. In Haiti, however, such treatment programs are of little use. In fact, the Haitian people seem to benefit most from seeking spiritual comfort from religious officials, singing, dancing, and praying. With an emphasis on folk medicine and spiritual healing, standard American treatment becomes nearly useless to the Haitian people.
Many issues contribute to the conflicts American mental health treatments can produce in Haiti. As with the cultural differences, language barriers are a great hindrance to any form of therapy and therapy is extremely difficult to do properly with a translator. Moreover, many traditional psychological terms simply do not translate into Haitian Creole. Most importantly, is seems that Americans and Haitians process stress and grief in very different ways, and many American diagnostic tools may prove ineffective when assessing disorders like PTSD and depression in Haitian patients.
Though Haitians do suffer from these disorders, their symptoms may differ so greatly from those of an American patient that American doctors may not, for example, recognize and properly diagnose depression in an extremely depressed Haitian. While Americans produce symptoms of depression that are easily recognized, like sleep problems and trouble concentrating, a Haitian may go about what looks like a normal life, accomplishing daily tasks, while suffering terribly from severe depression. Overall, the risks of misdiagnosis and improper treatment are high.